The following is the latest health policy news from the federal government as of 2:45 p.m. on Wednesday, June 30.  Some of the language used below is taken directly from government documents.

Supreme Court Decision in Site-Neutral Payment Case

  • The Supreme Court has declined to hear an appeal of a case rejecting the bid of hospital interests to prevent Medicare’s implementation of site-neutral payment rates for outpatient clinic visits.

Provider Relief Fund

CMS has updated the following pages on its Provider Relief Fund web site:  For Providers, General Information, Data, Reporting Requirements and Auditing, and FAQs.  The updates incorporate changes originally communicated in the June 11, 2021 update of the Post-Payment Notice of Reporting requirements.  CMS has summarized those changes in a revised answer to the question “What’s the latest regarding the CARES Act Provider Relief Fund” on the FAQ page?”, which reads as follows:

HHS revised the Post-Payment Notice of Reporting Requirements – PDF* as of June 11, 2021. This new version supersedes all previous versions of the Post-Payment Notice of Reporting Requirements documents. Key updates include:

  • The period of availability of funds is based on the date the payment is received (rather than requiring all payments be used by June 30, 2021, regardless of when they were received).
  • Recipients are required to report for each Payment Received Period in which they received one or more payments exceeding, in the aggregate, $10,000 (rather than $10,000 cumulatively across all PRF payments).
  • Recipients will have a 90-day period to complete reporting (rather than a 30-day reporting period).
  • The reporting requirements are now applicable to recipients of the Nursing Home Infection Control Distribution (formally known as the Skilled Nursing Facility and Nursing Home Infection Control Distribution) in addition to General and other Targeted Distributions.
  • The PRF Reporting Portal will open for providers to start submitting information on July 1, 2021.

Providers should review these changes carefully.

(Please note that the changes on several of the site’s pages refer visitors to the Provider Relief Fund Reporting Portal but that portal will be unavailable until Thursday morning, July 1 at 8:00 a.m. (eastern.)

Department of Health and Human Services

COVID-19

  • HHS’s Office of Minority Health (OMH) has awarded $250 million in grants to 73 local governments as part of a new, two-year initiative to identify and implement best practices for improving health literacy to enhance COVID-19 vaccination and other mitigation practices among underserved populations.  Learn more about the program and find a list of those awarded grants here.
  • HHS and its Office of Head Start at the Administration for Children and Families is awarding $1 billion in American Rescue Plan Act funds to Head Start programs nation-wide.  These funds will help more than 1500 Head Start programs build back to fully operational, in-person comprehensive services this fall and some of the money is expected to be used to support COVID-19 vaccinations for staff and participating families.  Learn more from this HHS announcement.

Centers for Medicare & Medicaid Services

Health Policy News

  • CMS has proposed a new rule that sets forth proposed revised 2022 user fee rates for insurers offering qualified health plans through federally-facilitated exchanges and state-based exchanges on the federal platform and proposes repealing billing requirements related to the collection of separate payments for the portion of qualified health plan premiums attributable to coverage for certain abortion services.  Under the proposed rule, exchange customers would have an extra 30 days to enroll, the enrollment period would be extended from November 1 to January 15 (it currently ends on December 15), and a new monthly special enrollment period would give low-income individuals and families additional opportunities to enroll in a no-premium plan.  Learn more from this CMS news release; a CMS fact sheet; and the proposed regulation itself.  Stakeholder comments are due by July 28.
  • CMS has published its proposed calendar year 2022 home health prospective payment system rate update.  Among other things, the proposed rule would increase rates 1.7 percent; expand the home health value-based purchasing model nation-wide, making participation mandatory; recalibrate case-mix weights; introduce an occupational therapy low-utilization payment adjustment add-on factor for assessments; introduce changes in the home health quality reporting program and solicit stakeholder input on possible future changes that address health equity; and make permanent certain regulatory waivers introduced in response to the COVID-19 emergency, including the use of telehealth.  Learn more from the CMS announcement about the proposed rule; a separate news release addressing how the rule seeks to improve home health services for older adults and people with disabilities; and the proposed rule itself.  The deadline for stakeholder comment is August 27.
  • CMS has published the latest edition of MLN Connects, its online publication.  For articles about the July 2021 update of the ambulatory surgical center payment system, 2021 alternative payment model (APM) incentive payments, and more, go here.
  • In a study to determine whether CMS has designed and implemented effective internal controls related to hospital preparedness for emerging infectious diseases such as COVID-19, CMS’s Office of the Inspector General has concluded that those controls were well-designed and implemented during the COVID-19 emergency but that CMS’s authority is insufficient for it to ensure preparedness at accredited hospitals.  Find a summary of the study here and the full report here.

Centers for Disease Control and Prevention

COVID-19

Stakeholder Events

CMS – Coronavirus (COVID-19) Stakeholder Calls 

HHS’s “We Can Do This” campaign is a national initiative to build confidence in COVID-19 vaccines and get more people vaccinated.  This campaign offers tailored resources and toolkits for stakeholders to use to provide COVID-19 vaccine information to at-risk populations.  CMS is partnering with the campaign to offer several webinars to walk through each toolkit and its resources and train community organizations, local voices, and trusted leaders to use the campaign tools for vaccine outreach efforts to diverse communities.  Webinar dates and registration links are below:

  • Thursday,  July 1, 1:00-2:00 pm ET:  Toolkits for Racial and Ethnic Minority Communities – Register here
  • Thursday, July 8, 1:00-1:30 pm ET:  Older Adults Toolkit – Register here

Wednesday, Thursday, and Friday, July 7, July 8, and July 9 – CMS

CMS – Revisions to the Healthcare Common Procedure Coding System (HCPCS) Code Set

CMS will hold virtual meetings on July 7, 8, and 9, to discuss its preliminary coding recommendations for revisions of the HCPCS Level II code set.  For information about times, registration, submission of materials, signing up to speak, and submitting comments, click here.

Tuesday, July 13 – Office of the National Coordinator for Health Information Technology (ONC)
ONC Workshop: Advancing SDOH Data Use and Interoperability for Achieving Health Equity
Tuesday, July 13 at 10:00 am – 4:00 pm ET  Click here for connection information
This workshop will explore existing and emerging data standards, tools, approaches, policies, models, and interventions for advancing the use and interoperability of non-clinical health data for individual and community health improvement.  It will share varying perspectives of health policy-makers and health improvement implementers to highlight inventive solutions, share challenges, and offer ideas on data modernization to advance health equity.  The workshop offers introductory content as well as deep exploration of key topics as part of social determinants of health IT data use and interoperability including facilitated, expert stakeholder engagement.