On January 31, 2020, the Centers for Medicare & Medicaid Services (CMS) issued the proposed annual Notice of Benefit and Payment Parameters Rule for 2021, also known as the Proposed 2021 Payment Notice. This proposed rule would update regulatory and financial standards applied to issuers and Exchanges, as well as set parameters for the risk adjustment program. Similar to Payment Notices issued in prior years, the Proposed 2021 Payment Notice contains a number of other provisions that support the Trump Administration’s ongoing commitment to lowering premiums, protecting taxpayer dollars and strengthening the health insurance markets to deliver more competition and choice for consumers.

In conjunction with the proposed rule issued today, we are also issuing several guidance documents.  Links to those documents are below.

To view the proposed rule, click here:  https://www.federalregister.gov/public-inspection/current or the direct link at https://www.federalregister.gov/documents/2020/02/06/2020-02021/benefit-and-payment-parameters-notice-requirement-for-non-federal-governmental-plans

To view the proposed Key Dates for Calendar Year 2020 for QHP Certification, Rate Review, and Risk Adjustment, click here https://www.cms.gov/files/document/proposed-key-dates-tables-cy2020.pdf

To view the Draft ICD-10 Crosswalk for Potential Updates to HHS-HCC Risk Adjustment Model for the 2021 Benefit Year, click here https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/index.html#Premium-Stabilization-Programs

To view the proposed 2021 Letter to Issuers, click here: https://www.cms.gov/files/document/2021-draft-letter-issuers-clearance-version-final-13120.pdf

To view the request from Alabama to decrease the volume of transfers for Risk Adjustment, click here

https://www.cms.gov/files/document/state-flexibility-requests-relating-risk-adjustment-transfer-reductions-2021-benefit-year.pdf

In a partnership that includes the National Governor’s Association and the Milbank Memorial Fund, the Center for Evidence-based Policy at Oregon Health & Science University created this searchable library of resources on opioids and the opioid crisis.  A search on rural resources includes promising practices for medication-assisted treatment in primary care and a spotlight on Project ECHO, the initiative that connects addiction medicine experts with clinicians in remote areas.  The information can be accessed here.

On January 23, 2020, Governor Tom Wolf today introduced an online form<https://www.governor.pa.gov/reach-out-pa-feedback-form/> for Pennsylvanians to provide feedback on mental health barriers, services and how the state can better support people’s mental health needs. The creation of the form is on the heels of the governor’s Jan. 2 announcement of Reach Out PA: Your Mental Health Matters<https://www.governor.pa.gov/newsroom/pennsylvania-launches-reach-out-pa-your-mental-health-matters/> initiative to reduce stigma and increase access to mental health and well-being services and supports.

“Having a way for all voices to be heard is critical to our goal of increasing access to mental health services, breaking down barriers, and detailing the ways we can meet the mental health needs of all,” Gov. Wolf said. “I encourage every Pennsylvanian to reach out via this online form to let us know their thoughts and suggestions.”

Of note is the first message on the form, which advises site visitors, “If you are in crisis, call the National Suicide Prevention Lifeline at 1-800-273-8255, or text PA to 741741.”

“It’s critical that people in crisis have a way to get immediate help, which is why we included the suicide prevention lifeline first,” Gov. Wolf said. “Our form is intended for feedback and suggestions for the commonwealth as we move forward with breaking down barriers, improving services and reducing mental health stigmas.”

The commonwealth will not share any identifying information without permission of those who submit information. Comments and suggestions will be compiled and reviewed to determine next steps in program and service development or redesign, as well to convey pertinent information to state agencies involved in the initiative. Forms may be submitted anonymously.

“You can help improve the state of mental health in Pennsylvania,” Gov. Wolf said. “Completing this form and sharing your thoughts and ideas is another step in the right direction to make mental health a priority for all.”

The online form<https://www.governor.pa.gov/reach-out-pa-feedback-form/> is available now.

https://www.governor.pa.gov/reach-out-pa-feedback-form/

The Health Resources and Services Administration (HRSA) is seeking nominations of candidates for consideration to serve on the Advisory Committee on Infant Mortality (ACIM). Written nominations must be received on or before February 24, 2020.   Click here for more information.

Read how the McKean County, Pennsylvania Department of Veteran Services in rural Pennsylvania has implemented a “collective impact” model designed to help veterans with federal benefits, employment, and medical care. The department collaborates with state and county representatives, advocates, and even the local airport to ensure veterans have access to necessary services.  Access the article here.

The Health Resources and Services Administration is seeking public comment on the information collection request, Bureau of Health Workforce (BHW) Substance Use Disorder (SUD) Evaluation. The evaluation purpose is to see if five programs aimed at increasing the access to the number of clinicians treating SUD have met their stated goals.   Click here to access the information.

The Census Bureau is seeking public comment on a new information collection called the Management and Organizational Practices Survey—Hospitals (MOPS-HP).  The survey will be used to collect data on management practices from chief nursing officers (CNOs) at general medical and surgical hospitals in an effort to identify factors affecting clinical and financial performance. Comments on the survey are due by March 27, 2020.  The information to submit comments can be accessed here.

The Centers for Disease Control and Prevention is seeking public comment on the National Hospital Ambulatory Medicare Care Survey (NHAMCS), which is used to collect information on healthcare facilities and visits for ambulatory care services in non-federal, short stay hospitals. Comments are due by March 30, 2020.  The proposed rules can be accessed here.

Recent research has found that not only are nearly 40% of surveyed physicians burned out, but 40% are also experiencing depression. For many reasons—stigma among them—these professionals are not getting mental health support. Physician health programs, in collaboration with professional societies, are trying to change that by working with state licensure boards and other groups.  Click here to access the article.