- 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
ACG Updates Colorectal Cancer Guidelines
A recent MedPage article states that the American College of Gastroenterology (ACG) has updated their colorectal cancer (CRC) guidelines that they last issued in 2009. The decision was made due to data on colorectal cancer (CRC) screening gathered over the past decade. The new recommendations, published online in the American Journal of Gastroenterology, state that screening should start at age 45 for persons of average risk.
CHWs and Peer Specialists Helping to Address Diabetes Control
A new issue brief showcases the important role of front-line community health workers (CHWs) and peer specialists in leveraging connections with their communities for diabetes control in response to demand and challenges of the COVID-19 health pandemic. MHP Salud and the Corporation for Supportive Housing (CSH), both HRSA-funded National Training and Technical Assistance Partners (NTTAPs), developed the brief.
The Power of the First Impression
The COVID-19 pandemic has reshaped how physicians are being recruited. But whether a first interview is on-site or virtual, it still is critical to master that interview and deliver a first-time “WOW” experience for the right candidate. Jackson Physician Search, in an article on its website, says the first interview is so powerful because first impressions stick and often overwhelm second and third impressions. “It may seem counterintuitive, but follow-up interviews do not necessarily increase the candidate’s feelings of confidence about the job and the likelihood that an offer will be accepted,” the article states.
Pandemic Fueling Interest in Public Health Careers
The COVID-19 pandemic has tested the public health and medical workforces like never before. And yet people in those fields say they see emerging signs that the crisis will inspire the next generation of doctors, nurses, and public health professionals to join the ranks. Public health schools, for example, saw a 23 percent jump in applicants for master’s and doctoral programs from fall 2019 to fall 2020, and are reporting an even bigger increase so far in this application cycle, according to the Association of Schools and Programs of Public Health.
COVID-19 Vaccine Administration Rates Adjusted
The Centers for Medicare and Medicaid Services (CMS) announced it is updating the Medicare payment rates for COVID-19 vaccine administration. Effective for services furnished on or after March 15, 2021, the new rate will be approximately $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for a single-dose vaccine, and $45 to $80 for vaccines requiring two doses. Exact payment rates depend on the type of entity furnishing the service and will be geographically adjusted based on where the service is furnished. To read more, click here. It is important to note that Medicare vaccine administration payment for FQHCs at the current time will still occur retroactively with the cost report. Also, whether this CMS payment change will also result in a payment increase by Medicaid is still being evaluated by the PA Department of Human Services (DHS). As shared previously, DHS is working on an FQHC/RHC-specific COVID-19 vaccine payment bulletin which has not yet been released but has shared some of the payment policy it will implement with PACHC:
- For fee-for-service (FFS) billing, PROMISe has been updated to allow FQHCs/RHCs to bill using the administrative codes identified in bulletin Medical Assistance Bulletin 01-20-59, Addition to the Medical Assistance Program Fee Schedule for Administration of SARS-CoV-2 Vaccines. DHS directs that you use your PT/Spec and POS.
- For HealthChoices Medicaid managed care plans, you will need to check with your contracted MCOs on how to bill.
- DHS is in the process of requesting CMS approval to use an alternate payment methodology (APM) for all COVID-19 vaccines administered outside of defined requirements for a T1015 visit/encounter billing. (PACHC Note: In other words, if a vaccination visit meets the definition of eligible FQHC/RHC encounter the visit is billable as a PPS encounter and you do not bill for the vaccine administration separately). The APM would pay vaccinations that are not part of an eligible FQHC encounter at Medicare rates.
- DHS is directly reimbursing the MCOs for the cost of vaccine administration and expects that MCOs will reimburse at least what DHS is reimbursing. However, FQHCs need to check with each of your MCOs on how they will handle vaccine administrative billing.
Health Alert Network Updates
The Pennsylvania Department of Health has issued several Health Alert Network (HAN) updates in the last week.
- Updated Quarantine Recommendations for Persons Exposed to COVID-19: This guidance replaces PA-HAN-538 and PA-HAN-551 and provides clarification on quarantine recommendations for persons exposed to COVID-19. This guidance provides information about the need for quarantine for both individuals who are and are not fully vaccinated.
- Work Restrictions for Healthcare Personnel with Exposure to COVID-19: The existing guidance on how to evaluate and respond to exposure of healthcare personnel (HCP) to COVID-19 in the healthcare setting has not changed, but additional items have been added to this guidance to clarify the post-exposure recommendations.
Click here for all 2021 Health Alerts, Advisories and Updates.
Quarterly 340B Program Registration Opens April 1
Quarterly 340B Program site registration is open from April 1 to 15. Health centers will be able to register a site that has been verified as implemented and with a site status reflected as “active” in EHB Form 5B through Friday, May 28. After that date, the system will close to prepare for the July 1 start. Email the 340B Prime Vendor Program or call 888-340-2787 (Monday-Friday, 9:00 am – 6:00 pm) to register a new site or ask questions. You will need to provide the following information when calling: health center name, site/clinic name, site IDs for all sites, HRSA/BPHC grant number, contact name and email address and authorizing official name and email address.
Updates to the Pennie Website
Pennie has made some design changes to its website, Pennie.com:
- The “Connect” tab has been renamed to “Support”
- Under the tab customers can request help from a Pennie CSR, Broker, or Assister
- Customers can send messages directly to Pennie
- Customers have access to the top Frequently Asked Questions
- Under the SHOP option at pennie.com, there is now a “Calculate Your Savings” option that uses the Kaiser Family Foundation Tool.
- Under the LEARN option at pennie.com, there are FAQs that help customers regarding the American Rescue Plan Act of 2021, COVID-19 and data matching issues.
Pennie Issues Joint Statement on ARPA
On March 11, 2021, the Pennsylvania Insurance Department and Pennie, Pennsylvania’s health insurance marketplace, issued a joint statement on the American Rescue Plan Act of 2021.
“The American Rescue Plan Act of 2021 will not only provide financial assistance through the forthcoming stimulus checks but will also provide an estimated $270 million in additional subsidies to current Pennie™ customers in 2021 alone. Through this law, marketplace premiums will be capped at 8.5% of a household’s income, meaning current Pennie™ customers will see lower monthly premiums and those without coverage or who were previously ineligible will now have access to financial help if they shop at pennie.com. In some cases, lower-income enrollees will have their monthly premiums eliminated entirely. Additionally, anyone who was eligible for unemployment income in 2021 will be eligible for coverage through Pennie™ with a $0 premium for the remainder of the year.
These changes allow Pennie™ to further support current customers and delivers an extraordinary opportunity for individuals seeking coverage to protect themselves and their families as we continue to grapple with the impacts of COVID-19. We will move quickly to implement these changes in the interest of delivering this financial relief as expeditiously as possible.”
Senate Confirms Becerra to Lead HHS
The Senate voted 50-49 to confirm Xavier Becerra as secretary of the Department of Health and Human Services (HHS). Becerra, the first Latino to lead HHS, is charged with overseeing the country’s pandemic response while executing the Biden administrator’s health agenda. The vote to confirm Becerra was delayed due to concerns with his lack of healthcare experience, past support for Medicare for All, and abortion. Others were concerned that further delay would hinder the country’s pandemic response. Becerra is currently serving as California’s Attorney General, leaving another appointment up to California Gov. Gavin Newsom. In a tweeted statement following his confirmation, Becerra said he is “honored and humbled by the vote” and “ready to get to work.”