The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, July 27.  Some of the language used below is taken directly from government documents.

Final Medicare Payment Regulations for FY 2023

  • CMS has issued its final FY 2023 Medicare inpatient rehabilitation facility (IRF) payment system regulation, finalizing a rate increase of 3.9 percent, which is greater than the 2.8 percent the agency proposed in April.  To learn more about CMS’s final IRF payment rule for FY 2023, see this CMS fact sheet and the final rule itself.
  • CMS also has finalized its Medicare inpatient psychiatric facility prospective payment system final rule for FY 2023, including a 2.5 percent rate increase.  Learn more from this CMS fact sheet and the final rule itself.
  • In addition, CMS has published its FY 2023 hospice payment rate update final rule, finalizing a 3.8 percent rate increase.  Learn more from this CMS fact sheet and from the final rule itself.

White House

The White House COVID-19 response team has briefed the press about the administration’s latest efforts in the response to COVID-19.  Find a transcript of its latest briefing here.

The White House has published its research priorities for addressing monkeypox.  Go here to find the statement of those priorities.


The House Ways and Means Committee has approved the Improving Seniors’ Timely Access to Care Act of 2022.  This bill seeks to improve the Medicare Advantage prior authorization process by requiring Medicare Advantage plans to establish an electronic prior authorization program; establishing a process for Medicare Advantage plans to provide real-time decisions on prior authorization requests for routinely approved services as identified by the HHS Secretary; and creating requirements for Medicare Advantage plans’ transparency reporting regarding prior authorization.

Centers for Medicare & Medicaid Services

  • CMS has introduced its “Maternity Care Action Plan” to support the implementation of the administration’s “Blueprint for Addressing the Maternal Health Crisis.”  The action plan seeks to take a holistic and coordinated approach across CMS to improve health outcomes and reduce inequities for people during pregnancy, childbirth, and the postpartum period.  The major components of the plan are coverage and access to care; data; quality of care; workforce; and social supports.  Learn more about the plan from this CMS news release.
  • CMS has released its first home- and community-based services (HCBS) quality measure set to promote consistent quality measurement within and across state Medicaid HCBS programs.  The measure set is intended to provide insight into the quality of HCBS programs and enable states to measure and improve health outcomes for people relying on long-term services and support (LTSS) in Medicaid.  CMS also views the release of this measure set as a step toward promoting health equity among the millions of older adults and people with disabilities who need LTSS because of disabling conditions and chronic illnesses.  State use of the quality measure set is voluntary.  Learn more about the release of this quality measure set from this CMS news release and from CMS’s memo to state Medicaid directors about the quality measure set.
  • CMS has written to state Medicaid and CHIP directors to remind states and stakeholders of existing federal beneficiary protections that help ensure appropriate beneficiary access to prescription medications, especially as state programs and stakeholders continue to negotiate novel payment arrangements with drug manufacturers as part of value-based purchasing initiatives.  Find that memo here.
  • CMS has posted a new edition of MLN Connects, its online newsletter with information about Medicare billing matters.  The new issue has features on new billing codes for the Novavax COVID-19 vaccine, the new 988 suicide and crisis hotline, and more.  Find it here.
  • CMS has approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in Connecticut, Massachusetts, and Kansas.  This brings to 18 the number of states that have now adopted this optional extension of benefits, which was authorized by the American Rescue Plan.  Learn more about this latest extension of benefits from this news release.
  • HHS’s Office of the Assistant Secretary for Health has announced that it has awarded $8.5 million in grants for initiatives designed to reduce pregnancy-related deaths and complications that disproportionately affect minority populations and those living in rural areas.  Learn more about the awards and how they will be used and find a link to grant recipients in this HHS news release.
  • CMS has proposed updating Clinical Laboratory Improvement Amendments of 1988 (CLIA) fees and clarifying CLIA fee regulations.  This proposed rule also calls for changes in federal regulation of CLIAs.  Learn more from this Federal Register notice.  Stakeholder comments are due by August 25.
  • CMS has launched its enhanced Nursing Home Five-Star Quality Rating System, which now integrates data nursing homes report on their weekend staffing rates for nurses and information on annual turnover among nurses and administrators.  The new nurse staffing information includes registered nurses, licensed practical nurses, vocational nurses, and nurse aides who work under the direction of licensed nurse staff and provide much of the day-to-day care for nursing home residents.  Learn more from this CMS news release; this CMS fact sheet on the changes in the agency’s methodology; and a separate fact sheet on the July 22 update of the Nursing Home Compare web site.
  • CMS is creating a technical expert panel for a project it calls “Addressing Social Needs Electronic Clinical Quality Measure” that will redesign a measure of screening for social needs (e.g., housing status, food insecurity, transportation).  The re-designed measure will be an electronic clinical quality measure (eCQM) evaluating hospitals addressing social needs.  To assist with this project CMS seeks individuals with varied perspectives and areas of expertise, including disparities in care and outcomes; equity measurement; collection of social data and knowledge of specific data collection tools; and the integration of social and clinical care.  In addition, the conceptualization and specification of this measure calls for experts to provide guidance on highly technical and complex concepts related to health information technology, interoperability and data standardization, and clinical informatics.  Learn more about the panel, the work it will do, the time commitments it will entail, and more from this CMS notice.  Nominations are due by September 6.
  • CMS writes about “The Medicare Value-Based Care Strategy: Alignment, Growth, And Equity” in the latest edition of the CMS blog.  Find it here.

Department of Health and Human Services

  • HHS, CMS, and HHS’s Office of Civil Rights have issued a proposed rule prohibiting discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities.  The proposed rule also would revise the current interpretation regarding whether Medicare Part B constitutes federal financial assistance for purposes of civil rights enforcement and revise non-discrimination provisions to prohibit discrimination on the basis of sexual orientation and gender identity in regulations issued by CMS governing Medicaid and the Children’s Health Insurance Program (CHIP); Programs of All-Inclusive Care for the Elderly (PACE); health insurance issuers and their officials, employees, agents, and representatives; states and the exchanges carrying out exchange requirements; agents, brokers, or web brokers that assist with or facilitate enrollment of qualified individuals, qualified employers, or qualified employees; insurers providing essential health benefits; and qualified health plan insurers.  Most of these provisions were included in the Affordable Care Act, weakened in 2020, and are now proposed for restoration and strengthening.  Learn more from this HHS news release and this pre-publication version of the proposed rule.  Comments will be due within 60 days of the proposed rule’s official publication in the Federal Register, which has not been scheduled at this time.
  • HHS’s Health Resources and Services Administration (HRSA) has announced the availability of nearly $15 million to grow the nursing workforce, improve access to nursing education, and advance health equity.  The funding consists of two components:  a “Clinical Faculty and Preceptor Academies Program” that will award $10 million over four years to grow the nursing workforce by recruiting, training, and supporting clinical nursing faculty and preceptors; and the “Registered Nurse Training Program,” which will award $4.75 million in grants over three years to increase the number of nursing students trained in acute-care settings, with an emphasis on addressing and responding to social determinants of health factors and improving health equity.  Learn more about the new initiative from this HRSA news release.  For information about applying for Clinical Faculty and Preceptor Academies Program funding go here; applications are due by August 22.  For information about applying for the Registered Nurse Training Program go here; these applications are due by August 19.
  • HHS has elevated its Office of the Assistant Secretary for Preparedness and Response (ASPR) from a staff division to an operating division and renamed it the “Administration for Strategic Preparedness and Response” (also ASPR).  The move elevates ASPR to a standalone agency within the department alongside other HHS agencies, such as the CDC, FDA, CMS, HRSA, SAMHSA, and others.  The change is intended to enable ASPR to mobilize a coordinated national response more effectively and efficiently during future disasters and emergencies in close collaboration with its sister agencies.  Learn more about this organizational change in this HHS news release.
  • HHS’s Agency for Healthcare Research and Quality (AHRQ) has issued the draft report “Use of Telehealth During the COVID-19 Era.”  The purpose of this review is to assess how to provide telehealth care by identifying characteristics of telehealth delivery, patient populations, settings, benefits and harms, and implementation strategies during the COVID-19 era.  The agency invites interested parties to comment both on how it performed its review and the conclusions it reached.  Go here for links to the report and to a web page for submitting comments.  Comments are due by August 12.
  • AHRQ also has released two video modules designed to help nursing home staff know when to test residents for COVID-19 and how COVID-19 vaccines can guard against the virus and serious illness.  Find the two modules here.
  • HHS’s Office of Information Security has published an overview of cybersecurity issues involving health care apps, including how attacks are made on such apps and how health care organizations can protect themselves from such attacks.  Learn about this and more in the HHS Office of Information Security publication “Web Application Attacks in Healthcare.”

Centers for Disease Control and Prevention

Medicare Payment Advisory Commission (MedPAC)

MedPAC has submitted formal comments to CMS in response to CMS’s proposed rule addressing Medicare and Medicaid conditions of participation for rural emergency hospitals and critical access hospitals.  The letter addresses CMS’s proposal for staffing requirements for rural emergency hospitals.  Find the MedPAC letter here.

Stakeholder Events

CDC – Novavax COVID-19 vaccine recommendations – July 28

The CDC will hold a webinar on Thursday, July 28 at 2:00 (eastern) to present the CDC’s new guidance on the Novavax COVID-19 vaccine for adults ages 18 years and older, including adults who are moderately or severely immunocompromised.  Learn more about the webinar’s objectives, the presenters, how to qualify for continuing education credits, and how to join the event from this CDC notice.

CMS – Medicare Ground Ambulance Data Collection System Webinar – August 4

Starting on January 1, 2023, selected ground ambulance organizations are required to report cost, utilization, revenue, and other information to CMS.  Organizations that fail to report may be subject to a 10 percent payment reduction.  With this in mind, CMS is holding a webinar on Thursday, August 4 at 2:00 (eastern) to present templates providers may use to import facility and vehicle costs in the Medicare Ground Ambulance Data Collection System.  Find the webinar presentation here and register for the webinar here.

CMS – Digital Quality Measurement – August 10 and 11

CMS will hold a webinar titled “Strategic Roadmap for Advancing Digital Quality Measurement” to highlight its multi-pronged strategy to provide better access to usable, timely data to improve quality measurement and patient care.  The webinar will be offered twice:  on Wednesday, August 10 at 3:00 (eastern) and Thursday, August 11 at noon (eastern).  To register for the August 10 session, go here; to register for the August 11 session, go here.  Space is limited so CMS encourages early registration.

HHS Office of the Assistant Secretary for Preparedness and Response – Disaster Available Supplies in Hospitals Tool – August 15

HHS’s Office of the Assistant Secretary for Preparedness and Response will hold a webinar on Monday, August 15 at 11:30 (eastern) to talk to hospitals about its Disaster Available Supplies in Hospitals Tool (DASH), an online, interactive tool for hospital emergency planners and supply chain staff to estimate supplies that may be needed immediately during various emergencies based on their hospital’s characteristics.  Speakers will provide an overview and demonstration of DASH and share information on how it may be used from both the hospital and supply chain perspective.  Go here to learn more about the webinar and the speakers and how to register to participate; registration is limited to 1000 participants, although the event will be recorded and made available at a later date.

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.