Health Care Policy Update – Weekly Wrap-Up and What’s Ahead – October 24, 2022


Notable Policy Events – 

  • Tuesday, October 25
    • Primary Care Collaborative, “October Lunch and Learn Discussion.” Additional information
    • KFF, “How the Pandemic Continues to Shape Medicaid Spending, Enrollment and Policy – Findings From KFF’s 22nd Annual Medicaid Budget Survey.” Additional information
    • Government Executive Media Group, “Innovations in Health IT.” Additional information
    • The Hill, “Health Care Innovations: The Next Big Breakthrough.” Additional information
    • Health Affairs, “Policy Spotlight: One-On-One with Dave A. Chokshi.” Additional information
    • Advisory Board, “Achieving Sustainable Growth in Medicare Advantage: Appealing to Seniors in a Crowded Market.” Additional information
    • LexisNexis, “Combating Social Determinants of Health: From Awareness to Action.” Additional information
  • Wednesday, October 26
  • Wednesday, October 26 – Thursday, October 27
  • Thursday, October 27
    • Bipartisan Policy Center, “Taming Health Insurance Costs for Employers and Employees.” Additional information
    • CATO Institute, “Can Prescribing Psychologists Help Solve the National Mental Health Crisis?” Additional information
    • Association for Behavioral Health and Wellness (ABHW), “CPT Coding and Billing Changes for Mental Health: What to Expect for Calendar Year 2023.” Additional information
  • Thursday, October 27 – Friday, October 28
    •  Medicaid and CHIP Payment and Access Commission (MACPAC), “October 2022 Public Meeting.” Additional information
  • Friday, October 28
    • Alliance for Health Policy, “An Introduction into Behavioral Health and Primary Care Integration.” Additional information
    • Center for Connected Health Policy, “Federal Policy & Telehealth: What to be Aware of Going Forward.” Additional information
Weekly Wrap-Up: Notable Health Care Developments from Last Week
Medicare – 

  • On October 19, CMS announced that it had expanded the archive for Doctors and Clinicians in the Provider Data Catalog on Care Compare, which allows users to access historic Merit-based Incentive Payment System (MIPS) program performance data. PDC Archive Files
  • On October 21, CMS announced that it is increasing scrutiny and oversight over the country’s poorest-performing nursing facilities through a series of revisions to the Special Focus Facility (SFF) Program. White House Fact Sheet

Medicaid – 

  • On October 17, CMS announced that New Hampshire requested an extension of the state’s Substance Use Disorder, Serious Mental Illness, and Serious Emotional Disturbance Treatment Recovery and Access section 1115 demonstration. Comments are due by November 16. Pending Application Link to Submit Comments
  • Also on October 17, CMS released a new set of COVID-19 Public Health Emergency (PHE) Unwinding Frequently Asked Questions (FAQs). FAQs
  • Also on October 17, CMS released a resource for states that adopted the optional COVID-19 group related to ending coverage when federal authority for the group expires on the last day of the COVID-19 PHE. Resource
  • Also on October 17, CMS released the Connecting Kids to Coverage (CKC) HEALTHY KIDS American Indian/Alaska Native (AI/AN) 2023 Outreach and Enrollment Cooperative Agreements Notice of Funding Opportunity (NOFO). The program provides funding to increase Medicaid and CHIP coverage among AI/AN children. Applications are due by December 20, 2022. NOFO
  • On October 20, CMS released a resource for states to support their unwinding efforts after the COVID-19 PHE ends, providing information on ex parte renewal requirements and considerations, and other strategies to better automate eligibility renewals. Resource

Marketplaces – 

  • On October 19, CMS sent a memo to Medicare Advantage organizations and Part D sponsors discussing CMS monitoring activities and sharing best practices during the 2023 Annual Election Period. Memo
  • On October 20, House Ways & Means Committee Ranking Member Brady (R-TX) and Rep. Buchanan (R-FL) sent a letter to Treasury Secretary Yellen requesting that she preserve all documents and communications relating to the Administration’s April 7 proposed rule aimed at fixing the “family glitch” in the ACA. Letter  Press Release

Payment & Delivery System Models –

  • On October 17, the CMS Innovation Center announced that Director Liz Fowler, Ph.D, J.D. had been elected to the National Academy of Medicine, considered one of the highest honors in the fields of health and medicine. Announcement
  • Also on October 17, CMS posted reports from the Medicare Advantage Value-Based Insurance Design Model: Evaluation of Phase II. Report At-A-Glance Report
Public Health Prevention, Surveillance & Data – 

  • COVID-19 Data: To date, there are 97,063,357 total COVID-19 cases and 1,065,152 COVID-19 deaths in the United States. Also, 882,774,235 COVID-19 vaccines have been delivered and 632,905,664 individual COVID-19 vaccine doses have been administered. Data
  • FDA Action Update: To date, FDA has authorized 441 tests under Emergency Use Authorizations (EUAs), including 305 molecular tests, 85 antibody tests and 51 antigen tests. FDA also continues to update COVID-19 FAQs.
  • On October 17, GAO released a report “Public Health Preparedness: HHS Should Address Strategic National Stockpile Requirements and Inventory Risks, finding that until HHS updates its procedures, the agency risks not meeting the statutory requirements designed to give Congress additional information about the SNS inventory. Report in Brief Report
  • Also on October 17, the Office of the Inspector General (OIG) released a report, finding that the Indian Health Service did not always provide the necessary resources and assistance to help ensure that Tribal programs met reporting requirements for vaccine administration data; used billing practices that conformed to Centers for Medicare & Medicaid Services (CMS) and CDC requirements and American Medical Association guidance regarding reimbursement for vaccine administration fees; and did not enter into unallowable dual-program agreements with both a State jurisdiction and IHS.  Report in Brief Report
  • On October 18, OIG released a report “Home Health Agencies Used Multiple Strategies to Respond to the COVID-19 Pandemic, Although Some Challenges Persist,” finding that CMS has an opportunity to assess how to best help HHAs prepare for and respond to future emergencies, as well as to evaluate how changes to the home health landscape can better serve patients.  Report in Brief Report
  • Also on October 18, the Biden Administration announced the release of the National Biodefense Strategy and Implementation Plan for Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security. The strategy outlines goals around the nation’s biodefenses and health security to detect, prevent, prepare for, respond to, and recover from biological incidents. White House Fact Sheet HHS Press Release Full Report
  • On October 19, House Committee on Oversight and Reform Republicans sent a letter to HHS Secretary Becerra, announcing their investigation of the Administration’s reliance on testing materials and equipment from China instead of investing in U.S. manufacturing Press Release Letter
Health IT, Privacy, & Digital Health –

  • On October 17, OIG released a report finding that HHS was in compliance with reporting requirements of the Digital Accountability and Transparency Act of 2014 (DATA Act) for the first quarter of fiscal year 2022. Report in Brief Report
  • On October 18, HHS Office of the National Coordinator for Health IT (ONC) published a blog on the development of the FHIRedApp and how health IT can be used to better identify and mitigate disparities while enhancing opportunities for underrepresented populations. Blog
  • On October 19, ONC published a blog on the differences between evidence-based and predictive clinical decision support interventions (DSIs) that are developed using machine learning (ML) algorithms. This blog is part of the ONC’s Artificial Intelligence & Machine Learning Blog Series. Blog Blog Series
  • Also on October 19, Reps. Kuster (D-NH) and Trahan (D-MA) sent a letter to the Drug Enforcement Agency (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) requesting the extension of temporary telehealth flexibilities for the treatment of opioid use disorder. Press Release Letter
  • On October 20, Sen. Warner (D-VA) sent a letter to Meta CEO Mark Zuckerberg expressing concern and requesting more information regarding Meta’s practice of collecting user’s health information through tracking applications. Press Release Letter
  • On October 21, as an ONC-funded FHIR project, the University of Texas at Austin’s Dell Medical School (Dell Med) has developed a health equity-focused patient engagement platform that supports patient data access through FHIR. Press Release
  • Also on October 21, National Coordinator for Health IT at HHS Dr. Trapathi spoke on a podcast about recent developments determining that  all health care organizations in the United States are legally required to give patients unrestricted access to all their health records in a digital format. Podcast

Mental Health and Substance Use Disorder Policy –

  • On October 18, SAMHSA announced a new funding opportunity, authorized by the Bipartisan Safer Communities Act (BSCA), for states to develop and transform Certified Community Behavioral Health Clinics (CCBHCs) to address the country’s mental health crisis. Applications are due by December 19, 2022 Grant Application Press Release
  • On October 20, United States Surgeon General Murthy released the Surgeon General’s Framework for Mental Health & Well-Being in the Workplace outlining the foundational role that workplaces should play in promoting the health and well-being of workers and our communities. Framework Press Release
  • On October 21, HHS announced more than $100 million in funding that had been allocated throughout the week from the Bipartisan Safer Communities Act (BSCA) to states and territories for mental health emergency preparedness, crisis response, and the expansion of 988 Suicide & Crisis Lifeline services. Press Release

Prescription Drugs, Medical Devices, and Biomedical Research –

  • On October 17, the FDA announced it awarded 19 new grants and two new contracts to support clinical trials, natural history studies and regulatory science tools related to rare diseases. Press Release
  • Also on October 17, HHS sent a letter to Amgen stating it had completed its review of Amgen Inc.’s policy, which places restrictions on 340B pricing to covered entities that dispense medications through pharmacies under contract, with limited exceptions. Letter
  • On October 19, Sens. Marshall (R-KS), Lankford (R-OK), Moore Capito (R-WV), and Blackburn (R-TN) sent a letter to FDA Commissioner Califf questioning the agency’s response to the opioid epidemic and requesting the FDA prioritize new drug and device applications for non-opioid therapies for the treatment of pain. Press Release Letter

Veterans Health and Military Health –

  • On October 17, Senate Committee on Veterans’ Affairs Chair Tester (D-MT) and Ranking Member Moran (R-KS) sent a letter to the Department of Veterans Affairs (VA) asking to expedite efforts to establish a telehealth grant and access point program to better care for rural veterans. Press Release Letter
  • On October 20, the VA OIG released a report on findings from healthcare inspections performed at 45 medical facilities during fiscal year 2021 that focused on selected management of disruptive and violent behavior requirements. The OIG found general compliance with many of the selected requirements and issued recommendations for identified areas of weakness. Report in Brief Report

Health Systems, Public Health & Health Equity –

  • On October 17, CMS recognized Health Literacy Month and  highlighted resources to help people understand their health coverage and connect to the primary care and preventive services. Resources
  • Also on October 17, GAO released a report on adult vaccination rates for flu, pneumococcal, shingles, and tetanus vaccinations. GAO found that rates varied by type of vaccine, state, and other factors. Black or African American and Hispanic or Latino adults generally had estimated vaccination rates 13 or more percentage points below that of White adults. Report
  • On October 18, NIH released a request for information (RFI) on research opportunities related to the NIH Scientific Workshop on Gender-Affirming Care for Transgender and Gender-Diverse Populations. RFI responses are due by November 18. RFI
  • Also on October 18, CDC released a Morbidity and Mortality Weekly Report (MMWR) which highlights racial and ethnic disparities in influenza disease severity and vaccination coverage, along with disparities in access to care. MMWR
  • On October 20, HHS released a notice that it is seeking scientific information submissions to inform it’s review on Strategies for Integrating Behavioral Health and Primary Care, which is currently being conducted by the Evidence-based Practice Centers (EPC) Program. Notice
  • On October 21, HHS released a notice with the proposed Healthy People 2030 Objectives. Comments are due by December 2. Notice

Reproductive, Maternal & Infant Health –

  • On October 19, GAO released a report, “Maternal Health: Outcomes Worsened and Disparities Persisted During the Pandemic” finding that COVID-19 was a contributing factor in one quarter of all maternal deaths in 2020 and 2021 combined.  Report in Brief Report
  • Also on October 19, GAO released a report, “Maternal Health: Availability of Hospital-Based Obstetric Care in Rural Areas” Report in Brief Report
  • On October 20, the White House held a meeting with state legislative leaders from states that have banned abortion. During the meeting, participants discussed efforts to protect access to reproductive health care in these states. Meeting Readout

Misc. –

  • On October 18, HHS released the Federal Independent Dispute Resolution (IDR) Process Guidance for Certified IDR Entities. IDR Guidance
  • On October 21, HHS awarded $13 million to bolster nursing education and training to grow the nursing workforce and improve access to nursing education. Press Release
  • Also on October 21, the Administration for Community Living announced that the national Direct Care Workforce Capacity Building Center will serve as a hub, providing tools, resources and training to assist state systems and service providers and to support the development and coordination of policies and programs that contribute to a stable, robust direct care workforce. Press Release

Legislative Activity –
Votes and Committee Activity –

  • On October 17, the Maximizing Outcomes through Better Investments in Lifesaving Equipment for (MOBILE) Health Care Act (S. 958) was signed into law by the President. The bill would expand the allowable use criteria for new access points grants for community health centers. Bill text Press release House Energy & Commerce Republicans Press release
  • On October 19, the Global Malnutrition Prevention and Treatment Act of 2021 (H.R. 4693) was signed into law by the President. The bill would advance targeted and evidence-based interventions for the prevention and treatment of global malnutrition and to improve the coordination of such programs. Press Release

Introduced Legislation –

  • On October 18, Reps. Houlahan (D-PA), Salazar (R-FL), and Bice (R-OK) introduced the Access to Donor Milk Act (ADMA) (H.R. 9196), which would protect and expand access to donor milk. Bill text Press release
  • Also on October 18, Reps. Stevens (D-MI) and Joyce (R-OH) introduced the Stop Nurse Shortages Act (H.R. 9200), which would increase access to accelerated nursing degree programs. Bill text Bill summary Press release
  • Also on October 18, Reps. Tonko (D-NY), Fitzpatrick (R-PA), and Castor (D-FL) introduced the Community Mental Wellness and Resilience Act (H.R. 9201), which would promote mental wellness and resilience and heal mental health, behavioral health, and psychosocial problems through age and culturally appropriate community programs, and award grants for the purpose of establishing, operating, or expanding community-based mental wellness and resilience programs. Bill summary Press release