The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, November 23.  Some of the language used below is taken directly from government documents.

The White House

• The White House has posted a transcript of the November 22 press briefing given by its COVID-19 response team and public officials.  Go here for the slides presented during that meeting.

Provider Relief Fund

• HHS announced that it has begun distributing $7.5 billion in American Rescue Plan rural payments to providers and suppliers that serve rural Medicaid, Children’s Health Insurance Program (CHIP), and Medicare beneficiaries.  The average payment is $170,700, with payments ranging from $500 to $43 million for an entire health system.  More than 40,000 providers in all 50 states, Washington, D.C., and six territories will receive these rural provider payments.  Learn more from this HHS news release.  In addition, go here for a state-by-state breakdown of the payments and here for a data set with all of the recipients of this $7.5 billion in rural provider payments.
• HHS’s Health Resources and Services Administration, which administers the Provider Relief Fund, has established a 60-day grace period for complying with the fund’s Reporting

The following is the latest health policy news from the federal government as of 2:45 p.m. on Friday, November 19.  Some of the language used below is taken directly from government documents.

Congress

On Friday the House passed a $1.7 trillion social spending bill, H.R. 5376 – Build Back Better Act, with no Republican votes and all but one Democratic vote.  The Congressional Budget Office score indicates that the health care policies in the bill are paid for by cuts in other health care programs.

The bill includes nearly $300 billion in health care provisions, including:

• $57 billion to provide insurance to more than two million people in non-expansion states
• $74 billion to temporarily extend subsidies for Affordable Care Act health plans
• $146 billion for home health services
• $36 billion to cover hearing services in Medicare
• $26 billion to expand the public health workforce, address maternal mortality, and prepare for future pandemics

This new spending would be paid for in part by:

• nearly $34 billion in savings from cuts in uncompensated care payments to hospitals in 12 states that have not expanded their Medicaid programs
• nearly $300 billion in savings through policies to negotiate the cost of some expensive drugs,

The question of whether Medicare should pay different rates for outpatient services delivered in different types of settings was very much on the minds of Medicare Payment Advisory Commission members during their public meetings last week.

The issue has been around for a while:  are there valid reasons for some facilities to be paid more for certain outpatient services than other facilities?  Or should the payment rate for a given service be the same regardless of where that service is delivered?  Does the site of the service matter – or should it?

At issue are Medicare payments made to private physician offices, hospital outpatient departments, and ambulatory surgical centers and whether they should be adjusted based on some of the underlying costs associated with those facilities or the matter of who owns them – or whether a service is a service that should be reimbursed at the same rate regardless of where it is delivered.  Underlying this issue is whether providers should be compensated for such services through Medicare’s outpatient prospective payment system or its physician fee schedule.

It matters where MedPAC ultimately comes down on this issue.  While the agency’s primary role is to advise Congress on Medicare payment …

Should Medicare continue to encourage the use of telehealth when the COVID-19 pandemic ends?

Should it continue to pay for telehealth when the there is no “tele” in the service and it is audio only?

And should Medicare pay different rates for visits in person, telehealth visits, and audio-only (that is, telephone) visits?

These were among the questions addressed by members of the Medicare Payment Advisory Commission during their public meetings last week.

Members also discussed the need for further analysis of the effectiveness of telehealth and audio-only visits, how to identify audio-only visits on Medicare claims, how to collect data from home health agencies and hospices, which are not required to submit telehealth data, and more.

Learn more about what MedPAC is thinking about the use of telehealth in the future in the MedPage Today article “Medicare Advisors Consider Post-Pandemic Telehealth Pay Policy.”…

The following is the latest health policy news from the federal government as of 2:45 p.m. on Monday, November 15.  Some of the language used below is taken directly from government documents.

The White House

• The White House has posted a transcript of the November 10 press briefing given by its COVID-19 response team and public officials.  Go here for the slides presented during that briefing.

Centers for Medicare & Medicaid Services – Final Guidance on Shared/Co-Located Hospital Spaces

• In a memo to state survey agencies, CMS has published final guidance for the evaluation of compliance with the Medicare Conditions of Participation that address shared space and services for hospitals co-located with other hospitals or health care entities, updating guidance issued in May of 2019.  The revised guidance is shorter and less prescriptive and does not contain nearly as much detail as the 2019 draft.  Find it here.

Centers for Medicare & Medicaid Services

COVID-19

• In a memo to state survey agencies, CMS has revised restrictions on nursing home visits, easing limits it introduced last year in an attempt to limit the spread of COVID-19.  Find the new guidance here.
• A second CMS memo to state survey