Rural Health Information Hub Latest News

Pharmacy Benefit Manager Fees Regulated

On December 14, 2021, the Centers for Medicare and Medicaid Services (CMS) unexpectedly issued a letter to U.S. Senator Ron Widen (D-OR) indicating that CMS plans to use its “administrative authority to issue proposed rulemaking” addressing price concessions and direct and indirect remuneration (DIR) fees that pharmacy benefit managers (PBMs) have increasingly charged to specialty and retail pharmacy providers in Medicare and other pharmacy benefit programs in recent years. The proposed regulation was issued on January 12.

Water Assistance Program Applications Available

The Low-Income Household Water Assistance Program (LIHWAP) is a temporary emergency program to help low-income families pay overdue water bills. LIHWAP is a grant. Recipients do not have to repay it. LIHWAP crisis grants may be available if an individual and/or household has an emergency and are in jeopardy of losing their water service. Eligible recipients can receive one crisis grant for their drinking water service and one crisis grant for their wastewater service, up to $2,500 each. Click here for more information about the program or how to apply.

Preventive Care Guidelines Mean Improved Coverage

The U.S. Department of Human Services, through the Health Resources and Services Administration (HRSA), has updated comprehensive preventive care and screening guidelines for women and for infants, children and adolescents. Under the Affordable Care Act, certain group health plans and insurance issuers must provide coverage with no out-of-pocket cost for preventive health services within these HRSA-supported comprehensive guidelines. Among a number of updates, for the first time the guidelines will require such group health plans and insurance plans to provide coverage without a co-pay or deductible for double electric breast pumps. Read more.

Health Center Volunteer Health Professional Program

The Senate HELP Committee released a discussion draft of the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act). This legislation focuses on strengthening the nation’s public health and medical preparedness and response systems in the wake of the COVID-19 pandemic. In particular, the bill includes language that removes the current statutory expiration date for the Health Center Volunteer Health Professionals Program. Currently, more than 100 health centers utilize more than 500 volunteer providers through the program. NACHC has pushed for an extension given the ongoing workforce shortages that many health centers are facing. A section-by-section summary and full text are available. The Senate HELP Committee is accepting comments on the draft through February 4, 2022, and could move to mark up the legislation after reviewing stakeholder feedback.

Build Back Better Act and Appropriations Continue

President Biden expressed support last week for breaking up the Build Back Better Act into smaller pieces of legislation. However, this strategy is problematic since the bill was designed to be passed using reconciliation, which can only be used a limited number of times per year and avoids a filibuster in the Senate by requiring only 51 votes. Republicans have resisted negotiating an omnibus FY22 with the BBB Act unresolved, and House and Senate appropriators have struggled to overcome issues in determining top-level funding numbers and including policy riders, like the Hyde Amendment. Another continuing resolution (CR) after the current one ends on February 18, 2022, is possible as House and Senate appropriators work to strike a deal. Congress is also considering including additional supplemental COVID-19 relief funding as well as telehealth flexibility extensions in an omnibus appropriations bill.

Waivers Extended

The state Senate passed SB 1019 this week by a 49-0 vote. Introduced by Senator Michelle Brooks, the legislation would further provide for COVID-19 regulatory flexibility authority, essentially extending some of the waivers and require the Departments to submit reports to the legislature by May 31, 2022, of any waived rules or regulations that should be made permanent.