The following is the latest health policy news from the federal government for the week of August 29 to September 2. Some of the language used below is taken directly from government documents.
The White House
The White House has introduced a new “National HIV Strategy” for 2022-2025. The new strategy updates the 2021 strategy and establishes targets for ending the HIV epidemic in the U.S. by 2030, including a 75 percent reduction in new HIV infections by 2025 and a 90 percent reduction by 2030. Find the strategy here.
Proposed Changes in Medicaid, CHIP, and Basic Health Program Enrollment Processes
CMS and HHS have proposed a new rule to overhaul enrollment processes for Medicaid, the Children’s Health Insurance Program (CHIP), and basic health programs and to eliminate arbitrary coverage caps for children in CHIP. The new rule seeks to simplify application and verification processes to make it easier for children, older adults, and people with lower incomes with Medicaid and CHIP coverage to enroll in and retain health insurance. Highlights of the rule include:
- limiting eligibility checks to once every 12 months
- allowing applicants 30 days to respond to information requests
- giving applicants 90 days to apply for reconsideration if their Medicaid eligibility has been revoked
- requiring pre-populated renewal forms
- establishing clear, consistent renewal processes across states
- providing more opportunities to retain eligibility for people who qualify for reasons other than income
- enabling states to switch children’s coverage between CHIP and Medicaid when family income changes
- improving access to programs that help make health coverage more affordable for older adults and individuals with disabilities
- providing automatic premium assistance to Medicare beneficiaries who already receive SSI
- updating and standardizing recordkeeping requirements for states
Comments on the proposed rule are due 60 days after its publication, which is currently scheduled for September 7. Learn more from the following resources:
Centers for Medicare & Medicaid Services
- CMS reports that the expansion of telehealth services during the COVID-19 pandemic was associated with individuals staying in treatment longer and reducing their risk of medically treated overdose. This finding comes from a study published in the journal JAMA Psychiatry. Learn more about the study from this CMS news release and the JAMA Psychiatry article “Receipt of Telehealth Services, Receipt and Retention of Medications for Opioid Use Disorder, and Medically Treated Overdose Among Medicare Beneficiaries Before and During the COVID-19 Pandemic.”
- CMS has finalized its proposal to delay the start of its radiation oncology model. Learn more about why introduction of the program has been delayed and about the agency’s plans for the model from this Federal Register notice.
- CMS has advised state survey agencies that it will give states, counties, and individual facilities additional time to certify temporary nursing assistants in situations in which pandemic-related challenges continue to prevent the complete training and certification of nursing assistants working in nursing facilities and skilled nursing facilities. Previous temporary extensions of certification requirements were scheduled to expire on October 15. Learn more from this CMS memo to state survey agencies.
- CMS has posted new editions of MLN Connects, its online newsletter covering the latest in Medicare reimbursement matters. Among the subjects addressed recently are corrected billing codes for the monkeypox vaccine, information about flu vaccine payment allowances, and a quarterly update of the home health grouper. Find this information and more in the latest editions of MLN Connects here and here.
- CMS has published a notice presenting newly available ICD-10 codes and separate National Coverage Determination coding revisions. Find the notice here.
- CMS has posted a draft of new minimum data set specifications for nursing homes with the expressed intention of releasing a final version later this year that would take effect on October 1, 2023. Find the draft here.
- CMS has published data on the use of Medicaid-covered long-term services and supports and the beneficiaries who receive these services. Find that report here.
- CMS has announced that its Medicare Shared Savings Program saved Medicare $1.66 billion in 2021 compared to spending targets. Learn more about the Medicare Shared Savings Program and how it produced these savings from this CMS news release.
Department of Health and Human Services
- HHS and its Substance Abuse and Mental Health Services Administration (SAMHSA) will award $47.6 million for two broad purposes:
- To develop a sustainable infrastructure for school-based mental health programs and services that promote the healthy social and emotional development of school-aged youth and prevent youth violence in school settings. Learn more about this program from this HHS news release and find the formal notice of the funding opportunity here. Applications are due by October 13.
- To help assist high-risk youth and families by promoting resilience and equity in communities that have recently faced civil unrest, community violence, and/or collective trauma through implementation of evidence-based, violence prevention, and community youth engagement programs and by developing linkages to trauma-informed behavioral health services. Learn more about this program from this HHS news release and find the formal notice of the funding opportunity here. Applications are due by October 17.
- HHS and SAMHSA awarded $40.22 million in youth mental health grants in August. Learn more about the eight categories in which grants were awarded and find links to lists of grant recipients in this HHS news release.
- HHS will provide $98.9 million in grant funding to 59 returning Navigator organizations for the 2023 Open Enrollment Period to help consumers navigate enrollment through the Marketplace, Medicaid, and CHIP. Learn more about HHS’s intentions and the role of Navigators from this HHS news release and find a list of grant recipients here.
- HHS and SAMHSA have awarded $79.1 million in overdose prevention grants. The funding is divided among seven distinct overdose prevention-focused programs. Learn more about the prevention grants in this HHS news release.
- HHS will distribute $20 million in grants to improve maternal and infant health and implement the “White House Blueprint for Addressing the Maternal Health Crisis.” The funding includes $9 million to support state-led maternal health innovation; $4 million to improve maternal care in rural communities; $3 million to improve access to community-based doulas; and $4.5 million to address infant mortality. Learn more about this initiative from this HHS news release, which also includes links to further information about the program’s individual components and lists of grant recipients.
- HHS has awarded more than $20 million in grants to 64 health centers to expand HIV prevention, testing, and treatment services at health centers nationwide. The funding is part of an HHS initiative that aims to reduce the number of new HIV infections in the U.S. by 90 percent by 2030. Learn more about the funding and its intended uses from this HHS news release and go here to see a list of grant recipients.
- HHS and SAMHSA have awarded $2 million to the American Academy of Pediatrics to establish a National Center of Excellence on Social Media and Mental Wellness. The purpose of the grant is to develop and disseminate information, guidance, and training on the impact of social media use on children and young people, especially the risks to their mental health, and to examine clinical and social interventions that can be used to prevent and mitigate those risks. Learn more from this HHS announcement.
- In a letter to the nation’s governors, HHS Secretary Xavier Becerra has written that “Access to the full range of reproductive health care is essential to individuals’ health” and that in the face of recent efforts in some states to ban abortions under most or all circumstances, “… where a state purports to prohibit providers from offering the emergency care that EMTALA [the federal Emergency Medical Treatment and Labor Act] requires, HHS will not hesitate to refer the matter to the Department of Justice to take appropriate legal action.” Read the HHS letter here.
- SAMHSA seeks input from the public about how it can best address the behavioral health effects of climate change and health equity considerations. Learn more about the agency and the input it seeks for this purpose from this Federal Register notice. Comments are due by October 31.
- The White House monkeypox response team and other public health officials have briefed the news media twice recently on the latest in the federal response to the current monkeypox outbreak. Find a transcript of the August 26 briefing here and of the August 30 briefing here.
- The White House National Monkeypox Response team has announced new actions the administration is taking to combat the monkeypox outbreak and protect individuals most at risk of contracting the virus, including providing additional vaccines and support to states and cities holding events that convene large groups of LGBTQI+ individuals and a new pilot to increase vaccine availability and other prevention resources to communities of color in light of recent CDC data showing the disproportionate reach of the virus among selected groups. Learn more from this response team fact sheet.
- The CDC has posted a series of updates about monkeypox-related issues.
- The New England Journal of Medicine has published an editorial by NIH officials addressing how the response to monkeypox can be informed by recent experiences in response to COVID-19. Learn more from this NIH news release and the New England Journal of Medicine editorial “Monkeypox – Past as Prologue.”
- The CDC has posted an updated map showing the distribution of 19,962 confirmed cases of monkeypox in the U.S. as of September 2.
Centers for Disease Control and Prevention
- The CDC has updated its advice for individuals about what they should do if they have been exposed to COVID-19. Find that updated guidance here.
- The CDC has updated its guidance on ending isolation and precautions for people with COVID-19 to reflect its new recommendations on these subjects. The guidance is for health care professionals to use when caring for patients in community settings and not for use in health care settings such as hospitals and nursing homes. Find the updated guidance here.
- The CDC has updated a variety of information related to COVID-19, including:
- information about potential adverse effects after receiving COVID-19 vaccines to align with updated guidance
- information about COVID-19 vaccines for people who are moderately or severely immunocompromised
- FAQ about COVID-19 vaccines
- information about COVID-19 for people with certain medical conditions
- information for clinicians about preparing for the management of anaphylaxis after administering COVID-19 vaccines.
- The CDC has issued a health alert advisory to provide updates on recent variant influenza virus infections and summarize its recommendations for identification, treatment, and prevention of variant influenza virus infection for the summer and fall of 2022. Find the alert here.
Food and Drug Administration
- The FDA has amended the emergency use authorizations of the Moderna COVID-19 vaccine and the Pfizer-BioNTech COVID-19 vaccine to authorize formulations of the vaccines for use as a single booster dose at least two months following primary or booster vaccination. Learn more about the vaccines and their expected use from this FDA announcement. The CDC endorsed the FDA action in this statement.
- The FDA has published updated guidance to help prescribers evaluate potential drug interactions when using Paxlovid therapy for COVID-19. Learn more from the agency’s “PAXLOVID Patient Eligibility Screening Checklist Tool for Prescribers.”
National Institutes of Health
A new study sponsored by the NIH has found that with age-appropriate instructions, school-aged children can successfully use a nasal swab to obtain their own COVID-19 test specimen. The study provides data to support recommendations regarding self-swabbing that can be implemented by schools and in other settings where children undergo COVID-19 testing. Learn more from this NIH news release.
Medicare Payment Advisory Commission (MedPAC)
- MedPAC has written to CMS in response to that agency’s proposed physician fee schedule regulation for calendar year 2023. Among the subjects MedPAC addresses in its letter are telehealth, billing codes for chronic pain management and treatment, billing codes for behavioral health services, nursing facility evaluation and management visits, and evaluation and management visits in non-office/outpatient settings. Find MedPAC’s letter here.
- MedPAC held public meetings on September 1 and 2. The meetings’ agenda consisted of:
Medicaid and CHIP Payment and Access Commission (MACPAC)
- In response to a request for information included in CMS’s proposed rule “Medicare program; Request for Information on Medicare (87 Federal Register, p. 46918, August 1, 2022), MACPAC has outlined how integrating care for people who are dually eligible for Medicare and Medicaid has the potential to improve beneficiary experience and outcomes, advance equity, and reduce federal and state spending. Find MACPAC’s comment letter here.
Training on December 2022 Transition to Reporting COVID-19 Data to the CDC
Data Submission: Overview of Webform and CSV Upload
- Tuesday, September 13th from 1-2pm ET (Live) – Register
- Tuesday, September 20th from 1-2pm ET (Replay with live chat) – Register
Data Submission: Overview of Bulk Submission
- Wednesday, September 14th from 3-4pm ET – (Live) – Register
- Wednesday, September 21st from 3-4pm ET (Replay with live chat) – Register
CDC – Briefing for Providers on Flu Vaccines – September 8
- The CDC will hold a webinar for clinicians on Thursday, September 8 at 2:00 (eastern) during which it will offer its recommendations for the 2022-2023 influenza vaccination season, including information on a new preferential vaccine recommendation for adults ages 65 and older. In addition, presenters will outline guidance for the co-administration of influenza and COVID-19 vaccines. Learn more about the webinar and how to participate from this CDC notice.
CDC – Briefing on COVID-19 Booster Vaccines – September 13
- On Tuesday, September 13 at 2:00 (eastern) the CDC will offer a webinar for clinicians to outline its new guidance on bivalent COVID-19 booster doses for people ages 12 years and older, including those who are moderately or severely immunocompromised. Learn more about the webinar, the presenters, and how to participate from this CDC announcement.
MACPAC – September 15-16
- MACPAC, the Medicaid and CHIP Payment and Access Commission, will meet virtually on Thursday, September 15 and Friday, September 16. An agenda and information about how to participate have not yet been published. When they are, they should be available here.
FDA – Oncologic Drugs Advisory Committee – October 28
- The FDA’s Oncologic Drugs Advisory Committee will meet virtually on Friday, October 28 at 10:00 (eastern). The general function of this committee is to provide advice and recommendations to the FDA on regulatory issues. Learn more about the meeting, including about the docket, how to submit comments, and how to participate, from this Federal Register notice.