- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Public Inspection: CMS: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- Public Inspection: CMS: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- CMS: Request for Information; Health Technology Ecosystem
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- State: 60-Day Notice of Proposed Information Collection: J-1 Visa Waiver Recommendation Application
- Public Inspection: CMS: Request for Information: Health Technology Ecosystem
- HHS: Request for Information (RFI): Ensuring Lawful Regulation and Unleashing Innovation To Make American Healthy Again
- VA: Solicitation of Nominations for the Appointment to the Advisory Committee on Tribal and Indian Affairs
- GAO Seeks New Members for Tribal and Indigenous Advisory Council
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
Children Need to Catch Up on Recommended Vaccines for School
The Director of the Centers for Disease Control and Prevention’s (CDC’s) National Center for Immunization and Respiratory Diseases recently issued a letter, Help Kids’ Safe Return to School – Get Caught Up on Recommended Vaccines. It asks for help getting children caught up on routine vaccines missed over the last year due to COVID-19. It categorizes specific catch-up efforts that can be undertaken by healthcare systems and healthcare providers, healthcare provider organizations, schools, and state and local government agencies. Other resources of interest on the topic include:
- CDC’s Catch-up Immunization Schedule for Persons Aged 4 Months–18 Years Who Start Late or Who Are More than 1 Month Behind, United States, 2021 gateway page
- IAC’s Repository of Resources for Maintaining Immunization During the COVID-19 Pandemic gateway page
The Immunization Action Coalition (IAC) has also revised its one-page reference table Administering Vaccines: Dose, Route, Site, and Needle Size by adding the COVID-19 vaccines by Pfizer-BioNTech, Moderna and Janssen (Johnson & Johnson).
Pennsylvania Extends License Renewal Deadline for State Board of Medicine
Due to licensees having difficulty meeting the March 31 deadline, Gov. Tom Wolf has granted the Department of State’s request for an additional 30 days to renew for all licensees under the Board of Medicine. This applies to a license that was set to expire on Dec. 31, 2020, that has not yet been renewed. The deadline is now April 30, 2021. Renewal fees were waived by the Board of Medicine due to a funding surplus, but all licensees are required to complete their renewal to retain their license. This will be the final extension for these licensees under the State Board of Medicine. Read more about the license renewal deadline extension.
New Report on FQHCs and Vaccine Equity
A new report by Kaiser Family Foundation (KFF) responds to the question of whether health centers are facilitating equitable access to COVID-19 vaccinations based on data from the HRSA Weekly Health Center COVID-19 Survey. The report finds that:
- Just over half (54%) of people who received their first dose of the vaccine from FQHCs were people of color, including 26% who were Hispanic and 12% who were Black.
- Health centers appear to be vaccinating people of color at similar or higher rates than their shares of the total population, but data suggest there remain opportunities for health centers to reach more of their patients of color.
It’s important to note that the report analyzes data from Jan. 8 through Feb. 6, largely before the start of the HRSA FQHC Vaccine Program that has made vaccine supply more available and predictable for participating health centers. The program has opened opportunities for better planning, outreach and partnership to better reach underserved populations. Read more.
How Does Reimbursement for the COVID-19 Vaccine Work?
COVID-19 vaccine is provided at 100% no cost to the vaccine recipient. COVID-19 vaccination providers cannot charge vaccine recipients for the vaccine (which is provided free by the U.S. government to enrolled providers) or charge recipients any administration fees, copays, or co-insurance. COVID-19 vaccination providers cannot deny vaccination to anyone who does not have health coverage, is underinsured, or is out of network. If a vaccine recipient has health coverage, providers may seek appropriate reimbursement from the recipient’s plan or program (e.g., private health insurance, Medicare, Medicaid) for a vaccine administration fee. However, providers cannot balance bill the recipient. Providers may also seek reimbursement for uninsured vaccine recipients from the Health Resources and Services Administration’s COVID-19 Uninsured Program. COVID-19 vaccination providers cannot charge an office visit or other fee to the recipient if the only service provided is a COVID-19 vaccination. Additional healthcare services can be provided at the same time and billed as appropriate. However, providers cannot require additional services in order for a person to receive a COVID-19 vaccine.
Medicare To Make Lump Sum Payments for COVID-19 Vaccine Administration
Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS will pay you for COVID-19 vaccines and administration at 100% reasonable cost like influenza and pneumonia vaccines. FQHCs will have the option to receive a lump sum adjustment based on the flu and pneumococcal vaccine costs from the most recent cost report or provide 60-90 days of actual COVID-19 vaccine and administration cost data. Contact your Medicare Administrative Contractor (MAC) for more information. Novitas is the MAC for Pennsylvania and their contact email address to request lump sum payments is NovitasReimbursement@novitas-solutions.com. Some Pennsylvania health centers still have National Government Service (NGS) as their MAC for some site locations. For more information from NGS on the lump sum process, visit their website.
Resources on Revisions to SAMHSA 42 CFR Part 2 Rule
A presentation and companion FAQ provide clarification and information about the new SAMHSA guidance for the revised SAMHSA 42 CFR Part 2 Rule. Released in July 2020, the revised rule was designed to improved coordination of care for patients in treatment for substance use disorder (SUD) while protecting their confidentiality against unauthorized disclosure and use of patient health information (PHI). Prepared by the Center of Excellence for Protected Health Information as well as the University of New Hampshire Institute for Health Policy and Practice, answers are provided for common questions that arose during the HITEQ Center’s webinar on Jan. 19, 2021, including clarification on health center specific questions regarding patient consent, telehealth, SUD and medication-assisted treatment (MAT). Access the slides, transcript and FAQs. HITEQ is a HRSA National Training & Technical Assistance Partner, under contract to the Bureau of Primary Health Care to support health centers in full optimization of their IT systems.
CMS Advisory Panel on Outreach and Education Meets
The Centers for Medicare and Medicaid Services (CMS) Advisory Panel on Outreach and Education (APOE) was established to advise the U.S. Secretary of the Department of Health and Human Services (HHS) and CMS concerning strategies for developing and implementing outreach and enrollment programs for individuals enrolled in, or eligible for, Medicare, Medicaid, CHIP, the Health Insurance Marketplace and other CMS programs. Tia Whitaker, PACHC’s Statewide Director for Outreach and Enrollment, was appointed to the panel in 2019 representing Community Health Centers. The APOE met on March 31 to discuss COVID-19 therapies, Medicare COVID-19 research and outreach and new cost savings available to consumers accessing healthcare coverage through the Federal and State-based Marketplaces from the American Rescue Plan Act. Presentations from Meredith K. Chuk, MD, lead for the COVID-19 Therapeutics Team, HHS Office of Assistant Secretary for Preparedness and Response, Chris Koepke, Ph.D., Director of the Strategic Marketing Group, Office of Communications, CMS, and Laura Salerno, Deputy Director of the Strategic Marketing Group, Office of Communications, CMS, focused on messaging, branding, outreach tactics, strategies and target populations to educate consumers and market COVID-19 therapies, reduce vaccine hesitancy and make consumers more aware of the availability of health insurance through the state and federal marketplaces.
New Guidance to Pennie Enrollment Assisters
Pennie’s Board of Directors approved a COBRA Special Enrollment Period (SEP) for those who are eligible for the COBRA subsidy under the American Rescue Plan Act (ARPA) and will receive 100% subsidy for their COBRA premium from April 1, 2021 to Sept. 30, 2021. The SEP will be available after the COBRA subsidy comes to an end.
- When the ARPA COBRA subsidy for a qualified individual runs out on Sept. 30, 2021, they can contact Pennie and open a COBRA special enrollment period (SEP) with a cost-sharing reduction (CSR), providing them with 60 days to secure coverage. The customer can begin reviewing plans Aug. 2nd in accordance with the SEP.
- Under the COBRA SEP, a customer will qualify for the maximum advance premium tax credit (APTC) as provided under ARPA for those claiming unemployment for at least one week, regardless of whether they collect unemployment compensation benefit payments. The exception – a person who has been discharged from their employer and ineligible for unemployment.
- If the customer transitions from the COBRA SEP to 2021 coverage with Pennie and seeks to continue coverage through Pennie for Plan Year 2022, enhanced subsidies due to unemployment in 2021 will NOT continue in 2022; however, the general ARPA subsidies will apply in 2022.
Bipartisan Bill Introduced to Allow NAP funds to Be Used for Mobile Vans and Facilities
On Thursday, March 25, Senators Jacky Rosen (D-NV) and Susan Collins (R-ME) introduced the Maximizing Outcomes through Better Investments in Lifesaving Equipment for (MOBILE) Health Care Act. This bipartisan legislation would allow New Access Point (NAP) funding to be used to acquire, expand, or renovate mobile medical equipment or vehicles, particularly to establish new delivery sites in areas that lack the population base to support a full-time CHC site. It would also allow NAP funds to be used for leasing, expanding, or renovating an existing health center building or constructing a new one. NACHC has endorsed the bill.
Several Key HHS Appointments Still Pending
Since Department of Health and Human Services (HHS) Secretary Xavier Becerra was confirmed by the Senate on March 18, nominations for several other key HHS officials have been confirmed: The Senate voted to confirm Vivek Murthy, MD, as Surgeon General on March 23 and former Pennsylvania Health Secretary Rachel Levine, MD, was confirmed on March 24 as Assistant Secretary of Health. However, there is no new information on when the Senate will hold a confirmation for Ms. Chiquita Brooks-LaSure, who has been nominated to serve as CMS Administrator. There is also no word on who will be nominated for the position of HRSA Administrator.