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

ASH Advocacy

  • Congresswoman Yvette Clarke (D-NY) has introduced H.R. 2665, the Supporting Safety Net Hospitals Act, bipartisan legislation that would delay pending cuts to Medicaid disproportionate share hospital (Medicaid DSH) payments.  Currently, Medicaid DSH payments would be cut, beginning in 2024, by $8 billion a year through 2027.  The legislation proposes delaying implementation of the cuts until 2026.  Find the proposed bill here and ASH’s endorsement of the bill here.
  • A House bill to raise the federal debt ceiling includes a provision establishing a work requirement for Medicaid beneficiaries.  In ASH’s view, such a provision, if implemented, would limit access to Medicaid services, so the organization has written to House members to express its opposition to this proposal.  Find ASH’s letter here.
  • This week the House Energy and Commerce Committee’s Health Subcommittee held a hearing on a variety of health care proposals.  In anticipation of that hearing, ASH wrote to committee members to express its support for H.R. 2665, the Supporting Safety Net Hospitals Act; to convey its opposition to proposed changes in the section 340B prescription drug discount program; and to express its opposition to mandating site-neutral Medicare payments for outpatient services provided in physician offices.  Go here to see ASH’s letter to committee and subcommittee leaders.

End of the COVID-19 Public Health Emergency

  • ASH has prepared a summary of the status of selected government health care waivers and flexibilities upon the expiration of the COVID-19 public health emergency on May 11.  The ASH summary covers telehealth, COVID-19 treatment and coverage, flexible hospital operations, long-term-care hospitals, inpatient rehabilitation facilities and units, patient cost-sharing, and state Medicaid waivers.  Find the ASH summary here.
  • CMS has posted a new FAQ that addresses its waivers and flexibilities upon the end of the COVID-19 public health emergency.  Find it here.
  • CMS has updated its “COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing” document to indicate that this FAQ will expire at the end of the COVID-19 public health emergency and will not be updated and directing stakeholders to other agency resources for answers to frequently asked questions.  Go here to learn more.

Centers for Medicare & Medicaid Services

  • CMS has issued a proposed rule that would reduce barriers to care for Deferred Action for Childhood Arrivals (DACA) individuals by removing the current exclusion that treats DACA individuals differently from others with deferred action who would otherwise be eligible for coverage under certain CMS programs.  It would amend the definition of “lawfully present” to include DACA individuals for the purposes of Medicaid and CHIP, thereby extending Medicaid and CHIP coverage to children and pregnant women in states that have elected the “CHIPRA 214” option for children and/or pregnant individuals, the Basic Health Program, and Affordable Care Act Marketplace coverage.  Learn more about the proposed rule from this HHS news release; this CMS fact sheet; and this HHS regulatory announcement, which includes a link to a Federal Register notice.  The deadline for stakeholder comments is June 23 and CMS intends for the final adopted version of the rule to take effect on November 1.
  • CMS has published an update on its efforts to encourage compliance with its hospital price transparency requirements.  The update outlines the tools it uses to monitor compliance, enforcement actions to date, and new steps CMS is taking to monitor and enforce compliance, including reducing the time hospitals will have to come into compliance after they have    of deficiencies in their performance.  Find this CMS update here.

Department of Health and Human Services

  • HHS and its Health Resources and Services Administration (HRSA) have awarded more than $147 million to 49 recipients to help reduce the number of new HIV infections in the U.S. by at least 90 percent by 2030.  This funding will help states and metropolitan areas with the highest levels of HIV transmission link people with HIV to essential care, support, and treatment and also will support training and other resources for these jurisdictions.  To learn more about the purpose of the funding and find a list of the jurisdictions receiving these grants, see this HHS news release.
  • HHS’s Office of the Inspector General has developed a toolkit with methods to analyze telehealth claims to identify program integrity risks associated with telehealth services.  This toolkit is intended to assist public and private sector partners, such as Medicare Advantage plan sponsors, private health plans, state Medicaid fraud control units, and other federal health care agencies, with their analysis of their own telehealth claims data to assess program integrity risks in their programs.  Learn more from this HHS announcement, which includes a link to the toolkit itself.
  • HHS’s Administration for Strategic Preparedness and Response (ASPR) has published a new toolkit to help hospitals quickly expand care capacity during the first hours of mass casualty incidents.  Find that toolkit here.
  • HHS’s Agency for Healthcare Research and Quality (AHRQ) has published a new guide offering strategies to reduce clinician burdens and burnout.  Find an introduction to the guide and a link to the complete guide here.
  • An HHS Office of the Inspector General audit has concluded that Medicare could have saved up to $128 million over five years if CMS had implemented controls to address duplicate payments for services provided to individuals with Medicare and Veterans Administration health benefits.  Go here for a summary of the OIG audit and a link to the audit itself.

HHS Newsletters

Provider Relief Fund

  • April 28 is the deadline for recipients of Provider Relief Fund Phase 4 payments to submit a request for an extension for reporting on their expenditure of these funds.
  • April 30 is the deadline for Provider Relief Fund participants to return any unused funds from their Phase 4 payments.  Go here to learn more about Provider Relief Fund repayment and debt collection.

Centers for Disease Control and Prevention

  • The CDC has updated its COVID-19 vaccination program operational guidance.  Find the updated collection of documents here.
  • A new CDC study found that adults reporting experiences of racial and ethnic discrimination in health care had a significantly higher prevalence of being unvaccinated against COVID-19 overall and among most racial and ethnic groups.  Find the report here.

Medicaid and CHIP Payment and Access Commission (MACPAC)

  • MACPAC has submitted comments to CMS in response to CMS’s proposed Medicaid disproportionate share hospital (Medicaid DSH) third-party payer rule.  The proposed rule calls for changes in how uncompensated care is calculated for Medicaid beneficiaries, streamlining of CMS’s process for recouping DSH payments, and changes in how CMS calculates DSH allotment reductions.  In its letter, MACPAC expresses support for many of these changes and recommends that CMS modify Medicaid DSH audits to separately identify costs and payments for individuals with third-party coverage from patients who use Medicaid as their primary payer among excepted hospitals; recommends that CMS use hospital-specific supplemental payment data to determine how much to reduce DSH funding that is diverted through Section 1115 demonstrations when allotments are reduced starting in FY 2024; and supports CMS’s proposed process to expedite the recoupment of DSH overpayments.  Find a summary of the MACPAC letter here and the complete letter here.
  • MACPAC has published a transcript of its April 13-14 public meetings.  Find an overview of those meetings and a link to the transcript here.

 Medicare Payment Advisory Commission (MedPAC)

MedPAC has posted a transcript of its April 13-14 public meetings.  Find that transcript here.

Government Accountability Office (GAO)

  • The GAO has submitted testimony to the House Ways and Means Committee’s Subcommittee on Oversight about IRS oversight of hospitals’ tax-exempt status.  Go here for an introduction to the testimony and a link to the complete testimony.
  • A new GAO report describes states’ use of Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) funding for health information exchange efforts and their plans to replace those funds; the extent to which use of electronic health information exchange has changed since the enactment of the HITECH Act; and federal efforts that seek to address challenges to electronic health information exchange.  Go here for links to a summary of the report and the full report.
  • A new GAO report provides information about the characteristics and health care expenditures among Medicaid beneficiaries with intellectual or developmental disabilities with long-term-care needs.  For selected states, this report describes health and demographic characteristics and health care expenditures for adults with intellectual or developmental disabilities enrolled in Medicaid home- and community-based services programs in 2019.  Go here for links to a summary of the report and the full report.

 Stakeholder Events

 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.

FDA – Considerations for Buprenorphine Initiation and Maintenance Care Public Meeting – May 10-11

In partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Reagan-Udall Foundation for the FDA, the FDA has announced a virtual public meeting on Wednesday and Thursday, May 10-11, on considerations for buprenorphine initiation and maintenance care.  The meeting is for stakeholders, including people who use drugs, their families and community, harm reduction programs, health professionals from inpatient and outpatient settings, academic researchers, and federal partners and will explore real-world experiences and scientific evidence for buprenorphine initiation strategies as well as medication dosing and management during continued treatment across different care settings.  Go here for additional information about the two-day public meeting and how to register to participate.