In March 2020, the Centers for Medicare & Medicaid Services (CMS) temporarily waived certain eligibility requirements for Medicaid and the Children’s Health Insurance Program (CHIP) to help people keep their health coverage during the pandemic.  Last  year, CMS announced states would have to return to normal eligibility and enrollment operations once the official Public Health Emergency (PHE) had ended – a process referred to as “unwinding.”  Last week, it was announced that the PHE would be extended by another 90 days to mid-April.  However, new legislation calls for eligibility waivers and other pandemic-related flexibilities to end on March 31, 2023.  See the communications toolkit for a plain-language explanation that will help both policymakers and beneficiaries understand Unwinding, and attend monthly webinars (Events section, below) held by CMS to get help with the process.

  Clinicians no longer need DATA 2000 Waiver training to prescribe buprenorphine; however, the payment program to defray earlier training costs is still active.  Launched in June 2021, the initiative pays for providers who previously received a waiver to prescribe buprenorphine, a medication used to treat opioid use disorder.  Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who previously trained to obtain the waiver necessary to prescribe buprenorphine after January 1, 2019.  Approximately $900,000 in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted.  Send questions to DATA2000WaiverPayments@hrsa.gov.

Last week, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced it will no longer require nor accept applications for the DATA 2000 Waiver previously needed to prescribe the drug most frequently used for the treatment of opioid use disorder (OUD).  All practitioners with a current DEA registration that includes prescribing authority for Schedule III substances may now prescribe buprenorphine for OUD if permitted in the state where they practice.  The change comes from Section 1262 of the Consolidated Appropriations Act, 2023, which removes the federal requirement for practitioners to submit a Notice of Intent to prescribe medications for the treatment of OUD.

The omnibus budget bill passed by Congress last month included a two-year telehealth extension. The goal is to give regulators more time to determine which flexibilities should be made permanent.

Black medical trainees were far more likely to carry a heavier debt burden than their peers in other racial and ethnic groups, a study published yesterday in Health Affairs found. Differences In Debt Among Postgraduate Medical Residents By Self-Designated Race And Ethnicity, 2014–19 finds that efforts to diversify the healthcare workforce — which has been tied to improved patient care and outcomes — have fallen short, even as recognition of the merits grows. Among the most intractable hurdles are the costs of medical school, including the add-on expenses. The study was led by the Icahn School of Medicine at Mount Sinai, and researchers examined the association between race and debt among roughly 121,000 medical residents between 2014 and 2019. “Scholarships, debt relief, and financial guidance should be explored to improve diversity and inclusion in medicine across specialties,” the authors write.

Would you like help to pay off your loans? The Nurse Corps Loan Repayment Program provides loan repayment to nurses in exchange for a minimum two-year full-time service commitment, at an eligible healthcare facility with a critical shortage of nurses or an eligible school of nursing. Community Health Centers automatically qualify as sites for Nurse Corps. To be eligible you must be a licensed registered nurse, advanced practice registered nurse, such as a nurse practitioner; or nurse faculty member and you received your nursing education from an accredited school of nursing located in a U.S. state or territory. You must also work full-time in either: an eligible critical shortage facility in a high-need area; or an eligible school of nursing. Applications will be accepted through Thursday, Feb. 23, at 7:30 pm. For more information review the Fact Sheet and read the Application & Program Guidance. Application assistance webinars will be held on Thursday, Jan. 26 from 2:00-3:30 pm via Zoom and Wednesday, Feb. 15, 2:00-3:30 pm via Zoom.

The U.S. needs more people, whether through Americans having more babies or more immigrants settling in this country, a new report, “Economic Policy in a More Uncertain World,” concludes. The report from an arm of the Aspen Institute led by two former Treasury Secretaries avers that failure to increase the U.S. population is among the biggest economic risks for the years and decades ahead. For much of the 21st century, a lack of adequate demand has been a predominant challenge, but now the central challenge is supply: improving the ability of the economy to make stuff. Worsening demographic trends imply persistent labor shortages, slumping growth, and struggles to fund Social Security and other retirement programs. The U.S. fertility rate has fallen sharply since 2007 and is well below the “replacement rate” that implies a steady population, in the absence of immigration. The “total fertility rate,” the average number of children born to a woman over her lifetime, was 2.12 in 2007 and dropped down to 1.65 in 2021, the lowest ever recorded in the U.S.