The following is the latest health policy news from the federal government for June 9-22. Some of the language used below is taken directly from government documents.
Centers for Medicare & Medicaid Services
- CMS has announced new flexibilities to help keep Americans insured as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals. The new flexibilities were announced in a letter sent by HHS Secretary Xavier Becerra to the nation’s governors urging them to adopt all available flexibilities to minimize avoidable coverage losses among children and families. The new flexibilities include permitting managed care plans to assist people currently covered by Medicaid with completing their renewal forms, including completing certain parts of the renewal forms on their behalf; permitting states to delay administrative terminations for one month while they conduct additional targeted outreach; and permitting pharmacies and community-based organizations to facilitate reinstatement of coverage for those who were recently disenrolled for procedural reasons based on presumptive eligibility criteria. Learn more from the following resources:
- the CMS news release
- the letter from HHS Secretary Becerra to governors
- a comprehensive list of the strategies states can employ to facilitate the unwinding of the public health emergency’s continuous Medicaid eligibility
- a web page with Medicaid and CHIP renewals outreach and educational resources
- CMS has issued guidance reminding state agencies, accrediting organizations, and hospitals of the requirements for discharges and transfers to post-acute care, including the provision of appropriate patient information to the post-acute-care provider and caregivers. The guidance identifies areas of concern related to missing or inaccurate patient information and offers recommendations for hospitals to improve and protect patients’ health and safety during the discharge and transfer process. Find the CMS guidance here.
- In the latest installment of the CMS blog, the agency presents the Center for Medicare and Medicaid Innovation’s strategy and goals to strengthen the primary care infrastructure by creating multiple pathways to support improved financing for advanced primary care, equitable access to high-quality primary care, and sustainable transformation among a heterogeneity of practices. It also offers an overview of its newest primary care model test – Making Care Primary – and outlines additional pathways the agency is exploring. Find it here.
- CMS has established a series of consumer-oriented web pages to help patients navigate their medical bills in light of implementation of the No Surprises Act. These web pages include a general consumer web page; a page that describes new protections for consumers; a page on how to dispute bills; and a page on submitting complaints to CMS.
Department of Health and Human Services
- HHS has introduced new tools to lower prescription drug costs for low-income people with Medicare through its Extra Help program, which helps eligible seniors and disabled people pay their Medicare Part D premiums and cost-sharing. These resources complement forthcoming expansions in Extra Help benefits and will seek to ensure that more people eligible for benefits are enrolled in this program. The 2022 Inflation Reduction Act expanded eligibility for the full low-income subsidy benefit – the Extra Help program – to individuals with limited resources and income, and beginning on January 1 of next year, revised eligibility criteria will enable more people to participate in the program. Learn more about the program from this HHS news release.
- HHS and its Health Resources and Services Administration (HRSA) have launched a new Pediatric Specialty Loan Repayment Program that will spend $15 million to recruit and retain clinicians who provide health care to children and adolescents. In exchange for three years of service in a health professional shortage area, medically underserved area, or providing care to a medically underserved population, the Pediatric Specialty Loan Repayment Program will provide up to $100,000 to eligible clinicians providing pediatric medical subspecialty, pediatric surgical specialty, or child and adolescent behavioral health care, including substance use prevention and treatment services. The application deadline is July 20. Learn more about eligible providers and how to apply for funding from this HHS news release.
- HHS and HRSA have awarded nearly $9 million to 20 grantees to train health care providers to provide care for individuals in need of mental health and substance use services as part of a broader effort to strengthen and expand the mental health and substance use workforce in underserved and rural communities. Learn more about the funding and its intended use and find a link to a list of grant recipients from this HHS news release.
- HHS has announced a partnership with the organization Upstream USA to expand access to contraception and address disparities in women’s health. To address the gaps in the health care system, HHS and Upstream will collaborate to help health care providers receive free technical assistance, training, and education on contraceptive care in primary care settings. Learn more about the partnership from this HHS news release.
- HHS and its Substance Abuse and Mental Health Services Administration (SAMHSA) have issued an advisory on identifying and managing mental health challenges associated with Long COVID. The advisory addresses the epidemiology of mental health symptoms and conditions of Long COVID and provides evidence-based resources for their assessment and treatment. Learn more from this HHS news release and from the SAMHSA advisory “Identification and Management of Mental Health Symptoms and Conditions Associated with Long COVID.”
- HHS’s Office of the Inspector General has updated its schedule of the audits and evaluations it will undertake. Find the additions here.
- HHS’s Administration for Community Living has proposed what it describes as the first substantial update of its program regulations since 1988. The proposed rule addresses issues that have emerged since the last update; clarifies a number of requirements for programs authorized under Titles III, VI, and VII; and seeks to better support the national aging services network that delivers Older Americans Act services and improve program implementation. Learn more from this HHS news release; this announcement of the proposed regulation; and a formal Federal Register notice. Stakeholder comments are due by August 15; go here for instructions on how to submit comments.
Provider Relief Fund
HRSA has posted the following deadlines for certain Provider Relief Fund-related activities.
- June 30 – deadline to apply Provider Relief Fund and/or American Rescue Plan rural funds to lost revenues.
- July 1 – reporting period 5 begins
Medicare Payment Advisory Commission (MedPAC)
- MedPAC has published its “June 2023 Report to the Congress: Medicare and the Health Care Delivery System.” The major subjects addressed in the 503-page report are the high prices of drugs covered under Medicare Part B; post-sale rebates for prescription drugs in Medicare Part D; standardized benefits in Medicare Advantage plans; favorable selection and future directions for Medicare Advantage payment policy; disparities in outcomes for Medicare beneficiaries with different social risks; aligning fee-for-service payment rates across ambulatory settings; and reforming Medicare’s wage index systems. The report also includes MedPAC’s response to a congressional request for information about behavioral health services in the Medicare program and two congressionally mandated reports: one on telehealth in Medicare and another evaluating a prototype design for a post-acute-care prospective payment system. Learn more from this summary of the report and from the report itself.
- MedPAC has published the comment letter it sent to CMS in response to CMS’s proposed changes in its Medicare inpatient prospective payment system for FY 2024. In its letter, MedPAC responds to CMS’s request for information on future hospital safety-net policies; CMS’s proposal to add a health equity adjustment bonus to the hospital value-based purchasing program; and a description of recent case law on geographic reclassifications and its estimated implications for wage index values and capital disproportionate share hospital (DSH) payments. Find the MedPAC letter here.
- MedPAC has published a report on using population-based outcome measures to assess the impact of telehealth expansions on Medicare beneficiaries’ access to care and quality of care. Find the report here.
Medicaid and CHIP Payment and Access Commission (MACPAC)
MACPAC has released its “June 2023 Report to Congress on Medicaid and CHIP,” which includes recommendations for modifying payment policy for safety-net hospitals. In addition, the report offers the agency’s perspective on integrating care for people who are dually eligible for Medicaid and Medicare; improving access to Medicaid coverage for adults leaving incarceration; and identifying barriers to Medicaid home- and community-based services. Learn more from this MACPAC news release and from the full report.
Government Accountability Office (GAO)
The GAO has reviewed the quality information provided on nursing homes on CMS’s Care Compare web site and reiterated its past recommendations for improving that data. Learn more from the GAO report “NURSING HOMES: CMS Offers Useful Information on Website and Is Considering Additional Steps to Assess Underlying Data.”
CMS Office of Minority Health – Minority Research Grant Program Webinars – June 26 and June 28
The CMS Office of Minority Health recently released a notice of funding opportunity for its Minority Research Grant Program and as part of this application cycle will host two webinars to help interested parties learn more about the application process. The first such webinar will be held on Monday, June 26 at 3:00 (eastern); go here to register to participate. The second webinar will be held on Wednesday, June 28 at noon (eastern); go here to register.
CMS – The Center for Program Integrity – Review Choice Demonstration for Inpatient Rehabilitation Facility Services Open-Door Forum – June 27
CMS’s Center for Program Integrity will hold an open-door forum to present its Review Choice Demonstration for Inpatient Facility Services on Tuesday, June 27 at 1:00 (eastern). The Review Choice Demonstration for Inpatient Rehabilitation Facility (IRF) Services seeks to ensure that Medicare beneficiaries continue to receive medically necessary care while protecting the Medicare Trust Funds from fraud, waste, and abuse. The demonstration establishes a review choice process for IRF services to test whether such a process improves methods for the investigation and prosecution of fraud; provides flexibility for IRFs; and offers a risk-based approach to reducing burden on providers demonstrating compliance with Medicare requirements for IRF services. CMS will implement the Review Choice Demonstration for IRF services in Alabama on August 23. Register for the forum here; prior to the event, the forum presentation will be posted here.
CMS – Medicaid and CHIP Continuous Enrollment Unwinding Webinar – June 28
HHS and CMS continue to host a series of webinars on Medicaid and CHIP continuous enrollment unwinding to educate partners. Topics covered during the webinar vary each month. Webinars take place on the fourth Wednesday of each month and the next webinar will be held on Wednesday, June 28 at noon (eastern). Go here to register to participate and here to find recordings, transcripts, and slides from past webinars.
CDC – Town Hall on CDC-Funded Public Health Preparedness and Response Centers – June 28
The CDC will hold a town hall meeting regarding the history and future of CDC-funded public health preparedness and response centers on Wednesday at 1:00 (eastern). Registration is required; go here to register and to learn more about the event.
HHS – Agency for Healthcare Research and Quality – Meeting of the National Advisory Council for Healthcare Research and Quality – July 12
The Agency for Healthcare Research and Quality’s National Advisory Council for Healthcare and Research and Quality will meet virtually on Wednesday, July 12 at 11:15 (eastern). For information about the council, the meeting’s agenda, and how to participate, see this agency notice.