Federal Policy Updates

Department of Health and Human Services
 
The Health Resources and Services Administration (HRSA) announced $125 million in workforce grants to support 14 nonprofit private and public organizations’ efforts toward underserved communities to “engage in locally tailored efforts to build vaccine confidence and bolster COVID-19 vaccinations.” These grants were authorized in the American Rescue Plan.
 
Centers for Medicare and Medicaid Services
 
CMS added 2019 Quality Payment Program performance information to the Doctors and Clinicians section of Medicare Care Compare and the Provider Data Catalog. More information.
 
Center for Medicare and Medicaid Innovation
 
Elizabeth Fowler, Deputy Administrator and Director of CMMI, has been engaged in a listening tour of stakeholders as part of a review of CMMI models and a new strategic focus. She has mentioned the importance of primary care in several public forums and has included the PCC in her stakeholder outreach. She has also spoken of the importance of incorporating health equity as a formal goal of alternative payment models.
 
MedPAC
 
In chapter two of its June report, MedPAC recommends that the Secretary of Health and Human Services “harmonize” and reduce its portfolio of alternative payment models and ensure they work together to support the strategic objectives of reducing spending and improving quality. This recommendation suggests that primary care stakeholders should evaluate the potential of all CMMI and CMS models to drive investment in and transformation of primary care.

As states are ending state-level public health emergencies that temporarily added new telehealth payment coverage in Medicaid and other state-funded or -regulated programs and payers, many states are codifying telehealth payment parity for telehealth on a permanent basis. Manatt has a helpful tracker.

In early June, the Department of Health and Human Services announced that a record 31 million Americans were enrolled in coverage related to the Affordable Care Act as of February 2021, demonstrating its role as a lifeline for people facing economic and health hardships during the COVID-19 pandemic. Enhanced premium tax credits included in the American Rescue Plan enacted in March 2021 and available during an extended special enrollment period have reduced average monthly premiums by over 40% for returning consumers. Later in June, the U.S. Supreme Court upheld the ACA for the third time and dismissed a challenge brought by Texas and 17 other states on grounds that they were not harmed and therefore lacked standing. The challengers had argued that the entire law was invalid after Congress reduced to zero the ACA’s penalty for failing to enroll in minimum essential coverage in 2017.

New CMS Administrator Confirmed

On May 25, Chiquita Brooks-LaSure was confirmed as the next Administrator of the Centers for Medicare & Medicaid Services. She is the first Black woman to fill the role. Her confirmation process had been delayed following controversy over the administration’s decision to revoke a Texas Medicaid 1115 Waiver, but ultimately went forward with 50 Democrats and 5 Republicans voting to confirm her.

 
CMS’s Next Gen Model Ending

The Centers for Medicare & Medicaid Services announced the week of May 24 that the Next Generation ACO model will end on December 31, without an additional year extension. However, Next Gen ACOs will be given the opportunity to apply for the Global and Professional Direct Contracting model. (Next year’s Direct Contracting model will not re-open to any other entities.) According to PCC Executive Member NAACOS, the Next Gen program saved Medicare $1.4 billion in 2019 after accounting for shared savings/losses and discounts paid to CMS.