The following is the latest health policy news from the federal government for January 4-10.  Some of the language used below is taken directly from government documents.

Congress

 Congressional leaders continued to refine their committee membership for the 119th Congress.  In the past week, the following additions were made to committees with jurisdiction over health care matters:

  • The House Energy and Commerce Committee has added six new Democratic members to the committee:  Reps. Kevin Mullin (CA), Troy Carter (LA), Jennifer McClellan (VA), Greg Landsman (OH), Jake Auchincloss (MA), and Alexandria Ocasio-Cortez (NY).
  • The House Ways and Means Committee has added Reps. Brendan Boyle (D-PA), Tom Suozzi (D-NY) and Delegate Stacy Plaskett (US Virgin Islands).

Additional committee assignments can be expected in the very near future.

Centers for Medicare & Medicaid Services

  • CMS has announced that 15 states will take part in the launch of its Transforming Maternal Health Model.  The model, announced in late December of 2023, seeks to focus on improving maternal health care for people enrolled in Medicaid and CHIP by supporting participating state Medicaid agencies in the development of a whole-person approach to pregnancy, childbirth, and postpartum care that addresses the physical, mental health, and social needs experienced during pregnancy.  The goal of the model is to reduce disparities in access and treatment and improve outcomes and experiences for mothers and their newborns while also reducing overall program expenditures.  Go here to learn more about the model and find a list of the 15 states chosen to participate.
  • CMS has added information to a previous bulletin on how to use the office and outpatient evaluation and management (E/M) visit complexity add-on code G2211.  Find the bulletin here.  The changes took effect on January 1.
  • CMS has updated its vaccine price web page with new rates for flu vaccines and COVID-19 vaccines and monoclonal antibodies.  Find the new rates and their billing codes here.
  • CMS has revised its Medicare Part B coverage of pneumonia vaccinations policy.  Find its bulletin on the revision here.  The policy took effect on October 23, 2024 and will be implemented as of February 3.
  • CMS has posted a bulletin with billing instructions for expedited determinations based on Medicare change-of-status notifications.  Find the bulletin here.  The instructions took effect on October 11, 2024 and will be implemented beginning on February 15.
  • On January 27, CMS will add a new product category to the electronic CMS-855S DMEPOS Enrollment Form for multi-function respiratory devices (excluding ventilators).  Learn more by going here and scrolling down to “DMEPOS:  Adding New Product Category to CMS-855S Enrollment Form on January 27.”
  • CMS has updated its fact sheet explaining to Medicare providers and suppliers about the intravenous immune globulin (IVIG) permanent benefit and giving information on payments for IVIG items and services and how to bill for them.  Find the updated fact sheet here.

Department of Health and Human Services

  • HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded 14 states and Washington, D.C. $1 million, one-year Certified Community Behavioral Health Clinic Medicaid Demonstration Program planning grants to expand access to mental health and substance use disorder services.  Learn more about the program, the services it provides, and the states that will receive this additional funding from this HHS news release.
  • HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE) has issued two reports on behavioral health treatment for children and adolescents enrolled in Medicaid and CHIP during the COVID-19 pandemic:  the first examines the treatment of mental health conditions and substance abuse disorders and the second considers the treatment of suicidal ideation and suicide related behaviors;
  • Another ASPE report takes a broader look at behavioral health service use among Medicaid and CHIP enrollees before and during the COVID-19 public health emergency.
  • ASPE has published an issue brief that explores how health insurance coverage, access, and affordability have changed in recent years, with an emphasis on policies implemented from 2021 to 2024.  Find that report here.
  • HHS’s Office of the Assistant Secretary for Technology Policy (ASTP) has published a brief post presenting the results of its survey to explore the evolution of health information exchange organizations (HIOs), the role they play in promoting health information interoperability, and the state of interoperability more broadly.  Find that blog post here.
  • ASTP has published an update on its work on advancing cancer care through Fast Healthcare Interoperability Resources (FHIR)-based reporting.  Find it here.

HHS Newsletters and Reports

HHS Videos

CMS – MIPS Data Submission Process Demonstration – a demonstration that reviews the MIPS data submission process, including the three MIPS reporting options, how to upload files, how to review previously submitted data, and how to delete data.

Centers for Disease Control and Prevention

The CDC has announced the first death in the U.S. from severe avian influenza A(H5N1) illness (“H5N1 bird flu”); the death occurred in Louisiana.  Learn more from this CDC statement.

Food and Drug Administration

The FDA has posted an alert explaining that Baxter Healthcare has issued a letter to affected health care providers recommending that certain lots of solution sets with duo-vent spikes be removed from use because of a potentially high-risk device issue.  Learn more about the problem and find a list of the specific products in question in this FDA alert.

Medicaid and CHIP Payment and Access Commission (MACPAC)

MACPAC has posted a report evaluating the effects of Medicaid payment changes on access to physician services.  Find its issue brief here.

Consumer Financial Protection Bureau

The Consumer Financial Protection Bureau has issued a final rule banning the inclusion of medical bills on credit reports used by lenders and prohibiting lenders from using medical information in their lending decisions.  Learn more from this bureau news release and the final rule, which will take effect 60 days after its upcoming publication.

Stakeholder Events

CMS – Hospital Open Door Forum – January 14

CMS will hold a hospital open-door forum on Tuesday, January 14 at 2:00 (eastern).  Go here to register to participate.

MedPAC – Commissioners Meeting – January 16-17

MedPAC’s commissioners will hold their next public meeting virtually on Thursday, January 16 and Friday, January 17.  An agenda and information about how to participate are not yet available but when they are they will be posted here.

CMS – Physicians, Nurses, and Allied Health Open Door Forum – January 16

CMS will hold an open-door forum for physicians, nurses, and allied health professionals on Thursday, January 16 at 2:00 (eastern).  Go here to register to participate.

MACPAC – Commissioners Meeting – January 23-24

MACPAC’s commissioners will hold their next public meeting virtually on Thursday, January 23 and Friday, January 24.  An agenda and information about how to participate are not yet available but when they are they will be posted here.

CMS – Rural Health Open Door Forum – January 23

CMS will hold an open-door forum for rural health care providers and organizations on Thursday, January 23 at 2:00 (eastern).  Go here to register to participate.

CMS – Long-Term Services and Support Open Door Forum – January 28

CMS will hold an open-door forum for providers of long-term services and supports on Tuesday, January 28 at 2:00 (eastern).  Go here to register to participate.