McDermottPlus June 12: HHS, COVID-19 Funding

This Week’s Dose

Following weeks of strain from stakeholders and lawmakers, the Division of Well being and Human Providers (HHS) introduced extra distributions from the Supplier Reduction Fund focused to Medicaid and “security internet” suppliers. HHS additionally introduced extra hotspot funding. Senate Well being, Training, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) is in search of suggestions on pandemic preparedness proposals.

Congress

Home Democrats Current an Formidable Summer season Agenda. The Democratic management of the Home of Representatives has outlined legislative objectives they hope to perform earlier than the scheduled August recess. Home Majority Chief Steny Hoyer (D-MD) has mentioned that the chamber will vote in July on laws to increase the Reasonably priced Care Act to mark the regulation’s 10th anniversary (March 24, 2020). The chamber will even vote this month on the Justice in Policing Act, which follows nationwide protests towards racism and police brutality. Hoyer additionally desires to advance an infrastructure package deal, annual appropriations payments, and extra coronavirus (COVID-19) aid laws. The Home is presently scheduled to conduct distant committee work till June 25, giving lawmakers only some weeks to finish this formidable agenda. The GOP managed Senate can be targeted on assembling regulation enforcement reform laws, however Majority Chief Mitch McConnell (R-KY) has mentioned the Senate is not going to take up one other COVID-19 aid package deal earlier than the July four recess, establishing a crucial two-week interval on the finish of July when each chambers might be in session. Anticipate negotiations on these varied proposals to ramp up within the coming weeks.

HELP Committee Chairman Launched White Paper on Pandemic Preparedness. The white paper from HELP Committee Chairman Lamar Alexander (R-TN) contains quite a lot of suggestions for the nation to organize for the following pandemic, together with accelerated analysis and improvement of checks and coverings, expanded illness surveillance, rising surge capability, bettering public well being capabilities, and bettering interdepartmental coordination. Chairman Alexander is in search of suggestions on proposals that Congress can think about and act on this yr. Responses are requested by June 26, 2020.

Administration

HHS Introduced Supplier Reduction Fund Distributions for Medicaid, Security Internet and Hotspot Suppliers. The Division will distribute roughly $15 billion to Medicaid suppliers who didn’t beforehand obtain funds from the Fund’s $50 billion Common Distribution. Suppliers should apply by means of a web-based portal by July 20, 2020. The software kind requires considerably extra data from Medicaid suppliers than HHS required from Medicare fee-for-service (FFS) suppliers, together with calculating misplaced revenues because of COVID-19, payer combine data, and another funding acquired by means of the Paycheck Safety Program. As well as, HHS allotted $10 billion to “security internet” hospitals and one other $10 billion to hospitals in “hotspots” (areas extremely affected by the COVID-19 outbreak). HHS beforehand allotted $12 billion to hotspot hospitals on Might 1, 2020. Extra particulars on this distribution can be found in these continuously requested questions. With this distribution, HHS has dedicated roughly $112.6 billion from the Fund, with $62.four billion remaining accessible to be distributed. Even with these bulletins, lawmakers are nonetheless pushing for extra distributions. Bipartisan management of the Senate Finance and Home Power and Commerce committees counseled the Medicaid distribution however urged HHS to offer extra funds for suppliers who depend on this system. 

 

CMS Launched New Steering on In-Individual Care. The Facilities for Medicare and Medicaid Providers (CMS) issued steering for healthcare amenities and sufferers in states which have moved to Section II of the Administration’s Tips for Opening Up America Once more. Throughout Section II, CMS recommends that amenities resume non-emergent however clinically obligatory care, whereas sustaining separate zones for screening and therapy of COVID-19 sufferers. Suppliers are instructed to prioritize look after at risk-populations and care that, if deferred, would trigger hurt for the sufferers. In its steering for sufferers, CMS calls for people to renew obligatory care whereas training virus mitigation methods and using digital visits. As healthcare amenities reopen, stakeholders might want to proceed to speak the info on the bottom about restoration to lawmakers and the Administration.

 

CMS Proclaims Second Cohort for Direct Contracting Mannequin. As a part of the fee mannequin flexibilities introduced final week in response to COVID-19, CMS introduced that the primary efficiency yr of the Direct Contracting mannequin for the Skilled and World choices will now start April 1, 2021, and a second cohort will start January 1, 2022. The adjusted timeline affords stakeholders extra time to evaluate the mannequin and to make participation selections, in addition to to share suggestions with CMS and the Heart for Medicare and Medicaid Innovation concerning the mannequin design. By transferring forward with the mannequin in 2021, the Administration retains momentum for the motion to value-based care and capitation. The COVID-19 pandemic has uncovered the issues and financial dangers inherent within the FFS system as quantity fell, and lots of supplier organizations confronted severe monetary shortfalls. Fashions like Direct Contracting, which embody capitated fee of some quantity of funding, might turn out to be extra enticing as organizations consider the teachings discovered from COVID-19 and put together for the way forward for healthcare supply and reimbursement. We define key concerns for entities contemplating participation within the Direct Contracting mannequin right here. 

 

ONC Seeks Suggestions for Digital Well being Document Reporting Program. The 21st Century Cures Act directed HHS to ascertain a brand new Digital Well being Document (EHR) Reporting Program. The Workplace of the Nationwide Coordinator for Well being IT (ONC) contracted with the City Institute to develop this system. The EHR Reporting Program will present publicly accessible, comparative data on licensed well being IT merchandise that can inform well being IT customers’ buying and implementation selections. This system will mirror builders’ and voluntary finish customers’ reporting of comparative data on licensed well being IT. This 60-day public suggestions interval focuses on the draft voluntary user-reported standards.

States

Missouri, Oklahoma Will Vote on Medicaid Enlargement This Summer season. This week, a Missouri appeals court docket dominated that the state’s referendum to increase Medicaid may stay on the poll within the state’s major election this August, rejecting the argument from conservative teams that the measure violates the state structure. If authorized, the Missouri referendum would increase Medicaid to people with incomes as much as 138% of the federal poverty line (FPL) (presently, the earnings cap for non-disabled adults in Missouri is 22% of the FPL). Oklahoma additionally will vote on the finish of June on a poll measure to increase Medicaid. The vote comes because the state continues to hunt CMS approval on a Part 1115 demonstration waiver that may set up a block grant funding construction for the state’s Medicaid program and impose extra eligibility necessities. Oklahoma beforehand sought to increase Medicaid starting July 1, 2020, coupled with the block grant proposal, however withdrew the growth request final month, citing the elevated prices ensuing from COVID-19. The block grant proposal remains to be pending CMS approval, however might be rendered moot if the poll measure passes. The poll initiative would prohibit the state from imposing any extra restrictions on enrollment or eligibility, similar to premiums or work necessities, which the 1115 demonstration proposal contains. 

Fast Hits

The Senate Homeland Safety and Governmental Affairs, Home Oversight and Reform and Senate Growing older Committees held hearings on the federal government’s procurement and distribution methods in response to COVID-19, supporting important staff, and combating isolation amongst seniors.

Chairman Chuck Grassley (R-IA) and Rating Member Ron Wyden (D-OR) of the Senate Finance Committee despatched a letter urging HHS to create a complete public database of funds distributed to healthcare suppliers by means of the CARES Act. 

Chairman James Clyburn (D-SC) introduced the workers of the Home Choose Subcommittee on the Coronavirus Disaster.

A bipartisan group of greater than 80 Home members despatched a letter to congressional management, calling for $75 billion to fund testing and tracing of COVID-19 within the subsequent aid package deal, with a deal with underserved communities.

Thirty bipartisan Home members despatched a letter urging HHS to distribute a portion of the emergency funding appropriated by Congress for COVID-19 testing on to scientific laboratories.

HHS issued a Request for Info on the makes use of of information and public-private partnerships to strengthen the healthcare system. HHS will settle for public feedback by means of July 8, 2020.

HHS launched a truth sheet on methods the federal government is working to deal with the disproportionate affect of COVID-19 on minority communities. 

Subsequent Week’s Prognosis

The Senate HELP Committee will maintain a listening to on classes discovered from increasing telehealth providers throughout COVID-19.