The following is the latest health policy news from the federal government for July 4-10.  Some of the language used below is taken directly from government documents.

Centers for Medicare & Medicaid Services

CMS has posted an FAQ on inpatient hospital reviews with an emphasis on short hospital stays and its MAC Targeted Probe and Educate (TPE) program.  Find that FAQ here.

Department of Health and Human Services
  • HHS has rescinded a 1998 interpretation of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) that extended certain federal public health care benefits to illegal residents.  Among the health care programs and services defined as “federal public benefits” and therefore subject to this policy are Head Start, certified community behavioral health clinics, and programs funded by the community mental health services block grant and the community services block grant; the health center program, health workforce programs, and mental health and substance use disorder treatment, prevention, and recovery support services programs administered by HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA); and others.  Learn more about what HHS is doing, why it is doing it, and other programs affected by this new policy from this HHS news release and go here for the full text of the notice, which will be published in the Federal Register.  That publication has not yet been scheduled, but when it is published interested parties will have 30 days to submit written comments but the policy will take effect immediately upon its official publication.
  • HHS’s Office of the Inspector General has issued an unfavorable opinion in response to a medical device company’s proposal to pay a third-party vendor to use an electronic billing system operated by the vendor that is used by some of the requestor’s customers for certain billing operations.  Find that opinion here.
  • In a new blog post, HHS’s Office of the Assistant Secretary for Technology Policy (ASTP) has posted information about its TEFCA (Trusted Exchange Framework and Common Agreement) priorities and plans for the remainder of the year.  Its priorities include increasing transparency, driving participation and use, and activating the agency’s federal partners, such as the Social Security Administration, Department of Veterans Affairs, Department of Defense, the CDC, CMS, the NIH, and Indian Health Services.  Find the complete ASTP statement here.
  • HHS’s Advanced Research Projects Agency for Health (ARPA-H) has announced a Functional Repair of Neocortical Tissue (FRONT) program that seeks to restore brain function by using cutting-edge neurodevelopmental principles and stem cell technology.  The program will span five years, beginning when ARPA-H solicit proposals in two areas:  graft tissue generation and engraftment procedures for functional brain recovery.  Learn more about the FRONT program from this HHS news release and the FRONT Program web page, which includes the solicitation for proposals, an FAQ about proposals, and information about a web event for prospective applicants for program funding.
Approved Medicaid State Plan Amendments

CMS has approved the following state plan amendments for Medicaid and CHIP programs.

  • To Utah, changing the qualifications for providers of extended services for pregnant women.
  • To Michigan, extending the MIDocs Consortium within the state’s Graduate Medical Education Innovations Sponsoring Institution Program.
  • To North Carolina, updating the state plan’s personal care services.
  • To Kansas, reflecting the repair rates for maintenance of the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) equipment that will be increased to 80 percent of the Medicare fee schedule.
  • To New York, adding an across-the-board cost-of-living adjustment of four percent to inpatient service psychiatric residential treatment facilities.
  • To New York, updating the inpatient psychiatric hospital statutorily required increases to the minimum wage for the “Remainder of the State” region.
  • To Ohio, removing obsolete pages from the state plan.
HHS Newsletters, Reports, and Videos
  • CMS – MLN Connects – July 10
  • AHRQ News Now –- July 8
  • HRSA – in mid-May, HRSA held a webinar to provide information about the new site application process for National Health Service Corps (NHSC) and to provide information about eligibility, completing the application, and more.  Now, HRSA has posted a video of that webinar; find it here.
Centers for Disease Control and Prevention (CDC)

Citing a low public health risk and no current cases of human-to-human transmission, the CDC is scaling back its emergency response to the avian (bird) flu and folding its periodic updates about the condition into its monthly influenza updates.  Learn more from the CDC’s avian flu web page.

Medicaid and CHIP Payment and Access Commission (MACPAC)

MACPAC has used data from the 2023 National Health Interview Survey to compare the demographics, health status, and financial barriers for adult Medicaid beneficiaries with adults who have either private insurance or no insurance.  It also stratified the results by income to understand how coverage affects access to care at different income levels and examined differences in access and utilization between the disabled and non-disabled adult Medicaid beneficiary population.  The results indicate that there were several differences in access to, use of, and barriers to health care among Medicaid beneficiaries and those with private or no insurance.  Learn more from MACPAC’s “Access in Brief:  Adults’ Experiences in Accessing Medical Care.”

Government Accountability Office (GAO)

Under assisted outpatient treatment, adults with serious mental illnesses can be ordered by a judge to undergo community-based treatment and in 2014 Congress authorized HHS to award grants to organizations to implement assisted outpatient treatment programs.  Since then, HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded $146 million in assisted outpatient treatment grants to 63 grantees and HHS has attempted to assess the effectiveness of the grant program, evaluating participant outcomes such as treatment adherence, psychiatric emergency room visits, hospitalizations, and arrests.  The GAO has evaluated these efforts and presents its findings in its new report “Serious Mental Illness:  HHS Assessments of Assisted Outpatient Treatment Have Yielded Inconclusive Results.”

Stakeholder Events

HHS – Agency for Healthcare Research and Quality – July 17

HHS’s Agency for Healthcare Research and Quality (AHRQ) will host a webinar on July 17 at 12:30 p.m. (eastern) that covers how empowering patients to take an active role in their health is key to driving meaningful and sustainable behavior change through tools such as clinical decision support systems, artificial intelligence (AI)-powered platforms, and mobile health apps.  Go here to learn more about the webinar and to register to participate.

CMS – Center for Medicare and Medicaid Innovation – WISeR Model Office Hour – July 17

The CMS Innovation Center is hosting an office hour to provide an overview and answer questions about its new Wasteful and Inappropriate Service Reduction (WISeR) Model.  WISeR is a voluntary model that will run from January 1, 2026 to December 31, 2031 and promote reducing fraud, waste, and abuse by
navigating patients toward safe and evidence-supported best practices.  During the event, Innovation Center staff will address frequently asked questions about the model and respond to submitted questions and live inquiries from the audience.  Learn more about the event and how to register to participate from this CMS notice.

CMS – Transition of Hospital Short Stay Patient Status Review Webinar – July 30

CMS will hold an informational session on the upcoming transition of hospital short stay patient status reviews on Wednesday July 30 at 2:00 (eastern), providing an overview of the transition and addressing questions from stakeholders.  For information about registering to participate and submitting questions, see this CMS notice.