The following is the latest health policy news from the federal government as of 2:30 p.m. on Friday, April 1.  Some of the language used below is taken directly from government documents.

Provider Relief Fund

  • After April 5, this program also will stop accepting claims for administering vaccines to uninsured individuals.  See this notice for further information about both deadlines for submitting claims.

Proposed Medicare Payment Regulations for FY 2023

  • CMS has published its proposed inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2023.  The agency proposes a 2.8 percent net increase in Medicare rates; a permanent cap of five percent on year-over-year wage index losses for any reason; an increase from $9491 to $13,038 in the outlier threshold; and changes in the IRF quality reporting program in future years – but not 2023 – that address patient vaccinations and health equity.  CMS also is soliciting comments on incorporating discharge to home health in an IRF transfer policy.  Learn more from this CMS news release and from the proposed rule itself.  Interested parties have until May 31 to submit formal comments.
  • CMS has published its proposed FY 2023 Medicare hospice payment rule, which calls for a net increase of 2.7 percent in Medicare hospice payments, an annual payment cap per patient of $32,143, and a permanent mitigation policy to smooth the impact of year-to-year changes in hospice payments related to changes in the hospice wage index.  The rule also provides an update on the development of a patient assessment instrument; discusses potential future quality measures within the hospice quality reporting program; announces a potential future update to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey; and seeks information on CMS’s health equity initiative within its hospice quality reporting program by describing its current assessment of health equity in the hospice environment.  Learn more from this CMS news release announcing the proposed FY 2023 and the proposed regulation itself.  Stakeholder comments are due by May 31.
  • CMS has published its proposed inpatient psychiatric facility prospective payment system for FY 2023.  The proposed rule calls for a rate increase of 2.7 percent, an increase in the outlier threshold, and a permanent cap of five percent on wage index reductions in any given year.  It also includes a request for information in which it seeks stakeholder input on a number of matters addressing how to identify, quantify, and address health disparities and health equity issues.  Learn more from this CMS news release and from the proposed regulation itself.  Stakeholder comments are due by May 31.

Centers for Medicare & Medicaid Services

Health Policy Update

  • CMS has released an informational bulletin informing state Medicaid agencies that CMS is exercising enforcement discretion during the COVID-19 public health emergency regarding state submissions of updated Medicaid access monitoring review plans.  CMS is delaying enforcement of the updated plans that are due by October 1, 2022 until October 1, 2024.  Find the CMS informational bulletin here.
  • CMS has announced that it will offer more than $110 million to expand access to home- and community-based services through Medicaid’s Money Follows the Person program.  Established in 2005, this program has provided states with $4.06 billion to support people who choose to transition out of institutions and back into their homes and communities.  CMS will make individual awards of up to $5 million for more than 20 states and territories not currently participating in the program to support initial planning and implementation.  Funding is available only for state Medicaid programs that are not already participating in the program; providers and community groups are not eligible.  Learn more from this HHS news release and the agency’s notice of funding opportunity.
  • CMS has posted information about how Rural Health Clinics and Federally Qualified Health Centers (FQHCs) should bill Medicare for mental health services delivered via telecommunications (telehealth or audio-only).

Centers for Disease Control and Prevention

  • The CDC has introduced a new COVID-19 quarantine and isolation calculator to help people follow quarantine and isolation guidance and get customized information for their individual situation.  It seeks to provide an easy-to-use way to figure out when and for how long people with COVID-19 and their close contacts need to stay home, get tested, and wear a well-fitting mask.  It is not intended for people who are moderately or severely ill with COVID-19, who should seek such guidance from their health care provider.  Go here to find a link to the CDC’s Quarantine and Isolation Calculator.

National Institutes of Health

  • A clinical trial sponsored by the NIH has begun enrolling adult participants in the U.S. to evaluate the effectiveness of various additional COVID-19 booster shots.  The trial seeks to understand if different vaccine regimens – prototype and variant vaccines alone and in combinations – can broaden immune responses in adults who already have received a primary vaccination series and a first booster shot.  Learn more from this NIH news release.

Government Accountability Office (GAO)

Congressional Research Service

  • The Congressional Research Service has updated its report on Medicare sequestration to reflect recent changes in the reintroduction of sequestration after its suspension during the COVID-19 public health emergency.
  • The Congressional Research Service has prepared a brief report on Congressionally Directed Medical Research Programs, a Department of Defense program that receives congressional appropriations explicitly for biomedical research in specific, congressionally identified health matters.  Find the report here.

Stakeholder Events

FDA – Identifying Key Competencies for Opioid Prescriber Education – April 4-5

The FDA and the Duke-Margolis Center for Public Policy are collaborating to host a two-day virtual public workshop focused on identifying gaps in the content of existing opioid prescriber education offerings and core competencies that should be included in educational content for opioid prescribers and other health care providers, including prescriber education under a Risk Evaluation and Mitigation Strategy.  The sessions will be held on Monday, April 4 and Tuesday, April 5 from 1:00 to 5:00 p.m. (eastern).  Go here for more information and to register to participate.

CMS/CMMI – ACO REACH Health Equity Webinar – April 5

CMMI will host a webinar on Tuesday, April 5, 2022 at 4:00 p.m. (eastern) to highlight health equity provisions added to the ACO REACH model.  Go here to register to participate.

CMS/CMMI – Medicare Advantage Value-Based Insurance Design Model – 2023 Hospice Benefit Component Overview – April 5

CMMI will host an office hours session on Tuesday, April 5, 2022 at 3:00 p.m. (eastern) to discuss the Medicare Advantage Value-Based Insurance Design Model and its Hospice Benefit Component. Participants will receive an overview of the model and the CY 2023 application process and have an opportunity for questions and answers with the model team.  For more information about the program and how to register for the event, go here.

CMS – Listening Session to Inform Provider Education Materials Regarding Site Selection for the Inpatient Only List – April 6

CMS will soon be developing provider education materials regarding site selection for procedures recently removed from the CMS Inpatient Only (IPO) list.  The focus of these materials will be necessary documentation supporting inpatient admission decisions for these procedures.  On Wednesday, April 6 at 3:00 (eastern) the agency will hold a listening session to give leaders, staff, and practitioners in hospital inpatient and outpatient departments an opportunity to provide input on important concepts and useful formats for future educational materials.  Go here to register to participate.

CMS/CMMI – ACO REACH General Office Hours – April 12

CMMI’s ACO REACH model team will host a general office hours session on Tuesday, April 12 at 3:00 p.m. (eastern) to answer questions as a follow-up to the financial and health equity webinars.  Go here to register to participate.

CMS – Medicare Cost Report E-Filing System: Interim Rate & Settlement Documentation Webinar – April 26

CMS will hold a webinar to provide information about new functionality in the Medicare Cost Report E-Filing system to Medicare Part A providers and organization that files cost reports on Tuesday, April 26 at 1:00 (eastern).  Go here to learn more about the webinar, including what it will cover and how to submit questions in advance, and go here to register to participate.