Legislative Update 9/13/2021: PATCH Act, Provider Relief, Nebraska Legislature

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This is the legislative update for September 13, 2021. View all updates here.

The September 13, 2021 legislative update includes highlights from both federal and state legislatures.

Federal Updates


The Senate will be in session next week, while the House will be on a committee work period. The House returns to full session on September 20.

This week, the House began moving forward with committee consideration of a “human infrastructure” legislative package, which congressional Democrats are planning to move through the budget reconciliation process (Translation: a process for passing legislation that can only be used for policies that change spending or revenues).

House Energy and Commerce Committee

On Monday, September 13, Children’s covered a hearing before the House Energy and Commerce Committee. The hearing was regarding marking up sections of the package under its jurisdiction, including:

  • Expanding care within Medicaid (adults) and Medicare (vision and hearing)
  • Lowering the cost of prescription drugs
  • Expanding home care options for elderly
  • Investing in public health investment, broadband access, and addressing climate change

As expected, the markup was wildly contested and is unlikely to pass the Senate as written.

Positive Provisions For Children

Late Thursday, September 9, 2021, committee Democrats released draft legislative language for the provisions it will consider, including some positive provisions related to kids.

These provisions include:

  • A permanent extension of funding for the Children’s Health Insurance Program (CHIP)
  • A mandate that all states provide 12-month continuous eligibility to children under Medicaid
  • Extensive investments in maternal health

At this point, the House package does not contain extensive relief for health care providers, outside of $10 billion to support hospital infrastructure generally.

The large health care investments are targeted towards beneficiaries in the form of expanded Medicare benefits and increasing access to Medicaid. It does not include expanding access to pediatric mental health or making investments specifically in pediatric care capacity.

While the release of draft language represents an important step in the process, legislatively there are many steps remaining with additional opportunities to influence the content of any package.


Representative Tony Cárdenas, D-Calif., has introduced H.R. 5131, the Pediatric Access to Critical Healthcare (PATCH) Act, which would provide $6 billion in dedicated funding over 10 years to bolster national pediatric care capacity.

This support is critical, as children’s hospitals grapple with a surge in caseloads due to increased COVID-19 cases, an ongoing national children’s mental health crisis, and a rise in RSV infection rates.

Provider Relief Funding

Last Friday, Health and Human Services (HHS) announced Phase 4 Provider Relief Funding (PRF) will be available for applications by September 29.

The agency announced $25.5 billion in total funding:

  • $17 billion for phase 4 distribution
  • $8.5 billion for rural providers

These funds are left over from the American Rescue Plan Act from earlier this year. The funding will go to providers who have revenue losses and expenses related to COVID-19 from July 1, 2020 to March 31, 2021.

Details suggest that 75% of the funding will be used to address lost revenues and increased expenses related to the pandemic and will provide base payments plus supplemental payments for small to medium size providers, with the smallest providers receiving the highest supplements.

In addition, 25% of the Phase 4 funding will be used to provide bonus payments based on the amount and type of services provided to Medicaid, CHIP, and Medicare patients.

To determine these bonus payments, Human and Health Services will price Medicaid and CHIP claims data at Medicare rates, with some limited exceptions for some services provided predominantly in Medicaid and CHIP.

State Updates

Legislative Redistricting

On Monday, September 13, the Nebraska Legislature began an unusual September special session to complete the required legislative redistricting plans using 2020 US Census Data — a contentious undertaking that has been accused of gerrymandering (Translation: drawing lines to include a majority of one party into a district).

Congress, the Nebraska Legislature, Public Service Commission, Board of Education, Board of Regents, and the Supreme Court Districts are all included in the redistricting plans.

Proposals for consideration were introduced, and Omaha’s second congressional district (Representative Don Bacon) and legislative district 49 in Gretna (Senator Jen Day) are facing a significant change in territory.

Additionally, Senator Mark Kolterman (R-Dist. 24, Seward) offered LR12, seeking to add a senator to the current 49 member body, helping to maintain rural districts and add a district to the rapidly growing metropolitan areas, likely in Sarpy County.

Public hearings to allow public comments on the proposed changes will take place before the special Redistricting Committee on Tuesday in Grand Island, Wednesday at the State Capitol in Lincoln, and Wednesday in Omaha.

It is important to know that special sessions such as this one are limited in scope, and members will only be taking (official) action on redistricting plans. The Legislature will also consider and approve Gubernatorial appointments at this time. Unrelated bills cannot be introduced, advanced, or killed — that action will wait until the regular session reconvenes in January 2022.

Members are expected to wrap up the work of the special session by September 24.

Children’s At The Capitol — Hearing Schedule

Tuesday, Sept. 14 at 9:30 a.m. in the Human and Health Services Committee:

  • LR221, Senator Vargas: Interim study to examine maternal and infant mortality and morbidity.
    • Dr. Ann Anderson-Berry testifying on behalf of Children’s.
  • LR142, Senator Cavanaugh: Interim study to determine whether legislation should be enacted to provide for additional supports and further address the issue of maternal depression in Nebraska.
    • Dr. Mel St. Germain testifying on behalf of Children’s.

Wednesday, September 15 at 9:30 a.m. in the Human and Health Services Committee:

  • LR143, Senator Stinner: Interim study to examine the mental and behavioral health needs of Nebraskans, assess the shortages of providers, and determine what is needed to ensure an adequate behavioral health service delivery system.
    • Mike Vance testifying on behalf of Children’s.

Other hearings we will be covering this week include:

  • LR163, Senator Stinner: Interim study to examine post-acute placement challenges in Nebraska’s health care system.
  • LR157, Senator Pansing Brooks: Interim study to examine how Nebraska schools can recruit teachers and administrators who accurately reflect the proportion of students of color attending Nebraska schools.
  • Public hearings for redistricting
    • Tuesday afternoon in Grand Island at 1:30 p.m.
    • Wednesday morning in Omaha at 10 a.m.
    • Wednesday afternoon in Lincoln at 1:30 p.m.

You can livestream the public hearings at www.nebraskalegislature.gov.

(Sources: CHA, HHS, E&C Committee, Congress.gov, Nebraska Legislature, World Herald, Peetz & Co.)


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