- 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
Biden-Harris Administration Extends Moratorium on Residential Evictions in USDA Multifamily Housing Communities in Accordance with CDC Guidance
The U.S. Centers for Disease Control and Prevention (CDC) extended the eviction moratorium to affected multifamily housing residents through June 30, 2021. This halt in residential evictions allows the U.S. Department of Agriculture (USDA) to extend relief to the hundreds-of-thousands of Americans who rely on USDA-supported multifamily housing communities.
“Due to COVID-19, the United States is facing a nationwide housing affordability crisis. That’s why, in a whole-of-government effort, USDA is taking this important action today to extend rental relief to the tens-of-thousands of individuals in USDA-supported multifamily housing communities,” said USDA Deputy Under Secretary for Rural Development Justin Maxson. “Currently, more than 40,000 tenants are rent overburdened, paying more than 30 percent of their income on rent. Today’s actions will give tenants at USDA-financed properties essential relief while the Department works as quickly as possible to extend the $100 million for emergency rental assistance provided by the American Rescue Plan Act to USDA’s most rent overburdened tenants.”
For more information about the protections provided under this moratorium extension, see the FACT SHEET: The Biden-Harris Administration’s Multi-Agency Effort to Support Renters and Landlords | The White House.
In a recent Census Bureau survey, nine million renters (or an estimated 15 percent of all renters) reported being behind on rent. The same survey showed that about 29 percent of Black families and 17 percent of Hispanic renters were behind on rent.
USDA’s Multi-Family Housing Programs provide affordable multi-family rental housing in rural areas by financing projects geared for low-income, elderly and disabled individuals and families, as well as domestic farm workers. USDA extends its reach by guaranteeing loans for affordable rental housing designed for low- to moderate-income residents in rural areas and towns. USDA also provides grants to sponsoring organizations to repair or rehabilitate housing for eligible families and subsidizes rents for low-income tenants who cannot afford to pay their full rent.
COVID-19 has had a lasting impact on Rural America. Families have lost their homes, students have resorted to unconventional solutions to access schoolwork online, the need for food assistance has grown, and access to COVID-19 testing and vaccinations have been limited. The American Rescue Plan implements funding that invests in the people of Rural America:
- $100 million through September 2022 in rental assistance for low-income and elderly borrowers.
- $39 million through September 2023 to help refinance direct loans under the Single-Family Housing Loan Program and the Single-Family Housing Repair Loans & Grants.
- $500 million in Community Facility Program funds to help rural hospitals and local communities broaden access to COVID-19 vaccines & food assistance.
In addition to programs facilitated by USDA, the American Rescue Plan provides significant investments into rural communities by expanding internet connectivity and establishing a homeowner assistance fund to assist struggling homeowners with mortgage payments, property taxes, property insurance, utilities and other housing related costs.
Under the Biden-Harris Administration, Rural Development provides loans and grants to help expand economic opportunities, create jobs and improve the quality of life for millions of Americans in rural areas. This assistance supports infrastructure improvements; business development; housing; community facilities such as schools, public safety and health care; and high-speed internet access in rural, Tribal and high-poverty areas. For more information, visit www.rd.usda.gov. If you’d like to subscribe to USDA Rural Development updates, visit our GovDelivery subscriber page.
USDA touches the lives of all Americans each day in so many positive ways. In the Biden-Harris Administration, USDA is transforming America’s food system with a greater focus on more resilient local and regional food production, ensuring access to healthy and nutritious food in all communities, building new markets and streams of income for farmers and producers using climate, smart food and forestry practices, making historic investments in infrastructure and clean energy capabilities in rural America, and committing to equity across the Department by removing systemic barriers and building a workforce more representative of America. To learn more, visit www.usda.gov.
3/29/21 COVID-19 Vaccine Resources: What Partners Need to Know Now
As COVID-19 vaccines continue rolling out across the country, CMS is taking action to protect the health and safety of our nation’s patients and providers and keeping you updated on the latest COVID-19 resources from HHS, CDC and CMS.
With information coming from many different sources, CMS has up-to-date resources and materials to help you share important and relevant information on the COVID-19 vaccine with the people that you serve. You can find these and more resources on the COVID-19 Partner Resources Page and the HHS COVID Education Campaign page. We look forward to partnering with you to promote vaccine safety and encourage our beneficiaries to get vaccinated when they have the opportunity. For more information, visit the CMS COVID-19 Policies and Guidance page.
FORGONE CARE DURING THE PANDEMIC
According to a recent CMS survey, many Medicare beneficiaries reported forgoing non-COVID-19 care such as regular check-ups or medical screening tests due to the pandemic. A recent CMS data analysis also showed a significant decline in service use for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries, particularly for mental health and substance use disorders. With that, the number of services delivered via telehealth has significantly increased during the public health emergency.
As COVID-19 vaccines are becoming more readily available, CMS is encouraging beneficiaries to contact their health care professionals to discuss getting vaccinated, schedule any missed appointments and discuss other healthcare needs, including preventive care, screenings, and mental health services, as well as utilize telehealth services when appropriate.
If you work with CMS beneficiaries
Share the messaging below to encourage beneficiaries to take care of their health during the pandemic:
- Don’t put off necessary care, especially if it’s urgent or may lead to complications, such as heart attack or stroke.
- Continue preventive care such as immunizations and cancer screenings. Talk to your doctor about which services are right for you.
- Learn about telehealth – Many regular health care services can be handled over the phone, a portal, app, or other option. Call your doctor to ask about your options.
- Be active in your health care by taking care of yourself and your family. Exercise, diet, sleep, and relaxation are important parts of staying healthy.
- Need health insurance coverage? Visit Healthcare.gov to sign up for coverage through the Health Insurance Marketplace.
Know What Telehealth Resources are Available
CMS updated policy changes effective January 1, 2021, which included adding services to the Medicare telehealth list during the public health emergency during for the pandemic. See the fact sheet and the list of services payable under the Medicare PFS, which includes office visits, psychotherapy, consultations and other medical or health services, for more information. Providers may also find the CMS COVID-19 Vaccine Provider Toolkit helpful for coverage on administering the vaccine.
Medicaid covers some telehealth services, but coverage differs from state to state. CMS developed a Medicaid & CHIP Telehealth toolkit to help states accelerate adoption of broader telehealth coverage policies in the Medicaid and Children’s Health Insurance Programs (CHIP) during the COVID-19 emergency.
In response to the increased use and expanded coverage of telehealth during the COVID-19 pandemic, From Coverage to Care (C2C) released two new resources to support providers and patients in making the most of virtual care:
Telehealth for Providers: What You Need to Know – Providers can learn how and when to use telehealth. Topics include how to set up telehealth services, how to conduct a successful visit, and how to keep up to date on telehealth payment (particularly for Medicare and Medicaid).
Telehealth: What to Know for Your Family – Patients can find out the types of care they can receive through telehealth, how to prepare for an appointment, what to expect during a visit, and more. This resource is also available in Spanish.
Providers and partners can download graphics to post on their social media channels and help spread the word about these new resources. All of these resources can be downloaded at go.cms.gov/c2ctelehealth.
For more information, please contact us at: Partnership@cms.hhs.gov
Pennsylvania Insurance Department Issues Guidance to Insurers for Consumer Protection, Calls for Clarity in Telehealth Policies
Pennsylvania Insurance Commissioner Jessica Altman announced that the Department of Insurance has issued guidance on health insurance-related services to protect consumers, and to call for clarity in insurers’ telehealth policies during the ongoing COVID-19 pandemic. A notice, which was included in the March 6 Pennsylvania Bulletin, outlines expectations regarding coverage by insurers of testing and vaccine administration to Pennsylvanians, and urges continued telehealth flexibility to make both COVID-related services and non-COVID-related services available to consumers.
“As we continue our fight against COVID-19, it is vital to make sure all Pennsylvanians have access to the resources needed to combat this public health crisis, and that includes testing and vaccination options,” Commissioner Altman said. “Health insurers play a critical role in access and affordability of these services and should ensure that most consumers can access these services at no cost to the consumers. The carriers have been an important partner in the commonwealth’s response to COVID, and we look forward to that continued partnership as we forge through the next stages of our pandemic response.”
The notice highlights the expectation that insurers will continue to cover COVID testing and vaccination without cost-sharing as required under The Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The notice also calls for health insurers to assist consumers in accessing in-network or publicly funded health services to avoid balance billing or surprise balance bills. Mechanisms should already be in place to prevent surprise balance billing for COVID-related services, but the department urges insurers to take steps now to make necessary changes to billing services in anticipation of the No Surprises Act, taking effect in 2022.
The notice also calls for clarity and consistency in insurers’ telehealth policies across the commonwealth while the COVID-19 health emergency is ongoing. A previous notice encouraged health insurers to allow for flexibility in telehealth services, and many insurers implemented flexibilities in their policies and coverage of telehealth services, some permanently. However, different approaches and timelines has caused confusion for both providers and consumers.
“We appreciate the insurers that have made an effort to expand access to telehealth services during the pandemic, allowing for continued routine and urgent health care for the duration of the public health emergency,” said Altman. “The department is now encouraging insurers to implement consistency in these policy flexibilities, most particularly by aligning policies with emergency declaration dates and offering network flexibility for providers that offer both telehealth and in-person services.”
The department notice encourages telehealth policy flexibilities to be extended through the end of the federal or Pennsylvania public health emergency and suggests a 60-day wind-down period for flexibilities to provide for an orderly transition for both providers and patients.
“As we enter the second year of the COVID-19 pandemic and the situation continues to evolve, we ask insurers for their continued readiness to make any necessary changes in policy to address the crisis head on,” added Altman. “We appreciate the commonwealth-wide response we have seen thus far in providing coverage and care for all Pennsylvanians.”
The department has submitted various notices to the Pennsylvania Bulletin to help ease the hardships that are being felt by Pennsylvanians during this crisis and ensure minimum disruption to the department and commonwealth-regulated operations.
If a consumer receives an unexpected bill related to COVID-19, or other healthcare services, they are encouraged to contact the department at 1-877-881-6388.
Pennsylvania Amends Universal Face Coverings Order to Align with CDC Guidance
Pennsylvania Acting Secretary of Health Alison Beam today amended the existing Universal Face Coverings order, issued on November 17, 2020, to align with the Centers for Disease Control and Prevention’s (CDC) Recommendations for Fully Vaccinated People. The amended order went into effect at 12:01 a.m. on March 17, 2021 and will remain in effect until further notice.
“The vaccines that are currently available across the state and country are highly effective at protecting vaccinated people against severe and symptomatic COVID-19,” Acting Secretary Beam said. “Research has shown that fully vaccinated people are less likely to have asymptomatic infection and potentially less likely to spread the virus that causes COVID-19 to others. However, there is still more to learn about how long protection lasts and how much vaccines protect against new variants of the virus, so some prevention measures will continue to be in place for all people, regardless of their vaccination status.”
According to the CDC, there are several activities that fully vaccinated people can resume now, as low risk to themselves, while being mindful of the potential risk of transmitting the virus to others. Those activities include:
- Visiting with other fully vaccinated people indoors without wearing masks or physical distancing;
- Visiting with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing; and
- Refraining from quarantine and testing following a known exposure, if asymptomatic.
However, it is important that fully vaccinated people continue to take precautions in public like wearing a mask and practicing physical distancing; avoid medium- and large-sized in-person gatherings; get tested if they experience COVID-19 symptoms; follow guidance issued by employers; and follow travel requirements and recommendations.
Individuals who are fully vaccinated should also continue to wear a mask, practice physical distancing and follow other prevention measures when visiting unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease and when visiting unvaccinated people from multiple households.
People are considered fully vaccinated for COVID-19 more than two weeks after they have received the second dose in a two-dose series or more than two weeks after they have received a single-dose vaccine. It is important to remember that the current mitigation Orders are still in effect and that physical distancing and capacity requirements for gatherings must still be followed.
United Way in Pennsylvania Launches COVID-19 Impact Survey
The United Way of Pennsylvania is conducting a survey to look at the impact of the COVID-19 pandemic on PA families. With it, they hope to learn how to advocate about the experiences of PA communities. It asks about child-care, food insecurity, housing, healthcare, and employment status. Please share the survey with your networks.
Click here for the survey in English.
Click here for the survey in Spanish.
New C2C Telehealth Resources Available
In response to the increased use and expanded coverage of telehealth during the COVID-19 pandemic, From Coverage to Care (C2C) released two new resources to support providers and patients in making the most of virtual care:
- Telehealth for Providers: What You Need to Know – Providers can learn how and when to use telehealth. Topics include how to set up telehealth services, how to conduct a successful visit, and how to keep up to date on telehealth payment (particularly for Medicare and Medicaid).
- Telehealth: What to Know for Your Family – Patients can find out the types of care they can receive through telehealth, how to prepare for an appointment, what to expect during a visit, and more. This resource is also available in Spanish.
Providers and partners can download graphics to post on their social media channels and help spread the word about these new resources. All of these resources can be downloaded at go.cms.gov/c2ctelehealth.
Find COVID-19 information and links to patient resources in additional languages at go.cms.gov/omhcovid19.
Want to receive updates on From Coverage to Care? Subscribe to the C2C listserv. To learn more or download C2C resources, please visit go.cms.gov/c2c or email CoverageToCare@cms.hhs.gov.
Insights from Experts: COVID-19 Case Rates in Rural and Urban Pennsylvania
When the COVID-19 pandemic became widespread in the United States, much of the discussion and attention centered on urban epicenters with rapid spread due to the high population density. While rural areas are less populous, other characteristics of rural America make those individuals living there far more vulnerable than their urban counterparts.
In this post, Penn State researchers Raeven Chandler, Katrina Alford and Leif Jensen describe the unique dynamics making rural residents more vulnerable, provide a comparison of COVID-19 trends in rural and urban areas in Pennsylvania, and offer insight as to why the COVID-19 pandemic highlights and magnifies the longstanding factors contributing to rural-urban health disparities.
For more, visit the Insights from Experts website — a partnership of Penn State’s Social Science Research Institute and the Center for Health Care and Policy Research.
Pennsylvanians are Experiencing Hunger at Highest Levels Since Onset of Pandemic
At the end of 2020, more than 12% of Pennsylvania households were experiencing hunger — the highest rate since the onset of the COVID-19 pandemic, according to researchers in Penn State’s College of Agricultural Sciences. Their report confirms anecdotal and media reports and highlights the role that community resources, such as food pantries and free school lunches, are playing in the state.
“We’ve seen the media accounts of exceptionally long lines at food banks and wanted to get a better understanding of the magnitude of the problem,” said Stephan Goetz, professor of agricultural and regional economics and director of the Northeast Regional Center for Rural Development (NERCRD).
“Our synthesis suggests that while the state’s rate of food insufficiency tends to be lower than the nation’s as a whole, it is still a significant and growing problem,” he said. “More than one in 10 households in Pennsylvania sometimes or often didn’t have enough food to eat last year, and food insufficiency status has grown worse for all but the wealthiest Pennsylvanians since the beginning of the pandemic.”
Goetz and his colleagues examined data from the U.S. Census Household Pulse Survey, a survey administered in three phases beginning in 2020 to a randomly selected representative sample of U.S. households. The goal of the survey is to better understand the social and economic effects that the coronavirus pandemic has had on households across the country.
Survey respondents answer questions about their employment status, food and housing security, education disruptions, and physical and mental well-being. When responding to questions about food sufficiency and availability, they base their answers on the previous seven days.
Focusing on Pennsylvania, the researchers analyzed the survey data to assess the most recent levels of household food security, how food security has changed over the course of the pandemic, and how households in different income brackets have experienced the crisis. They also assessed how families have adapted to food insufficiency by accessing free food. They released their findings this week in a new report titled “Pennsylvania Food Insufficiency Reached New High at the End of 2020.”
The report shows that food insufficiency in Pennsylvania is closely linked to the state’s unemployment rate. During weeks when unemployment claims are at their highest in the state, reports of food insufficiency also are relatively high, or rising. For policymakers, this underscores the close connection between income from working and food security of individuals. Community safety nets, such as free school lunches and food pantries, play a significant role in meeting household food needs.
“Our synthesis shows an increasingly dire food insecurity situation for many households in Pennsylvania and beyond,” Goetz said. “As the pandemic drags on, it is likely to become an even more serious problem as families deplete their savings and are forced to choose between paying for food or paying for other necessities.”
The report is part of an ongoing series of briefs and reports authored by NERCRD researchers, focusing on the coronavirus pandemic in the context of direct farm sales, the fruit and vegetable industry, consumer spending and sourcing, network science, and regional science.
The center also has available the data included in the report for other states in the northeastern U.S.
Other members of the research team who contributed to the report described here include Zheng Tian, research associate; Claudia Schmidt, assistant professor of marketing and local/regional food systems; and Yuxuan Pan, graduate research assistant.
Visiting Loved Ones in a Nursing Home – UPDATED Graphic Available (English and Spanish)
On March 10, 2021, the Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), issued updated guidance for nursing homes to safely expand visitation options during the COVID-19 pandemic public health emergency (PHE). Today, CMS is releasing a graphic to further explain the expanded visitation options.
According to the updated guidance, facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor, unless certain scenarios arise that would limit visitation. Read the full press release and review the graphic in English and Spanish.
Pennsylvania Governor and COVID-19 Vaccine Task Force Announce Targeted Vaccination Strategies, Including for Food Processing & Farmworkers
Agriculture is essential. While so many people saw their world turn upside down last March, not much changed for this industry. People need to eat, so we continued farming, planting, growing; caring for livestock; processing and packing; and putting food on the shelves.
Governor Tom Wolf and the Legislative Vaccine Taskforce recognize agriculture’s invaluable service. On March 12, 2021, they announced that farm workers, food manufacturing employees, and grocery workers are the next targeted groups to receive the FDA approved Johnson & Johnson COVID-19 vaccine which has been approved by the FDA for targeted administration.
This effort is separate from Phase 1B, where agriculture falls in the commonwealth’s vaccine rollout plan. It’s recognition that these groups have had no choice but to continue working to keep Pennsylvania and the world fed through a pandemic.
Strengthening the resiliency of agriculture requires acknowledging the transformative power of science and research. And that’s what we have in the COVID-19 vaccine.
Read the Governor’s announcement here. Check out the FAQs here.