Just before the New Year, Congress passed and the President signed the final fiscal year (FY) 2023 omnibus appropriations bill into law. The year-end spending package includes funding for the Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) and Department of Defense (DoD), and other key health care provisions.
The package appropriates FY 2023 funds for many programs of interest to SGO members. Below are some of the highlights.
-$47.5 billion for the National Institutes of Health (NIH), including $7.1 billion for the National Cancer Institute (NCI) and $76.5 million for the Office of Research on Women’s Health (ORWH), which includes $5 million for the Building Interdisciplinary Research Centers in Women’s Health (BIRCWH) program.
-Authorization of the Advanced Research Projects Agency for Health (ARPA-H), placing it within NIH, not outside NIH as the House-passed ARPA-H Act did. Despite the authorization formally placing ARPA-H within NIH, the legislation appropriates $1.5 billion in funding for FY 2023, an increase of $500 million above the FY 2022 enacted level, but this funding is in addition to the $47.5 billion provided to NIH.
-SGO’s report language on endometrial cancer has now been formally adopted:
Endometrial Cancer—The Committee remains concerned about the significant racial and ethnic disparities in mortality rates for endometrial cancer that adversely impact Black women. The age- adjusted mortality rate for Black women with endometrial cancer is nearly twice the rate of White women, which is partly attributed to cancer stage at diagnosis. The Committee commends NCI’s efforts to address these disparities through projects like the Discovery and Evaluation of Testing for Endometrial Cancer in Tampons (DETECT) Study, and encourages NCI to continue supporting research activities that will lead to the development of targeted interventions to improve early diagnosis among Black women with endometrial cancer. The Committee also encourages NCI to research innovative community-based outreach methods to improve access to high-quality care, with the goal of increasing enrollment and participation by Black women in clinical trials. The Committee requests an update on NCI’s activities regarding endometrial cancer in the fiscal year 2024 Congressional Justification, including progress made in endometrial cancer early diagnosis, survival rates, and clinical trial enrollment by race and ethnicity.
-Additionally, we were pleased to see that the agreement also includes $2 million within ORWH to contract with the National Academies of Science, Engineering, and Medicine to conduct a study on the gaps present in women’s health research across all NIH institutes and centers. SGO supported and advocated for the inclusion of this language as a member of the Women First Research Coalition (WFRC).
-The Congressionally Directed Medical Research Programs (CDMRP) were flat funded with the Peer Reviewed Cancer Research Program (PRCRP) and Ovarian Cancer Research Program receiving $130 million and $45 million respectively. While SGO’s request for an endometrial cancer line-item was not included in the final bill, the funds provided for the PRCRP are directed to be used to conduct research in the multiple areas, including endometrial cancer.
The 4,000+ page omnibus bill also includes a number of health care provisions, including Medicare policies:
-Regarding the impending cuts to physician payment, there will be a 2 percent cut to the conversion factor rather than 4.5 percent we were expecting for 2023. The cut will increase to 3.25 percent in 2024. Additionally, the 4 percent PAYGO cut has been delayed, but not eliminated. The PAYGO cut will not be implemented in 2023 and 2024.
-The Medicare Advanced Payment Model bonus, which was set to expire this year, was extended for one year for providers who are part of alternative payment models (APMs), but rather than the previous bonus of 5 percent, the bill lowers the bonus to 3.5 percent.
-Medicare telehealth flexibilities, including the waiver of originating site and geographic restrictions, coverage of audio-only, and others, are extended through the end of 2024.
-The Food and Drug Administration (FDA) is required to take a series of actions intended to modernize and improve clinical trials, including increasing the diversity and engagement of trial participants. Please note that these provisions are different than the provisions included in the DIVERSE Trials Act, which SGO has supported and advocated for. We will continue to monitor this important legislation in the new Congress.
A full analysis of the FY 2023 appropriations funding levels and report language of interest to SGO members can be found here.
We appreciate SGO members’ ongoing commitment to advocacy and look forward to working together to advance the society’s mission in the year ahead!