- CMS: Request for Information; Health Technology Ecosystem
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- State: 60-Day Notice of Proposed Information Collection: J-1 Visa Waiver Recommendation Application
- Public Inspection: CMS: Request for Information: Health Technology Ecosystem
- HHS: Request for Information (RFI): Ensuring Lawful Regulation and Unleashing Innovation To Make American Healthy Again
- VA: Solicitation of Nominations for the Appointment to the Advisory Committee on Tribal and Indian Affairs
- GAO Seeks New Members for Tribal and Indigenous Advisory Council
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
- Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) - Request for Information
- Dr. Mehmet Oz Shares Vision for CMS
- CMS Refocuses on its Core Mission and Preserving the State-Federal Medicaid Partnership
- Social Factors Help Explain Worse Cardiovascular Health among Adults in Rural Vs. Urban Communities
Where Potential COVID-19 Vaccines Stand in the U.S.
Four vaccines for the novel coronavirus are now in late-stage testing in people in the United States. Here are some details:
- Johnson & Johnson vaccine – The vaccine uses noninfectious adenovirus, a common cold virus, to deliver a gene from the novel coronavirus to human cells and produce copies of the SARS-CoV-2 protein, potentially priming immune cells to fight infection. The vaccine is being tested as a single dose and can be stored refrigerated for at least three months, potentially alleviating some of the concerns about the logistics of distribution.
- Moderna vaccine – Messenger RNA, genetic material carrying information about a viral protein, is delivered to cells that produce the protein, which the immune system is then trained to recognize. RNA vaccines are a newer technology, favored for their potential speed in development, but none have been approved for humans for any virus. The vaccine is being given in two doses and is stored frozen.
- Pfizer vaccine – This vaccine is also an mRNA vaccine being tested as two doses. It currently requires storage at -70°C (-94°F). Pfizer has an initial agreement with the U.S. government for 100 million doses if the vaccine is approved, with an option for 500 million more doses.
- AstraZeneca/Oxford University vaccine – Similar to the Johnson & Johnson vaccine, this candidate is a viral vector vaccine but uses a different adenovirus. The vaccine’s trial in the U.S. is currently paused after a “suspected adverse event” in a participant in a U.K. trial of the vaccine. It is being given in two doses and is expected to require refrigeration.
Amidst growing public skepticism and distrust of vaccines, the FDA is planning to tighten requirements for assessing a vaccine’s safety and effectiveness, the Washington Post reported.
Pittsburgh School of Medicine Rewrites Hippocratic Oath
At the suggestion of one of the assistant deans at the medical school, the incoming students at the University of Pittsburgh School of Medicine decided to update their oath for the first time in the 137-year history of the school. As they rewrote it, it became more explicitly inclusive of all people, including those historically overlooked by the medical community. It was embraced full-heartedly by the administration. The oath, which was taken by the entire 149-member class last month, acknowledges the lives lost to COVID-19, the killings of Breonna Taylor, George Floyd and Ahmaud Arbery, and the history of the “fundamental failings of our health care and political systems in serving vulnerable communities.” Read more.
Age Distribution of the COVID-19 Pandemic Is Changing
The Centers for Disease Control and Prevention (CDC) released an MMWR on the Changing Age Distribution of the COVID-19 Pandemic in the U.S. between May and August, 2020. A key finding is that during June-August 2020, COVID-19 incidence was highest in persons aged 20-29 years, who accounted for >20% of all confirmed cases. Strict adherence to community mitigation strategies and personal preventive behaviors by younger adults is needed to help reduce infection and subsequent transmission to persons at higher risk for severe illness.
HHS Announces Additional PRF Funding Available
HHS announced on Oct. 1 that it is making an additional $20 billion in Provider Relief Fund (PRF) funding available to “frontline” providers — including those who have already received the full amount they were eligible for under the General Distribution. For FQHCs, this amount was two percent of 2018 net patient revenues. It is unclear how much any provider will be eligible for; it will likely depend on total requests received. HHS recommends that providers apply early, starting the week of October 4. NACHC and PACHC are working to learn more and will share more information as we can. Click here for a copy of the HHS press release.
Update on DHS Vision PPS Implementation
As reported earlier, the Department of Human Services (DHS) has issued a Medical Assistance Bulletin establishing a separate vision PPS rate, effective Oct. 1, 2020, as well as adding vision to allow for up to four FQHC encounters per day (now medical, dental, behavioral and vision). Here are some points on the new vision PPS:
- Health centers already offering vision services are to individually work with DHS on calculation of a vision PPS rate from the prior cost report.
- PACHC has shared the updated cost report template as an attachment to the weekly All PA FQHC CEO Call summary, as well as with health center finance leaders.
- The medical and dental provider productivity benchmarks have not changed in the new cost report template and Opthalmology is 3,599 and Optometry is 2,530.
PACHC is awaiting DHS’ decision on how payments will be made from Oct.1, 2020 until the vision PPS rate is established for health centers currently offering vision. For example, retroactive reconciliation back to Oct.1, 2020 or just start the new rate when it is calculated.
MEI Increases on the Way – DHS Says MCOs Should Not Delay
Each year, FQHC/RHC prospective payment system (PPS) rates are updated on Oct. 1 by the Medicare Economic Index (MEI). The Department of Human Services (DHS) has notified PACHC that the state is having a system issue with letter download to email and therefore email notifications to health centers might be delayed. That does not mean that managed care organizations (MCOs) should delay implementation of the MEI adjustments. Per DHS:
- The MCOs and Promise received the data extract last week, which is available now to the MCOs and is set up to be easily imported into the MCOs’ systems.
- For these mass MEI rate increases, DHS expects MCOs to implement the MEI increase using the data extract provided and not wait for the rate confirmation letter DHS sends to each FQHC/RHC.
- It is important to note that this is different than the process for interim to final FQHC rate changes for individual health centers. While these are also communicated to MCOs through a (quarterly) data extract update from DHS, DHS directs MCOs to use the official rate letter DHS provides to the health center as validation of the rate change.
Questions? Contact Julie Korick, PACHC COO/CFO.
Health Reimbursement Arrangements
In June 2019, the Departments of Treasury, Labor and Health and Human Services jointly published a final rule to expand the flexibility and use of health reimbursement arrangements (HRAs). An HRA is a group health plan funded solely by employer contributions that reimburses an employee’s medical care expenses up to a maximum dollar amount for a coverage period. HRA reimbursements are excludable from the employee’s income and wages for federal income tax and employment tax purposes. In addition to the employee, an HRA may also reimburse expenses incurred by the employee’s spouse, dependents, and children who as of the end of the taxable year, have not attained age 27.
President Trump, First Lady Test Positive for COVID-19
The White House physician confirmed on October 1 that President Donald Trump and First Lady Melania Trump have both tested positive for COVID-19. The President and First Lady are well currently and plan to quarantine. Click here to read the memorandum from the President’s physician.
House of Representatives Announces ‘Skinny’ HEROES Bill
This week, House leadership released a trimmed-down version of the HEROES Act, their original fourth COVID-19 relief package, which was first passed by the chamber last May. The ‘skinny’ HEROES Act is a $2.2 trillion bill that offers a compromise between the House’s original three trillion-dollar bill and the Senate’s one trillion dollar HEALS Act. The package contains $7.6 billion in emergency funding for Community Health Centers , as well as $1 billion for health workforce programs, including the National Health Service Corps and the Nurse Corps. For more information on the bill, see the bill’s section-by-section breakdown available on the House Appropriations Committee website.
US Senate Passes Continuing Resolution Extending Funding
The Senate voted to limit debate on short-term agency spending, and passed the Continuing Resolution (CR) previously passed by the House of Representatives last Tuesday, Sept. 22. The CR provides a stopgap for government funding to avoid a shutdown and extend government-funded programs until Dec. 11, 2020. The bill also includes an extension of mandatory funding for the Health Center Fund, the National Health Service Corps, and the Teaching Health Centers Graduate Medical Education Program until Dec. 11.