New Client Resources – 

Join the Sirona Strategies team for a webinar to review the major health policy developments that took place over the summer, and what’s next for the fall! Register Here

What’s Ahead: This Week

Hearings and Markups – 

  • No notable hearings or markups, Congress is in August recess.

Notable Policy Events – 

  • Monday, August 21
  • Tuesday, August 22
    • Administration for Community Living (ACL), “Partnership to Align Social Care Webinar on Proposed Medicare Physician Fee Schedule.” Additional Information
    • Association of State and Territorial Health Officials (ASTO), “Artificial Intelligence in State and Territorial Public Health.” Additional Information
    • CATO Institute, “Seemed Like a Good Idea: The State of Evidence in Health Care Management.” Additional Information
  • Wednesday, August 23
    • CMS, “Medicaid and CHIP Renewals: What to Know and How to Prepare, A Partner Education Monthly Series.” Additional Information
  • Thursday, August 24
    • Primary Care Collaborative (PCC), “Access & Equity in Medicaid: Robust Primary Care is a Must.” Additional Information

Weekly Wrap-Up: Notable Health Care Developments from Last Week

Medicare & Medicaid –

  • On August 15, CMS released an Informational Bulletin advising state Medicaid agencies to apply spousal impoverishment rules to married applicants and beneficiaries eligible for home and community-based services (HCBS) through September 30, 2027. Informational Bulletin
  • On August 17, House Energy and Commerce Committee Ranking Member Pallone (D-NJ) announced an inquiry into prior authorization denials by Medicaid managed care health insurance plans, following a recent HHS Office of Inspector General (OIG) report. Press Release HHS OIG Report
  • Also on August 17, HHS OIG released a report which found that Medicare has paid up to $17.8 million in potentially improper payments to opioid treatment programs for opioid use disorder treatment. Report in Brief Report

Payment & Delivery System Models – On August 14, CMS announced a set of changes to the ACO REACH Model for performance year (PY) 2024 which are intended to increase predictability for model participants, protect against inappropriate risk score growth, maintain consistency across CMS programs and models, and further advance health equity. ACO REACH PY24 Updates

Public Health Prevention, Preparedness, Surveillance & Data – On August 15, the Government Accountability Office (GAO) issued a report on HHS funding options to address immediate needs of a public health emergency or threat. Report

Health IT, Privacy, & Digital Health – 

  • On August 13, the HHS Office of the Chief Artificial Intelligence Officer (OCAIO) created an inventory of HHS artificial intelligence (AI) use cases to increase awareness of and cross-agency collaboration on AI initiatives. Inventory
  • On August 14, HHS Office of the National Coordinator for Health IT (ONC) announced two awards, totaling $2 million, under the Leading Edge Acceleration Projects in Health Information Technology (LEAP in Health IT) funding opportunity. Press Release
  • Also on August 14, ONC published a blog on the Lantern Project, created to help ONC monitor nationwide analytics about the availability and standardization of FHIR API service base URLs (“FHIR Endpoints”) deployed by health care organizations. Blog
  • On August 16, the White House published a readout of a roundtable with civil society leaders, researchers, and policymakers on how the data broker industry monetizes personal information and actions the White House is taking to address potential harms. Readout
  • On August 17, the Health Resources & Services Administration (HRSA) announced revisions to its currently approved evidence-based telehealth network program measures. The proposed adjusted measures allow for the inclusion of broader health care services and expanded outcome measures. Notice
  • Also on August 17, the Advanced Research Projects Agency for Health (ARPA-H) launched the Digital Health Security (DIGIHEALS) project to protect the health care system’s electronic infrastructure. Through a Broad Agency Announcement (BAA), the project will solicit proposals for technologies developed for national security and apply them to health systems, clinical care facilities, and personal health devices. Proposals are due September 7, 2023 at 12:00pm ET.  Announcement BAA

Mental Health and Substance Use Disorder Policy –

  • On August 15, SAMHSA announced the winners of its Behavioral Health Equity Challenge, all of whom presented approaches to effective outreach and engage with racial and ethnic underserved individuals in order to foster behavioral health equity. Press Release
  • On August 17, SAMHSA released a blog, “Back to School and Mental Health: Supporting Our Children for a Successful Year Ahead,” outlining strategies to continue supporting youth mental health. Blog

Misc. –

  • On August 16, the Department of Veterans Affairs OIG conducted a focused review of Veterans Health Administration guidelines for lung cancer screening (LCS) and the requirements for a VA facility LCS program. The OIG determined just over half of surveyed VHA facilities reported having an established LCS program consistent with VHA guidelines for LCS. Report in Brief Report
  • On August 17, the Department of Homeland Security (DHS), in partnership with HHS, launched a public awareness campaign to highlight federal school safety resources and evidence-based practices. Press Release
  • Also on August 17, the White House Office of Science and Technology Policy (OSTP) and the Office of Management and Budget (OMB) released a memo highlighting multi-agency research and development priorities for the President’s Fiscal Year 2025 Budget. Press Release Memo

Legislative Activity –

Introduced Legislation –

  • On August 15, Reps. Carter (R-GA) and Dunn (R-FL) introduced the Health Care Provider Shortage Minimization Act (H.R. 5208), which would clarify the treatment of locum tenens physicians and advanced care practitioners as independent contractors to help alleviate physician shortages, including in underserved areas. Bill Text Press Release
  • Also on August 15, Rep. Green (R-TN) introduced the Reducing Medically Unnecessary Delays in Care Act (H.R. 5213), which would ensure that prior authorization medical decisions under Medicare are determined by physicians. Bill Text Press Release