Federal Health Policy Update for Monday, June 28

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

Supreme Court Decision in Affordable Care Act Case

  • The Supreme Court has declined to hear an appeal of a case in which insurers unsuccessfully sued to recover reductions in their Affordable Care Act federal cost-sharing reduction payments.

White House

Department of Health and Human Services

COVID-19

  • HHS and the FDA have paused all distribution of bamlanivimab and etesevimab together and etesevimab alone, to pair with existing supply of bamlanivimab, on a national basis until further notice.  In addition, the FDA has recommended that health care providers nation-wide use alternative authorized monoclonal antibody therapies and not use bamlanivimab and etesevimab administered together at this time.  Learn more about why the agencies have taken this action and what they propose as alternatives from this message distributed by HHS’s Office of the Assistant Secretary for Preparedness and Response,
  • HHS’s Office of the Inspector General has published a report on the impact of COVID-19 on Medicare beneficiaries residing in nursing homes during 2020.  Learn more from the OIG’s announcement and summary of the report and from the OIG report “COVID-19 Had a Devastating Impact on Medicare Beneficiaries in Nursing Homes During 2020.”

Health Policy News

  • HHS and the CDC have awarded 59 jurisdictions with $200 million to bolster support for and enhance the disease intervention specialists workforce.  These awards represent the initial funding of a $1.13 billion investment being made over the next five years under the American Rescue Plan and will provide these jurisdictions, public health programs, and the CDC with support to expand and leverage the work of disease intervention specialists.  Learn more from the CDC’s announcement and find a list of the funding recipients here.

Centers for Medicare & Medicaid Services

COVID-19

  • CMS has provided guidance to state Medicaid programs about the circumstances under which health care facilities still operating under their emergency preparedness plans because of COVID-19 will temporarily remain exempt from participating in required full-scale emergency preparedness exercises and testing.  See the CMS guidance letter here.

Health Policy News

  • CMS has announced the appointment of Daniel Tsai as deputy administrator and director of its Center for Medicaid and CHIP Services.  Tsai comes from Massachusetts, where he served as the assistant secretary for MassHealth and state Medicaid director.  Learn more about Tsai and the agency he will help lead in this CMS news release.
  • CMS has released a Center for Medicaid and CHIP Services bulletin to introduce a series of tools and toolkits for states and CMS to use to improve the monitoring and oversight of managed care in Medicaid and the Children’s Health Insurance Program (CHIP) that will help improve beneficiaries’ access to care.  This bulletin also provides guidance setting the content and format of the Annual Managed Care Program Report required by CMS regulations and introduces additional resources and technical assistance toolkits that states can use to improve compliance with managed care standards and requirements.  Learn more from the new CMS bulletin.
  • CMS has published the latest edition of MLN Connects, its online publication.  For articles about updates of the hospital outpatient prospective payment system and the clinical laboratory fee schedule and more, go here.
  • CMS has updated its FAQ on its final rule on interoperability and patient access.  Find the information here.
  • CMS announced that it will provide $20 million in American Rescue Plan money to support state-based marketplaces to improve access to affordable, comprehensive health insurance coverage for consumers in their states.  States can apply for funding to help modernize or update their systems, programs, or technology to comply with federal marketplace requirements.  Learn more about the new funding from this CMS announcement.
  • CMS’s Center for Medicare and Medicaid Innovation has announced an anti-kickback safe harbor for CMS-sponsored model patient incentives under the agency’s Maternal Opioid Misuse Model.  Learn more here.

Centers for Disease Control and Prevention

COVID-19

Food and Drug Administration

COVID-19

Health Policy News

  • The FDA has approved the drug Pradaxa (dabigatran etexilate), the first oral blood thinning medication for children.  Learn more from this FDA news release.
  • The FDA has issued draft guidance encouraging industry to include patients with incurable cancers (when there is no potential for cure or for prolonged/near normal survival) in cancer clinical trials regardless of whether they have received existing alternative treatment options.  See the FDA announcement of this new policy and the draft guidance itself, which was published in the Federal Register.

Occupational Safety and Health Administration

  • OSHA has issued an emergency temporary standard to protect health care and health care support service workers from occupational exposure to COVID-19 in settings where people with COVID-19 are reasonably expected to be present.  Compliance with some of the new requirements is mandatory as of July 6 and compliance with the rest of the requirements is mandatory as of July 21.  Learn more from OSHA’s notice in the Federal Register.

National Institutes of Health

  • NIH director Francis S. Collins and other leaders have outlined their vision for a new science entity, the Advanced Research Projects Agency for Health, that was included in the president’s fiscal year 2022 budget with requested funding of $6.5 billion.  The purpose of the agency is to accelerate biomedical innovation and adoption of technologies and approaches to revolutionize health care and medicine.  Find the NIH announcement and a link to additional information about the agency here.
  • An NIH study published in the journal Science Translational Medicine concludes that “…there were 4.8 undiagnosed SARS-CoV-2 infections for every diagnosed case of COVID-19, and an estimated 16.8 million infections were undiagnosed by mid-July 2020 in the United States.”  Find the study here.

Medicare Payment Advisory Commission (MedPAC)

  • MedPAC has submitted formal comments to CMS about that agency’s proposed regulation describing how it plans to pay for acute-care hospital and long-term-care hospital inpatient care in FY 2022.  The MedPAC letter addresses limited parts of the proposed regulation.  Go here to see MedPAC’s letter to CMS.

Medicaid and CHIP Payment and Access Commission (MACPAC)

  • MACPAC has published a fact sheet with an updated analysis of physician acceptance of new Medicaid patients, including at the state level.  The analysis found that physicians were significantly less likely to accept new patients covered by Medicaid than patients with Medicare or private insurance, although acceptance varied by specialty and by state.  Learn more from the new MACPAC fact sheet “Physician Acceptance of New Medicaid Patients:  Findings from the National Electronic Health Records Survey.”
  • MACPAC has published an issue brief that describes how Medicaid programs can pay for certain housing-related services.  Learn more from the MACPAC issue brief “Medicaid’s Role in Housing.”

Government Accountability Office

Stakeholder Events

CMS – Coronavirus (COVID-19) Stakeholder Calls 

HHS’s “We Can Do This” campaign is a national initiative to build confidence in COVID-19 vaccines and get more people vaccinated.  This campaign offers tailored resources and toolkits for stakeholders to use to provide COVID-19 vaccine information to at-risk populations.  CMS is partnering with the campaign to offer several webinars to walk through each toolkit and its resources and train community organizations, local voices, and trusted leaders to use the campaign tools for vaccine outreach efforts to diverse communities.  Webinar dates and registration links are below:

  • Tuesday, June 29, 1:00-1:30 pm ET:  Faith-Based Toolkit – Register here
  • Thursday,  July 1, 1:00-2:00 pm ET:  Toolkits for Racial and Ethnic Minority Communities – Register here
  • Thursday, July 8, 1:00-1:30 pm ET:  Older Adults Toolkit – Register here

Wednesday, Thursday, and Friday, July 7, July 8, and July 9 CMS

CMS – Revisions to the Healthcare Common Procedure Coding System (HCPCS) Code Set

CMS will hold virtual meetings on July 7, 8, and 9, to discuss its preliminary coding recommendations for revisions of the HCPCS Level II code set.  For information about times, registration, submission of materials, signing up to speak, and submitting comments, click here.

Tuesday, July 13 Office of the National Coordinator for Health Information Technology (ONC)
ONC Workshop: Advancing SDOH Data Use and Interoperability for Achieving Health Equity
Tuesday, July 13 at 10:00 am – 4:00 pm ET  Click here for connection information
This workshop will explore existing and emerging data standards, tools, approaches, policies, models, and interventions for advancing the use and interoperability of non-clinical health data for individual and community health improvement.  It will share varying perspectives of health policy-makers and health improvement implementers to highlight inventive solutions, share challenges, and offer ideas on data modernization to advance health equity.  The workshop offers introductory content as well as deep exploration of key topics as part of social determinants of health IT data use and interoperability including facilitated, expert stakeholder engagement.

Federal Health Policy Update for Monday, June 21

The following is the latest health policy news from the federal government as of 2:15 p.m. on Monday, June 21.  Some of the language used below is taken directly from government documents.

Supreme Court Decision in Affordable Care Act Challenge

  • The Supreme Court upheld the constitutionality of the Affordable Care Act in the California v. Texas case by a 7-2 vote in which the court concluded that the plaintiffs did not have standing to pursue the matter because they were not directly harmed.  See the court’s opinion here.

White House

Department of Health and Human Services

COVID-19

  • HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) has suspended distribution of the monoclonal antibodies bamlanivimab/etesevimab in Rhode Island because of the rising prevalence in that state of the COVID-19 P.1 (Gamma) variant (first identified in Brazil) and the B.1.351 (Beta) variant (first identified in South Africa) and the relative ineffectiveness of these therapies in fighting these variants.  ASPR has already suspended distribution of these monoclonal antibodies in Arizona, California, Florida, Indiana, Oregon, Washington, Illinois, and Massachusetts for the same reason and recommends the use of alternative therapies.  Go here for further information.
  • HHS announced that the administration will invest more than $3 billion in American Rescue Plan money to accelerate the discovery, development, and manufacture of antiviral medicines as treatments for COVID-19 and other viruses.  For more information on the plan and how the $3 billion will be allocated, see the HHS announcement.
  • HHS and its Office of the National Coordinator for Health Information Technology (ONC) announced the establishment of an $80 million Public Health Informatics & Technology Workforce Development Program (PHIT Workforce Program) to strengthen U.S. public health informatics and data science.  As part of this launch, ONC is inviting colleges and universities – particularly Historically Black Colleges and Universities (HBCUs), Tribal Colleges and Universities (TCUs), Hispanic Serving Institutions (HSIs), Asian American and Native American Pacific Islander-Serving Institutions (AANAPISIs), and other minority-serving institutions (MSIs) to apply for funding through a consortium that will develop the curriculum, recruit and train participants, secure paid internship opportunities, and assist in career placement at public health agencies, public health-focused non-profits, or public health-focused private sector or clinical settings.  Learn more about the program from this HHS announcement and this notice of the funding opportunity.  Applications are due August 11.

Health Policy News

  • HHS’s Office of the National Coordinator for Health Information Technology (ONC), in collaboration with standards development organizations and others, has released the Project US@ (‘USA’) Draft Technical Specification Version 1.0 for public comment.  Project US@ was created to develop a unified, cross-standards, health care industry-wide specification for representing patient addresses to improve patient matching.  See the HHS/ONC announcement about the release here and find the draft specifications here.  Comments are due July 31.
  • The White House has nominated Christi Grimm to be HHS’s inspector general.  The position is subject to Senate confirmation.  Learn more about her here.
  • Medicaid enrollment rose by nearly 9.9 million individuals, a 13.9 percent increase, between February 2020, the month before the COVID-19 emergency was declared, and the end of January 2021.  Among the 50 states and the District of Columbia more than 80.5 million people were enrolled and receiving full benefits from the Medicaid and CHIP programs by the end of January 2021.  Learn more from this HHS news release.

Centers for Medicare & Medicaid Services

COVID-19

  • CMS has written a letter about hospital recertification survey suspensions that may become necessary due to new COVID-19 case surges. The last national hospital survey suspension expired on March 23, 2021, and while CMS has concluded that extending the suspension is not merited, it outlines in the letter the conditions under which it will consider suspending individual surveys.  See the CMS letter here.
  • On May 11 CMS published an interim final rule with comment period that added new COVID-19 vaccination reporting requirements for nursing home staff and residents and provided a four-week grace period for facilities to educate themselves on the new requirements and to operationalize reporting.  On June 10 CMS posted the first set of weekly nursing home COVID-19 vaccination data, which includes vaccination status of both residents and staff, as reported by facilities.  Current data shows that at nursing homes that have reported, approximately 75 percent of residents and 50 percent of staff have received a COVID-19 vaccine.  Learn more from the Nursing Home Data web site.

Health Policy News

  • CMS has published the latest edition of MLN Connects, its online publication.  For articles about monoclonal antibodies, HCPCS coding additions, and more, go here.

Centers for Disease Control and Prevention

COVID-19

Food and Drug Administration

  • The FDA has translated its Pfizer vaccine fact sheet for recipients and caregivers into additional languages.  Find the complete collection here.
  • The FDA has approved a nasal antihistamine for non-prescription use through a process called a partial prescription to non-prescription switch.  The FDA approved Astepro (azelastine hydrochloride nasal spray, 0.15 percent) for seasonal and perennial allergic rhinitis for adults and children six years of age and older.  See the FDA announcement here.

Stakeholder Events

Tuesday, June 22 – FDA
FDA Drug Topics: Overview of Risk Evaluation and Mitigation Strategies (REMS) for Health Care Providers
Tuesday, June 22 at 1:00 – 2:15 pm ET  Click here to learn more
This webinar will provide an overview of REMS and discuss how REMS safety requirements affect prescribers, dispensers, and patients.  Participants should gain an understanding of the REMS authorities, how REMS are implemented, and the entities that provide oversite and support.  REMS is a drug safety program that the FDA can require for certain medications with serious safety concerns to help ensure that the benefits of the medication outweigh its risks.

Wednesday, Thursday, and Friday, July 7, July 8, and July 9 – CMS

CMS – Revisions to the Healthcare Common Procedure Coding System (HCPCS) Code Set

CMS will hold virtual meetings on July 7, 8, and 9, to discuss its preliminary coding recommendations for revisions of the HCPCS Level II code set.  For information about times, registration, submission of materials, signing up to speak, and submitting comments, click here.

CMS – Coronavirus (COVID-19) Stakeholder Calls 

HHS’s “We Can Do This” campaign is a national initiative to build confidence in COVID-19 vaccines and get more people vaccinated.  This campaign offers tailored resources and toolkits for stakeholders to use to provide COVID-19 vaccine information to at-risk populations.  CMS is partnering with the campaign to offer several webinars to walk through each toolkit and its resources and train community organizations, local voices, and trusted leaders to use the campaign tools for vaccine outreach efforts to diverse communities.  Webinar dates and registration links are below:

  • Tuesday, June 22, 1:00-1:30 pm ET:  Spanish Language Toolkits – Register here
  • Thursday June 24, 1:00-1:30 pm ET:  Healthcare workers Toolkit – Register here
  • Tuesday, June 29, 1:00-1:30 pm ET:  Faith-Based Toolkit – Register here
  • Thursday,  July 1, 1:00-2:00 pm ET:  Toolkits for Racial and Ethnic Minority Communities – Register here
  • Thursday, July 8, 1:00-1:30 pm ET:  Older Adults Toolkit – Register here

Federal Health Policy Update for Wednesday, March 24

Beginning today, NASH is expanding its regular updates to encompass a broader scope of federal health policy endeavors to include other matters of importance to providers.  Feel free to share this newsletter with others in your organization or to send us the email addresses of those you think might be interested and we will send it directly to them.

The following is the latest such information from the federal government as of 2:45 p.m. on Wednesday, March 24.

Congress

The temporary delay of implementation of the Medicare two percent sequester expires at the end of the month and amid considerable advocacy by the health care community, Congress is considering extending this delay.  Last week the House passed a bill that would extend the current moratorium through December 31, 2021 and would waive “PAYGO” rules that apply to the American Rescue Plan Act that would necessitate an additional two percent sequester on Medicare payments starting in January, which would be added to the existing sequester to result in a four percent sequester. The Senate will not take up the House bill but could take up S. 748, which would extend the current moratorium for the duration of the COVID-19 public health emergency.  Even if it does take up S. 748 this week the House is unlikely to address it immediately because both chambers will recess after Friday until April 9.  It is possible CMS may hold claims for a short period after March 31 if it appears Congress will act on this matter without much delay.

Provider Relief Fund

New Provider Relief Fund reporting requirements – PDF* were issued on January 15, 2021 in accordance with the Coronavirus Response and Relief Supplemental Appropriations Act of 2021.  In response to stakeholder feedback, HHS is currently reviewing this guidance and Provider Relief Fund reporting timelines.  We will post any updates on this website as soon as they are available.  We continue to encourage recipients of $10,000 or more in aggregate Provider Relief Fund payments to register in the Provider Relief Fund Reporting Portal.

White House

COVID-19

  • The White House has posted transcripts of the March 19, March 22, and March 24 press briefings provided by its COVID-19 response team and public health officials.

Department of Health and Human Services

Health Policy News

  • The Biden administration has nominated the following individuals to positions in the Department of Health and Human Services.

Office of the Secretary
Kristina Schake, Counselor to the Secretary for Strategic Communications

Office of the Assistant Secretary for Public Affairs
Israel Igualate, Deputy Speechwriter

Office of the General Counsel
Barbara McGarey, Deputy General Counsel

Office of the Assistant Secretary for Planning and Evaluation
Rebecca Haffajee, Principal Deputy Assistant Secretary for Planning and Evaluation
Miranda Lynch, Deputy Assistant Secretary for Planning and Evaluation (Human Services Policy)

Office of the Assistant Secretary for Preparedness and Response
Jonathan Warsh, Senior Policy Advisor COVID Response
Leni Hirsch, Special Assistant COVID Response

Office of the Assistant Secretary for Administration
Cheryl Campbell, Principal Deputy Assistant Secretary for Administration

Office of Global Affairs
Stephanie Psaki, Senior Advisor on Human Rights and Gender Equity

Substance Abuse and Mental Health Services Administration
Trina Dutta, Senior Advisor

See this HHS news release for further information.

  • HHS announced that it is extending access to the special enrollment period of the Affordable Care Act’s health insurance marketplace until August 15.  The purpose of this extension is to give consumers additional time to take advantage of new savings made available through the American Rescue Plan and give new and current enrollees an additional three months to enroll or re-evaluate their coverage needs with increased tax credits available to reduce premiums.  Learn more from this HHS announcement.HH  Find additional information in this accompanying HHS fact sheet.
  • HHS’s Office of the Inspector General has published the report “Hospitals Reported that the COVID-19 Pandemic Has Significantly Strained Health Care Delivery.”  HHS describes the report as “…a national snapshot, from the perspective of front-line hospital administrators, on how responding to the COVID-19 pandemic has affected their capacity to care for patients, staff, and communities.  This is not a review of the HHS response to the COVID-19 pandemic.”

Centers for Medicare & Medicaid Services

COVID-19

National Nursing Home Stakeholder Call

On Thursday, March 25, 2021 at 4:00pm (eastern), CMS will address questions about its updated nursing home visitation guidance.  In addition, participants will hear from a nursing home administrator currently implementing the new guidance.   Register for this Zoom call here.  Resources for the call are:

Centers for Disease Control and Prevention

COVID-19

Food and Drug Administration – COVID-19

COVID-19

  • The FDA has issued emergency use authorization for the first machine learning-based COVID-19 non-diagnostic screening device that identifies certain biomarkers that are indicative of some types of conditions, such as hypercoagulation.  The device is worn as an arm band and uses artificial intelligence.  See the FDA’s announcement and its emergency use authorization letter.

National Institutes of Health

COVID-19

  • In a news release, the NIH announced that “Results from a large clinical trial in the United States and South America indicate that AstraZeneca’s COVID-19 vaccine, AZD1222, is well-tolerated and protects against symptomatic COVID-19 disease, including severe disease or hospitalization. The independent Data and Safety Monitoring Board (DSMB) overseeing the trial identified no safety concerns related to the vaccine.”
  • Later the same day, the NIH’s Data and Safety Monitoring Board (DSMB) announced that it has notified NIAID (the National Institute of Allergy and Infectious Diseases), BARDA (the Biomedical Advanced Research and Development Authority), and AstraZeneca that “it was concerned by information released by AstraZeneca on initial data from its COVID-19 vaccine clinical trial.  The DSMB expressed concern that AstraZeneca may have included outdated information from that trial, which may have provided an incomplete view of the efficacy data.”

 

ACA Medicaid Expansion Cut Young Adult Uninsurance in Half

The number of uninsured young adults fell nearly 50 percent after the Affordable Care Act authorized states to expand their Medicaid programs, a new study has found.

According to the Urban Institute, the uninsured rate among people between the ages of 19 and 25 fell from 30.2 percent to 16 percent between 2011 and 2018, with most of the decline coming between 2013 and 2016, when the first round of states expanded their Medicaid programs.

The decline in the rate of uninsured young adults mirrored declines in the overall U.S. uninsured rate, which fell from 27.7 percent to 11.3 percent in states that expanded their Medicaid programs.  This decline has contributed greatly to the ability of private safety-net hospitals to serve their communities.

Learn more about how implementation of the Affordable Care Act affected the insurance status of young adults in the Urban Institute report “Impacts of the ACA’s Medicaid Expansion on Health Insurance Coverage and Health Care Access Among Young Adults.”

Coronavirus Update for Friday, January 29

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Friday, January 29.

The Biden Administration

The Biden administration has issued an “Executive Order on Strengthening Medicaid and the Affordable Care Act” to make it easier for the uninsured to get coverage during the COVID-19 pandemic.  The order:

  • reopens access to the federal Affordable Care Act health insurance marketplace for three months, from February 15 through May 15, and restores some of the Affordable Care Act exchange marketing funds that had been eliminated by the previous administration and
  • calls for the review of all existing regulations, orders, guidance documents, policies, and any other agency actions that may be inconsistent with the administration’s desire to enhance access to health insurance through the Affordable Care Act, including policies that undermine protections for people with pre-existing conditions and policies that make it harder for people to get insurance coverage or to enroll in Medicaid.

Resources for learning more about this executive order are:

Provider Relief Fund

HHS has updated its Provider Relief Fund FAQ with 19 new and modified questions.  The new information, marked “Modified 1/28/2021” or “Added 1/28/2021,” addresses the relationship between parent and subsidiary organizations receiving Provider Relief Fund grants, financial reporting and accounting requirements, the use of Provider Relief Fund money, and more.  The new information can be found on pages 10, 11, 16, 26, 28, 40, 41, 56, and 57 of the revised FAQ.  Providers that have received Provider Relief Fund grants or seek to receive such grants should review the new information carefully.

Department of Health and Human Services

  • HHS has established parameters under which retired and inactive health care providers may return to work to administer COVID-19 vaccinations.  It did so by amending the current COVID-19 emergency declaration under the Public Readiness and Emergency Preparedness Act (PREP Act).  See the HHS announcement of the new policy here and find the PREP Act amendment itself here.

HHS and CMS COVID-19 Stakeholder Calls

HHS Clinical Rounds Peer-to-Peer Virtual Communities of Practice

HHS’s Office of the Assistant Secretary for Preparedness and Response sponsors COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice that are interactive virtual learning sessions that seek to create a peer-to-peer learning network in which clinicians from the U.S. and abroad who have experience treating patients with COVID-19 share their challenges and successes.  These webinar topics are covered every week:

  • EMS:  Patient Care and Operations (Mondays, 12:00-1:00 PM eastern)
  • Critical Care:  Lifesaving Treatment and Clinical Operations (Tuesdays, 12:00-1:00 PM eastern)
  • Emergency Department:  Patient Care and Clinical Operations (Thursdays, 12:00-1:00 PM eastern)

Go here for information about signing up to participate in the sessions and go here for access to materials and video recordings of past sessions.

CMS Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information about the agency’s response to COVID-19.  These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer participants an opportunity to ask questions of CMS and other subject matter experts.

CMS COVID-19 Office Hours Calls

Tuesday, February 23 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  2528725

Audio Webcast link:  go here

Tuesday, March 16 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  4177586

Audio Webcast link:  go here

Tuesday, April 6 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  2769397

Audio Webcast link:  go here

Centers for Disease Control and Prevention

National Institutes of Health

  • An NIH news release explains that “An investigational COVID-19 vaccine developed by Janssen Pharmaceuticals appears to be safe and effective at preventing moderate and severe COVID-19 in adults, according to an interim analysis of Phase 3 clinical data conducted Jan. 21.”  This is a single-dose vaccine.  Learn more from the NIH news release.
  • Pregnant women who experienced severe symptoms of COVID-19 had a higher risk of complications during and after pregnancy, according to the preliminary findings of an NIH-funded study.  Compared to COVID-19 patients without symptoms, those with severe symptoms were at higher risk for cesarean delivery, postpartum hemorrhage, hypertensive disorders of pregnancy and preterm birth.  The study also suggests that mother-to-infant transmission of COVID-19 appears to be rare.

Food and Drug Administration

Department of Labor

Eliminate Medicaid DSH Cut, NASH Asks Congress

A Continuing Resolution to fund the federal government in FY 2021 should eliminate a cut in Medicaid disproportionate share (Medicaid DSH) allotments to the states, the National Alliance of Safety-Net Hospitals has written in a letter to congressional leaders.

The cut was mandated by the 2010 Affordable Care Act but has never been implemented.

In its letter to congressional leaders, NASH wrote that

The Medicaid DSH cut was predicated on the expectation that the Affordable Care Act would greatly reduce the number of uninsured Americans, and while it has, millions remain uninsured. Just this week the Centers for Disease Control and Prevention reported that the number of Americans without health insurance rose in 2019 – for the third consecutive year – and the job loss associated with COVID-19 is expected to continue this trend in 2020. As a result, private safety-net hospitals and others like them, serving communities with large numbers of low-income and uninsured residents, have never needed the resources afforded by Medicaid DSH more than they do today. Congress has always questioned the wisdom of this cut and has never allowed those cuts to go into effect. The most recent delay expires after November 30.

Learn more from NASH’s Medicaid DSH letter to congressional leaders.

Azar: Budget Proposes Reducing Medicaid Matching $

The federal government would reduce its financial commitment to state Medicaid programs under the FY 2021 budget the Trump administration proposed earlier this month.

While testifying before the Senate Appropriations Committee’s Subcommittee on Labor, Health and Human Services and Education, Health and Human Services Secretary Alex Azar acknowledged that the administration’s proposed FY 2021 would eliminate the enhanced rate at which the federal government matches state funds used to serve individuals who enrolled in Medicaid through the Affordable Care Act’s Medicaid expansion provision.  That enhanced rate calls for the federal government to pay 100 percent of the costs associated with the Medicaid population during the first year of Medicaid expansion, eventually scaling down to 90 percent after 2020.  Nationally, the federal government’s matching rate for the pre-expansion population is 57 percent; that matching rate would not be affected by this proposal.

This aspect of the administration’s proposed FY 2021 budget has mostly flown under the radar since the budget’s release and has received little public attention.

In explaining the proposal, Azar said that enhanced funding for the Affordable Care Act’s Medicaid expansion population was biased against the disabled, women, and children.

Such a policy change could be a blow to private safety-net hospitals in Medicaid expansion states.

Learn more about what Secretary Azar said about federal matching funds for state Medicaid programs in the McKnight’s Long-Term Care News article “Official confirms Trump budget proposed to eliminate enhanced Medicaid match.”

 

NASH Unveils 2020 Advocacy Agenda

The National Alliance of Safety-Net Hospitals has published its 2020 advocacy agenda.

To advance the interests of private safety-net hospitals, in the coming year NASH will:

  • Continue to address the major policy challenges of 2019 that had not been resolved as that year ended:  an extended delay of Medicaid disproportionate share (Medicaid DSH) cuts, surprise medical bills, and prescription drug prices.
  • Respond to administration-driven policies such as the calculation of Medicare disproportionate share (Medicare DSH) payments, reduced payments for prescription drugs under the 340B prescription drug discount program, and efforts to reduce Medicaid eligibility and benefits and to limit the means through which states may finance their share of Medicaid payments.
  • Respond to expected judicial decisions addressing the extension of site-neutral Medicare outpatient payments to additional outpatient settings and the implementation of a new public charge regulation.

For a more detailed look at NASH’s advocacy plans for the coming year, see its complete 2020 advocacy agenda.

Interview With Seema Verma

In late December, PBS broadcast an interview with Centers for Medicare & Medicaid Services administrator Seema Verma.  Kaiser Health News has published a transcript of excerpts from that interview during which Verma discusses Medicaid – including enrollment, eligibility, services, and children – Medicare for all, administration attempts to reduce health care costs, protection for people with pre-existing conditions, and more.  Read those excerpts in the Kaiser Health News article “One-On-One With Trump’s Medicare And Medicaid Chief: Seema Verma.”

NASH Conveys End-of-Year Priorities to Congress

Preventing Medicaid DSH cuts, a fair approach to protecting patients from surprise medical bills, and reducing prescription drug costs are among the policy positions that the National Alliance of Safety-Net Hospitals recently shared with Congress.

In its message to Congress, NASH also asked lawmakers to protect 340B prescription drug discounts for private safety-net hospitals and to preserve dedicated funding for community health centers, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education.

Learn more about NASH’s end-of-year policy priorities from the message “Protect Safety-Net Hospitals and the Communities They Serve in Upcoming Budget and Legislative Deliberations” that NASH delivered yesterday to all 535 members of Congress.