The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, December 9.  Some of the language used below is taken directly from government documents.

Update on Efforts to Delay Medicare Sequestration Cuts

The Senate has advanced S 610, a bill that would:

• Extend the COVID-19-driven moratorium on the long-time two percent Medicare sequestration until the end of March 2022, reducing that sequestration from two percent to one percent from the beginning of April through the end of June 2022.
• Avoid the additional four percent sequestration necessitated by federal PAYGO rules by moving the additional spending PAYGO cuts need to offset onto the federal balance sheet for FY 2023.
• Include a procedural provision that would enable the Senate to pass legislation to lift the debt ceiling with only 50 votes (addressing the debt ceiling will require separate legislation).
• Reduce the 3.75 percent cut in Medicare evaluation and management rates, which Congress halted last year but that was scheduled to resume on January 1, to a 0.75 percent cut.
• Delay certain Medicare laboratory payment cuts.
• Delay the launch of the Radiation Oncology Model until 2023.

Final passage of this bill is expected by the end …

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

MACPAC kicked off its January meeting with a review of a draft chapter for the March 2021 report to Congress and recommendations on a mandatory extension of Medicaid coverage for 12 months postpartum. The Commission received extensive public comment on the recommendations. On Friday, the Commission approved three recommendations as drafted related to postpartum coverage. The Commission recommended that Congress should:

• extend the postpartum coverage period for individuals who were eligible and enrolled in Medicaid while pregnant to a full year of coverage, regardless of changes in income. Services provided to individuals during the extended postpartum coverage period will receive an enhanced 100 percent federal matching rate;
• extend the postpartum coverage period for individuals who were eligible and enrolled in the State Children’s Health Insurance Program (CHIP) while pregnant (if the state provides such coverage) to a full year of coverage, regardless of changes in income; and
• require states to provide full Medicaid benefits to individuals enrolled in all pregnancy-related pathways.

Commissioners then turned their attention to Medicaid estate recovery policies that affect beneficiaries …

Maybe.

At least that is what Department of Health and Human Services Secretary Alex Azar hinted during a recent symposium held in Salt Lake City.

During the event, Azar said that HHS’s Center for Medicare and Medicaid Innovation seeks

…solutions for the whole person, including addressing housing, nutrition, and other social needs.

Azar hinted at future CMMI action, saying that

What if we gave organizations more flexibility so they could pay a beneficiary’s rent if they were in unstable housing, or make sure that a diabetic had access to, and could afford, nutritious food? If that sounds like an exciting idea … I want you to stay tuned to what CMMI is up to.

CMMI currently operates one major program that seeks to address social determinants of health:  the Accountable Health Communities model, which screens participants based on social determinants of health metrics, identifies those it considers to be at risk, and then works to link those individuals to local and community services that can help them address their health-related needs.

Learn more about Secretary Azar’s comments and the federal government’s outlook on using Medicaid to help address social determinants of health in this article in Becker’s Hospital Review.…

The federal government is giving state three additional years to improve their Medicaid-funded efforts to help keep the elderly and the disabled in the community.

The requirement, established in 2014 for implementation by 2019, requires states to do more to enable the elderly to remain in their homes rather than go to nursing homes and to help the disabled live and work in the community or at least have greater control of their own lives while residing in group home settings.

Among the approaches states have been developing in response to the federal requirements are offering seniors programs of long-term services and supports as an alternative to nursing homes; requiring group homes to offer greater privacy to residents and greater freedom to manage their own money; offering more housing choices to the disabled; find ways for the disabled to work in settings that are not sheltered workshops; and more.

While most states have been working to develop new approaches in response to this Medicaid challenge, many were struggling and the additional three years is intended to give them more time.

States are still required to obtain approval for their plans by 2019 but will have three years to implement them.…