Federal Health Policy Update for Tuesday, September 28

The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, September 28.  Some of the language used below is taken directly from government documents.

Provider Relief Fund:  Application Reminder

  • Beginning on September 29, health care providers may apply for $25.5 billion in health care relief funds, including $8.5 billion in American Rescue Plan resources for providers that serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program and $17 billion for Provider Relief Fund Phase 4 grants for a broad range of providers that have experienced changes in operating revenues and expenses as a result of the COVID-19 emergency.  The application period will run for four weeks.  Providers must submit their completed application by October 26.  Go here for further information.

Provider Relief Fund:  More Information

  • HHS has updated its information on Phase 4 Provider Relief Fund grants and American Rescue Plan grants for rural providers.  The new information includes:
    • Types of eligible providers.
    • An explanation that although general distribution payments will be allocated based on “changes to operating revenue and expenses” from July 1, 2020 to March 31, 2021, the payments can be used to cover eligible lost revenue and expenses incurred from January 1, 2020 through December 31, 2022.
    • The addition of the time period for identifying care provided to individuals living in rural areas:  January 1, 2019 through September 30, 2020.
  • The Health Resources and Services Administration will hold web events on Thursday, September 30 and Tuesday, October 5 for providers interested in pursuing Provider Relief Fund grants and funding for rural hospitals provided through the American Rescue Plan.  The purpose of these events is to provide guidance on how to navigate the application portal for seeking grants.  Learn more here and find a link to register to participate.  HRSA has announced that it will hold additional sessions during the weeks of October 11 and October 18; dates and times for those events have not yet been announced.
  • HHS recently hosted a briefing session to provide information about these upcoming funding opportunities.  View a video of that session here.

Department of Health and Human Services

COVID-19

Health Policy News

  • HHS has awarded nearly $1 billion in American Rescue Plan funding to nearly 1300 Health Resources and Services Administration (HRSA) Health Center Program-funded health centers in all 50 states, the District of Columbia, and the U.S. territories to support major health care construction and renovation projects.  According to HHS, health centers will use this funding for COVID-19-related capital needs, constructing new facilities, renovating and expanding existing facilities to enhance response to pandemics, and purchasing new state-of-the-art equipment, including telehealth technology, mobile medical vans, and freezers to store vaccines.  Learn more about the funding, its intended use, and how much money was granted to facilities in each state in this HHS news release.
  • Following up on a previously announced commitment, HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) has announced the distribution of $825 million in federal funds to 231 community mental health centers across the country.  This grant program is intended to enable community mental health centers to more effectively address the needs of individuals who have a serious emotional disturbance or mental illness, often accompanied by substance use disorders.  For a more detailed description of the work the community mental health centers are expected to do with this money and a link to a list of the 231 facilities awarded grants, see this HHS news release.

Centers for Medicare & Medicaid Services

COVID-19

  • Following the FDA’s recent authorization of a booster dose of the Pfizer COVID-19 vaccine for certain high-risk populations and a recommendation from the CDC, CMS will continue to provide coverage for booster doses without cost-sharing.  Beneficiaries with Medicare will pay nothing for COVID-19 vaccines or their administration and there is no copayment, coinsurance, or deductible.  In addition, nearly all Medicaid and CHIP beneficiaries must receive coverage of COVID-19 vaccines and their administration without cost-sharing.  COVID-19 vaccines and their administration, including boosters, will also be covered without cost-sharing for eligible consumers of most issuers of health insurance in the commercial market.  Learn more from this CMS news release.

Health Policy News

  • CMS has posted a special edition of its online newsletter MLN Connects explaining that effective September 20 it is exercising enforcement discretion for skilled nursing facility consolidated billing provisions related to flu and pneumococcal vaccines that enables Medicare-enrolled immunizers, including pharmacies, to bill directly and get direct reimbursement from Medicare, including for vaccine administration and product, whether these vaccines are administered at the same time (co-administered) as a COVID-19 vaccine or at different times.  Find the notice here.

Centers for Disease Control and Prevention

National Institutes of Health

  • The National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, has awarded approximately $36.3 million to three academic institutions to conduct research to develop vaccines to protect against multiple types of coronaviruses and viral variants.  The awards are intended to fuel vaccine research for a diverse family of coronaviruses, with a primary focus on potential pandemic-causing coronaviruses such as COVID-19.  Learn more about the anticipated research and the grant recipients in this NIH news release.

Medicaid and CHIP Payment and Access Commission (MACPAC)

  • MACPAC commissioners met last week to discuss a variety of Medicaid and CHIP payment and access issues, including communicating with beneficiaries, workforce issues, monitoring access to care, health IT adoption among behavioral health providers, and vaccines for adults.  Go here for a summary of the meeting and links to issue briefs prepared to support the commissioners’ discussions.

Government Accountability Office (GAO)

  • The GAO has published a short report that draws from a number of past GAO reports to describe examples of racial and ethnic health disparities, barriers that may contribute to disparities, and federal efforts to help address them.  In this report the GAO cites policy considerations and reiterates recommendations to improve gaps in race and ethnicity data.  Learn more in “GAO Health Care Capsule:  Racial and Ethnic Health Disparities.”
  • In 2016, HHS selected eight states to participate in a time-limited demonstration to establish certified community behavioral health clinics to help improve their response to depression and opioid use challenges within their Medicaid populations.  The GAO has now reviewed the efforts of those states, including the degree to which spending on these services changed during the demonstration period, and has offered recommendations on provider payments and overlap with other Medicaid payments.  Learn more from the GAO report “Medicaid Behavioral Health:  CMS Guidance Needed to Better Align Demonstration Payment Rates with Costs and Prevent Duplication.”

Stakeholder Events

HRSA – New Provider Relief Fund and Rural Hospital Grants – September 30 and October 5

The Health Resources and Services Administration will hold web events on Thursday, September 30 and Tuesday, October 5 for providers interested in pursuing Provider Relief Fund grants and funding for rural hospitals provided through the American Rescue Plan.  The purpose of the event is to provide guidance on how to navigate the application portal for seeking these grants.  Learn more here and find a link to register to participate.

CDC – Evaluating and Supporting Patients Presenting With Fatigue Following COVID-19 – September 30

The CDC will hold a webinar on evaluating and supporting patients who present with fatigue following treatment for COVID-19.  The webinar will be held on Thursday, September 30.  For further information on the subjects the webinar will cover, those who will be participating in the event, and how to join the webinar, go here.

HHS/Office of the Assistant Secretary for Preparedness and Response – Grand Rounds for EMS, Critical Care, and Emergency Department ICU Care of Pediatric COVID Patients – September 30

The agency’s “clinical rounds” sessions return on Thursday, September 30 at noon (eastern) with presenters who will discuss emergency management resources and information that can be used to improve operations during the COVID-19 pandemic.  Go here to register to participate in the remote event.

CDC – Recommendations for Influenza Prevention and Treatment in Children – October 7

The CDC and experts from the American Academy of Pediatrics will hold a webinar on Thursday, October 7 at 2:00 p.m. (eastern) to discuss strategies that primary care providers and medical subspecialists can use to improve, prevent, and control influenza among children during the upcoming flu season.  Go here to learn more about the webinar and how to participate.

FDA – Workshop Addressing Response to the Opioid Crisis – October 13 and October 14

The FDA will hold a workshop titled “Reconsidering Mandatory Opioid Prescriber Education Through a Risk Evaluation and Mitigation Strategy (REMS)” to give stakeholders an opportunity to provide input on aspects of the current opioid crisis that could be mitigated in a measurable way by requiring mandatory prescriber education as part of a REMS effort.  The public workshop will be held on October 13 and October 14.  For information about participating in the workshop or submitting comments or materials, see this Federal Register notice.