Weekly Roundup: December 16, 2022

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Bipartisan Data Mapping to Save Moms’ Lives Act Heads to President’s Desk
On Tuesday night, the U.S. Senate passed the bipartisan Data Mapping to Save Moms’ Lives Act by unanimous consent, sending the legislation to the President’s desk to be signed into law. The House passed the legislation (H.R. 1218) on April 5, 2022, by a vote of 409-11. The legislation would require the Federal Communications Commission (FCC) to include data on maternal health outcomes in its broadband mapping tool and identify areas where rates of poor maternal health outcomes with overlap with a lack of access to broadband services at the state and county levels. The bill will enable policymakers to pinpoint where telehealth services can be most effective. The FCC must consult with the Centers for Disease Control and Prevention to determine which maternal health outcomes should be incorporated into the dataset. Additionally, the Government Accountability Office must study how broadband access can improve maternal health outcomes.
Industry and Advocacy Groups Urge Congress to Include Medicaid and CHIP Policies in End-of-Year Package
The American Academy of Pediatrics, Association for Community Affiliated Plans, Children’s Hospital Association, Community Catalyst, Families USA, and First Focus Campaign for Children submitted a letter urging Congressional leaders to include Medicaid and Children’s Health Insurance Program (CHIP) provisions in the end-of-year omnibus package, including:
  • National Medicaid and CHIP continuous eligibility for children
  • Permanent CHIP funding
  • Medicaid and CHIP postpartum coverage
  • Medicaid Reentry Act to address the Medicaid Inmate Exclusion Policy
Administration Action
  • CMS published the 2021 National Health Expenditures (NHE) Report which found U.S. health spending grew to $4.3 trillion in 2021, only a 2.7% increase over the prior year. Federal expenditures on COVID-19 supplemental funding and federal public health activities declined over 60%, driving much of the slowdown. Spending increased for each of the major funds sources: private health insurance (5.8%), Medicare (8.4%), Medicaid (9.2%) and out of pocket (10.4%) as well across the three largest service categories: hospital care (4.4%), physician and clinical services (5.6%), and retail prescription drugs (7.8%). The report also notes that enrollment in Medicaid and private insurance increased for the second consecutive year, decreasing the number of uninsured individuals.
  • HHS, through the Substance Abuse and Mental Health Services Administration (SAMHSA), proposed changes to federal regulations to expand access to treatment for opioid use disorder (OUD). The proposal would update 42 CFR Part 8 to improve access to and experiences with OUD treatment by allowing take home doses of methadone and the use of telehealth in initiating buprenorphine at opioid treatment programs (OTPS). According to Centers for Disease Control and Prevention (CDC) data, more than 107,000 Americans died from drug overdoses in 2021, an increase of more than 15 percent from 2020. This follows a 30 percent increase in overdose deaths from 2019 to 2020.
Congressional Action
  • Last week, the House Select Subcommittee on the Coronavirus Crisis published its final report assessing the nation’s response to the COVID-19 pandemic. The report claims that early warnings from the CDC were ignored or downplayed by leadership, and were followed by a federal response hampered by poor strategic planning. The subcommittee also highlighted how business relief funds, loans, and contracts were potentially improperly awarded or exploited by companies. Finally, the report concludes with 30 recommendations for federal activities and investments to prevent and respond to future public health emergencies, including: Adoption of the report will be the subcommittee’s final act during the December 14th hearing, unless the House Republicans decide to continue into the next session.
Medicare
  • CMS released their annual Medicare Advantage (MA) and Part D Proposed Rule for 2024 (fact sheet) which governs requirements for MA and Part D plans. Among its provisions, the rule includes stricter prior authorization requirements, increases beneficiary marketing protections, better incorporates health equity into Star Ratings, provider directories, and quality improvement programs, improves access to behavioral health, and expands access to the Medication Therapy Management (MTM) program.  A summary of the proposed changes follows, and Healthsperien is in the process of developing a more detailed analysis of the rule.
  • CMS released the Center for Medicare and Medicaid Innovation’s (the Innovation Center) 2022 Report to Congress (RTC). The Innovation Center is required by statute to report to Congress on its activities, at minimum, every other year. This is the Innovation Center’s sixth RTC and covers activities from October 1, 2020 through September 30, 2022. During the period of report, the CMS Innovation Center had 33 models operational (either launched or continued).
  • The Committee for a Responsible Federal Budget, Employ America, and Paragon Health urged Congress in a letter to avoid any policy changes that would increase Medicare costs for fear of additional inflationary pressure. These policy changes include extending COVID-19 payment boosts or Medicare physician fee schedule increases, or suspending the Medicare sequester.
Medicaid
  • The Centers for Medicare and Medicaid Services (CMS) convened multiple federal health agencies at the We Can Do Better: Advancing Maternity Care Together meeting discussing the urgent need for a stronger, more diverse maternity care workforce and improved maternal health care navigation. At the convening, CMS introduced the logo for the Birthing-Friendly Hospital designation, which is a public designation of hospitals with quality and safe maternity care that CMS established earlier this year. The Department of Health and Human Services (HHS) also released a new report on doulas in maternal health care, which discusses how doulas can improve maternal and infant health outcomes, prevent birth complications, and help women navigate health care and social service systems.
Marketplace
  • HHS released their annual Notice of Benefit and Payment Parameters proposed rule for 2024 (fact sheet), which outlines requirements for issuers and Marketplaces. The rule notably includes several provisions to expand access to Marketplace coverage, including access to behavioral health care.  As well, the proposed rule includes provisions related to network adequacy and access, plan options, reducing barriers to coverage, and user fees, risk adjustment, and program integrity.
Research
  • Last month, the National Council on Disability (NCD) released a report outlining gaps in the current HCBS delivery system and providing recommendations to address these identified issues. Of note, the report identifies issues in lack of affordable and accessible housing and shortages in the current direct care workforce.
  • The Commonwealth Fund released a study showing that the U.S. has administered over 655 million COVID-19 doses and prevented over 18 million hospitalizations and 3 million deaths from COVID-19 in the process. The study showed that the rapid preparation and rollout of these vaccines have helped minimize the costly and potentially fatal consequences of COVID-19 and its variants. These findings highlight the importance of preventive care of vaccines in preventing infections, hospitalizations, and mortality while keeping children in school and businesses running.
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