GREATER NEW YORK HOSPITAL ASSOCIATION

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Oppose changes to Affordable Care Act in H.R.1: limitations on premium tax credit eligibility, reductions to special enrollment period. Urge legislative delay of premium tax credit eligibility restrictions included in H.R. 1. Discuss support for permanently extending expiring Affordable Care Act premium tax credits with Congressional staff. Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comments on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635); oppose back-end rebate proposals. Discuss with HHS staff and Congressional staff recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training sites, and immigration reforms that expedite entry for foreign health care workers. Support passage of the SAVE Healthcare Workers Act (H.R. 3178/S. 1600). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702). Support SEPSIS Act (S.1929). Discuss New York State application for Section 1331 Basic Health Plan waiver with Congressional staff and CMS staff. Discuss Section 1332 State Innovation Waiver with Congressional staff. Discuss legislative proposals to regulate the use of artificial intelligence in health care settings with Congressional staff. Discuss non-profit tax-exempt status of hospitals with Congressional staff and discuss examples of community benefit for IRS purposes.

Discuss with Congressional staff and HHS staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act, additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act,; concerns on Rural Physician Workforce Preservation Act; Senate Finance Committee proposals to increase GME slots. Discuss technical amendment to CAA, 2021, Sec. 131 to address artificially low GME caps with Congressional staff. Discuss with Congressional staff distribution methodology for Medicare GME slots created in the CAA, 2021. Discuss rural reclassification for Medicare wage index and Medicare GME purposes with Congressional staff. Discuss COVID-19 Public Health Emergency (PHE) Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to permanently extend PHE telehealth flexibilities and two-year extension of Acute Hospital Care at Home Waiver. Support extension of Medicare Dependent Hospital and Low-Volume Adjustment programs. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Oppose changes to NPIs for hospital outpatient departments. Discuss FY 2025 Medicare IPPS comments with Congressional, HHS staff: to increase payment update to hospitals, Transforming Episodic Accountability Model, AHEAD Model. Support Medicare Advantage prior authorization reforms - Improving Seniors Timely Access to Care Act (H.R. 3514/S. 1816). Discuss wage index issues with Congressional staff: H.R. 8561 to address MA local area growth under projection, FY 2025 IPPS/LTCH interim final rule. Discuss Medicare wage index issues with CMS. Discuss proposals that stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support), make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Urge Congress to legislatively waive Statutory Pay-As-You-Go Medicare sequester triggered by H.R. 1. Discuss with Congressional staff opposition to Medicaid policies in H.R.1: work requirements as a condition of coverage, changes to state-directed payments, reductions to Federal matching funds, reductions to the safe harbor threshold for provider taxes, sunset of broad-based and uniform provider tax waivers, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule, reductions to retroactive coverage. Discuss support for three-year phase-out of non-broad-based and uniform Medicaid provider tax waivers included in H.R. 1 with Congressional staff and CMS staff. Support certain changes to Medicaid DSH payments: support two-year elimination of Medicaid DSH cut; support Save Our Safety Net Hospitals Act to restore pre-CAA, 2021 DSH cap calculation methodology and include dual-eligible patients in state DSH cap calculation. Discuss Medicaid Section 1115 waiver with Congressional staff and HHS. Discuss Medicaid IMD exclusion policies with Congressional staff. Oppose CMS final rule to establish minimum nurse staffing in Medicare- and Medicaid-certified long-term care facilities (89 FR 40876) and support legislative efforts to repeal rule. Discuss proposed rule - Medicare and Medicaid Conditions of Participation: Limiting Participation Based on the Performance of Sex Trait Modification Procedures on Children with Congressional staff. Discuss support for Emergency Medicaid with Congressional staff. Discuss CMMI initiatives on global budgets and primary care in NYS Medicaid waiver. Discuss Graduate Nurse Education demonstration with Congressional staff.

Discuss Medicare GME funding in CAA, 2021 and CAA, 2023 with Congressional staff and HHS staff. Discuss disaster relief funding and health and hospital provisions in American Relief Act, 2025; Full-Year Continuing Appropriations and Extensions Act, 2025 (H.R. 1968). Support health extenders in H.R. 1968 (Full-Year Continuing Appropriations and Extensions Act, 2025): extend COVID-19 Medicare-covered telehealth flexibilities, Acute Hospital Care at Home waiver, Medicaid DSH cut delay; discuss with Congressional staff and HHS staff.