The following is the latest health policy news from the federal government for February 2 – 8. Some of the language used below is taken directly from government documents.
Members of the Senate’s 340B bipartisan working group have released a discussion draft of legislation that would update the 340B prescription drug discount program. Last year the group sought stakeholder input on policy solutions that might provide stability and transparency to the 340B program to ensure that the program can continue to achieve its original intent of supporting entities serving eligible patients. Find a news release describing the discussion draft and the cover note that accompanied its release here and find the discussion draft itself here. The deadline for submitting comments is April 1.
Medicare Advantage Coverage Criteria and Utilization Management Requirements (Prior Authorization)
Following publication of its final Medicare Advantage rule for 2024, CMS has published an FAQ providing additional guidance to Medicare Advantage plans and Medicare-Medicaid plans about the use of prior authorization and their future use of artificial intelligence (AI), algorithms, and other software tools in their coverage criteria and utilization management practices. The questions in the FAQ address major issues for health care providers, including prior authorization for discharge from acute-care hospitals into post-acute care, the two-midnight rule, local coverage determinations, the use of internal coverage criteria by Medicare Advantage plans, how CMS will enforce these new standards, and more. Learn more from CMS’s Medicare Advantage FAQ.
Centers for Medicare & Medicaid Services
CMS has updated its Medicaid and CHIP telehealth toolkit, which was created to help states accelerate adoption of broader telehealth coverage policies in Medicaid and the Children’s Health Insurance Program. Find the updated toolkit here.
Department of Health and Human Services
- HHS, its Office for Civil Rights, and its Substance Abuse and Mental Health Services Administration have finalized modifications to the Confidentiality of Substance Use Disorder (SUD) Patient Records regulations, which protect the privacy of patients’ SUD treatment records. The final rule increases coordination among providers treating patients for SUDs, strengthens confidentiality protections through civil enforcement, and enhances integration of behavioral health information with other medical records to improve patient health outcomes. Learn more about the changes introduced by this new rule from this HHS news release; an HHS fact sheet; and this preview version of the final rule, which will officially be published on February 16 and take effect 60 days later.
- HHS’s Health Resources and Services Administration (HRSA) has released a notice of funding opportunity to integrate behavioral health services into primary care settings using telehealth technology. HRSA will award approximately $8.75 million to up to 25 grantees over a period of five years. Find the grant notice here and go here to view a technical assistance webinar about the program and how to apply. Applications are due March 22.
- HRSA has updated its organ procurement and transplantation network modernization effort web page to describe the latest steps in its modernization effort. Those steps include publishing a contract solicitation to create an independent board of directors for its organ procurement and transplantation network; issuing a multi-vendor contract solicitation to support competition and find quality vendors for critical transplantation network functions; launching the discovery and development phase of a transition to a modernized transplantation network IT matching system; and working to address pre-waitlist inequities in the organ waitlist process and reduce variations in referrals to transplants and in organ procurement practices. Learn more from the organ procurement and transplantation network’s updated web page.
- HHS and its Substance Abuse and Mental Health Services Administration (SAMHSA) have published notices of funding opportunities for two grant programs that seek to expand substance use disorder treatment services among pregnant and postpartum women and through adult and family treatment drug courts. Grants of more than $24 million will seek to expand substance use disorder treatment capacity in adult and family treatment drug courts; seek to expand substance use disorder treatment and recovery support services in existing drug courts; and support a continuum of care, including prevention, harm reduction, treatment, and recovery services, for individuals with substance abuse disorders involved with the courts. In addition, SAMHSA will award nearly $4 million in state pilot grants for treatment for pregnant and postpartum women and to enhance flexibility in the use of funds designed to support family-based services for pregnant and postpartum women who have a primary diagnosis of a substance use disorder. Learn more about the grant programs from this HHS news release. Find the notice of funding opportunity for the adult and family treatment drug courts program here; the deadline for applying is April 1 and SAMHSA anticipates awarding 61 grants of up to $400,000. Only government agencies are eligible for the state pilot program.
- HHS has published a national public health strategy to prevent and control vector-borne diseases in people. Among the plan’s many components, it addresses tools, methods, and guidance for preventing, diagnosing, and treating vector-borne illnesses such as Lyme disease, Zika virus, West Nile virus, dengue, malaria, Rocky Mountain spotted fever, alpha-gal syndrome, and others. Learn more from this HHS news release; the CDC’s updated vector-borne disease web page; and the new national public health strategy for vector-borne diseases.
- HHS’s Office of Information Security and its Health Sector Cybersecurity Coordination Center have issued a bulletin about Akira ransomware, a relatively new, aggressive, and capable ransomware group that has been targeting the U.S. health sector. The bulletin, written for a technical audience, describes how the ransomware attacks information systems, provides defense and mitigation strategies, and offers resources for further review and FBI recommendations for organizations. Find the bulletin here.
- CMS – MLN Connects – February 8
- AHRQ News Now – February 6
- HRSA eNews – February 1
- HHS Office of Information Security and HHS Health Sector Cybersecurity Coordination Center – January Cybersecurity Vulnerability Bulletin
Centers for Disease Control and Prevention
Amid the current epidemic in reported syphilis cases over the past three years, the CDC has published a report with updated recommendations for syphilis testing. Find it here.
Medicaid and CHIP Payment and Access Commission (MACPAC)
In the face of rising state Medicaid spending for high-cost specialty drugs with benefits that have not conclusively been proven, MedPAC looks at the challenge this poses for state Medicaid programs in the new issue brief “High-Cost Drugs and the Medicaid Program: MACPAC Evidence and Recommendations.”
HHS – Office of Climate Change and Health Equity – Webinars on Taking Advantage of Provisions in the Inflation Reduction Act – February 15 (and March 7 and 2, and April 4 and 18)
HHS’s Office of Climate Change and Health Equity is holding a series of webinars to help health care providers, and especially safety-net organization, take advantage of the tax credits, grants and other supports made available by the Inflation Reduction Act, which creates opportunities for health sector organizations to invest in clean energy, building efficiency, infrastructure resilience, and more. The next webinar will be held on Thursday, February 8, with additional events scheduled on February 22, March 7 and 21, and April 4 and 18. Separate break-out sessions will be held for essential hospitals, community health centers, and rural providers. Go here to learn more about the webinar series, future events, and the break-out sessions; go here for a recording of a November briefing on Inflation Reduction Act resources available to health care providers; and go here to register to participate.
HHS – Advisory Committee on Minority Health – February 13-14
HHS’s Advisory Committee on Minority Health, which advises the Deputy Assistant Secretary for Minority Health on ways to improve the health of racial and ethnic minority populations, will meet on February 13 – 14 at 8:30 a.m. (eastern) in Rockville, Maryland to discuss implementation of the anticipated updates of the Office of Management and Budget federal race and ethnicity data collection standards. Discussion will focus on opportunities for supporting community awareness of and engagement in future efforts to implement the revised race and ethnicity data collection standards.
The meeting is open to the public; in-person and webcast options for participation are available. Pre-registration is required for the public to attend the meeting, provide comments, and/or distribute printed materials to committee members. Learn more about the meeting and how to participate from this notice.
CMS will hold a webinar on the Medicare cost report e-filing system on Wednesday, February 14 at 1:00 (eastern). The webinar will offer information about new and upcoming functionality for Medicare Part A cost reports in the Medicare cost report e-filing system; the target audience is Medicare Part A providers and entities that file cost reports for providers. Learn more from this notice and go here to register to participate.
CMS – AHEAD Model Hospital Global Budgets Webinar – February 14
CMS will hold a webinar on the hospital global budgeting methodology for Medicare fee-for-service patients under the agency’s States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD Model) on Wednesday, February 14 at 3:00 (eastern). Go here to register to participate.
CMS – Value-Based Insurance Design Model Request for Applications Webinar – February 15
CMS’s Value-Based Insurance Design (VBID) Model team will host a request for applications webinar on Thursday, February 15 at 3:00 (eastern). Presenters will provide an overview of the recently released 2025 requests for applications for the VBID Model and the hospice benefit component, payment design related to the hospice benefit component of the VBID Model, and other updates for the CY 2025 application process. This session will also offer participants an opportunity to ask follow-up questions. Registration is required. Go here for further information and a link through which to regulate.
HHS – Agency for Healthcare Research and Quality – Integrating Patient-Reported Outcomes into Practice – February 27
The Agency for Healthcare Research and Quality (AHRQ) will hold a webinar on integrating patient-reported outcomes into practice on Tuesday, February 27 at 3:00 (eastern). During the webinar, AHRQ will host presentations of research findings on how best to use patient-reported outcomes for patients with varying health conditions and how to scale and spread patient-reported outcomes use within health systems. Go here to learn more and register to participate.
MedPAC – Commissioners Meeting – March 7-8
MedPAC’s commissioners will hold their next public meeting on Thursday, March 7 and Friday, March 8. An agenda and directions on how to participate in the meeting is not yet available but when that information is announced it will be posted here.
MACPAC – Commissioners Meeting – March 7-9
MACPAC’s commissioners will hold their next public meeting on Thursday, March 7 and Friday, March 8. An agenda and directions on how to participate in the meeting is not yet available but when that information is announced it will be posted here.
CMS – Health Equity Conference – May 29-30
CMS will hold its second annual CMS Health Equity Conference on Wednesday, May 29 and Thursday, May 30. The free, hybrid conference will be held in person in Bethesda, Maryland and available online for virtual participation and involve health equity leaders from federal and local agencies, health provider organizations, academia, community-based organizations, and others. Conference participants will hear from CMS leadership on recent developments and updates to CMS programs; explore the latest health equity research; discuss promising practices and creative solutions; and collaborate on community engagement strategies. CMS is now accepting proposals for breakout session speakers and poster presenters. Learn more from the conference web page.