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Bipartisan Funding Bill Will Make a Difference Now, But More Action Will Be Needed

The bipartisan bill passed by the House and the Senate and signed by the president provides urgently needed resources to confront COVID-19, funds critical programs across the government in 2021 and offers great hope for recovery from some of the pandemic’s damaging impacts in the year to come.

Two highly effective vaccines have demonstrated the remarkable power of science. The support the bill provides to optimize vaccine manufacture, procurement, roll out and education and to build our public health infrastructure is significant and promising. Funding supplied in the COVID-19 relief legislation to expand testing, contact tracing, surveillance and monitoring will be vital to gaining control of the pandemic, while resources included for therapeutics and supplies will save lives. Funding in the bill to support vaccine procurement and delivery in low- and middle-income countries is important.

In addition, the FY 2021 bill includes increased funding for global health security. The last year has demonstrated more starkly than ever that an infectious disease threat anywhere is an infectious disease threat everywhere. Resources that enable the United States to work collaboratively with the rest of the world toward the end of this pandemic and the prevention of future pandemics will be essential. Disappointingly, the bill also flat-funds the U.S. President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria, failing to provide the increased resources needed to address service disruptions due to the pandemic.

As vaccines are rolled out over the months to come, funding in the bill will help to reduce the impact of economic hardships at home caused by the pandemic. The bill adds support that is critical to prevent continued worsening of health disparities and supports public health measures necessary to slow the spread of COVID-19. At the same time, following a year of unprecedented challenges to public health service delivery, the bill falls generally short in new funding for public health, biomedical research and the scientific workforce through programs at the Centers for Disease Control and Prevention and the National Institutes of Health.

Similarly, while wording in the bill recognizes pressing needs to combat antimicrobial resistance — including calling for CDC and NIH congressional briefings on the ongoing crisis — it does not provide sufficient funding to meet the growing needs for stewardship, prevention, research and innovation that the impacts of infections that do not respond to available treatments demand. The bill does provide important new resources for the Ending the HIV Epidemic initiative.

Of note, in a year when the crucial value of infectious disease specialists has been underscored by unmet needs, the bill allows updates to outpatient evaluation and management codes to move forward, while providing some funding to help mitigate cuts in physician compensation due to budget neutrality rules. The Centers for Medicare and Medicaid Services is expected to provide clarity on how the funding provided will ultimately impact payment to infectious diseases physicians, who had been expected to take a 4% cut. Unfortunately, the bill imposes a three-year delay before implementation of a new outpatient code that is intended to provide increased reimbursement for highly complex care. A CMS update to inpatient evaluation and management codes will be critical in the next year to help ensure compensation for infectious diseases physicians that appropriately reflects their value.

IDSA and HIVMA thank Congress for taking the action that it has to ensure needed resources are available in the pivotal days and weeks ahead. We urge House and Senate members to stand ready in 2021 to work with the new administration to act and provide the additional resources necessary to end the pandemic, reduce health inequities and address other longstanding and emerging infectious diseases threats.

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