INSIDE THE ISSUE

> The Agenda Before Congress
> Extending Telehealth Flexibilities
> DPH’s Respiratory Guidance
> Mass. Health Council Awards
> Happy Labor Day!

MONDAY REPORT

Congress Has Full Fall Agenda Including Key Hospital Priorities

As Congress returns from its August recess tomorrow, it will look to address a number of critical deadlines before the end of the fiscal and calendar year 2025. Foremost among these is the government funding deadline of September 30.

The annual appropriations process is behind schedule, with the House and Senate having only advanced within their own chambers a handful of the necessary 12 appropriations bills. On funding for the Department of Health and Human Services, the two chambers are more than $25 billion apart in their budget target. Healthcare earmarks have been included in the Senate proposal being advanced but remain prohibited in the House process. Given the imminent September 30 deadline, the possibility for a temporary Continuing Resolution (CR) grows more likely; however debate remains on the length of a CR (possibly into December) and whether the spending will include some health programs set to expire.

A number of federal health programs, often called “health extenders,” are set to expire over the next few months, with many expiring at the end of the fiscal year. Among the programs set to expire by October 1 are the Medicare telehealth flexibilities (see story below), the Acute Hospital Care at Home program, the moratorium on scheduled Medicaid disproportionate share hospital cuts, and the Medicare-Dependent Hospital and Low-Volume Hospital programs. Additionally, after December, the Enhanced Premium Tax Credits for the Affordable Care Act marketplace programs will also expire, lengthening the list of key Congressional advocacy priorities for hospitals.

While a bit under the radar, a budgetary requirement, the Statutory Pay-As-You-Go Act (S-PAYGO), is also set to trigger in 2026 if Congress does not take action before the end of year. The so-called S-PAYGO is an automatic cut, or sequester, of all federal programs when Congress passes legislation that increases the deficit by more than $2.3 trillion, as is the case with the recently passed One Big Beautiful Bill Act, according to a Congressional Budget Office analysis. While some federal programs, like Social Security, are exempt from the cuts, Medicare reimbursements would be cut but capped at 4%. Many members of Congress have voiced support for action to waive S-PAYGO, but with a fall agenda consisting of many expiring programs, the timeline and political challenges may make it a heavy lift.

There is still some optimism for an end-of-year bipartisan healthcare package, which could include some of the health extenders as well as bipartisan proposals like legislation to address Medicare Advantage prior authorization reform. Medicare site neutrality payment reform has also been proposed as an offset for some of the healthcare priorities noted above. CRs and other last-minute legislative solutions have often been successfully crafted and passed, but for the hospital community a great deal is at stake with so many important and challenging issues on the table.

Hundreds of Groups Plead With Congress to Extend Telehealth Flexibilities

Nearly 350 groups from around the U.S. signed a letter to Congressional leaders in August, advocating strongly for the extension of telehealth flexibilities now in place but set to expire at month’s end.

“Telehealth is a continuation of standing, bipartisan policy over the last five years and will not lead to new costs,” the letter reads. “Access to telehealth services serve as a lifeline to Medicare beneficiaries across the country, allowing patients to access critical health care services even when they have barriers to accessing in-person care, such as weakened immune systems, neurodegenerative disorders, and chronic conditions, which can make travel and in-person visits especially burdensome. Both patients and practitioners seek assurance that services will remain available, as they have for the past five years.”

The groups called for making Medicare telehealth access permanent, or if that is not possible, for Congress to pass at least a two-year extension of the flexibility. Among those signing the letter were Mass General Brigham, as well as tMED – The Massachusetts Telemedicine Coalition, consisting of 50 groups in Massachusetts convened by MHA.

As Respiratory Season Begins, DPH Issues Healthcare Worker Guidance

The Massachusetts Department of Public Health (DPH) has issued updated standards for managing healthcare personnel (HCP) exposed to respiratory viruses, including COVID-19, influenza, and respiratory syncytial virus (RSV). The guidance is effective today, September 1, and focuses on isolation and return to work protocols, appropriate mitigation precautions, and immunizations.

Among the directives from DPH are the following: HCP who have either tested positive for a respiratory viral pathogen (i.e., SARS-CoV2, influenza, RSV, etc.) or who are exhibiting two or more symptoms of a respiratory viral illness, even in the absence of a test, should isolate. Any HCP who returns to work prior to seven days since their symptom onset or first positive test was taken must wear a facemask until after seven days have passed. Healthcare personnel who have been exposed to someone who has a respiratory viral illness but are not themselves exhibiting any symptoms and have not tested positive for a respiratory viral pathogen do not need to be restricted from work, but they should wear personal protective equipment appropriate for their duties and self-monitor for symptoms for five days after exposure.

Massachusetts Health Council’s Annual Awards Event September 18

The Massachusetts Health Council is holding its 2025 Annual Awards: Honoring Beacons for the Common Good on September 18, 2025.

The Council’s signature event brings together the Massachusetts healthcare community to recognize individuals and organizations for their commitment to the common good.

The 2025 honorees are: Massachusetts Attorney General Andrea Joy Campbell; Lou Brady, president & CEO, Family Health Center of Worcester; Anna-Maria Siega-Riz, dean, School of Public Health & Health Sciences, UMass Amherst; Jessica Bartlett, medical reporter, Boston Globe; Fenway Health; and Mass Medical Society.

This year’s Beacons for the Common Good honorees were nominated by MHC’s diverse member organizations and selected by the executive committee of MHC’s Board of Directors for their dedication to public health.

Happy Labor Day!

Massachusetts was one of the first states to recognize the day celebrating workers. New York was the first state to introduce a Labor Day bill, but Oregon was the first in 1887 to sign such a bill into law. Later in 1887, Colorado, Massachusetts, New Jersey, and New York created a Labor Day holiday. Congress in 1894 passed a law, signed by President Grover Cleveland, making the first Monday in September of each year a legal holiday.

According to KFF’s analysis of Bureau of Labor Statistics Quarterly Census of Employment and Wages data for 2023, there were 213,778 people employed in Massachusetts hospitals (not including local government hospital employment). Some working in hospitals are not counted, such as doctors working in separate physician practices. Hospitals and health systems are among the top employers in the commonwealth and are almost always among the largest sources of jobs in their service areas, making them a critical component of the state’s economy. The largest component of hospital spending – by some estimates up to two-thirds of spending – is devoted to the wages and salary of their talented and committed workforce.

John LoDico, Editor