The following is the latest health policy news from the federal government for July 13-18.  Some of the language used below is taken directly from government documents.

Centers for Medicare & Medicaid Services
  • CMS has issued a notice alerting certain clinicians who are qualifying alternative payment model (APM) participants and who have earned an APM incentive payment that the agency does not have the current contact information it needs to disburse their payments.  The notice provides information to qualified participants on how to update their Medicare billing information so that CMS can disburse these payments.  Learn more from this CMS notice, which includes a link to information about how to submit the needed data to CMS.  The deadline for submitting information to claim these payments is September 1.
  • CMS has issued its part two guidance on plan outreach and education for the Medicare Prescription Payment Plan, which seeks to ensure that people with Medicare prescription drug coverage are aware of a new payment option.  Starting in 2025, the Medicare Prescription Payment Plan gives people with Medicare prescription drug coverage the option of spreading the costs of their prescription drugs over the calendar year rather than paying in full at the pharmacy each time they fill a prescription until they have reached their annual payment limit.  People with Medicare must opt into the Medicare Prescription Payment Plan to use the new benefit.  This payment option launches at the same time that all individuals with Medicare prescription drug coverage will begin to have their annual out-of-pocket prescription drug costs capped at $2000.  Learn more from the following resources:
  • In May, CMS published the Ensuring Access to Medicaid Services final rule.  Now, the agency has published a guide for states that focuses on one of the major aspects of that rule:  documentation of access to care and service payment rates, which is specific to Medicaid fee-for-service delivery systems and rates.  Find that guide here.
  • CMS has provided guidance to state Medicaid officials explaining how they can bring Medicaid provider directories mandated by the Consolidated Appropriations Act of 2023 into compliance with that legislation’s requirement of accurate, updated, and searchable provider directories.  That law modified previous requirements for provider directories for state Medicaid fee-for-service and managed care programs.  Learn more from the CMS guidance letter to state health officials.
  • CMS has asked the Office of Management and Budget (OMB) for permission to revise information it currently collects from Medicare beneficiaries through the Medicare Current Beneficiary Survey (MCBS).  The MCBS is the most comprehensive and complete survey available on the Medicare population and is viewed by CMS as essential for capturing information not otherwise collected through operational or administrative data on the Medicare program.  The MCBS is a nationally-representative, longitudinal survey of Medicare beneficiaries.  MCBS data collection includes both in-person and phone interviewing and is enhanced with administrative data such as fee-for-service claims, prescription drug event data, enrollment, and more to provide users with more accurate and complete estimates of total health care costs and utilization.  In this request, CMS proposes adding new measures to the questionnaire and removing a few items that it considers no longer relevant. The revisions would result in a net increase in respondent burden.  Learn more about the data CMS collects and how it uses it from this CMS notice.  The deadline for submitting comments is August 15.
  • CMS has announced that 133 organizations will participate in its new Making Care Primary (MCP) Model, which launched on July 1.  The ten-year model seeks to improve care management and care coordination, equip primary care clinicians with tools to form partnerships with health care specialists, and leverage community-based connections to address patients’ health needs as well as their health-related social needs such as housing and nutrition.  The model will be tested for more than ten years in eight states.  Learn more about the program and find a link to a downloadable list of the participants on the Making Care Primary Model web page.
  • CMS has updated its lists of diagnosis codes effective for patient encounters and discharges on or after October 1, 2024.  Go here for updated downloads of those lists.
  • CMS has created a technical expert panel to obtain input on the end-stage renal disease (ESRD) quality incentive program scoring methodology.  This panel will bring together stakeholders and experts to provide direction and input on the agency’s work and analysis.  Input from the technical expert panel will inform potential modifications involving quality incentive program scoring methods, potential health equity adjustments, and data validation adjustments.  CMS seeks individuals with differing perspectives and areas of expertise, such as individuals with clinical subject matter expertise; individuals with methodological and/or health care disparities expertise; and individuals with ESRD and care partners of individuals with ESRD.  Learn more about the technical expert panel, the specific types of experts it seeks, the work it will undertake, the time commitment involved, and how to apply to participate from this CMS notice.  The deadline for applying to join the panel is July 26.
  • In May, CMS hosted a webinar offering an overview of the early look performance score report for its skilled nursing facility value-based purchasing program.  Now, CMS has posted a recording of that webinar and the materials associated with it.  Find those resources here.
Department of Health and Human Services
  • HHS has asked OMB for permission to introduce a new data collection tool:  the 0990-New-30D, the purpose of which is to gather quantitative and qualitative information common to the assessment of recipient performance on individual grants and cooperative agreements managed by HHS’s Office of the Assistant Secretary for Health.  That agency would collect common data elements measuring the performance of each recipient against approved grant project plans, including progress toward goals and outcomes.  Among the programs the agency administers are Advancing System Improvements for Key Issues in Women’s Health, Community Programs to Improve Minority Health Grant Programs, Family Planning Service Delivery Improvement Research Grants, and others.  Learn more about these and the other programs the data collection would encompass, how the data would be used, and HHS’s assessment of the burden of gathering and reporting this data from this HHS notice.  The deadline for submitting comments is August 14.
  • HHS and its Health Resources and Services Administration (HRSA) will spend $2.5 million to support a multi-state social worker licensure compact.  State licensure compacts enable states to come together on a common approach to licensing health care providers, enabling providers to practice across state lines without having to apply for a license in each state.  Streamlining licensure while maintaining quality standards improves access to services both better facilitating hiring and by easing pathways to using telehealth.  Learn more from this HHS news release.
  • HHS’s Office of the Inspector General has updated its July workplan of audits and reviews.  Find the updated plan here.
  • In response to the continuing public health concern posed by medical product shortages, HHS’s Office of the Assistance Secretary for Planning and Evaluation (ASPE) has published the issue brief “Medical Product Shortages in the United States:  Demographic and Geographic Factors and Impacts.”  The report describes both the quantitative and qualitative effect of medical product shortages and the socioeconomic characteristics and geographic distribution of those who have been affected.  Find the report here.
HHS Newsletters
  • CMS – MLN Connects – July 18
  • AHRQ News Now – July 16
  • HRSA eNews – July 5 (includes funding opportunities)
Centers for Disease Control and Prevention
  • The CDC has published an update on its response to the avian influenza A(H5N1) virus or “H5N1 bird flu.”  Find the update here.
  • The CDC is seeking nominations for membership on its Advisory Committee on Immunization Practices (ACIP).  The committee consists of up to 19 experts in fields associated with immunization practices and public health, use of vaccines and other immunobiological agents in clinical practice or preventive medicine, clinical or laboratory vaccine research, and assessment of vaccine efficacy and safety or who have knowledge about consumer perspectives and/or social and community aspects of immunization programs.  For further information about the committee, the background it seeks among potential members, and how to apply for membership or submit nominations, see this CDC notice.  The deadline for submitting applications is August 15.
MedPAC

MedPAC has published its annual data book Health Care Spending and the Medicare Program.  The book provides information on national health care and Medicare spending, Medicare beneficiary demographics, and data on dual-eligible beneficiaries, quality of care in the Medicare program, and Medicare beneficiary and other payer liabilities.  It also examines provider settings such as hospitals and post-acute care and presents data on Medicare spending, beneficiaries’ access to care in the different settings, and the sectors’ Medicare profit margins, if applicable.  The book also covers the Medicare Advantage program and prescription drug coverage for Medicare beneficiaries, including Part D.  Find this and more in MedPAC’s new publication Health Care Spending and the Medicare Program.

Government Accounting Office

Following the end of the COVID-19 public health emergency, states faced the challenge of redetermining the eligibility of their Medicaid beneficiaries following an extended period during which they were not permitted to remove anyone from their Medicaid rolls.  In many states this proved to be especially challenging, with numerous obstacles that affected their ability to inform people of the need to reapply for Medicaid eligibility and for states to gather the required paperwork and verify income data and eligibility.  In a new report, the GAO examines the problems states encountered and how they addressed them and offers recommendations based on the lessons that have been learned for improving their processes for communicating with Medicaid beneficiaries and reviewing their eligibility for Medicaid-covered care.  Learn more from the GAO report Medicaid: Federal Oversight of State Eligibility Redeterminations Should Reflect Lessons Learned after COVID-19.

Stakeholder Events

CMS – Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests – July 25-26

CMS’s Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests will hold public meetings on Thursday, July 25 and Friday, July 26.  The panel advises the Secretary of the Department of Health and Human Services and the CMS Administrator on issues involving clinical diagnostic laboratory tests.  Learn more about the meetings and how to participate from this CMS notice.

CMS – Skilled Nursing Facility/Long-Term Care Open Door Forum – July 25

CMS will hold an open-door forum for skilled nursing facility and long-term care facility operators on Thursday, July 25 at 2:00 (eastern).  Go here to register to participate.

CMS – Long-Term Services and Supports Open Door Forum – July 30

CMS will hold an open-door forum for long-term services and supports providers on Tuesday, July 30 at 2:00 (eastern).  Go here to register to participate.

CMS – Post-Acute Care Health Equity Confidential Feedback Report Listening Session – July 31

CMS will hold a listening session on Wednesday, July 31 at 2:00 (eastern) to discuss the 2023 Health Equity Confidential Feedback Reports, which were released to post-acute-care providers in home health, inpatient rehabilitation facility, long-term-care hospital, and skilled nursing facility settings.  The goal of the listening session is to gather feedback from providers and stakeholders on the post-acute care health equity confidential feedback to guide the development of this report in the future.  Go here to learn more about the listening session and to register to participate.

CMS – CMS Leadership National Call Update – August 1

CMS Administrator Chiquita Brooks-LaSure and her leadership team will provide an update on CMS’s recent accomplishments and the agency’s recent policy announcements on Thursday, August 1 at 3:30 (eastern).  For more information about the event and how to participate, see this CMS announcement.

CMS – Ambulance Open Door Forum – August 1

CMS will hold an open-door forum for ambulance providers on Thursday, August 1 at 2:00 (eastern).  Go here to register to participate.

CMS – Skilled Nursing Facilities/Long-Term Care Open Door Forum – August 6

CMS will hold an open-door forum for skilled nursing facility and long-term-care facility leaders on Wednesday, August 6 at 2:00 (eastern).  Go here to register to participate.

CMS – Home Health, Hospice, and DME Open Door Forum – August 7

CMS will hold an open-door forum for home health, hospice, and durable medical equipment providers on Wednesday, August 7 at 2:00 (eastern).  Go here to register to participate.

CMS – National Provider Compliance Conference – August 7-8

CMS will hold its National Provider Compliance Conference on Wednesday, August 7 and Thursday, August 8.  The conference will bring together Medicare Administrative Contractors (MACs) and program integrity experts to provide compliance professionals with the information and tools they need to efficiently and effectively submit Medicare Part A, Part B, home health, hospice, and durable medical equipment claims.  The target audience is anyone who processes Medicare Part A and Part B, home health, hospice, or DME claims, including physicians, non-physician practitioners, billing specialists, suppliers, associations, coders, and medical review contractors.  Go here to learn more about the conference and to register to participate in the virtual event.  The deadline for registering is July 31.

CMS – 2024 “Rural Health Hackathon” – August 14, 22, and 29

In August CMS and its Center for Medicare and Medicaid Innovation will hold a series of collaborative sessions, to be held in person, designed to generate and develop creative and actionable ideas to address rural health challenges.  The event seeks to build on CMS’s outreach to rural communities through site visits and listening sessions to better understand rural health care issues.  At these sessions CMS will bring together rural health community care providers, community organizations, industry and tech entrepreneurs, funders, policy experts, and beneficiaries to attempt to take advantage of the collective experience and expertise of participants to generate new ideas to address some of the top challenges affecting health care in rural health settings and drive action to improve clinical outcomes, increase access, and foster a better care experience for patients and providers in rural communities.  Hackathon events will be held in person on August 14 in Bozeman, Montana; on August 22 in Dallas; and on August 29 in Wilson, North Carolina.  Learn more about the event, including how to participate in person or submit ideas virtually, from this CMS announcement.

CMS – Physicians, Nurses, and Allied Health Professionals Open Door Forum – August 15

CMS will hold an open-door forum for physicians, nurses, and allied health professionals on Thursday, August 15 at 2:00 (eastern).  Go here to register to participate.

FDA –Implementation of New In Vitro Diagnostic Products Regulation – August 22

Earlier this year the FDA issued a final rule amending its regulations to make explicit that in vitro diagnostic products (IVDs) are devices under the Federal Food, Drug, and Cosmetic Act, including when the manufacturer of the IVD is a laboratory.  At the time, the FDA outlined a policy to phase out its general enforcement discretion approach to laboratory-developed tests.  On Thursday, August 22 at 1:00 (eastern) the FDA will host a webinar for laboratory manufacturers and other interested stakeholders to discuss how to comply with medical device reporting requirements, correction and removal reporting requirements, and quality system requirements regarding complaint files beginning May 6, 2025.  Go here for more information about the webinar and how to participate.

CMS – Advisory Panel on Hospital Outpatient Payment Meeting – August 26-27

CMS’s Advisory Panel on Hospital Outpatient Payment will meet virtually on Monday, August 26 and Tuesday, August 27. The purpose of the panel is to advise the Secretary on the clinical integrity of the Ambulatory Payment Classification groups and their associated weights, which are major elements of the Medicare hospital outpatient prospective payment system, the ambulatory surgical center payment system, and the supervision of hospital outpatient therapeutic services.  The panel invites presentations and comment letters.  Learn more about the panel, submitting materials, and how to participate in the meeting from this CMS notice.

CMS – Rural Health Open Door Forum – August 29

CMS will hold an open-door forum for rural health providers on Thursday, August 29 at 2:00 (eastern).  Go here to register to participate.