Federal Health Policy Update for Tuesday, August 23

The following is the latest health policy news from the federal government as of 2:45 p.m. on Tuesday, August 23. Some of the language used below is taken directly from government documents.

CMS “Roadmap for the End of the COVID-19 Public Health Emergency”

While the COVID-19 public health emergency (PHE) has not ended and HHS Secretary Becerra has committed to giving states and the health care community 60 days’ notice before formally ending it – notice he has not given – the federal government is already planning for life after the PHE and its latest step in this process is a new CMS “roadmap” for the end of the COVID-19 PHE. As the agency notes, “Throughout the COVID-19 public health emergency (PHE), CMS has used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure access to care and give health care providers the flexibilities needed to respond to COVID-19 and help keep people safer. Many of these waivers and broad flexibilities will terminate at the eventual end of the PHE, as they were intended to address the acute and extraordinary circumstances of a rapidly evolving pandemic and not replace existing requirements.”

CMS further explains that “…we have learned a great deal from health care providers, facilities, insurers, and other stakeholders’ experience and use of the waivers and flexibilities. In many cases, these have proven to be especially useful during the initial challenges of the pandemic. In fact, we determined that some of these measures should remain in place even after the end of the PHE to promote innovation, maintain or improve quality, advance health equity, and expand access to care.” CMS notes that some of the temporary changes, such as expanded use of telehealth, were directed by Congress, and that it has “…identified certain flexibilities that, while useful during the initial response to COVID-19, are no longer needed in the current stage of the pandemic.”

Learn more about the CMS roadmap from the following resources:

CMS introduces its roadmap and its intentions on the CMS blog.
It explores its plans and objectives further in the document “Health Care System Resiliency: Preparing the Health Care System for Operation After the Public Health Emergency.”
CMS also has extensively updated its document “COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers,” which it introduced early in the public health emergency and updated frequently thereafter. That document has always noted, and CMS now reiterates, that unless otherwise noted, these waivers will expire at the end of the COVID-19 public health emergency.
CMS also has updated provider-specific fact sheets with information about COVID-19 public health emergency waivers and flexibilities. These fact sheets, the agency notes, include information about which waivers and flexibilities have already been terminated, have been made permanent, or will be terminated at the end of the public health emergency. Those fact sheets are:

Department of Health and Human Services

HHS, the Department of Labor, and the Treasury Department have published a regulation governing the independent dispute resolution (IDR) process that is a major aspect of the 2020 No Surprises Act, the law passed by Congress to help protect consumers from surprise medical bills. This latest regulation addresses payment determinations under that IDR process; the role of qualifying payment amounts (QPA) in decisions about disputed payments; and a requirement that the entities adjudicating those disputes explain to participants in writing how they reached their decisions. Learn more about the regulation from the following resources:
- A news release announcing the new rules.
- An FAQ about the new rules. This FAQ also summarizes previous No Surprises Act regulations.
- A pre-publication version of the new final rule. The rule will take effect 60 days after its official publication in the Federal Register but a publication date has not been announced at this time.
- Separately, CMS has established a web page with resources to assist parties seeking to initiate IDR proceedings. Find that web page here.
HHS’s Health Services and Resources Administration (HRSA) has redesigned its Provider Relief Fund web page. The refreshed site includes a section on Provider Relief Fund reporting period 3, the portal for which opened on July 1 and will remain open through September 30. Find the updated site here and the section on reporting period 3 here.
Later this year hospitals will start reporting their COVID-19 data to the CDC and its National Healthcare Safety Network rather than TeleTracking, the contractor currently employed by HHS for this purpose. Learn more about this transition, including how to participate in training for it, from a CDC web page on this mid-December transition.
HHS has announced that distribution of the monoclonal antibody bebtelovimab, a major drug used to treat COVID-19, is now transitioning from the federal government’s Health Partner Ordering Portal to a distributor working with the drug’s manufacturer. To facilitate this transition, HHS has published a detailed description of how the transition will work, how payment and cost sharing will work, and how hospitals and other providers can order bebtelovimab in the future. Find that explanation here.
HHS’s Agency for Healthcare Research and Quality (AHRQ) has published the draft report “Respectful Maternity Care: Dissemination and Implementation of Perinatal Safety Culture to Improve Equitable Maternal Healthcare Delivery and Outcomes” and is inviting stakeholder comment on key questions about the draft. Find the draft report here and find instructions for responding to the key questions here. Comments are due by September 9.

Centers for Medicare & Medicaid Services

CMS and HHS have announced three actions to strengthen and expand access to high-quality, comprehensive health care for children. They issued new guidance reminding states of their mandate to cover behavioral health services for children in Medicaid and urging states to leverage every resource to strengthen mental health care for children; guidance urging states to expand school-based health care for children, including mental health care; and a proposed rule, described in greater detail below, that would require states to report certain quality measures to strengthen Medicaid and the Children’s Health Insurance Program (CHIP). Learn more from the following resources:
As noted above, CMS has published a proposed regulation to advance consistent use of nationally standardized quality measures in Medicaid and the Children’s Health Insurance Program (CHIP). These quality measures will seek to identify gaps and health disparities among the millions of people enrolled in these programs. The rule proposes requiring mandatory annual state reporting of three different quality measure sets: a Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP; behavioral health measures in a Core Set of Adult Health Care Quality Measures for Medicaid; and a Core Set of Health Home Quality Measures for Medicaid. Together, these core sets are designed to measure the overall national quality of care for beneficiaries, monitor performance at the state level, and improve the quality of health care. In addition, CMS also proposes reporting requirements for states that elect to implement one or both of the optional Medicaid health home benefits under sections 1945 or 1945A of the Social Security Act; these requirements would measure health care quality for states that choose to establish “health homes.” Learn more about this CMS proposal from this CMS news release and this Federal Register notice. Stakeholder comments are due by October 21.
CMS has sent an informational bulletin to states detailing actions states can take using existing Medicaid authorities to drive better health outcomes for nursing home residents and improve staff pay, training, and retention efforts. The bulletin also provides examples of current state Medicaid initiatives to support this work. Learn more from this CMS news release and from the informational bulletin itself.
CMS has posted a new edition of MLN Connects, its online newsletter with information about Medicare payment issues. The latest issue includes features on ICD-10 and other Medicare code revisions, quarterly updates for some laboratory services, updates of hospice rates, caps, and wage indexes for FY 2023, and more. Find the latest MLN Connects here.
Earlier this year the administration announced policies that seek to improve the safety and quality of nursing home care, hold nursing homes accountable for the care they provide, and make the quality of care and facility ownership more transparent so that potential residents and their families can make informed care choices. One aspect of this strategy was to establish new minimum staffing requirements so every nursing home has sufficient staff that is adequately trained to provide the safe and quality care residents need. In support of this effort, CMS issued a Request for Information earlier this year as a part of its FY 2023 skilled nursing facility prospective payment system proposed rule and will begin conducting a study this month to inform an eventual minimum staffing proposal. Learn more about the administration’s focus on nursing home staffing, what CMS learned from stakeholders through their comments in response to the request for information in the proposed skilled nursing facility payment rule, and the study the agency is now undertaking from this article on the CMS blog.
HHS and CMS have awarded approximately $25 million in planning grants to five states and territories – Illinois, Kansas, and New Hampshire, American Samoa, and Puerto Rico – to expand access to home and community-based services through Medicaid’s Money Follows the Person demonstration program. With these awards, 41 states and territories across the country will now participate in the Money Follows the Person program. Learn more about the program, the latest grant recipients, and how those recipients are expected to use the money from this HHS news release.
CMS has published an update on the status of states’ efforts to facilitate the transition of Medicaid beneficiaries from long-term institutional care to home- and community-based long-term services and supports. Find that study here.
CMS has released a bulletin to states inviting them to apply to participate in a U.S. Department of Agriculture demonstration project to use Medicaid eligibility data to qualify children for free and reduced price school meals. Find the CMS announcement here and find the CMS bulletin to states here. Applications for the 2023-2024 school year are due by September 30.
CMS has issued a memo to states on applicable federal cost principles for ground emergency medical transportation. The purpose of this memo is to remind states of existing federal requirements relevant to payment for ground emergency medical transportation services in Medicaid to assist them with developing state plan amendments and other proposals that are consistent with such federal requirements. Find the memo here.
CMS is offering virtual training on use of the Outcome and Assessment Information Set (OASIS)-E system for the home health quality reporting program, which includes changes that take effect on January 1, 2023. The training includes videos, live practice coding events, and additional resources. Learn more here.

Monkeypox

HHS has updated its monkeypox resources page. Find it here.
The CDC has updated its monkeypox web page. Updated sections address prevention, pediatric considerations, schools, early care and education programs, and other settings serving children or adolescents, and information for health care professionals. In addition, the CDC has issued the following separate updates:
The White House monkeypox response team and other government health officials have briefed the news media on the latest in the federal government’s response to the monkeypox outbreak. Find a transcript of that briefing here.
The White House has released a fact sheet sharing its latest actions in response to the monkeypox outbreak. Highlights of those actions include making 1.8 million doses of vaccine available for ordering beginning this week; making more vaccines available for jurisdictions hosting large LGBTQI+ events; and making 50,000 courses of TPOXX (the primary treatment for monkeypox) available to jurisdictions to facilitate timely access to TPOXX for eligible patients. Find that fact sheet here.
The CDC has posted an updated map showing the distribution of 15,433 confirmed cases of monkeypox in the U.S. as of August 22.
HHS has contracted for 5.5 million vials of monkeypox vaccine to be filled, finished, and delivered from U.S. government-owned bulk vaccine stored in Denmark and for a European contractor to complete a technology transfer that would provide for 2.5 million of those vials to be filled and finished by a U.S.-based contract manufacturer. Learn more from this HHS news release.

Centers for Disease Control and Prevention

The CDC is inviting nominations for membership on its Board of Scientific Counselors of the National Center for Health Statistics. The board consists of up to 15 experts from fields associated with statistical, demographic, and epidemiological research, such as biostatistics/biometry, survey methodology and polling, sociology, reproductive health, minority health, nutrition, social and behavioral health sciences, and population-based public and environmental health; public health practice, such as state and local health data systems; operations research, health policy, and health services research, including health economics and econometrics; provision of health services, including medicine, nursing, rehabilitation, other allied health care, and preventive medicine; health quality measurement and health indicators; health promotion; medical informatics; and data and health information security, storage, confidentiality, and dissemination. Learn more about the board and what the CDC seeks from prospective nominees from this Federal Register notice. Nominations are due by October 14.

Food and Drug Administration

The FDA has authorized the emergency use of the Novavax COVID-19 vaccine for individuals 12 through 17 years of age. The agency previously authorized the vaccine for individuals 18 years and older. Learn more here. Find the CDC’s adoption of this recommendation here.

National Institutes of Health

The National Cancer Institute will award $23 million to four academic institutions to establish centers of excellence that will conduct research on the role of telehealth in delivering cancer-related health care. Learn more about the purpose of the funding and the institutions to which it has been awarded from this NIH news release.

Medicare Payment Advisory Commission (MedPAC)

MedPAC has submitted formal comments to CMS in response to that agency’s proposed end-stage renal diseases prospective payment system and other aspects of payment for renal care services for calendar year 2023. Find MedPAC’s letter here.

Stakeholder Events

CMS – National Stakeholder Call with the CMS Administrator on the Inflation Reduction Act – August 25

CMS Administrator Chiquita Brooks-LaSure and members of the agency’s leadership team will review the impact of the Inflation Reduction Act and discuss CMS’s implementation of its portions of the new law during a national stakeholder call on Thursday, August 25 at 2:00 (eastern). Go here to register and submit questions.

CMS – Home Health Value-Based Purchasing Model Performance Reporting Training – August 25

CMS’s Home Health Value-Based Purchasing technical assistance team will present the webinar “Navigating Performance Feedback Reports: Interim Performance Report (IPR) and Annual Performance Report (APR)” on Thursday, August 25 at 2:00 (eastern). The purpose of this webinar is to familiarize home health agencies with the IPR and APR, which are expanded versions of Home Health Value-Based Purchasing Model performance feedback reports. Go here to learn more about the training and to register to participate.

Federal Health Policy Update for Tuesday, August 23