Weekly Roundup: August 5, 2022

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CMS Releases Guidance on Section 1902(e)(14)(A) Waivers

In preparation for the end of the COVID-19 Public Health Emergency (PHE), The Centers for Medicare and Medicaid Services (CMS) has released a table outlining the Section 1902(e)(14)(A) waivers that CMS has approved for each state.

Section 1902(e)(14)(A) of the Social Security Act (the Act) allows states the option to manage the overflow of coverage renewals after the end of limited coverage given by the PHE. Several waivers under Section 1902(e)(14)(A) include:

  • Targeted SNAP Renewal;
  • MCO Beneficiary Contact Updates;
  • Premium Resumption Delay; and others

20 states have adopted the option with waivers, combining to total 61 approved waivers.

HHS Secretary Becerra and CMS Administrator Brooks-LaSure Issue Statements Marking 25th Anniversary of CHIP

The Department of Health and Human Services (HHS) Secretary Xavier Becerra and Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure released a statement to mark the 25th anniversary of the Children’s Health Insurance Program (CHIP). “Making affordable, quality health care coverage accessible for all Americans is a key priority for the Biden-Harris Administration, and CHIP plays a key role in advancing health equity and driving down the uninsured rate among children,” said Secretary Becerra. Click here to access the CMS fact sheet about the program.

Administration Action
  • The Biden Administration declared a public health emergency (PHE) for monkeypox in an effort to speed up vaccine distribution and expand testing. This decision was prompted from concerns about Biden administration officials that the virus is spreading faster than previous outbreaks, and advocacy from LGBTQ groups focused on the monkeypox response. This declaration authorizes the Department of Health and Human Services (HHS) to ship out an additional 800,000 monkeypox vaccines, though more doses will likely not be available for several months.
  • President Joe Biden issued an Executive Order on Securing Access to Reproductive and Other Healthcare Services, marking another step by the Administration to protect access to reproductive healthcare services. The Executive Order includes directive to support patients traveling out of state for medical care, ensure health care providers comply with federal non-discrimination law, and promote research and data collection on maternal health outcomes. President Biden signed the Executive Order at the first meeting of the interagency Task Force on Reproductive Healthcare Access.
  • The Biden Administration sued the state of Idaho over their restrictive abortion law. The Idaho law, which is set to take effect next month, makes it a felony for doctors to perform abortions in nearly all but extremely narrow circumstances. The Department of Justice alleges that the Idaho law would make it a criminal offense to comply with the federal Emergency Medical Treatment and Labor Act (EMTALA) requirement to provide stabilizing treatment – abortion care – even where a doctor determines that abortion is the medical treatment necessary to prevent a patient from suffering severe health risks or even death. The suit, filed in the U.S. District Court for the District of Idaho, is the first legal action the Biden administration has taken against states that have restricted access to abortion in the aftermath of the Supreme Court ruling to overturn the constitutional right to abortion.
Congressional Action 
  • Last month, Sen. Maggie Hassan (D-NH) sent a letter to several members of the Biden Administration, urging them to apply the No Surprises Act (NSA) to any in-network facility where a consumer may be treated by an out-of-network provider. In 2021, the administration issued an interim final rule listing types of facilities that must adhere to the NSA. The statues authorize the agencies to identify additional facilities, which they asked for comment on in July. Sen. Hassan urged the agencies to provide clarity over the status of facilities whose status has yet to be determined, including birthing centers, clinics, hospice facilities, addiction treatment centers, nursing homes, and urgent care centers.
  • The Congressional Budget Office (CBO) released the Estimated Budgetary Effects of H.R. 5376, the Inflation Reduction Act of 2022. CBO estimates that the Democrat-introduced tax, climate, and drug-pricing bill would result in a net decrease in the deficit totaling $102 billion over the period of 2022-2031. They further estimate that an increase in the Internal Revenue Service (IRS) budget would generate $204 billion in new revenue by cracking down on tax avoidance. The deficit decrease is partially driven by a repeal of a Trump-era rule banning prescription drug rebates and allowing Medicare to negotiate the cost of high-priced drugs. 
Regulatory Action
  • The Department of Health and Human Services (HHS) released two reports: The National Research Action Plan on Long COVID (the Research Plan) and The Services and Supports for Longer-Term Impacts of COVID-19 Report (Services Report). These reports follow a memorandum by President Joe Biden on addressing the long-term effects of COVID-19. Pursuant to Section 4 of the memorandum, the Research Plan aims to increase collaboration among federal agencies for the purpose of researching the prevention, diagnosis, and treatment of Long COVID. Pursuant to Section 3 of the memorandum, HHS published the Services Report outlining support services currently available to those affected by Long COVID.
  • The Centers for Medicare and Medicaid Services (CMS) announced the availability of new Home Health programs for children with complex medical conditions, allowing states to have the option to provide care coordination, patient and family support, comprehensive care management, referrals and other services. Health Home initiative have been successfully implemented in the past for Medicare beneficiaries with chronic conditions, and CMS aims to expand this program beginning October 1, 2022.
  • The Centers for Medicare & Medicaid Services (CMS) released the FY2023 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospitals Prospective Payment System (LTCH PPS) final rule, which updates the fee-for-service payment policies and rates for Medicare’s prospective payment system for inpatient hospitals and LTCHs (fact sheet). The rule addresses key priorities of the Biden administration, including health equity and maternal health disparities. CMS also published a guidance memo for hospitals with evidence-based practices for obstetric emergencies and submitted a request for information to advance maternal health equity (fact sheet). The full text of the rule can be found here.
  • The Urban Institute released a report finding that 3.7 million people would gain health care coverage in 2023, or a 29% reduction in national uninsurance, if the remaining 12 states were to expand Medicaid eligibility. To date, more than 20 million people in 38 states have enrolled in Medicaid because of Affordable Care Act (ACA) expansion opportunities and have benefitted from reduced mortality and improved financial security. The report also found that the greatest coverage gains would be realized by Black individuals, young adults, and women, especially women of reproductive age. Federal and state spending on Medicaid in the 12 non-expansion states would be partially offset by federal government savings on uncompensated care. Comprehensive analyses of states which expanded Medicaid demonstrate that the expansion generated savings and increased revenues which outweigh new spending.
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