Archive for October, 2022


Federal Health Policy Update for October 27

The following is the latest health policy news from the federal government for the week of October  21 to October 27.  Some of the language used below is taken directly from government documents.


  • Responding to a federal court ruling that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, CMS has announced how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year.  According to CMS, it “…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year.  CMS also will reprocess claims our contractors paid on or after September 28, 2022, using the default rate (generally ASP plus 6%).”  Learn more here.

Centers for Medicare & Medicaid Services

  • CMS has published a guide for states on how they can maximize the use of automation when they review current Medicaid participants’ eligibility when the COVID-19 public health emergency ends, doing so by using reliable information that is already available to state Medicaid agencies and without seeking information directly from the individuals whose Medicaid eligibility is under review.  Learn more from the CMS document “Ex Parte Renewal:  Strategies to Maximize Automation,

Results of Annual Survey of State Medicaid Programs

The Kaiser Family Foundation has published the results of its annual survey of state Medicaid programs for the 2022 and 2023 fiscal years.  Among the survey’s findings (in language taken directly from the Kaiser report):

  • More than 3/4 of states that contract with MCOs [managed care organizations] enroll ≥75% of all beneficiaries in MCOs
  • Some states reported newly implementing or expanding MCO programs
  • States also report continued use of other service delivery and payment system reforms
  • Two-thirds of states are using strategies to improve race, ethnicity, and language data
  • About one-quarter of states are tying MCO financial incentives to health equity
  • States are also leveraging MCO contracts in other ways to promote equity-related goals
  • States report far more benefit expansions than benefit cuts
  • States are most frequently expanding behavioral health and pregnancy/postpartum services
  • Most states allow MCOs to cover “in lieu of” services, especially BH [behavioral health] and SDOH [social determinants of health] services
  • States have seen high telehealth utilization across Medicaid enrollees
  • States are addressing telehealth quality and other challenges
  • Most states are adopting permanent telehealth expansions, though some are considering limits

Other subjects addressed in the report include provider taxes and intergovernmental transfers, supplemental Medicaid payments, health equity, …

Hospitals to Continue to Face Staffing Challenges

While the number of health care employment openings is now declining and fewer health care workers are leaving their jobs, non-profit hospitals can expect to continue facing staffing challenges in the near future.

At least that’s what Fitch Ratings says in a new report.

“Despite some relief of late, U.S. not-for-profit hospitals are in for several challenging months with healthcare and social assistance job vacancies still high against a backdrop of low unemployment, according to Fitch Ratings in its labor dashboard for the sector,” the report said.

Learn more from this Fitch Ratings news release.…


The following is the latest health policy news from the federal government for the week of October 14 to October 20.  Some of the language used below is taken directly from government documents.

White House

  • President Biden has signed an executive order on lowering prescription drug costs.  The order directs HHS to consider additional actions to further drive down prescription drug costs, encourages it to pursue such actions through its Center for Medicare and Medicaid Innovation (CMMI), and directs HHS to submit a formal report within 90 days outlining any plans to use CMMI’s authority to lower drug costs and promote access to innovative drug therapies for Medicare beneficiaries.  Find the executive order here and a fact sheet elaborating on that order here.
  • The White House has released a new “National Biodefense Strategy and Implementation Plan for Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security.”  Find the plan here; learn more about its objectives and how the administration plans to go about fulfilling them from this White House news release; and about the role of the Department of Health and Human Services from this HHS news release.

Federal Emergency Management Agency (FEMA)

  • The

COVID Pandemic: It’s Over? It’s Not?

An average of 400 daily COVID-related deaths.

The potential loss of access to telehealth services.

The need to redetermine Medicaid eligibility for people who benefited from the loosening of eligibility standards under the 2020 Family First Coronavirus Response Act.

The upcoming commercialization of COVID vaccines.

A promise to the nation’s governors of 60 days’ advance notice.

These are among the reasons the federal government recently extended the declaration of the COVID-19 public health emergency for another 90 days.

Becker’s Hospital Review takes a closer look at these and other reasons for the public health emergency’s extension in the article “HHS renews COVID-19 PHE for 11th time – here’s why.”  Find it here.…