- 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
State Strategies to Support Substance Use Disorder Treatment in the Primary Care Safety Net
The National Academy for State Health Policy (NASHP) released a toolkit, “State Strategies to Support Substance Use Disorder Treatment in the Primary Care Safety.” It features lessons learned from five states (Alabama, Illinois, South Dakota, Virginia, and Wisconsin) that strengthen the capacity of health centers to deliver substance use disorder care.
The toolkit was produced through HRSA’s cooperative agreement with National Organizations of State and Local Officials.
Ending the HIV Epidemic Through Community Engagement
The Association for State and Territorial Health Officials (ASTHO) published a blog post that outlines the importance of community engagement in addressing the severe disparities in new HIV diagnoses as a part of the Ending the HIV Epidemic: A Plan for America.
The toolkit was produced through HRSA’s cooperative agreement with National Organizations of State and Local Officials.
Vaccine Administration for Those Without Health Care Coverage
Health care providers who have conducted COVID-19 testing, provided treatment for uninsured individuals with a COVID-19 diagnosis, and/or incurred vaccination administration fees on or after February 4, 2020 can request claims reimbursement through the HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured program.
More than $2.8 billion in claims have been paid for COVID-19 testing and treatment of uninsured individuals. Get started today to receive reimbursement typically within 30 working days.
Request for Medicare Payment Advisory Commission (MedPAC) Nominations
The Medicare Payment Advisory Commission (MedPAC) is a nonpartisan legislative branch agency that provides the U.S. Congress with analysis and policy advice on the Medicare program. GAO is now accepting nominations for MedPAC appointments that will be effective May 2021. Nominations should be sent to MedPACappointments@gao.gov. Letters of nomination and resumes should be submitted no later than February 12, 2021, to ensure adequate opportunity for review and consideration of nominees prior to appointment.
Pennsylvania 2021 Nonprofit Security Grant Fund Program Now Open
Penn State Extension is partnering with the Adams County Food Policy Council to offer a webinar titled Governor Tom Wolf announced today the availability of $5 million in funding for security enhancement projects for nonprofit organizations serving diverse communities throughout the commonwealth.
Administered by the Pennsylvania Commission on Crime and Delinquency (PCCD), the Nonprofit Security Grant Fund Program issues grants to 501(c)(3) nonprofit organizations that principally serve individuals, groups or institutions that are included within a bias motivation category for single bias hate crime incidents as identified by the FBI’s Hate Crime Statistics publication. Applicants are eligible for security enhancements designed to protect the safety and security of the users of a facility located in the commonwealth that is owned or operated by the nonprofit organization.
“These grants expand the school safety and security grants introduced in 2019,” Gov. Wolf said. “And will continue to help our many nonprofits address security needs and any safety concerns that exist for religious, social and other nonprofit organizations across the commonwealth.”
Applicants can find the application and information about the Program on PCCD’s website at http://www.pccd.pa.gov. Grant awards can range from $5,000 to $150,000 for a wide variety of eligible items, including:
- Safety and security planning and training;
- Purchase of safety and security equipment and technology;
- Upgrades to existing structures that enhance safety and security; and
- Vulnerability and threat assessments.
The application period will be open for a 30-day window from Monday, January 4 to Wednesday, February 3. Applications will be reviewed on a rolling basis by a PCCD-established workgroup comprised of representatives of PCCD, the Pennsylvania State Police, and the Governor’s Office of Homeland Security, with awards being considered at the March 10 PCCD meeting.
Questions regarding the Program and the application process should be forwarded to: RA-CD-NPSEC-GRANT@pa.gov.
DentaQuest Partnership Releases New Oral Health Report
The DentaQuest Partnership released a report, “Public Health Dental Providers Embrace COVID-19-Related Changes.” This new report outlines how dental public health providers are taking strategic action in response to COVID-19. The report also discusses how some dental providers are preparing for long-term changes expected beyond the pandemic.
Analyzing Changes in Employment During the COVID-19 Recession by Education, Race, Ethnicity, and Gender
The current recession has had a disproportionate impact on lower-wage jobs and the workers who hold them. Because workers of color and women are overrepresented in the nation’s lower-wage economy, this recession has the potential to impact some groups of workers more severely than others.
Focusing on Pennsylvania, New Jersey, and Delaware, this new research explores recent changes in employment by residents’ education, race, ethnicity, and gender. Overall, the employment rate — or the share of working-age residents employed — fell by roughly 8 percentage points between May 2019–October 2019 and the same period in 2020, from 76.5 percent to 68.4 percent. Employment rate declines approached or exceeded 20 percentage points for three groups of workers with no more than a high school diploma: Black men, Black women, and Hispanic women. White men, regardless of their educational attainment, experienced much more modest declines, as did both Hispanic men and White women with at least some college education. The underlying drivers of these uneven outcomes, including the potential roles played by occupational segregation, labor market discrimination, and access to affordable, high-quality childcare, should be explored in order to ensure the economic recovery is not only full but also equitable.
This report is the latest in our Equity in Recovery series, which looks at the workers, small businesses, and places most affected by economic disruption caused by the COVID-19 pandemic. For additional resources on COVID-19 and the economy, visit our website.
Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Suspended Through March
The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31. The Consolidated Appropriations Act, 2021, signed into law on December 27, extends the suspension period to March 31, 2021.
Pennsylvania Health Secretary Signs Order Directing Vaccine Access for Health Care Personnel
Pennsylvania Secretary of Health Dr. Rachel Levine today signed an order directing that a percentage of all vaccine distributions to hospitals, health systems, federally qualified health centers (FQHCs) and pharmacies be designated for health care personnel within Phase 1A, including those health care personnel working in Emergency Medical Services, that are not affiliated with a hospital or health system. This order goes into effect January 6, 2021.
“Getting Pennsylvanians immunized with a safe and effective COVID-19 vaccine is an essential step in reducing the number of virus-related cases, hospitalizations and deaths, including all those who continue to take care of us,” Dr. Levine said. “There are nearly one million health care personnel across the commonwealth who work directly or indirectly with patients and are eligible for vaccine initially. The department will continue to follow and update our COVID-19 interim vaccination plan to address how and when all Pennsylvanians can receive their vaccine.”
Health care personnel are defined by the Advisory Committee on Immunization Practices as paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials. This may include, but is not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, direct support professionals, clinical personnel in school settings or correctional facilities, contractual staff not employed by the health care facility, and persons (e.g., clerical, dietary, environmental services, laundry, security, maintenance, engineering and facilities management, administrative, billing, and volunteer personnel) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted among from health care personnel and patients.
Interested health care personnel not affiliated with a hospital or health system should take the following steps to ensure they can receive the vaccine:
- Review the COVID-19 interim vaccination plan, including Phase 1A sub-prioritization guidance;
- Talk with their employer to identify which type of enrolled COVID-19 vaccine provider is most appropriate;
- Find a participating location if their employer does not assign one;
- Be patient with providers;
- Schedule full vaccine regimen; and
- Provide necessary documentation when being vaccinated.
This order requires providers to designate at least 10 percent of each vaccine shipment received for vaccination of Phase 1A non-hospital affiliated health care personnel.
The Pfizer-BioNTech COVID-19 vaccine and Moderna COVID-19 vaccine will be distributed as outlined in Pennsylvania’s COVID-19 Interim Vaccination Plan.There are three phases to vaccinate residents across the commonwealth. The first phase is broken out into three parts starting with 1A for all health care personnel and those working and living in long-term care facilities.
“The vaccination process will take time. We need Pennsylvanians, including health care personnel to be patient as we continue to get the vaccine into the hands of the right people at the right time so we can protect against COVID-19,” Dr. Levine said. “We appreciate the work of our health systems, hospitals, FQHCs and pharmacies for their partnership on this effort to ensure all health care personnel can receive the vaccine. We are hopeful as we move forward, additional vaccines trials will be completed and receive an Emergency Use Authorization, enhancing the number of vaccines we receive.”
You can find more information regarding the COVID-19 vaccine, guidance and fact sheets for health care personnel and enrolled providers related to this order and the COVID-19 Interim Vaccination Plan at the Department of Health’s website here.
HHS Releases Advisory Opinion Clarifying that 340B Discounts Apply to Contract Pharmacies
The HHS Office of the General Counsel released an advisory opinion concluding that drug manufacturers are required to deliver discounts under the 340B Drug Pricing Program (340B Program) on covered outpatient drugs when contract pharmacies are acting as agents of 340B covered entities.
The 340B Program requires drug manufacturers (in exchange for coverage of drugs under Medicaid) to offer substantial discounts to “covered entities,” which include safety net hospitals, community health centers, and other institutions that serve vulnerable populations. Estimates suggest that discounts in the 340B Program can range between 25 and 50 percent and that approximately $30 billion of drugs are sold to covered entities each year, representing almost 6 percent of prescription drugs sold in the United States.
HHS has become aware of drug manufacturers refusing to provide 340B discounts to covered entities when covered entities order the drugs themselves but then have the drug physically delivered to patients through “contract pharmacies.” Through the new advisory opinion, HHS has clarified that drug manufacturers must provide 340B discounts when a contract pharmacy is acting as an agent of a covered entity, providing services on behalf of the covered entity.
“President Trump has been steadfastly devoted to lowering drug prices for American patients, and that includes ensuring that drug companies are offering the discounts they’re legally required to give to providers that serve the vulnerable,” said HHS Secretary Alex Azar. “Whether it’s making sure 340B discounts are passed on to patients or ensuring that drug companies are delivering these discounts in the first place, we’ve ensured that the deep discounts offered under 340B are helping the vulnerable populations the program was set up to benefit.”
Although advisory opinions do not carry the force of law, they set out the agency’s current views on issues. Those views may be reflected in the various regulatory, enforcement, and oversight powers the federal government has to run the 340B Program.
Read the advisory opinion here: https://www.hhs.gov/guidance/document/ao-contract-pharmacies-under-340b-program-12-30-2020-2