2023 Government Funding Legislation

January 3, 2023

2023 Government Funding Legislation

Congress released the 4,155-page FY 2023 omnibus appropriations bill in December which funds the federal government for the remainder of the 2023 fiscal year (through Sept. 30, 2023). Congress has agreed on a bipartisan government funding bill comprising all 12 appropriations bills.

The College successfully advocated two food allergy provisions in the funding bill and other provisions in the omnibus bill:

  1. Department of Defense Peer-Reviewed Medical Research Program (PRMPP)
    The College advocated for, and Congress continued to include funding for food allergy research, as we requested. 
  2. NIAID Consortium of Food Allergy Research (CoFAR)
    The bill includes $12.1 million for the National Institute of Allergy and Infectious Disease (NIAID) Consortium of Food Allergy Research (CoFAR). This is an increase of $3,000,000 above the fiscal year 2022 enacted level. The funding is intended for CoFAR to expand its clinical research network to add new centers of excellence in food allergy clinical care and to select such centers from those with proven expertise in food allergy research. ACAAI supported an appropriation request to fund this program at $15 million. 

In addition:

 NIH Funding 

The NIH will receive $47.5 billion in funding, a $2.5 billion increase. Of this total, $6.5 billion is dedicated to NIAID, a $239 million increase from the previous fiscal year.

Environmental Health

The bill provides $246.8 million for Environmental Health programs, of which, $33.5 million is dedicated to asthma. The College’s Environmental Health Committee provided comments on the effects of air pollution on allergies and asthma, household air pollution, and climate change.  The NIH Institute of Environmental Health Sciences will receive $40 million.

Preventing Medicare Reimbursement Reductions

Through the College’s Advocacy Council and members’ grassroots efforts, we were able to minimize the reduction in Medicare reimbursement.

The bill addresses Medicare reimbursement reductions that were set to take effect in 2023 by:

  • Congress provided a one-time 3.75% increase to the 2021 PFS Conversion Factor (CF) to help mitigate the impact new E/M code values would have on certain specialties. Congress provided a similar increase of 3% for the 2022 PFS CF and extending this increase, albeit at lower amounts, for two years with the goal of phasing it out.
  • The bill provides a:
    • 2.5% increase to the 2023 PFS Conversion Factor
    • 1.25% increase to the 2024 PFS Conversion Factor
  • The bill does not include a separate offset for the 1.5% budget neutrality reduction to the 2023 PFS conversion factor. Prior to this bill, providers were set to receive a 4.5% reduction to the 2023 PFS CF due to the expiration of the one-time 3% bonus after 2022 and the 1.5% budget neutrality adjustment. By including a 2.5% increase to the CF for 2023, the total 2023 PFS CF reduction will be 2%.
  • Delays the 4% PAYGO reduction that was set to take effect in 2023 for two years. 
  • To help offset the cost, the bill extends the 2% sequestration reduction to Medicare payments
  • Providing a 3.5% Advanced APM Incentive Payment for 2023. The Advanced APM Incentive Payment (which was originally 5%) was set to expire after this year.


Congress already proactively extended certain Medicare telehealth coverage policies for 151 days after the COVID-19 PHE. The bill further extends these policies through 2024. These policies include:

  • Geographic requirement.
  • Originating site requirement.
  • The bill would require a new study on program integrity for Medicare telehealth services.

CMS E/M Evaluations

The bill requests an update from CMS in next year’s budget justification on a process to evaluate E/M services more regularly and comprehensively. The College plans to submit comments on this issue.




doctor talking to male patient on laptop