News

• On April 20, CMS released its strategy for continuing to provide high-quality, affordable health care and advancing health equity across HHS. CMS encourages health care leaders to also make commitments to address and advance health equity. CMS wants health equity to be at the center of the work of all CMS centers and offices, including all work with states, health care facilities, providers, payers, the pharmaceutical industry, and all other stakeholders. To do so, CMS advises each regional CMS Center and Office to include the following actions into their work:
  • Close gaps in health care access, quality, and outcomes
  • Promote culturally and linguistically appropriate services
  • Continue outreach efforts for enrollment
  • Expand and standardize the collection and use of data (including social determinants of health)
  • Evaluate policies to determine how CMS can support safety net providers
  • Continue engagement and accountability with communities served by CMS
  • Include screening for broader access to health-related social needs
  • Have CMS serve as a model in advancing health equity
  • Promote the highest quality outcomes for all individuals under the CMS National Quality Strategy

CMS also announced that it will convene industry stakeholders in the Summer of 2022 to share best practices and commitments to improve and strengthen maternal health (CMS, April 20).

• In efforts to address the opioid overdose epidemic, the Biden administration plans to increase access to Naloxone and make other harm reduction interventions consistent across states. The plan, however, does not switch Naloxone from prescription to over-the-counter status, which many lawmakers, medical groups, and harm reduction experts have called for and believe is integral to increasing Naloxone access. Currently, Naloxone is available only by prescription as an auto-injector or a nasal spray. The plan to addressing the opioid epidemic is part of the broader White House Drug Control Strategy. According to recent data from the Centers for Disease Control and Prevention (CDC), there have been an estimated 106,854 drug overdose deaths in the country in the 12 months ending in November 2021, a 15.6% increase from the previous 12-month period (Inside Health Policy, April 21; Reuters, April 21; The Hill, April 21).
• According to a new report from the Center for Healthcare Quality and Payment Reform, Medicare payment reductions via sequestration will disproportionately affect small, rural hospitals due to revenue loss. The report highlighted that more than 600, or one third of rural hospitals in the country, will experience revenue loss due to sequestration and other combined factors of decreasing reimbursements from private insurers, declining COVID-19 relief grants, lower patient volumes, and higher operating costs. The sequestration, under the Pay-As-You-Go Act (PAYGO), reduced Medicare payments by 1% on April 1 and will scale up to 2% on July 1 with an additional 4% reduction expected for 2023. The Medicare sequester under PAYGO is expected to reduce rural hospital revenues by nearly $230 million in 2022. Larger health systems would have more of a buffer as they can shift their resources to other payers and service lines (Modern Healthcare, April 21).

Federal Regulation

• A proposed rule released by CMS on Friday would grant certain Medicare beneficiaries’ access to Part B coverage outside the normal open enrollment periods. Special enrollment periods for Medicare enrollees with exceptional conditions have not been offered previously. The five illnesses or circumstances that would be considered for special enrollment and help improve equity and access are the following:
  • Individuals impacted by an emergency or disaster.
  • Formerly incarcerated individuals.
  • Individuals who were subject to a health plan or employer error that prevented them from enrolling.
  • Individuals who need to enroll after their Medicaid eligibility is terminated.
  • Individuals experiencing “exceptional conditions” (case-by-case basis).

Additionally, CMS proposed modernizing regulations regarding state payments for Medicare Parts A and B premiums for low-income individuals and expanding immunosuppressive drug coverage for kidney transplant patients without other insurance coverage (Modern Healthcare, April 22).

Studies and Reports

• The Government Accountability Office (GAO) released a report on scientific integrity and the need for HHS agencies to develop policies that prevent political pressure from influencing decisions on COVID-19. The GAO examined the Food and Drug Administration (FDA), CDC, the National Institutes of Health (NIH), and the Office of the Assistant Secretary for Preparedness and Response. Some agency employees who were interviewed expressed concern that political pressure could have altered public health guidance on COVID-19. Based on the reports’ findings, the GAO recommends agencies develop and document clear policies to maintain scientific integrity, including guidelines on how to report potential political influence. HHS agreed with the GAO findings and plans to send Congress an action plan addressing the recommendations in the next 180 days (Inside Health Policy, April 21).
• Health Affairs released a research article using analyzed data from CMS and the Service Employees International Union (SEIU) on 13,350 nursing homes between June 8, 2020, and March 21, 2021. Data shows that unionized nursing homes had a 10.8% lower resident COVID-19 mortality rate and a 6.8% lower worker COVID-19 infection rate than non-unionized nursing homes. Healthcare worker unions were present in 16.8% (2,242) of the nursing homes examined and played an important role in advocating for workplace safety. Additionally, unionized facilities were found to have higher registered nurse staff-to-resident ratios and higher rates of Medicaid residents (Modern Healthcare, April 21).