The following is the latest health policy news from the federal government for the week of January 13-20.  Some of the language used below is taken directly from government documents.

Centers for Medicare & Medicaid Services

  • CMS has published updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List.  The update adds ten codes to the list of items that require a face-to-face encounter between provider and patient and a written order prior to delivery as a condition of payment.  Go here for a summary of the update and a link to a formal Federal Register notice.  The update takes effect on April 17.
  • CMS has published a technical update of codes used for billing by ambulatory surgical centers.  Find it here.
  • The latest edition of MLN Connects, CMS’s online newsletter with information about Medicare reimbursement matters, includes features on the latest FY 2023 ICD-10 codes and grouper software effective April 1; January 2023 integrated outpatient code editor files, including updates; tip sheets for post-acute-care quality reporting programs during the COVID-19 public health emergency; and more.  Find it here.
  • CMS has updated and expanded its Home Health Value-Based Purchasing FAQ.  Find it here.
  • CMS has announced new actions to reduce the inappropriate use of antipsychotic medications and to create greater transparency about nursing home citations.  Among those actions are conducting targeted, off-site audits to determine whether nursing homes are accurately assessing and coding individuals with a schizophrenia diagnosis and adjusting Nursing Home Care Compare ratings based on its findings.  CMS also intends to post survey citations that facilities are disputing on the Care Compare site until the dispute process is completed.  Learn more about CMS’s plans from this news release and this CMS memo to state survey agencies.

Department of Health and Human Services

  • HHS’s Health Resources and Services Administration (HRSA) has updated its Provider Relief Fund FAQ with a new question about the single-audit accounting standards applied to Provider Relief Fund payments to non-profit organizations.  Find it here, on page 20, marked “Modified 1/12/2023.”
  • HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) will award 14 grants of up to $500,000 a year for up to three years to non-profit hospitals and emergency departments, including free-standing emergency departments and Rural Emergency Hospitals, to develop and implement alternatives to opioids for pain management in hospitals and emergency department settings and reduce the likelihood of future opioid misuse.  This program also will support identification of, and intervention for, individuals presenting with opioid use disorder.  Learn more about this funding opportunity here.  The deadline for applications is March 6.
  • HHS’s Office of the Inspector General has updated its work plan for audits and reviews of health care provider activity to be undertaken in January.
  • HHS’s Office of the Inspector General reports that more than 1000 nursing homes reached infection rates of 75 percent or more during the first year of the COVID-19 pandemic and has called on nursing homes to develop better protections against future emergencies.  Learn more about the agency’s findings and recommendations from this summary of the report, which also includes a link to the complete report.

Centers for Disease Control and Prevention


  • Both MedPAC and MACPAC have written to a bipartisan group of senators in response to their request for information on how to improve care for dually eligible Medicare/Medicaid beneficiaries.  MedPAC’s response summarizes the agency’s work on improving the integration of Medicare and Medicaid for dual-eligible beneficiaries over the past decade and can be found here.  MACPAC’s response offers comments in three areas – requiring state strategies to integrate care, state capacity to integrate care, and considerations for a new, unified program for dually eligible beneficiaries – and can be found here.

Stakeholder Events

CMS National Stakeholder Call – January 24

CMS administrator Chiquita Brooks-LaSure, and her leadership team will discuss CMS’s key 2022 accomplishments and discuss how the agency’s 2023 priorities will advance the CMS Strategic Plan during a national stakeholder call on Wednesday, January 24 at 1:00 (eastern).  Go here to register to participate.

CDC – Updates to COVID-19 Testing and Treatment for the Current COVID-19 Variants – January 24

The CDC will hold a webinar presenting an overview of COVID-19 epidemiology and the current variant landscape, current CDC testing guidance and NIH treatment guidelines, and risk assessment and considerations for treatment options.  The webinar is targeted for health care providers and will be held on Tuesday, January 24 at 2:00 (eastern).  Go here for further information about the webinar and how to participate.

HRSA – Women’s Preventive Services Initiative – January 24

HRSA’s Office of Intergovernmental and External Affairs and its Maternal and Child Health Bureau are hosting a webinar on the Women’s Preventive Services Initiative on Tuesday, January 24 at 3:00 (eastern) in collaboration with the American College of Obstetricians and Gynecologists.  The webinar will share information about the Women’s Preventive Services Guidelines, HRSA’s cooperative agreement with American College of Obstetricians and Gynecologists to develop, review, and update recommendations for women’s preventive healthcare services, and opportunities to support implementation of the current recommendations into standard clinical practice.  Go here to register to participate.

MACPAC – January 26-27

The Medicaid and CHIP Payment and Access Commission will hold public meetings on Thursday, January 26 and Friday, January 27, beginning at 9:30 (eastern) both days.  Register here to participate.

CMS – Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule Educational Session – February 9

CMS’s Office of Burden Reduction and Health Informatics is holding a virtual education session on the Advancing Interoperability and Improving Prior Authorization Processes proposed rule on February 9 at noon (eastern).  The session is directed to administrative, health IT, and government affairs professionals.  Participants must register by February 8.  Go here to register.

HRSA – Data Bank Administrator Training Webinar – February 22

HHS’s Health Resources and Services Administration and the National Practitioner Data Bank will hold a webinar on Wednesday, February 22 at 2:00 (eastern) to explain the roles and responsibilities of data bank administrators and National Practitioner Data Bank account management.The webinar will include a Q&A session with National Practitioner Data Bank staff members.  Participants are eligible for continuing education credits.  Go here for further information and to register to participate.