The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, March 22.  Some of the language used below is taken directly from government documents.

Provider Relief Fund

  • As of March 22 at 11:59 p.m. (eastern) the HRSA (Health Resources and Services Administration) COVID-19 Uninsured Program will stop accepting claims for testing and treatment due to lack of funds and on April 5 at 11:59 p.m. (eastern) the HRSA COVID-19 Uninsured Program and COVID-19 Coverage Assistance Fund will stop accepting vaccination claims due to a lack of funds.  HRSA has released additional information about this significant change in federal COVID policy with the publication of two new documents:

o   HRSA COVID-19 Uninsured Program Shutdown FAQs

o   HRSA COVID-19 Coverage Assistance Fund Shutdown FAQs

Separately, HRSA advises that “Submitted claims will be paid subject to the availability of funds.”  This means that when the money is gone HRSA will no longer be able to pay claims.  The administration continues to encourage Congress to provide additional funding to support COVID-related activities and replenish this fund but it is not clear at this point if it will succeed in doing so.

  • Providers that received Provider Relief Fund payments of more than $10,000 in the aggregate between July 1 and December 31, 2020 must report on their use of those funds to HHS by March 31.  For information about reporting requirements, forms, reporting instructions, and more on what the agency refers to as “Reporting Period 2,” go here.

White House

Department of Health and Human Services

Health Policy Update

  • Some hospitals that have participated in the 340B prescription drug discount program in the past lost their eligibility for that program after their Medicare disproportionate share (Medicare DSH) percentage fell below the program’s eligibility criteria as a result of changes in inpatient hospitalization during the COVID-19 pandemic.  HRSA has posted a notice explaining that the Consolidated Appropriations Act of 2022 permits certain hospitals to be reinstated into the 340B program if they meet certain conditions.  Learn about those conditions and about what affected hospitals should do to pursue restoration of their participation in 340B in this HRSA notice.  Affected hospitals must submit their attestation within 30 days of no longer meeting the requirement, or for those that already lost their status, within 30 days of the law’s enactment.
  • HHS and its the Substance Abuse and Mental Health Services Administration (SAMHSA) have announced three funding opportunities totaling $43.7 million to strengthen mental health and substance use services for individuals at risk for or living with HIV/AIDS:
    • “Substance Use Disorder Treatment for Racial Ethnic/Minority Populations at High Risk for HIV/AIDS” – up to 61 grants worth $30.5 million over five years, application deadline April 29
    • “Substance Abuse and HIV Prevention Navigator Program for Racial Ethnic Minorities” – up to 18 grants worth $4.5 million over five years, application deadline May 2
    • “Minority AIDS Initiative – Service Integration” – $8.7 million over four years for up to 18 grantees, application deadline April 25

Learn more about the funding and find links to more detailed information about the individual programs, including grant, eligibility, and application information, from this HHS news release.

  • SAMHSA has released a toolkit in support of its new 988 Suicide and Crisis Lifeline.  The toolkit consists of key messages, an FAQ, and a fact sheet.

COVID-19 Update

  • HHS’s Office of the Inspector General has issued a data brief quantifying the use of telehealth in both Medicare fee-for-service and Medicare Advantage during the first year of the COVID-19 pandemic.  The study found that more than 28 million Medicare beneficiaries used telehealth during the first year of the pandemic and that overall, beneficiaries used telehealth to receive 12 percent of their services during that time, most commonly for office visits but also for behavioral health services in significant numbers.  Learn more from the OIG data brief “Telehealth Was Critical for Providing Services to Medicare Beneficiaries During the First Year of the COVID-19 Pandemic.”

Centers for Medicare & Medicaid Services

COVID-19 Update

  • CMS has updated its “Novel Coronavirus (COVID-19) Medicare Provider Enrollment Relief Frequently Asked Questions.”  The changes are neither dated nor highlighted but in general reflect the agency’s expectation that the declared public health emergency will soon end and that certain practices instituted since the beginning of the pandemic to facilitate the delivery of care are already being phased out or soon will be.  Providers should review the updated FAQ carefully.

Health Policy Update

  • CMS’s Center for Medicare and Medicaid Innovation (CMMI) continues to share information about ACO REACH, a redesigned version of its Global and Professional Direct Contracting Model that seeks to promote health equity and focus on bringing the benefits of accountable care to Medicare beneficiaries in underserved communities.  Its goals are to improve quality of care and care coordination for patients in traditional Medicare, especially for patients in underserved communities, and it does so in part by providing tools and resources to empower doctors and other health care providers to achieve these goals.  This approach seeks to give patients greater individual attention while preserving choice of providers and all other services and flexibilities in traditional Medicare.  Learn more about ACO REACH on the program’s web page.  For additional information, CMMI is holding a series of virtual webinars in which it will provide more information about the program and respond to questions.  Those webinars are:
  • CMS has released templates and resources for two state reporting requirements that will help CMS and states monitor enrollment and renewal efforts as states resume routine Medicaid, Children’s Health Insurance Program (CHIP), and Basic Health Program operations following the end of the COVID-19 public health emergency.  The State Report on Plans for Prioritizing and Distributing Renewals Following the End of the Medicaid Continuous Enrollment Provisions is a form that states will be required to complete and submit to CMS to summarize a state’s plan to distribute renewals and mitigate against inappropriate coverage loss within the state’s 12-month unwinding period.  The Unwinding Eligibility and Enrollment Data Report Excel Workbook (this link opens an Excel file) and specifications document are tools states can use to support their efforts to report on certain metrics to demonstrate their progress toward restoring timely application processing, initiating and completing renewals of eligibility for all Medicaid and CHIP enrollees, and processing fair hearings.  Learn more about these new resources from CMS’s announcement and from the CMS web page on unwinding and returning to regular operations after COVID-19.
  • CMS has announced plans to update the quality measure (QM) rating threshold for its Nursing Home Compare and Five Star Rating System.  In March of 2019 the agency released a memorandum that outlined its plan to update the QM rating thresholds every six months.  The initial threshold changes were scheduled to take effect in April of 2020 but were put on hold due to the COVID-19 public health emergency.  Now, CMS plans to resume the QM threshold changes in April of 2022 and also to release a new Five-Star Quality Rating System Technical Users Guide with the updated QM rating thresholds.  Learn more from this notice about CMS’s plan to resume its updating of the QM rating for its Nursing Home Compare and Five Star Rating System and go here to find the March 5, 2019 memo in which CMS outlined its plan to update the QM rating thresholds every six months.

Centers for Disease Control and Prevention

Occupational Safety and Health Administration (OSHA)

  • OSHA has partially reopened the rulemaking record on its development of a final standard to protect health care workers from workplace exposure to the COVID-19 virus and has scheduled an informal public hearing to seek comments on specific aspects of that standard.  For a general overview of what the agency is doing and why it is doing it, see this OSHA news release.  In addition, a Federal Register notice presents more detailed information about the scope of OSHA’s reconsideration of this issue and how to submit comments and participate in the hearing.  The deadline for submitting comments is April 22 and the hearing will be held on April 27.

Medicaid and CHIP Payment and Access Commission (MACPAC)

Stakeholder Events

FDA – Access to Naloxone – March 29

The FDA will host a virtual public workshop on March 29 at 12:30 (eastern) to address some of the most frequently asked questions about access to naloxone, a drug used to reverse opioid overdoses.  Learn more about the workshop here and go here to register to participate.

CMS – Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Learning Collaborative – March 31

CMS’s Improving Maternal Health by Reducing Low-Risk Cesarean Delivery Learning Collaborative will hold a webinar titled “The Role of Medicaid in Reducing Low-Risk Cesarean Delivery: Improving Outcomes and Reducing Disparities” on Thursday, March 31 at 2:00 p.m. (eastern). During the webinar, experts will describe the initiatives they took to reduce the number of low-risk cesarean deliveries.  To learn more about the webinar and register to participate, go here.

CMS – Emerging Technologies – March 31

CMS will hold public listening sessions on transitional coverage for emerging technologies on Thursday, March 31, also at 3:00 (eastern).  The purpose of these sessions is to obtain feedback to help inform CMS’s development of an alternative coverage pathway to provide transitional coverage for emerging technologies following the repeal of the January 2021 Medicare Coverage of Innovative Technology and Definition of “Reasonable and Necessary” final rule.  For additional information about the listening sessions and to register to participate, go here.

FDA – Identifying Key Competencies for Opioid Prescriber Education – April 4-5

The FDA and the Duke-Margolis Center for Public Policy are collaborating to host a two-day virtual public workshop focused on identifying gaps in the content of existing opioid prescriber education offerings and core competencies that should be included in educational content for opioid prescribers and other health care providers, including prescriber education under a Risk Evaluation and Mitigation Strategy.  The sessions will be held on Monday, April 4 and Tuesday, April 5 from 1:00 to 5:00 p.m. (eastern).  Go here for more information and to register to participate.

CMMI – Medicare Advantage Value-Based Insurance Design Model – 2023 Hospice Benefit Component Overview – April 5

CMMI will host an office hours session on Tuesday, April 5, 2022 at 3:00 p.m. (eastern) to discuss the Medicare Advantage Value-Based Insurance Design Model and its Hospice Benefit Component. Participants will receive an overview of the model and the CY 2023 application process and have an opportunity for questions and answers with the model team.  For more information about the program and how to register for the event, go here.