The following is the latest health policy news from the federal government as of 3:15 p.m. on Wednesday, August 17. Some of the language used below is taken directly from government documents.

White House

  • The White House has released a fact sheet outlining key supports and guidance it is providing for protecting students, teachers, and school communities and for managing the risks of COVID-19 spread for the upcoming school year. These resources and guidance focus on using COVID-19 vaccines and boosters as the first line of defense to protect in-person learning; providing robust access to COVID-19 testing at schools to help detect infection early;  and helping schools plan and implement indoor air quality improvements, including through use of federal funds.  You can find more details in this fact sheet.

 

Department of Health and Human Services

  • Today the U.S. Departments of Health and Human Services, Labor, and the Treasury (the Departments) released technical assistance (TA) for certified Independent Dispute Resolution (IDR) entities on various aspects of the Federal IDR process, which can be found here. This TA provides more in-depth direction to certified IDR entities on the following topics:
    • Batching and Bundling
    • Eligibility for the Federal IDR Process
    • Failure to Submit Required Information in Response to a Certified IDR Entity’s Request

The Departments are hosting a webinar via REGTAP on Monday, August 22, 2022 to discuss the August 2022 Edition of Technical Assistance for Certified IDR Entities. If interested in attending, register here.

  • The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), has approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in Hawaii, Maryland, and Ohio. With today’s approval, in combination with previously approved state extensions, an estimated 318,000 Americans annually in 21 states and D.C. are eligible for 12 months of postpartum coverage.  Read more in this press release from HHS.

 

Centers for Medicare & Medicaid Services 

  • CMS has announced that it has suspended the requirement for prior authorization for specified durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) currently on the Required Prior Authorization List as a condition of payment under certain circumstances when reported with certain modifiers. Items subject to face-to-face encounter and written order prior to delivery requirements are not affected by this new policy. Learn more about the affected items and their billing codes from this Federal Register notice.
  • CMS has announced the agency will discontinue the use of Certificates of Medical Necessity (CMN) and Durable Medical Equipment (DME) Information Forms (DIFs) for claims with dates of service on or after January 1, 2023. CMS suppliers must continue to submit CMN and DIF information for claims with dates of service before January 1, 2023 if it is required.  View the CMS news release here and the MLN Matters article on the topic here.
  • CMS has announced its list of provisionally accepted applicants and Implementation Period #3 for the newly redesigned ACO REACH model, which will begin January 2023. This is not the final list of ACOs that will begin participation in the ACO REACH Model next year, further conditions must be met before final approval.  Learn more from this CMS update.
  • CMS has issued an advisory to alert certain clinicians who are qualifying alternative payment model participants and eligible to receive alternative payment model incentive payments that the agency does not have the current billing information needed to disburse those payments. This advisory provides information to these clinicians on how to update their billing information to receive their payments. Learn more from this Federal Register notice. 

 

Monkeypox

  • Last week, the White House monkeypox response team briefed the press on the current state of the federal response to the disease. Go here to view a video of that briefing.
  • The CDC has posted an updated map showing the distribution of 12,689 confirmed cases of monkeypox in the U.S. as of August 16.
  • CMS has issued two new CPT codes that went into effect starting July 26, 2022. Code 90611 for smallpox and monkeypox vaccine products, and code 90622 for vaccinia (smallpox) virus vaccine products. Learn more about these vaccine codes here.
  • The CDC has released interim guidance recommending that vaccination with JYNNEOS should be considered for people who are at elevated risk for infection of the monkeypox disease. The guidance document also touches on the duration of immunity from the vaccine, dosing intervals, and evidence quality. More information can be found here and from this FDA news release.
  • The CDC has updated its interim recommendations for vaccine administration errors and deviations for JYNNEOS vaccine. You can find those recommendations here.
  • The CDC has updated their monkeypox infection control recommendations for health care settings. Changes include how to monitor exposed patients and an updated risk assessments table. Learn more about these changes here.
  • The CDC has released guidance intended for monitoring persons who have had monkeypox exposures in their communities and healthcare settings. Guidance for exposures can be found here.
  • The CDC has updated their Clinical Considerations for Treatment and Prophylaxis of Monkeypox Virus Infection in People with HIV. Find updated information here.

 

Centers for Disease Control and Prevention

  • The Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR), in partnership with the Department of Health and Human Services’ Office of Environmental Justice, announced the release of the Environmental Justice Index (EJI). The EJI builds off existing environmental justice indexes to provide a single environmental justice score for local communities across the United States so that public health officials can identify and map areas most at risk for the health impacts of environmental burden.  Learn more about this initiative from this HHS news release.
  • The CDC has encouraged health care providers, insurers, policymakers, and public health professionals to work to improve access to treatment for people with hepatitis C and issued recommendations for doing so. Go here to see the CDC’s recommendations and its documentation of the current state of hepatitis C treatment in the U.S. In support of this recommendation, the CDC has published research documenting the state of hepatitis C treatment among adults in the U.S.  In addition, the CDC has held a briefing on this issue; find a link to an audio recording of that briefing here.

 

Food and Drug Administration

  • The FDA issued a final rule that is expected to lower costs of hearing aids for millions of Americans. This action establishes a new category of over-the-counter hearing aids, enabling consumers with mild to moderate hearing impairments to purchase hearing aids directly from stores or online retailers without the need for medical exams or prescriptions. Learn more about this final rule here.

 

Medicare Payment Advisory Commission (MedPAC)

  • MedPAC has submitted formal comments to CMS in response to CMS’s proposed rule on the home health prospective payment system for CY 2023. The MedPAC comments address several proposals in the rule related to Medicare payment policies for home health agencies (HHAs). Find the MedPAC letter here.

 

Stakeholder Events

HHS, Department of Labor, and the Treasury Department – Webinar to Discuss the August 2022 Edition of Technical Assistance for Certified Independent Dispute Resolution (IDR) Entities – August 22

The U.S. Departments of Health and Human Services, Labor, and the Treasury (the Departments) released technical assistance (TA) for certified Independent Dispute Resolution (IDR) entities on various aspects of the Federal IDR process. This TA provides more in-depth direction to certified IDR entities on batching and bundling; eligibility for the Federal IDR Process; and more.  If interested in attending, register here.

CMS – Advisory Panel on Hospital Outpatient Payment – August 22 and 23

CMS’s Advisory Panel on Hospital Outpatient Payment will meet virtually on Monday, August 22 at 9:30 a.m. (eastern) and Tuesday, August 23, also at 9:30 a.m. (eastern). The purpose of the panel is to advise the Secretary of HHS and the Administrator of CMS about the clinical integrity of the Ambulatory Payment Classification groups and their associated weights, which are important components of Medicare’s outpatient prospective payment system. Stakeholders are invited to submit presentations and comment letters. Learn more about the panel and its work, the meeting agenda, how to submit materials, and how to join the meeting from this Federal Register notice.

CDC – Healthcare Infection Control Practices Advisory Committee – August 23

The CDC’s Healthcare Infection Control Practices Advisory Committee will meet via webinar on Tuesday, August 23 at 12:00 p.m. (eastern). Participation is limited to three hundred individuals and registration is required. Learn more about the role of the committee, the meeting agenda, and how to register from this Federal Register notice.

CMS – Coronavirus (COVID-19) National Nursing Home Stakeholder Call – August 25

CMS and CDC will meet virtually on Wednesday, August 25 at 4:00p.m. (eastern) for a National Nursing Home Stakeholder Call. The purpose of this call is to provide a recap of recent announcements and provide National Healthcare Safety Network (NHSN) updates. Learn more about how to join this meeting here.