- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- Announcing the 2030 Census Disclosure Avoidance Research Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- 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
Licensing Tools for Health Professionals
The Federal Office of Rural Health Policy (FORHP) has created the following web-based tools for certain health professions:
- Online Resource for Licensure of Health Professionals. As telehealth usage increased during the pandemic, FORHP funded new work with the Association of State and Provincial Psychology Boards to reduce the burden of multi-state licensure. The site provides up-to-date information on emergency regulation and licensing in each state for psychologists, occupational therapists, physical therapists assistants and social workers.
Mobilizing Health Care Workforce via Telehealth. ProviderBridge.org was created by the Federation of State Medical Boards through the CARES Act and the FORHP-supported Licensure Portability Grant Program. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities.
COVID-19 Increases Long-term Heart Risks
A large-scale scientific study of U.S. veterans found that coronavirus patients were at “substantial” risk of heart disease one year after their illness, increasing the odds of clots, arrhythmias, heart failure and related conditions. Read more.
COVID-19 Can Destroy Placenta and Lead to Stillbirths
New research bolsters evidence from small case reports and confirms that placenta damage rather than an infection of the fetus is the likely cause of many COVID-19-related stillbirths. Researchers in 12 countries, including the U.S., analyzed placental and autopsy tissue from stillbirths and newborns who died shortly after birth. The cases all involved unvaccinated women who had COVID-19 during their pregnancy. Researchers found that placentas were infected and extensively destroyed. Read more.
The Science is Clear: Racism is a Public Health Threat
On February 7, Health Affairs published a special issue highlighting the impact of structural racism on America’s health and healthcare—featuring new research on racial health disparities and the policies to address structural racism. Understanding and addressing the impact of racism, particularly structural racism, on health is essential to building equity in health. Read the full special issue.
Contract Pharmacy Restrictions Implemented
This week, GlaxoSmithKline (GSK) announced that it is implementing contract pharmacy restrictions under 340B. Fortunately, (and despite the somewhat confusing wording in the announcement) all FQHCs and other Federal “grantees” are exempted from these rules. GSK marks the 14th drug maker to implement 340B contract pharmacy restrictions and the 10th to explicitly exempt Federal “grantees” (which includes both FQHC grantees and look-alikes). Notably, GSK has informed hospitals that they can avoid the contract pharmacy restrictions if they provide data about their 340B drugs to the 340BESP website.
Share Lifeline with Qualified Patients
Lifeline is a federal government program that offers a monthly discount on phone, internet, or bundled package bills to qualified low-income people, which can give them the tools to access services like telehealth. Customers living on Tribal lands can receive an additional benefit.
Special Enrollment Period
In 2021, the Pennie Board of Directors approved a Low-Income Special Enrollment Period (SEP) for individuals and dependents with household incomes that do not exceed 150% of the Federal Poverty Levels in accordance with the 2022 Notice of Benefit and Payment Parameters. These monthly SEPs are available for both new and current enrollees. New enrollees can enroll in a plan in any metal level now. Soon, Pennie will announce current enrollees can move to a silver-level plan. This SEP is available while subsidies under the American Rescue Plan remain in effect.
Insurance Commissioner Leaves Pennsylvania
Jessica Altman, Pennsylvania’s Insurance Commissioner, was named as new CEO of Covered California the state’s health insurance marketplace for ACA coverage. She serves as the Insurance Commissioner and chair of the Pennsylvania Health Insurance Exchange (Pennie) Authority Board of Directors. She also holds a leadership position with the National Association of Insurance Commissioners and is chair of the Health Insurance and Managed Care Committee. Mike Humphreys, Chief of Staff at the Pennsylvania Insurance Department, will fill Jessica’s position on the Pennie Board. Pennsylvania is the 5th largest insurance market in the nation.
Get Connected Through Lifeline
Get Connected Through Lifeline is a Federal program which offers a monthly discount on phone, internet, or bundled package bills to qualified low-income people, that can give them the tools to access services like telehealth. Customers living on Tribal lands can receive an additional benefit: https://www.lifelinesupport.org/tribal-benefit/
Diabetes Standards of Care
The American Diabetes Association (ADA) recently released its much-anticipated annual Standards of Medical Care in Diabetes. Based upon the latest scientific diabetes research and clinical trials, Standards of Care is the gold-standard for professionals in the medical field and includes vital new and updated practice guidelines to care for people with diabetes and prediabetes. Read the full ADA press release and access additional guidelines and tools for health care professionals on their professional website, DiabetesPro.