The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, March 16. Some of the language used below is taken directly from government documents.
Provider Relief Fund
- On March 22, 2022 at 11:59 p.m. (eastern), the HRSA COVID-19 Uninsured Program will stop accepting claims for testing and treatment due to lack of funds. On April 5, 2022 at 11:59 p.m. (eastern), the HRSA COVID-19 Uninsured Program and COVID-19 Coverage Assistance Fund will stop accepting vaccination claims due to a lack of funds. See the announcement of these changes.
- Providers that received Provider Relief Fund payments of more than $10,000 in the aggregate between July 1 and December 31, 2020 must report on their use of those funds to HHS by March 31. For information about reporting requirements, forms, reporting instructions, and more on what the agency refers to as “Reporting Period 2,” go here.
- Senior White House officials held a background briefing for the press on the administration’s COVID-19 response and funding needs. Learn more from this transcript of the briefing.
- The White House also released a fact sheet on the consequences of lack of funding for efforts to combat COVID-19.
Department of Health and Human Services
Health Policy Update
- CMS has published final federal Medicaid disproportionate share hospital (Medicaid DSH) allotments for federal fiscal years 2018 and 2019 and the preliminary federal DSH allotments for FY 2020 and FY 2021. This notice also announces the final FY 2018 and FY 2019 and the preliminary FY 2020 and FY 2021 limits on aggregate DSH payments states may make to institutions for mental disease and other mental health facilities. In addition, the notice includes background information describing the methodology for determining the amounts of states’ DSH allotments. Learn more from this Federal Register announcement.
- HHS and its Substance Abuse and Mental Health Services Administration (SAMHSA) have announced two grant programs totaling $25.6 million that will expand access to medication-assisted treatment for opioid use disorder and prevent the misuse of prescription drugs. The Strategic Prevention Framework for Prescription Drugs grant program will provide funds for state agencies, territories, and tribal entities that have completed a Strategic Prevention Framework State Incentive Grant plan or a similar state plan to target prescription drug misuse. The program will award $3 million in grants over five years to up to six recipients. The Medication-Assisted Treatment – Prescription Drug and Opioid Addiction grant program will provide resources to help expand and enhance access to medications for opioid use disorder and decrease illicit opioid use and prescription opioid misuse. This program will award $22.6 million in grants over five years to up to 30 recipients. Learn more from the following resources:
- an HHS news release
- grant information for the Strategic Prevention Framework for Prescription Drugs grant program (application deadline of April 25)
- grant information for the Medication-Assisted Treatment – Prescription Drug and Opioid Addiction grant program (application deadline of April 29)
Centers for Medicare & Medicaid Services
- CMS has updated its FAQ on nursing home visitation to reflect the changing nature of the COVID-19 pandemic.
- CMS has revised its guidance to state survey agencies on long-term-care facility COVID-19 testing requirements to reflect other recent changes in federal testing guidelines.
Health Policy Update
- CMS has announced the launch of its Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Learning Collaborative, which will offer technical assistance to states and their partners through a webinar series and an affinity group. The learning collaborative will begin with a webinar series demonstrating the potential impact of the program on maternal and infant health, describing disparities in the populations that have low-risk cesarean deliveries, and outlining the approaches Medicaid and CHIP agencies may put in place to reduce the number of such births. Affinity groups will support the design and implementation of a low-risk cesarean delivery quality improvement project. Go here to learn more about the program, find a fact sheet, and find registration information for the first webinar, to be held on March 31, and about future webinars.
- CMS has published the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Quarterly Q&As, March 2022, Consolidated June 2020 to March 2022 document, so IRF providers can see clarifications of existing guidance. The Quarterly Q&As document can be found in the downloads section of the IRF-PAI and IRF QRP Manual webpage.
- CMS has posted a new MLN Connects, its online newsletter with information about Medicare reimbursement issues. The latest edition includes features on application deadlines to participate in the Medicare Shared Savings Program in 2023, quarterly average sales prices for Medicare Part B drugs, the new home health web pricer for 2020-2022, an opportunity to ask questions about Medicare’s ground ambulance data collection system, and more. Find it all here.
Centers for Disease Control and Prevention
- The CDC has updated its COVID-19 reporting requirements for laboratories. Beginning April 4, COVID-19 testing facilities are no longer required to report negative results for tests authorized for use under a CLIA certificate of waiver. In addition, testing facilities are no longer required to report positive or negative antibody test results. The updated guidance still requires laboratories to report both positive and negative results for laboratory-based tests that are performed in a facility that is certified under CLIA to perform moderate- or high-complexity tests. This updated guidance replaces a blanket requirement to report all COVID-19 test results and reflects more tailored reporting requirements that are specific to entity and test type. Find an overview of this revised guidance here and more detailed information here.
- The CDC has updated its data about COVID-19 levels in communities across the country. This data is used at the county level to inform changes in COVID-19 testing, restrictions, mask requirements, and other public health measures.
Medicare Payment Advisory Commission (MedPAC)
MedPAC has released its March 2022 Report to the Congress: Medicare Payment Policy. The report includes MedPAC’s analysis of payment adequacy in traditional fee-for-service Medicare and its recommendations to Congress for fee-for-service rate changes for 2023:
- hospital inpatient payments – up 2.5 percent
- hospital outpatient payments – up 2.0 percent
- long-term care hospital payments – up approximately 2.0 percent
- outpatient dialysis payments – up 1.2 percent
- physician payments – no change
- ambulatory surgical center payments – no change
- hospice payments – no change
- skilled nursing facility payments – down 5.0 percent
- home health payments – down 5.0 percent
- inpatient rehabilitation facilities – down 5.0 percent
The report also reviews the status of Medicare Advantage and the Medicare prescription drug benefit (Part D). In addition, it satisfies four legislative mandates that address the following matters: a payment adjustment for certain low-volume acute-care hospitals; recent changes of the home health payment system; the performance of certain specialized Medicare Advantage plans; and a value-based payment program for post-acute-care services. Learn more from MedPAC’s news release introducing the report; an executive summary; and the report itself.
Medicaid and CHIP Payment and Access Commission (MACPAC)
MACPAC has released its March 2022 Report to Congress on Medicaid and CHIP. The report addresses issues of specific interest to Congress, including transitioning Medicaid beneficiaries out of institutions and back into the community under the Money Follows the Person program; improving vaccination rates and access for adults enrolled in Medicaid; and assessing hospital payment policy for the nation’s safety- net hospitals, including Medicaid disproportionate share (Medicaid DSH) allotments to the states. Learn more from this MACPAC news release and from the report itself.
National Institutes of Health
The NIH has launched a Phase 1 clinical trial evaluating three experimental HIV vaccines based on a messenger RNA (mRNA) platform – the same technology used in the Pfizer and Moderna COVID-19 vaccines. Learn more from this NIH news release.
CMS – Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Learning Collaborative – March 31
CMS’s Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Learning Collaborative will hold a webinar titled “The Role of Medicaid in Reducing Low-Risk Cesarean Delivery: Improving Outcomes and Reducing Disparities” on Thursday, March 31 at 2:00 p.m. (eastern). During the webinar, experts will describe the initiatives they took to reduce the number of low-risk cesarean deliveries. To learn more about the webinar and register to participate, go here.
CMS – Emerging Technologies – March 31
CMS will hold public listening sessions on transitional coverage for emerging technologies on Thursday, March 31, also at 3:00 (eastern). The purpose of these sessions is to obtain feedback to help inform CMS’s development of an alternative coverage pathway to provide transitional coverage for emerging technologies following the repeal of the January 2021 Medicare Coverage of Innovative Technology and Definition of “Reasonable and Necessary” final rule. For additional information about the listening sessions and to register to participate, go here.
FDA – Identifying Key Competencies for Opioid Prescriber Education – April 4-5
The FDA and the Duke-Margolis Center for Public Policy are collaborating to host a two-day virtual public workshop focused on identifying gaps in the content of existing opioid prescriber education offerings and core competencies that should be included in educational content for opioid prescribers and other health care providers, including prescriber education under a Risk Evaluation and Mitigation Strategy. The sessions will be held on Monday, April 4 and Tuesday, April 5 from 1:00 to 5:00 p.m. (eastern). Go here for more information and to register to participate.
CMMI – Medicare Advantage Value-Based Insurance Design Model – 2023 Hospice Benefit Component Overview – April 5
CMMI will host an office hours session on Tuesday, April 5, 2022 at 3:00 p.m. (eastern) to discuss the Medicare Advantage Value-Based Insurance Design Model and its Hospice Benefit Component. Participants will receive an overview of the model and the CY 2023 application process and have an opportunity for questions and answers with the model team. For more information about the program and how to register for the event, go here.