The following is the latest health policy news from the federal government as of 1:15 p.m. on Thursday, April 14.  Some of the language used below is taken directly from government documents.

Public Health Emergency Renewed

HHS Secretary Xavier Becerra has extended the COVID-19 public health emergency for another 90 days effective April 16.

White House

  • In response to an executive order President Biden issued on his first day in office titled “Advancing Racial Equity and Support for Underserved Communities Through the Federal Government,” 90 federal agencies and cabinet departments have released equity action plans that lay out more than 300 concrete strategies and commitments to address systemic barriers in federal policies and programs.  A White House fact sheet describes the Department of Health and Human Services initiatives as follows:

The Department of Health and Human Services is increasing outreach to communities of color to encourage enrollment in free and low-cost health care, and is addressing the maternal mortality crisis that disproportionately impacts Black and Native families, including by working with states to extend postpartum coverage in Medicaid and the Children’s Health Insurance Program. 

Descriptions of other agencies’ plans touch on health care interests as well, and among the approaches envisioned to equity in the everyday business of government are:

  • building accountability for equity through data collection and reporting
  • reducing administrative burdens and simplifying government services
  • reimagining federal service design and delivery through life experiences
  • engaging with stakeholders and communities that have been historically excluded
  • narrowing wealth gaps through federal contracting and procurement
  • delivering equity through grant-making
  • advancing equity through American Rescue Plan and Bipartisan Infrastructure Law implementation

Learn more from this White House fact sheet and new guidance for federal agencies issued by the Office of Management and Budget.  Also, see HHS’s equity plan.

  • The White House has announced an initiative that seeks to hold medical providers and debt collectors accountable for harmful practices; reduce the role that medical debt plays in determining whether Americans can gain credit; help over a half-million low-income American veterans get their medical debt forgiven; and inform consumers of their rights.  Among the steps included in this initiative:
  • HHS Secretary Becerra will direct his department to evaluate how providers’ billing practices affect access and affordability of care and the accrual of medical debt.  HHS will request data from more than 2000 providers on medical bill collection practices, lawsuits against patients, financial assistance, financial product offerings, and third-party contracting or debt-buying practices.  HHS will weigh this information in its grant-making decisions, publish topline data and policy recommendations for the public, and share potential violations with the relevant enforcement agencies.
  • The administration is providing guidance to all agencies to eliminate medical debt as a factor for underwriting in credit programs whenever possible and consistent with law.
  • The Department of Veterans Affairs has published a final rule under which it will virtually cease reporting unfavorable debt, including medical debt, to consumer reporting agencies.

Learn more from the following documents:

Department of Health and Human Services

Health Policy News

  • HHS and the White House have announced a series of initiatives designed to address maternal mortality and morbidity.  They include:
    • approving states’ requests to extend post-partum Medicaid coverage for mothers and their children from the current 60 days to one year
    • introducing a “birthing-friendly” hospital designation to drive improvements in maternal health outcomes and maternal health equity
    • awarding $16 million in grants to strengthen Maternal, Infant, and Early Childhood Home Visiting Programs
    • announcing that they will award $9 million in grants, through nine cooperative agreements of up to $1 million over five years, to build state capacity to deliver high-quality maternity care services and provide training for maternal care clinicians
    • posting a new Maternal Health Best Practice Guide for providers to incorporate telehealth for prenatal and post-partum care and for monitoring within high-risk pregnancy

Learn more about these initiatives from the following resources:

  • a White House fact sheet summarizing the overall initiative
  • an HHS news release describing the extension of post-partum Medicaid coverage and the birthing-friendly hospital designation (with more information promised in upcoming proposed regulations)
  • another HHS news release describing the two funding programs noted above in greater detail, providing a link to a list of those that have already been awarded grants, and including a link to the notice of funding opportunity for the State Maternal Health Innovation & Data Capacity Program (for which applications are due by June 13)
  • HHS and HRSA have released a request for information (RFI) seeking input on ways to strengthen and improve the Organ Procurement and Transplantation Network (OPTN) through the upcoming FY 2023 Request for Proposal (RFP).  The RFI seeks to support HRSA’s efforts to increase accountability in OPTN operations, modernize performance of the transplantation network’s IT system and related tools, and improve engagement with donors and patients.  It specifically focuses on opportunities to strengthen equity, access, and transparency in the organ donation, allocation, procurement, and transplantation processes in the contract arrangement that results from the forthcoming RFP.  Learn more from this HRSA announcement and go here for an introduction to the RFI and a link through which to download it.  Responses to the RFI are due by May 9 at 1:00 p.m. (eastern).
  • HHS has issued a request for information to receive input from the public on its draft outline to further the development of its 2022 Environmental Justice Strategy and Implementation Plan.  HHS seeks to identify priority actions and strategies to best address environmental injustices and health inequities for people of color, disadvantaged, vulnerable, low-income, marginalized, and indigenous populations.  The agency’s intention is for its 2022 Environmental Justice Strategy and Implementation Plan to serve as a guide to confront environmental and health disparities and implement a multi-faceted approach that will serve vulnerable populations and communities disproportionately affected by environmental burdens.  Learn more from this Federal Register notice, which includes the HHS draft outline.  Comments are due by May 19.
  • AHRQ has posted a toolkit to help hospital ICUs reduce rates of central line-associated bloodstream infection and catheter-associated urinary tract infection.  Go here for access to a variety of resources.

Centers for Medicare & Medicaid Services

COVID-19

The federal government will pay for a second COVID-19 booster shot of either the Pfizer or Moderna COVID-19 vaccines for Medicare and Medicaid beneficiaries at no cost and with no copayment, coinsurance, or deductible, CMS has announced.

Health Policy News

  • CMS has issued its FY 2023 skilled nursing facilities prospective payment system proposed regulation.  Highlights of the proposed rule include a 4.7 percent reduction in payments to skilled nursing facilities to offset an unintended increase in payments resulting from the October 2019 introduction of a new patient-driven payment model; a proposed permanent cap on wage index decreases; and a request for stakeholder feedback on nurse staffing requirements and the impact of nursing home staffing requirements.  Comments on the proposed rule are due by June 10.  For further information, see the following resources:
  • CMS has released a national policy for coverage of aducanumab (brand name Aduhelm™) and any future monoclonal antibodies directed against amyloid approved by the FDA with an indication for use in treating Alzheimer’s disease.  Under this policy, Medicare will cover monoclonal antibodies that target amyloid (or plaque) for the treatment of Alzheimer’s disease that receive traditional approval from the Food and Drug Administration under coverage with evidence development.  CMS, as a part of this decision, will provide enhanced access and coverage for people with Medicare participating in CMS-approved studies.  Learn more about this decision from the following resources:
  • CMS has posted a new edition of MLN Connects, its online publication summarizing the latest in Medicare reimbursement policy developments.  This week’s newsletter includes information about new billing codes for Moderna COVID-19 booster vaccinations; a summary of CMS initiatives to advance health equity, expand coverage, and improve health outcomes; information on the Medicare Advantage hospice benefit; and more.  Find these items and more in this week’s MLN Connects.

Provider Relief Fund

  • The Provider Relief Fund has distributed another $1.75 billion in grants to 3680 providers across the country.  With this disbursement it has distributed approximately $13.5 billion from the Provider Relief Fund to nearly 86,000 providers and nearly $7.5 billion in American Rescue Plan Rural payments to more than 44,000 providers since November of 2021.  Go here to learn more about this latest distribution.
  • The Health Resources and Services Administration (HRSA), which administers the Provider Relief Fund and American Rescue Plan Rural Payments fund, has updated the FAQ for those programs with six changes that can be found on pages 22, 37 (two changes), 38 (two changes), and 42.  All are dated “4/6/2022.”  Providers that have received grants from these funds should review them carefully.
  • Based on changes introduced last week, HRSA has added a “Request to Report Late Due to Extenuating Circumstances” page to its Provider Relief Fund web site.

Centers for Disease Control and Prevention

Food and Drug Administration

  • The FDA has issued new draft guidance to the pharmaceutical industry for developing plans to enroll more participants from underrepresented racial and ethnic populations into clinical trials.  Learn more from an FDA news release explaining this initiative; the draft guidance itself; and a Federal Register notice about the proposed policy.  Comments on the proposed policy are due by June 13.

Department of Agriculture

  • The Department of Agriculture has awarded $43 million in American Rescue Plan grants to 93 rural health care organizations and community groups in 22 states to expand rural hospitals’ and providers’ access to COVID-19 vaccines, testing, and supplies while attempting to help rural health care providers stay financially solvent in the long-term.  Learn more about the grant funding and how it will be used in this Department of Agriculture news release and go here to see a list of those awarded grants.

Medicare Payment Advisory Commission (MedPAC)

MedPAC met last week in Washington D.C.  The issues on its agenda were:

  • addressing high prices of drugs covered under Medicare Part B
  • initial findings from MedPAC’s analysis of Part D data on drug rebates and discounts
  • segmentation in the stand-alone Part D prescription drug plan market
  • leveraging Medicare policies to address social determinants of health
  • an approach to streamline and harmonize Medicare’s portfolio of alternative payment models
  • aligning fee-for-service payment rates across ambulatory settings

For brief descriptions of these issues and links to the presentations given for each of them during the meetings, go here.  In addition, see this transcript of the MedPAC meeting.

Medicaid and CHIP Payment and Access Commission (MACPAC)

  • MACPAC met last week in Washington, D.C.  For a summary of the two-day session and links to nine presentations delivered during the sessions, go here.

Stakeholder Events

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.