A report (PDF) from the HHS National Syphilis and Congenital Syphilis Syndemic Federal Task Force explores differences between point of care (POC) tests and laboratory-based serologic tests. It also highlights when POC testing may be the best. Visit HIV.gov to learn more. HHS will hold a webinar on the topic on July 31 from 12:00 – 1:00 pm. Registration is available.

Pennsylvania is joining the legislative bandwagon to limit noncompetition agreements for certain health care workers. In a purported effort to retain health care practitioners for the commonwealth and promote continuity of care for patients, Gov. Josh Shapiro signed the Fair Contracting for Health Care Practitioners Act into law on July 17, 2024. In addition to narrowing the scope of noncompete in certain limited instances, it imposes a separate patient notice requirement following the “departure” of a health care practitioner. The act is not effective until January 1, 2025. The act:

·     Prohibits noncompete covenants for more than one year in length in certain circumstances

·     Prohibits the enforcement of a noncompete covenant against a health care practitioner if the health care practitioner is “dismissed”

·     Permits an employer to recover certain reasonable expenses “related to relocation, training and establishment of a patient base” but prohibits recovery if the health care practitioner is “dismissed”

·     Permits noncompete covenants related to sales or merger of a business entity

·     Permits noncompete covenants where the health care practitioner receives by purchase, grant, award or issuance of an ownership interest in a “business entity”

·     In addition, the act requires an employer to notify “patients seen within the past year” of: (1) the “departure” of a health care practitioner, (2) how to transfer patient records to “departed health care practitioner or another health care practitioner” and (3) “that the patient may be assigned to a new health care practitioner within the existing employer if the patient chooses to continue receiving care from the employer.” An employer is required to provide these notifications within 90 days of the health care practitioner’s departure. However, the notification requirement applies only where the health care practitioner had an “ongoing outpatient relationship with the patient for two or more years.”

In 2022, the national nonprofit Build Healthy Places Network (BHPN) released “A Playbook for New Rural Healthcare Partnership Models of Investment,” a resource for addressing social determinants of health in rural communities.  In this update, BPHN reconnects with organizations featured in the original playbook to gain a deeper understanding of the partnership landscape.

Research published in the Journal of Appalachian Health reports on disasters in eight rural southeast Kentucky counties in 2021-2022, the changing nature of the disasters, and the behavioral health impact on the residents affected.

The Federal Emergency Management Agency (FEMA) indicates that disasters are occurring more frequently, often impacting communities still recovering from a previous disaster.  This timeline lays out the phases of federal response before and after a disaster.  The compendium of housing and shelter programs includes 10 cabinet-level departments, including FEMA, the U.S. Departments of Health & Human Services (HHS), Agriculture (USDA), and Housing and Urban Development (HUD).

Comment by September 1, 2024.  On July 10, The U.S. Department of Health and Human Services (HHS), through the Office of the National Coordinator for Health Information Technology (ONC), released the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule for public comment. The HTI-2 proposed rule has two sets of new certification criteria designed to enable health IT for public health as well as health IT for payers to be certified under the ONC Health IT Certification Program. These new certification criteria, which would improve public health response and advance the delivery of value-based care, focuses heavily on standards-based application programming interfaces to improve end-to-end interoperability between data exchange health care providers and public health organizations or payers. This rule also establishes the standards and implementation of a new, real-time prescription benefit tool certification criterion, which would empower providers and their patients to make more informed decisions with more transparent information comparing the patient-specific cost of drugs and suitable alternatives. In addition, the proposed rule also updates policy within the HTI-1 final rule published January 2024 related to the exchange of conical images and information blocking.

The Physician-Focused Payment Model Technical Advisory Committee (PTAC), an independent federal advisory committee, has transmitted a Report to the Secretary of Health and Human Services on key issues related to encouraging rural participation in population-based total cost of care (PB-TCOC) models, which are a type of alternative payment model where payment is made up of costs and utilization for all covered medical services delivered to an individual or group. This report compiles information from previous payment model proposals PTAC reviewed, literature addressing the topic, and input received during a rural-focused meeting last year.  They conclude that while value-based care often focuses on improving quality while reducing spending, achieving value in rural areas may require increasing spending.  Increasing rural provider participation in PB-TCOC models requires a sustainable glidepath to value-based care that includes a multi-payer approach and a longer glidepath for taking on risk in rural areas.  They recommend a multi-pronged approach that would improve rural infrastructure, increase and enhance sustainable funding, enhance recruitment and training of rural health physicians and providers, increase community health organization capacity, and address health disparities.

During the COVID-19 public health emergency, Congress provided temporary enhanced federal funding to states to keep enrollees continuously enrolled in Medicaid. Beginning in April 2023, states resumed full eligibility redeterminations (unwinding). States had flexibility in the in their pace of unwinding and many states were still in the process as of May 2024. The CARES Act includes a provision for the Government Accountability Office (GAO), the federal agency that examines how taxpayer dollars are spent, to report on the federal response to the COVID-19 pandemic. Among other things, this report examines the Centers for Medicare & Medicaid Services (CMS) oversight of Medicaid unwinding. The unwinding of the continuous Medicaid coverage provision has resulted in over 22 million enrollees being disenrolled as of May 23, 2024, and over 49 million have had their coverage renewed.  GAO reviewed documentation of CMS’s efforts to assess state compliance with federal unwinding requirements and resolve any noncompliance from March 2023 through April 2024 and interviewed CMS officials about plans for future oversight. According to the report, during the unwinding, CMS found compliance issues with federal redetermination requirements in almost all states, including with long-standing requirements. GAO is recommending that CMS document and implement the oversight practices the agency learned during unwinding were needed for preventing and detecting states compliance issues with redetermination.

 On July 16^th, the Centers for Medicare and Medicaid Services (CMS) released final part two guidance regarding the plan outreach and education for the Medicare Prescription Payment Plan. This guidance includes policy directing plan outreach and education to increase awareness of the Medicare Prescription Payment Plan. To access the payment options outlined in the latest guidance, individuals with Medicare must opt into the Medicare Prescription Payment Plan to utilize the new benefit. Starting in 2025, Medicare Prescription Payment Plans will provide the option to people with Medicare prescription drug coverage to spread the costs of their prescription drugs over the calendar year instead of paying a lump sum at the time of purchase. In addition, the policy to cap the annual out-of-pocket prescription drug costs at $2,000 for all individuals enrolled in the Medicare prescription drug program will also begin. Authorized in the Inflation Reduction Act, the new cap on out-of-pocket drug costs is expected to provide needed financial relief for high prescription drug costs. The cap will also significantly impact rural enrollees who have higher rates of certain health conditions that requires costly medications.