On May 17, the National Association of Medicaid Directors (NAMD) sent a letter to the Federal Communications Commission (FCC) supporting the Department of Health and Human Services (HHS) recent request for legal clarification on the use of text messages and automated calls during the public health emergency unwinding. Allowing state Medicaid agencies – along with their contractors and managed care organizations – to use text messages and automated calls is crucial to ensuring that Medicaid members know when they need to return renewal forms and other information to maintain coverage. Read NAMD’s letter here.

 

The Pennsylvania Department of Human Services (DHS) removed language from its proposed HealthChoices Medicaid managed care contracts that would have prevented non-unionized providers that had work stoppages in the last five years from inclusion in managed care organization (MCO) networks. The 2022 contracts are set to be implemented on September 1. Read More.

Summer is right around the corner. It’s a time for fun in the sun, vacations and, of course, no school. Whether your kids are home for summer, on the road with you or away at camp, we have some tips to keep your family safe and healthy.

There’s a higher risk of certain injuries occurring during the summer months. Kids are out of school and active, families are traveling and trying new activities, and everyone’s attention is more relaxed — which isn’t always a good thing when it comes to safety.
Being prepared can help reduce safety risks.

Here’s what you need to know so you can be aware of the risks, take precautions, and share some important safety tips with your kids. Together, we can ensure your family is as safe as possible while enjoying the fun and new adventures summertime can bring.

1. Beat the Heat (and Sun)

Preventing heat-related illnesses, including heat stroke and heat exhaustion, is important for people of all ages, but extreme heat poses the greatest risk for people under age 4 and over 65. The best ways to protect yourself from heat include:

• Staying cool  — Find air-conditioning during hot hours and wear cool clothing.
• Stay Hydrated — Drink plenty of liquids, specifically water.
• Stay Informed — Pay attention to heat advisories.

Sunburn is a common summertime injury. Unprotected skin can be burned by the sun’s UV rays in as little as 15 minutes, but can take up to 12 hours for the skin to show the damage. The Centers for Disease Control and Prevention (CDC) recommends staying out of the sun between 10 a.m. and 4 p.m., when its UV rays are at their highest level. Sunscreen is recommended for anyone working and playing outside in the summer, even on cloudy days. Be sure to use SPF 15 or higher, and reapply every two hours or after swimming, sweating or toweling off. For extra protection, it is recommended to use hats, sunglasses, and long sleeves.

2. Keep Your Head Above Water

Swimming — one of the most popular activities in the country — is a fun, active, and healthy way to spend summer leisure time. Every year, millions of people visit “recreational water” sites such as swimming pools, water parks, hot tubs, lakes, rivers or oceans. But water safety isn’t just about keeping kids safe in the pool. There are things you might not think about — such as catchment ponds, drainage ditches and runoff areas in your neighborhood — that can be hazards, as well. It’s important for parents to know about how to protect kids, avoid risks, and respond in an emergency.

• Pool Safety — PA Department of Health
• Water Safety — Kids Health
• Drowning Facts — CDC
• Drowning is Preventable: Tips for Safety In and Around Water — Pool Safely
• Make a Splash: Swallowing Water in Inactive Waters Can Make You Sick — CDC
• Diarrhea and Swimming — CDC

3. Look Before You Lock

Never leave a child, older adult, or pet in a car unattended — not for a few minutes, not with the window cracked, not in the shade. Never. Leaving loved ones alone in a car can lead to serious injury or death from heatstroke. It takes only minutes for a vehicle to heat up and become deadly. Young children are particularly at risk, as their bodies heat up three to five times faster than an adult’s. A change in a schedule, being overly tired or distracted, or even a new pattern of behavior can cause a caring parent or caregiver to put a child at risk. Find more information in the links below to keep your loved ones safe:

• Where’s Baby? Look Before You Lock — PA Promise for Children
• Child Heatstroke Prevention — National Highway Traffic Safety Administration
• www.wheresbaby.org
• Kids are Dying in Hot Cars — National Security Council (NSC)

4. Beware of Bugs

Ticks

Tick populations are at an all-time high, raising the risk of dangerous diseases such as Lyme Disease and other tick-carried conditions. Pennsylvania has led the nation in the number of Lyme Disease cases diagnosed over the past decade. As more people head outdoors, that means an increased likelihood of encounters with ticks, as well as other insects. Taking the proper precautions can keep you safe from bites and illnesses.

Mosquitos

• Mosquito-bourne Diseases — PA Department of Health
• Mosquitos — CDC
• Avoid Bug Bites — CDC
• Reduce the Threat of Zika Virus and Other Mosquito-borne Illnesses — NSC
• Find the Repellent that’s Right for You — Environment Protection Agency (EPA)

5. Catch Up on Immunizations

Watch a video from Sesame Street featuring Elmo and U.S. Surgeon General Vivek Murthy as they explain how vaccines work, and why they’re so important for children’s health.

Routine childhood vaccinations are safe and keep your children healthy and strong — like eating vegetables and brushing their teeth. Whether your child is behind on a vaccine, missing a dose or completely unvaccinated, now is the time get your child caught up on childhood vaccinations! It’s easy to get back on track. Simply call your child’s healthcare provider to schedule an appointment as soon as possible.

• Now is the Time to Catch-Up On Routine Vaccines! — PA Promise for Children
• 2022 Recommended Immunizations for Children from Birth Through 6 Years Old — CDC
• Catch-up Immunization Schedule for Children and Adolescents Who Start Late or Who Are More than 1 Month Behind — CDC
• www.vaccinateyourfamily.org

6. Lock up Your Firearms

The American Academy of Pediatrics (AAP) advises that the safest home for a child is one without guns. The most effective way to prevent unintentional gun injuries, suicide and homicide to children and adolescents, research shows, is the absence of guns from homes and communities. But statistics show that roughly a third of U.S. homes with children have guns. If you decide to keep guns in the home, be aware that many studies show that teaching kids about gun safety, or to not touch a firearm if they find one, is not enough. You can reduce the chances of children being injured, however, by following important safety rules like those in the video below:

Watch a video from the Pennsylvania State Police (PSP) about firearms safety and how to properly store and secure your firearms.

Telehealth stakeholders are urging HHS to designate at least $28 million for its Telehealth Resource Centers program to provide a financial boost to the centers that provided technical support for providers and health care entities that rapidly established telehealth programs during the COVID-19 pandemic. The program has received the same level of funding since 2006 even though demand for technical assistance from TRCs increased drastically during the pandemic.

Currently, each center receives $325,000 annually, according to a letter spearheaded by the Alliance for Connected Care and other telehealth stakeholders. An allotment of $28 million to the TRCs program would ensure that each regional and national TRCs can receive at least $2 million. The stakeholders also want Congress to restore the statutory requirement that TRCS be nonprofits — a requirement that lawmakers unexpectedly removed as part of the CARES Act.

TRCs, which are under the Health Resources and Services Administration (HRSA), offer telehealth assistance to public and private stakeholders. There are 14 TRCs, which include national resource centers that focus on technology and policy, and regional centers that provide technical assistance to states. The various TRCs work together to provide assistance to consumers, rural health clinics, hospital systems, individual providers and others.

Although there was a bipartisan effort by Reps. Abigail Spanberger (D-VA), Dusty Johnson (R-SD) and Dan Meuser (R-PA) to add $5 million to the baseline appropriation for TRCs in the fiscal 2022 budget, the increase did not make it into the final budget. HRSA did not ask for an increase in its fiscal 2023 budget request.

TRCs experienced an 800% increase in demand for telehealth assistance across the nation during the COVID-19 pandemic, according to the letter. Throughout the pandemic, TRCs were the only entities that were able to immediately provide technical assistance as health care providers requested help in developing telehealth programs. Federal and state officials also relied on TRCs to consult on telehealth use and implementation as the centers were the only entities with in-depth knowledge around technology.

Mei Kwong, executive director of the Center for Connected Health Policy, told Inside Telehealth that TRCs are not only expected to assist the general public, but also help HRSA grantees.

“With the increased interest in telehealth, there has been an explosion of newly funded telehealth programs, some who may need technical assistance from the TRCs,” Kwong said. “So the workload on the TRCs has increased significantly, but yet there’s been no funding increase in over a decade.”

TRCs are historically underfunded, with each center receiving $325,000 annually. Although each center received $828,000 under the CARES Act in March 2020, that funding has since expired. The support provided to TRCs has not been sufficient to meet the nation’s significantly increased demand for telehealth assistance.

“Lack of sufficient funding is creating a strain on TRCs’ ability to keep wages in line with inflation and many are losing experienced staff to the private sector,” the letter reads.

Experienced staff have been leaving TRCs as demand for telehealth support increases with no comparable boost in funding, the stakeholders say. It is unclear how TRCs will be able to function if increased funding is not allocated, according to the letter.

The letter also calls for restoration of the statutory requirement that TRCS be nonprofits. The nonprofit status is significant because TRCs need to be unbiased purveyors of telehealth technical assistance, according to Kwong.

Since TRCs assist organizations in their creation of a telehealth program, the centers must remain neutral when giving advice to entities about which technologies they need or should buy. If TRCs were for-profit entities, it would be easier to steer those who seek help from the centers to specific vendors or providers.

“As the telehealth policy resource center, I’m often contacted by federal and state policymakers,” Kwong said. “They need to be able to trust that any information I provide to them isn’t influenced financially by any specific group. The non-profit language helps ensure the neutrality of the information we give.”

https://insidehealthpolicy.com/inside-telehealth-daily-news/stakeholders-hhs-boost-hrsa-telehealth-resource-centers%E2%80%99-funding

The Centers for Medicare & Medicaid Services (CMS) shared our vision to make equitable, high-quality, affordable, data-informed care for mental health and substance use challenges available to the people served by our programs, as outlined in Health Affairs.

CMS recently released a Behavioral Health Strategy that demonstrates the Biden-Harris Administration’s ongoing efforts to support the Strategy to Address Our National Mental Health Crisis and underscores the importance of access, equity, quality, and effective data integration in preventing and treating mental health conditions, substance use disorders and acute and chronic pain.

The CMS Behavioral Health Strategy consists of five bold and interrelated goals:

• Strengthen equity and quality in behavioral health care;
• Improve access to substance use disorders prevention, treatment and recovery services;
• Ensure effective pain treatment and management;
• Improve access to and quality of mental health care and services; and
• Utilize data to inform effective actions and measure impact on behavioral health.

The CMS Behavioral Health Strategy seeks to remove barriers to care and services, and to adopt a data-informed approach to evaluate our behavioral health programs and policies. The Strategy will strive to support a person’s whole emotional and mental well-being and promotes person-centered behavioral health care.

This is part of HHS’ ongoing efforts to support President Joe Biden’s whole-of-government strategy to transform mental health services for all Americans—a key part of the President’s Unity Agenda that is reflected in the President’s Fiscal Year 2023 budget. Following the President’s State of the Union in March, Secretary Becerra kicked off the HHS National Tour to Strengthen Mental Health to address the mental health challenges that have been exacerbated by the COVID-19 pandemic, including substance use, youth mental health, and suicide.

For additional details on the Strategy, please visit the CMS Behavioral Health Strategy page.

The Centers for Medicare & Medicaid Services (CMS) released a report that recommends cost savings from lower-than-expected Medicare Part B spending be passed along to people with Medicare Part B coverage in the calculation of the 2023 Part B premium. Earlier this year, Department of Health and Human Services (HHS) Secretary Xavier Becerra instructed CMS to reassess the 2022 Part B premium amount in response to a price reduction for Aduhelm™, a monoclonal antibody directed against amyloid for use in treating Alzheimer’s disease. Given the information available today, it is expected that the 2023 premium will be lower than 2022. The final determination will be made later this fall.

“At the Secretary’s direction, CMS reassessed the Medicare Part B premium and recommends that the identified savings be incorporated into the Medicare Part B premium for 2023,” said CMS Administrator Chiquita Brooks-LaSure. “Due to changes in the cost of Aduhelm™ and coverage since the premium was established, CMS recommends that the lower-than-anticipated spending in 2022 be incorporated into the 2023 Part B premium determination. The Biden-Harris Administration remains committed to lowering health care costs for beneficiaries by increasing price transparency, lowering the cost of prescription drugs, and connecting people to savings programs.”

Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A, which covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care.

As detailed in the report, when calculating the Part B premium, CMS builds in a reserve to ensure the Medicare Supplementary Medical Insurance (SMI) Trust Fund remains adequately financed for the year. In 2022, CMS appropriately built in a reserve to ensure the SMI Trust Fund could cover the potential costs of Aduhelm™ and similar drugs. At the time CMS announced the premium in Fall 2021, Aduhelm™ cost an average of $56,000 per year, and CMS had not yet issued a National Coverage Determination (NCD). After the 2022 Medicare Part B premium was set, the manufacturer of Aduhelm™ reduced the price to an average of $26,200, and CMS finalized Medicare coverage with evidence development for Aduhelm™ and similar, future FDA-approved drugs with an indication for use in treating the Alzheimer’s disease. CMS determined that reflecting these savings in the calculation of the 2023 Medicare Part B premium is the most effective way to deliver these savings back to people with Medicare Part B. CMS is still assessing other current and projected Medicare Part B costs to inform the premium recommendation for 2023, which will be announced in Fall 2022 consistent with the statutory process.

In November 2021, CMS announced that the Part B standard monthly premium increased from $148.50 in 2021 to $170.10 in 2022. This increase was driven in part by the statutory requirement to prepare for potential expenses, such as spending trends driven by COVID-19 and uncertain pricing and utilization of Aduhelm™. Despite the increase, most people with Medicare saw a significant net increase in Social Security benefits due to a higher-than-usual Cost of Living Adjustment (COLA) in 2022.

People with Medicare coverage may be eligible for help paying their Medicare costs through the Medicare Savings Programs (MSP). CMS encourages people with Medicare to check their eligibility to receive financial assistance from MSP as they may also help pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, coinsurance, and copayments if individuals meet the eligibility criteria. People with Medicare can learn more about the Medicare Savings Programs by calling 1-800-MEDICARE or visiting Medicare.gov at https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs.

The report and analysis of the reexamination of the 2022 Medicare Part B premium is available at www.cms.gov/files/document/cms-report-secretary-2022-medicare-part-b-premium-reexamination.pdf.

The national nonprofit Build Healthy Places Network (BHPN) created an action-oriented guide to investment models for health care partnerships with the local community and economic development sectors in rural areas.  After interviewing dozens of experts, BHPN shares case studies from all over the country highlighting core strategies used by rural healthcare entities as examples for future multi-sector partnerships to follow.

On May 19, HRSA finalized the criteria to identify Maternity Care Target Areas (MCTA). MCTAs are geographic areas within health professional shortage areas (HPSAs) that have a shortage of maternity care health professionals, for the purpose of providing maternity health care assistance to such health professional shortage areas. As of 2017, 59 percent of HPSAs were in rural areas.