- 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
New Resource Released: Adopting Oral Health to Advance Minimally-Invasive Care
Community Catalyst released a new resource, “Adopting Oral Health Integration to Advance Minimally-Invasive Care.” The resource provides information about how minimally invasive health care can be used in conjunction with the integration of oral health care and medical care to improve oral health and overall health, as well as people’s experiences with receiving oral health care.
Click here to view the resource.
HHS Finalizes End of COVID-19 Vaccination Rule for Hospitals
From Becker’s
The federal government is formally withdrawing the COVID-19 vaccine mandate for employees of CMS-certified healthcare facilities that was enacted in November 2021 and moving to treat the virus, from an oversight standpoint, more like the flu.
The Biden administration announced on May 1 that HHS would begin the process to end the COVID-19 vaccine requirement for employees of CMS-certified healthcare facilities. Requirements under the Omnibus COVID-19 Health Care Staff Vaccination rule were no longer enforced at the end of the day May 11, 2023, the same day the COVID-19 PHE ended, a CMS spokesperson told Becker’s.
While CMS might be done enforcing the rule, it still needs to come off the books. To do so, CMS has issued an 82-page final rule formalizing the end of the vaccination requirement. In the final rule set to be published in the Federal Register June 5, HHS and CMS withdraw the 2021 vaccination requirement, outline reasoning for its end, and note upcoming plans to regulate healthcare workers’ protections against COVID-19 as part of certain Medicare quality programs.
The final rule is set to take effect 60 days after the date it is published in the federal register. As scheduled, that would be Aug. 4. CMS told Becker’s it will not enforce the vaccination requirement before the effective date of the rule — it is no longer in effect as of May 11.
“As conditions and circumstances of the COVID-19 PHE have evolved, so too has CMS’ response. At this point in time, we believe that the risks targeted by the staff vaccination [interim final rule with comment] have been largely addressed, so we are now aligning our approach with those for other infectious diseases, specifically influenza,” the 82-page final rule states. “Accordingly, CMS intends to encourage ongoing COVID-19 vaccination through its quality reporting and value-based incentive programs in the near future.”
Hospitals’ COVID-19 vaccination rates will effectively go from being a condition of participation in Medicare to being part of a quality reporting process, which hospitals are familiar with.
“CMS has been pretty clear that it no longer needs the condition of participation mechanism to follow through on the vaccination process,” Mark Howell, director of policy and patient safety for the American Hospital Association, told Becker’s. “It feels comfortable with the outlook that the quality measures provide. The [public health emergency] is over and COVID-19 has moved from pandemic to endemic stage, but that doesn’t mean COVID is gone. It makes sense [CMS] would want some measurement there.”
Hospitals and health systems would learn of the vaccination-related measures under consideration for inclusion in CMS programs by Dec. 1, the deadline by which HHS is required to publicly release a list of measures on the table for adoption in certain Medicare programs.
CMS, in its Hospital Inpatient Prospective Payment System proposed rule for fiscal year 2024, had proposed adjusting the measure for COVID-19 vaccination among healthcare personnel to go from reporting on the primary vaccination series only to reporting on the cumulative number of healthcare personnel who are up to date with recommended COVID-19 vaccinations.
Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said the association is prepared to give CMS feedback that recommends the shift from primary series to up-to-date vaccination reporting coincide with improvements to the recommended cadence of COVID-19 vaccinations. U.S. health officials proposed simplifications to COVID-19 vaccine protocol, making it more like the routine process for annual flu shots, earlier this year.
“There is a challenge with the measure right now in trying to figure out if someone is up to date in their vaccination,” Ms. Foster told Becker’s. “It is so haphazard. When we know everyone should have gotten their shot sometime between September and December, for instance, that will make it administratively much easier to know who has been vaccinated if they are up to date.”
In the new final rule from HHS and CMS, the agencies note that withdrawal of the vaccination rule does not prohibit healthcare organizations from instating their own COVID-19 vaccination requirements for staff, consistent with other federal, state and local laws. It is likely that hospitals and health systems are in internal conversations and decision-making about what changes, if any, to make to their own individual COVID-19 vaccination requirements in light of the federal-level change.
The final rule from HHS and CMS also requires long-term care facilities to educate and offer the COVID-19 vaccine to residents, resident representatives and staff, as well as perform the appropriate documentation for these activities, as terms of participation in Medicare and Medicaid.
Pennsylvania EMS Workers Say Problems ‘Kicked Down the Road’ Caused Crisis
The Center Square
Pennsylvania’s emergency services face a serious financial crisis — and a dire situation to recruit first responders and ensure their health.
The state’s inaction, combined with mounting demands, leaves firefighters frustrated. Emergency workers scale back their voluntary commitments or quit for easier jobs with higher pay. Many of them suffer from PTSD and health problems. Suicide rates eclipse the generation population.
During a House Republican Policy Committee hearing on Tuesday, politicians heard this and more about the plight of rural and smaller departments trying to provide public safety.
“Our fire service is imploded already. We’re past a crisis mode,” Whitehall Township Fire Chief David Nelson said. “All the stuff we’ve been talking about should’ve been done 10-15 years ago.”
Fire chiefs said their departments remain stretched thin. Fundraisers and grants keep them operating in the absence of local and state support.
“This is a problem that gets kicked down the road every time,” Slatedale Fire Department Captain Dennis Wetherhold said. “There is never a resolution.”
The Emerald Star Hose Fire Company in Lehigh County, for example, has a budget of about $200,000. It gets a $26,000 donation from the township, $12,000-$15,000 from state grants, and $11,000 from firemen’s relief, about $52,000.
“We have to make up the rest by fundraising,” Emerald Fire Chief Tito Burgos said.
“My vehicles are paid for by our hoagie money and our money that we raise here,” he added. Preventative maintenance, too, runs about $30,000 a year.
Grants are not automatic or easy to get, either. Simply finding grants to apply for takes time.
“You can go on Google and look for a grant, but you can’t go to one place to find all the state grants,” Burgos said. “A one-stop shop would be great if there was such a certain thing.”
The financial issue isn’t the full equation. A smaller cadre of volunteer firefighters means a heavier burden on the company, making more people less reluctant to answer a call.
“Burnout, not enough volunteers, relying on the same individuals — it’s hard for us to have families and life balance,” Burgos said.
Much of that burnout doesn’t come from devastating fires, but from less-critical problems like EMS calls, “water in the basement” calls, and medical calls.
“I really don’t think the general public has any idea — or very little idea — in the situation that we’re into today, and really how it could dynamically change in the next few years,” Brian Carl, deputy chief of the Weisenberg Volunteer Fire Department, said. “When you dial 911, you might be waiting a while.”
Burgos and Carl listed some ideas to boost recruitment, such as earned income tax credits, retirement plans, tax incentives for employers who let workers leave to respond to a call, length of service rewards, and recruitment at the high school level.
Regionalization and consolidation, in some cases, could also help firefighters pool resources and lower costs, Carl said.
“County-wide services is where we need to start going,” Nelson said.
“This committee really needs to come up with some bold moves and suggestions,” said John Price, director of emergency services and fire chief in Emmaus.
Without such changes, officials warned of more-dire consequences. EMS providers have noticed a greater threat of physical violence against their workers in recent years, at the hands of the public and themselves.
“A disturbing trend has been realized over the last several years. Suicides in EMS and emergency services have surpassed line-of-duty deaths,” said Donald DeReamus, the legislative committee chair for the Ambulance Association of Pennsylvania and a paramedic.
If reform comes, firefighters want to see the changes be straightforward.
“We would appreciate any help you guys can provide for this situation, but please try to make it simple,” Carl said.
Legislators spoke of how more rules and regulations have worsened the position of first responders.
“We make it harder, it seems like every year, for someone to become a firefighter, and then we complain or are concerned that there’s not more people becoming firefighters,” Rep. Josh Kail, R-Beaver, said. “We’re creating a part of the problem ourselves.”
They also showed a recognition that change won’t come without more government spending.
“I do want fellow legislators to understand that there’s gonna be a cost involved, there’s gonna be a vote involved — we cannot vote to do nothing,” Rep. Mark Gillen, R-Reading, said. “We have to proactively decide what is the best route to the finish line.”
The Republican Policy Committee hearing comes a few weeks after a similar one from House Democrats. That hearing, as The Center Square previously reported, focused on the decline of fundraising and volunteer staff, and talked of potential state-level fees to cover costs.
New Report Released on Dangers of Oral Health Home Remedies
The CareQuest Institute for Oral Health released a new visual report, “Dental Danger: Home Remedies to Avoid When Awaiting Care.” More than half of adults in the United States do not have consistent access to dental care and may resort to home remedies, which are not always safe. Unsafe home remedies include tobacco, pain medication prescribed for another purpose, illegal narcotics, a needle to lance a gum abscess, aspirin powder applied to the gums, and alcohol.
HRSA Comment Period: Make the Case for Oral Health
The Health Resources and Services Administration (HRSA) has proposed transitioning the oral health national performance measure (NPM) to a state performance measure (SPM). Oral health has been an NPM since 1997. If oral health is transitioned to an SPM, it will no longer be a national priority, and efforts to promote oral health care at the national, state, and local levels will suffer.
Send your comments by e-mail to paperwork@hrsa.gov or by mail to Health Resources and Services Administration, Information Collection Clearance Officer, 5600 Fishers Lane, Room 14N39, Rockville, MD 20857. In your communication, state that you are commenting on “Title V Maternal and Child Health Services Block Grant to States Program: Guidance and Forms for the Title V Application/Annual Report, OMB No. 0915–0172—Revision.”
The deadline to submit comments is July 5th.
Ambulance Desert Report Highlights Severity in Rural Communities
The Maine Rural Health Research Center released its Ambulance Desert Chartbook. This chartbook analyzes 42 states in 2021-2022 and identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert. The report found that out of 4.5 million people living in an ambulance desert, 2.3 million (52%) were in rural counties. The reports also found that 84% of rural counties are an ambulance desert.
Congress Introduces Farmer Mental Health Bill
Sens. Baldwin (D-WI), Bennet (D-CO), and Ernst (R-IA), introduced S. 1736, the Farmers First Act of 2023, to address the mental health crisis in rural communities and expand access to mental health support for farmers and ranchers. This legislation reauthorizes the Farm and Ranch Stress Assistance Network (FRSAN) and provides additional funding to help agricultural workers access behavioral health specialists and services. NRHA is proud to endorse this legislation and supports expanding the network of rural providers to deliver critical services to farming and ranching populations.
293 Hospitals at Immediate Risk of Closure
There are 293 rural hospitals at immediate risk of closure due to inflation, staffing shortages and other financial stress, according to the Center for Healthcare Quality & Payment Reform.
Hospitals at immediate risk of closure have lost money on patient services for multiple years, excluding 2020 during the pandemic, and aren’t likely to receive sufficient funds to cover the losses with public assistance ending, according to the report. These hospitals also have low reserves and more debt than assets.
Click here to see the state-by-state list.
New 2020 Census Data Released
The U.S. Census Bureau released the 2020 Census Demographic and Characteristics File (DHC). These products provide the next round of data available from the 2020 Census, adding more detail to the population counts and basic demographic and housing statistics previously released.
This release includes population counts (total, by race and Hispanic ethnicity, age, and sex) as well as housing counts. These data are available through the U.S. Census Bureau’s data dissemination platform data.census.gov.
PA Census 2020 Data Portal
Today, in conjunction with the release of the 2020 DHC data, the PA State Data Center launched the Census 2020 Data Portal. The portal serves as a tool to host data localized to Pennsylvania and also provides guidance, overviews, and interactive reports/visualizations to help users make sense of the Census 2020 data.
View the portal at: https://census2020-pasdc.opendata.arcgis.com/
While you’re there, check out our latest dashboard and report which make DHC data for the state, counties, and municipalities easy to view!
This resource is a living catalog of data releases and supporting documentation and analysis from the U.S. Census Bureau and the PA State Data Center. Existing data, resources, and reports/visualizations, such as those for the Redistricting (P.L. 1994) data, have been added to the portal, and more will come soon!
Updated Coverage to Care Partner Resources Now Available
Coverage to Care has updated its partner resources! Now available on the C2C website, these materials are designed to help partners across the country share more information about C2C with their communities on how to make the most of their health coverage.
Coverage to Care is one of CMS OMH’s signature initiatives to help consumers understand their health coverage and connect them to the primary care and preventive services that are right for them. C2C offers resources to assist community partners in their outreach. Please be sure to use the newly updated C2C Partner Toolkit and presentation resources linked below!
Resources
- C2C Partner Toolkit provides prepared information and graphics for partners to use in their own emails, listservs, or social posts, as well as ideas on how to get started with health literacy in your community. Spanish coming soon!
- Updated C2C Community Presentation slide deck, a visual aid featuring the 8 Steps of the Roadmap to Better Care with prepared script and slides.
- C2C Presenter’s Guide (PDF) provides an overview of the C2C Community Presentation slide deck and tips for a better discussion.
- Accompanying Resources handout (PDF) with additional links to help with consumers’ health care journey.
Be sure to check out these and other resources on the C2C partner resources webpage.
To learn more about C2C, please visit go.cms.gov/c2c.
To continue receiving updates from about new C2C resources and programs, please sign up for our C2C listserv.