The following is the latest health policy news from the federal government for March 17-23.  Some of the language used below is taken directly from government documents.

No Surprises Act

After a February ruling in federal court that aspects of CMS’s implementation of the 2020 No Surprises Act contradicted the language of the act itself and unfairly favored payers over providers, CMS ordered a moratorium on new arbitration decisions for disputes filed on or after October 25, 2022 while it reviewed and revised its guidance on how payment disputes should be decided.  Now, CMS has completed that task and issued new guidance to the Independent Dispute Resolution entities that adjudicate the disputes and to the parties in those disputes and ordered the resumption of the arbitration of disputed cases.  Go here to see the new CMS guidance to the parties in disputes and here for the new guidance to the Independent Dispute Resolution entities.

Department of Health and Human Services

  • HHS has published a notice explaining that even though the COVID-19 public health emergency is expected to end formally on May 11, the continued prevalence of COVID-19 and its variants merits the continuation of FDA emergency use authorizations that would otherwise expire.  Specifically, HHS has concluded that current circumstances continue to justify the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19; personal respiratory protective devices; other medical devices, including alternative products used as medical devices; and drugs and biological products.  Learn more from this announcement, which includes a link to a Federal Register notice.
  • HHS’s Health Resources and Services Administration (HRSA) is updating income levels used to identify a “low-income family” to determine eligibility for various programs that provide health professions and nursing training to individuals from disadvantaged backgrounds.  Learn more about the types of programs for which these income levels are used, the entities eligible for funding for such training, and the new income levels themselves from this HRSA announcement, which includes a link to a Federal Register notice.
  • HRSA has announced a modernization initiative that includes several actions to strengthen accountability and transparency in the current Organ Procurement and Transplantation Network (OPTN).  The major components of this initiative are the creation of data dashboards detailing individual transplant center and organ procurement organization data; modernization of the OPTN IT system, improved OPTN governance, and increased transparency and accountability; plans for a future request for proposals to establish multiple entities to manage the OPTN; a proposed doubling of federal funding for organ procurement and transplantation; and a request that Congress update the nearly 40-year-old National Organ Transplant Act.  Learn more from this HRSA news release; HRSA’s organ procurement and transplantation network modernization initiative web page; and the new data dashboard web page mentioned in the news release.
  • HRSA has published new editions of its HRSA eNews, its online newsletter.  These issues include information about HRSA’s proposed FY 2024 budget, recent agency public activities, funding opportunities in the areas of health care workforce, health centers, rural health development, congressionally directed grants, maternal and child health, and more.  Find the March 16 edition here and the March 21 edition here.
  • HRSA is seeking nominations of qualified candidates for consideration for appointment to the Council on Graduate Medical Education, which provides advice and recommendations on policy, program development, and other matters of significance concerning physician training and the physician workforce.  Learn more about the council and its responsibilities from this HRSA announcement, which includes a link to a Federal Register notice.  HRSA accepts nominations continuously.
  • HHS’s Agency for Healthcare Research and Quality (AHRQ) has issued a request for Information seeking views about a potential Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey to assess patients’ prenatal care and childbirth care experiences in ambulatory and inpatient care settings.  Currently, no such CAHPS instrument is specifically designed to measure prenatal and childbirth care from the patient’s perspective in these settings. AHRQ seeks comments regarding methodologically sound approaches to assessing prenatal and childbirth care experiences in health care settings about topics such as communication with providers, respect, access to services, and patients’ perceptions of bias in receiving care.  Learn more from this AHRQ announcement, which includes a link to a Federal Register notice.  The deadline for submitting comments is May 5.
  • AHRQ has published a new guide on finding sustainable funding for primary care extension programs.  The guide includes strategies for securing funding, potential funding resources, and more.  Find it here.

Provider Relief Fund

The Provider Relief Fund reporting portal is now open for reporting period 4.  Providers that received a Provider Relief Fund general or targeted and/or American Rescue Plan Rural payment(s) exceeding $10,000 in the aggregate between July 1, 2021 and December 31, 2021 are required to report on their use of those funds during reporting period 4. The deadline to submit a report is March 31.  Go here to learn more.

Centers for Medicare & Medicaid Services

  • CMS has posted documents from its March 7 webinar on ICD-10-PCS subjects.  Find those documents here.
  • In 2016, CMS issued its emergency preparedness requirements for Medicare and Medicaid participating providers and suppliers final rule to establish consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid.  With the introduction of the new “rural emergency hospital” designation, CMS has now issued a new “Rural Emergency Hospitals Requirements CMS Emergency Preparedness Final Rule” document to clarify how the 2016 rule applies to rural emergency hospitals.  Find the new document here.
  • CMS has posted new resources for long-term-care hospitals:  BIMS, PHQ-2 to 9, and pain interview cue cards; a transfer to health items explainer video; and GG0170C, GG0170L, and GG0170P video tutorials.  Find them here.
  • CMS has posted a new edition of MLN Connects, its online newsletter with information about Medicare payment matters.  The latest issue includes a reminder that the deadline for applying for additional residency positions is March 31; information for critical access hospitals about documenting and billing for services; April updates of the ambulatory surgical center payment system; and more.  Find the new MLN Connects here.
  • In a new post on the CMS blog, the agency offers a preview of its future patient safety initiatives, writing that

Going forward, CMS is engaged in a number of initiatives to promote patient safety across our programs. We are working to incentivize health care providers to make meaningful improvements, rewarding providers for improved patient safety and penalizing those who do not meet standards. We will issue guidance for facilities to implement an effective, data-driven quality assessment and performance improvement program, including tracking and monitoring medical errors. Finally, CMS will update requirements for providers who participate in Medicare and Medicaid to better address inequities in quality of care and access.

See the entire post here.

Centers for Disease Control and Prevention

  • The CDC has updated its guidance on isolation and other precautions for people who have contracted COVID-19.  Find the updated guidance here.
  • The CDC has updated its information for health care professionals on mpox vaccines.  Find the updated information here.
  • The CDC has posted a brief report on maternal mortality rates in the U.S. for 2021.  Among its findings: the maternal mortality rate for 2021 was 32.9 deaths per 100,000 live births, compared with a rate of 23.8 in 2020 and 20.1 in 2019; the maternal mortality rate for non-Hispanic Black women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White women (26.6); rates for Black women were significantly higher than rates for White and Hispanic women; the increases from 2020 to 2021 for all race and Hispanic-origin groups were significant; and rates increased with maternal age.  Learn more from the CDC report “Maternal Mortality Rates in the United States, 2021.”

Medicaid and CHIP Payment and Access Commission (MACPAC)

With nearly one in five children and youth have special health care needs and more than one-third of them are covered by Medicaid, MACPAC has published an issue brief that uses 2018 and 2019 data to examine differences in health status, access to care, referrals, needed care, and the cost of care between those covered by Medicaid, private insurance, both Medicaid and private insurance, and those without insurance.  Go here to see “Medicaid Access in Brief: Children and Youth with Special Health Care Needs.”

Department of Homeland Security/Cybersecurity & Infrastructure Security Agency

The FBI, the Cybersecurity and Infrastructure Security Agency (CISA), and the Multi-State Information Sharing & Analysis Center have released a joint cybersecurity advisory to share information about LockBit 3.0 ransomware IOCs and TTPs identified through FBI investigations as recently as March of 2023.  The alert describes LockBit 3.0’s capabilities, execution and infection processes, indications of compromise, and mitigation strategies and tools.  Find the alert here.

Government Accountability Office (GAO)

In response to the impact of COVID-19 on nursing homes and their patients, the GAO convened a roundtable of 13 experts and interviewed CMS and CDC officials to discuss actions to improve infection prevention and control in nursing homes in the future.  The GAO presents its findings and offers recommendations for future actions in the new report “COVID-19 IN NURSING HOMES:  Experts Identified Actions Aimed at Improving Infection Prevention and Control.”

Congressional Research Service

In the wake of the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, the Congressional Research Service has published a brief document about the Emergency Medical Treatment and Active Labor Act (EMTALA) and its relationship to state law, particularly in the context of emergency abortion services.  The report outlines EMTALA’s central requirements and enforcement mechanisms; highlights its preemptive scope and recent issues related to emergency abortion; and concludes with considerations for the 118th Congress.  Find the report here.

Federal Communications Commission

The FCC has published a final rule that seeks to make it easier for rural health care providers to receive support, reduce delays in funding commitments, and improve the overall efficiency of the Rural Health Care Program, which expands access to telehealth and telemedicine services by providing financial support to eligible health care providers for high-speed broadband connections and telecommunications services.  Learn more about the program from an FCC news release that can be found here and this FCC announcement, which includes a link to a Federal Register notice.

Stakeholder Events

CMS – Medicare Home Health Prospective Payment System CY 2023 Webinar – March 29

CMS will hold a webinar on Medicare’s calendar year 2023 home health prospective payment system on Wednesday, March 29 at 1:30 (eastern).  During this webinar CMS will provide an overview of several provisions from the CY 2023 home health prospective payment system final rule related to behavior changes, the construction of 60-day episodes, and payment rate development.  Learn more about the webinar here and go here to register to participate.

HHS – Health Resources and Services Administration – Medical Home Health Equity – March 29-30

The Bureau of Primary Care within the Health Resources and Services Administration (HRSA) will hold a patient-centered medical home health equity technical assistance symposium on Wednesday, March 29 and Thursday, March 30 at 11:00 (eastern) both days.  Participants will hear about and discuss best practices and lessons learned from health centers and experts in the fields of health equity, quality improvement, and accreditation/recognition.  Go here to register to participate.

CMS – Medicare Cost Report e-Filing Webinar – March 30

CMS will hold a webinar for Medicare Part A providers to learn about new and upcoming functionality in the Medicare cost report e-filing system on Thursday, March 30 at 1:00 (eastern).  Go here to register to participate.

MedPAC – Commissioners’ Meeting – April 13-14

MedPAC’s commissioners will hold their next public meeting on Thursday, April 13 and Friday, April 14.  An agenda for the meeting and information about participation are not yet posted, but when they are they will be here.

MACPAC – Commissioners’ Meeting – April 13-14

MACPAC’s commissioners will hold their next public meeting on Thursday, April 13 and Friday, April 14.  An agenda for the meeting and information about participation are not yet posted, but when they are they will be here.

CMS – Medicaid and CHIP Continuous Enrollment Unwinding Webinar – April 26

CMS will hold a webinar on the unwinding of Medicaid and CHIP continuous enrollment and what providers need to know and how to prepare for that unwinding on Wednesday, March 22 at noon (eastern).  During the webinar, CMS officials will review recently released CMS unwinding resources to help partners with their outreach efforts and respond to questions about Medicaid renewals and terminations, Medicaid to marketplace transitions, Medicaid to Medicare transitions, communication and outreach strategies, and more.  Go here to register to participate.  CMS will offer the same webinar on May 24 and June 28.  Go here and scroll down for materials from previous webinars on Medicaid unwinding.

CMS Quality Conference – May 1-3

The 2023 CMS Quality Conference, “Building Resilient Communities:  Having an Equitable Foundation for Quality Health Care,” will be held virtually on Monday, May 1 through Wednesday, May 3.  The conference will feature expert speakers who will address improving quality, equity, and innovation and discuss how advocates, providers, researchers, and champions in health care quality improvement can develop and spread solutions to address America’s most pervasive health system challenges.  Go here to learn more about the conference and how to register to participate.