The following is the latest health policy news from the federal government as of 3:00 p.m. on Wednesday, March 2.  Some of the language used below is taken directly from government documents.

Provider Relief Fund

  • The Provider Relief Fund FAQ has been updated with three modified questions that address 1099 forms and procedures involved in returning Provider Relief Fund money to the federal government.  Find the three updates, all marked “Modified 2/25/2022,” on pages 6 and 8 of the Provider Relief Fund FAQ.

Federal Response to Surprise Billing Regulation Court Decision

Last week a federal court decision invalidated a major aspect of federal implementation of the No Surprises Act, the 2020 law intended to protect consumers from surprise medical bills for out-of-network services.  Specifically, the court ruled that the regulation imposed a requirement for use in arbitrating payment disputes in an independent dispute resolution (IDR) process that was contrary to the enabling legislation’s intent.  Now, the Department of Labor, one of the agencies involved in creating the regulations implementing the No Surprises Act, has published a news release outlining how the federal agencies involved are responding to the court decision.  Specifically, the Labor Department wrote that:

  • Effective immediately, the agencies will withdraw guidance documents that are based on, or that refer to, the portions of the rule the court invalidated.  Once these documents have been updated to conform with the court’s order the agencies will promptly repost the updated documents.
  • The agencies will provide training on the revised guidance for certified IDR entities and disputing parties.  This training will be offered through webinars and roundtable discussions and will occur after the documents noted above are updated.
  • The agencies will open the IDR process for submissions through the IDR Portal.  For disputes for which the open negotiation period has expired, the agencies will permit submission of a notice of initiation of the IDR process within 15 business days following the opening of the IDR Portal.

White House

  • The White House has released a “National COVID-⁠19 Preparedness Plan” built on four pillars:  protect against and treat COVID-19; prepare for new variants; prevent educational and economic shutdowns; and continue to vaccinate the world.  Among the steps that would be undertaken under these objectives are shortening the time between COVID-19 testing and treatment, including through greater use of pharmacy-based clinics and new one-stop sites that should be established this month across the country; improving case tracking; pursuing universal vaccination; paying special attention to the needs of the immunocompromised; addressing hospital capacity issues; and undertaking research on Long-COVID.  In addition, the plan calls for ensuring “…equitable access to COVID-19 health care and public health resources.”  Most of these endeavors will require funding from Congress.  Learn more from the “National COVID-19 Preparedness Plan.”
  • The White House announced new steps by HHS and CMS to improve the quality and safety of nursing homes, to protect vulnerable residents and the health care providers who care for them, and to crack down on those who pose potential harm to them.  As part of ensuring that taxpayer dollars support nursing homes that provide safe, adequate, and dignified care, HHS and CMS will work to:
    • establish a minimum nursing home staffing requirement
    • reduce resident room crowding
    • strengthen the Skilled Nursing Facility Value-Based Purchasing Program
    • reinforce safeguards against unnecessary medications and treatments
    • enhance accountability and oversight
    • increase transparency
    • create pathways to good-paying jobs with opportunities to join unions
    • ensure pandemic and emergency preparedness in nursing homes

Learn more from this White House fact sheet summarizing the administration’s proposals.

  • The White House has announced a new initiative to address the current addiction and overdose epidemics by expanding evidence-based prevention, harm reduction, treatment, recovery, and supply reduction approaches.  The major steps in this effort include increasing funding for public health and supply reduction; removing barriers to treatment; reducing harm and saving lives; and stopping the trafficking of illicit drugs.  Learn more from this White House fact sheet.
  • The White House has announced a strategy to address the national mental health crisis.  The strategy’s major components consist of strengthening system capacity, connecting Americans to care, and supporting Americans by creating healthy environments.  Learn more, including the underlying details, from this White House fact sheet about the initiative.
  • The White House has issued a memorandum to the Department of Homeland Security directing the Federal Emergency Management Agency (FEMA) to continue reimbursing 100 percent of selected COVID-19 emergency costs incurred by the states through July 1.

Centers for Medicare & Medicaid Services

Health Policy Update

  • In response to the continuing effects of the COVID-19 emergency, CMS is applying the Merit-based Incentive Payment System (MIPS) automatic extreme and uncontrollable circumstances policy to all individually MIPS-eligible clinicians for the 2021 performance year.  The automatic EUC policy only applies to MIPS-eligible clinicians who are eligible to participate in MIPS as individuals; it does not apply to groups, virtual groups, or Alternative Payment Model (APM) entities.  Learn more from this CMS notice.
  • CMS’s Center for Medicare and Medicaid Innovation (CMMI) has released a request for applications (RFA) to solicit a second cohort of participants for its Medicare Kidney Care Choices Model, an accountable care organization model.  Successful applicants would begin participating on January 1, 2023.  RFA responses are due March 25, 2022.  Learn more about the Kidney Care Choice Model and find information to help applicants here and find the RFA here.
  • CMMI has issued a request for applications for participants in calendar year 2023 of its Medicare Advantage Value-Based Insurance Design Model, a program that is testing a broad array of complementary Medicare Advantage health plan innovations designed to reduce Medicare expenditures; enhance the quality of care for Medicare beneficiaries, including those with low incomes such as dual-eligibles; and improve the coordination and efficiency of health care service delivery.  Learn more about the program here and find the request for applications here.  Applications are due April 15.
  • CMS is seeking nominations for membership on the Medicare Evidence Development & Coverage Advisory Committee.  Among other duties, the committee provides advice and guidance to the Secretary of HHS and CMS administrator on the adequacy of scientific evidence available to CMS in making coverage determinations under the Medicare program.  The panel’s fundamental purpose is to support the principles of an evidence-based determination process for Medicare’s coverage policies.  Learn more about the committee, its objectives, and the nomination process in this Federal Register notice.  Nominations are due by March 28.

COVID-19 Update

  • CMS has written to state survey agencies to clarify CLIA (Clinical Laboratory Improvement Amendments) guidance during the COVID-19 public health emergency related to the temporary testing site multiple site exception and enforcement discretion related to remote testing.  Find the CMS memo here.

Department of Health and Human Services

COVID-19 Update

  • HHS’s Health Resources and Services Administration (HRSA) has developed a new fact sheet to help explain why providers might ask to see a patient’s insurance card when administering COVID-19 vaccines even though the vaccines are free of charge to patients.  Find the fact sheet here.

Health Policy Update

  • HHS is inviting public comment on its “Vaccines Federal Implementation Plan 2021-2025.”  Comments on the plan, which does not address COVID-19-related vaccination issues, are due by March 29.  Learn more from this Federal Register notice.

Centers for Disease Control and Prevention

  • The CDC has updated its guidance on wearing face masks as protection against COVID-19.  The new guidance is based on levels of COVID-19 cases at the county level.  For more information about the guidance, how to interpret it, and county-level activity, go here and here.

Food and Drug Administration

  • The FDA has revised its emergency use authorization for Evusheld (tixagevimab co-packaged with cilgavimab) to change the initial dose for the authorized use as pre-exposure prevention of COVID-19 in certain adults and pediatric patients.  Based on the most recent information and data available, Evusheld may be less active against certain Omicron subvariants and the recommended dosage has been revised to reflect this.  Learn more from this FDA announcement.

Medicaid and CHIP Payment and Access Commission (MACPAC)

  • MACPAC has published an issue brief that provides background information about nursing facility staffing challenges before the COVID-19 pandemic, summarizes current state policies related to staffing, and discusses previous research about the effectiveness of these policies.  Learn more in the MACPAC issue brief “State Policy Levers to Address Nursing Facility Staffing Issues.”

Stakeholder Events

MedPAC – commissioners meeting – March 3 and 4

MedPAC will hold four virtual sessions on Thursday, March 3 and Friday, March 4.  Participation will be limited.  Go here to see the agendas for each session and to find instructions on how to join those sessions.

MACPAC – commissioners meeting – March 3 and 4

MACPAC will hold its next public meeting virtually on Thursday, March 3 and Friday, March 4.  Go here to find a meeting agenda and information about how to register for and participate in the meeting.

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.