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policy

Together, these rules establish access standards and standardize review and assessment of Medicaid payment policies across states.

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policy

CDC reports no link between COVID-19 vaccination and sudden cardiac death; FDA grants EUA to an at-home test for both COVID-19 and the flu.

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policy

The final rule incorporates feedback from the association and coalition partners on the administrative dispute resolution process.

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policy

Hospitals at or above the 97th percentile of one of two metrics are subject to exceptions when calculating Medicaid DSH funding limits.

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policy

The rule includes payment and quality reporting provisions, a mandatory episode-based model proposal, and requests for feedback on maternity care and data reporting.

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quality

This meningococcal strain is disproportionately affecting individuals ages 30 to 60, Black or African American individuals, and individuals with HIV.

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quality

After a confirmed human infection with highly pathogenic avian influenza, CDC issues guidance for health care providers, health departments, and the public.

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policy

The rule aims to align state marketplace requirements with federal marketplace requirements, including by standardizing open enrollment dates.

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policy

The guidance requires hospitals to set clear guidelines to obtain informed consent before conducting sensitive examinations.

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policy

HHS modifies the definition of short-term, limited-duration insurance, as well as conditions under which indemnity insurance is an excepted benefit.

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policy

A CMS final rule removes administrative barriers, automates the renewal process, and updates outdated record-keeping regulations for Medicaid and the Children's Health Insurance Program.

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policy

The proposed rule includes guidelines for reporting cyber incidents and ransomware payments, along with consequences for noncompliance.

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policy

CMS extended the special enrollment period for individuals who lost Medicaid and CHIP coverage at the end of continuous enrollment to Nov. 30.

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policy

CDC reported an increase in MIS-C cases among unvaccinated children, and FDA authorized the first monoclonal antibody to prevent COVID-19.

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policy

A new letter and toolkit outline the administration's response to the Change Healthcare cyberattack and provide resources for health care providers.

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policy

The amicus brief, filed with other hospital associations, aims to ensure that physicians can rely on their medical judgment in stabilizing pregnant patients with emergency medical conditions.

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policy

Federal agencies report health insurance enrollment to mark the 10th anniversary of the Affordable Care Act marketplaces.

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policy

The Office of Climate Change and Health Equity announced a new round of office hours for its Inflation Reduction Act catalytic program to provide technical assistance with elective pay and transferability of clean energy credits.

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policy

CMS encourages all states to review their renewal processes and to test the renewal logic in eligibility systems.

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policy

The Government Accountability Office recommends that CMS require states to report on the outcomes of Medicaid managed care appeals.

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policy

The White House Challenge to Save Lives from Overdose asks stakeholders to commit to increasing access to opioid overdose reversal medications.

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policy

The Medicaid and CHIP Payment and Access Commission discusses widening its scope to review disproportionate share hospital funding policy in the context of other Medicaid payments.

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policy

Medicare Part A providers and Part B suppliers affected by the Change Healthcare cyberattack may apply for accelerated and advance payments.

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policy

CDC says Americans who tested positive no longer must isolate for five days under certain conditions; FDA grants emergency use authorization to the first at-home test detecting both the flu and COVID-19.

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policy

Following action to avert a partial government shutdown March 1, congressional lawmakers released an appropriations plan for the remainder of the current fiscal year that would eliminate the looming $8 billion cut to Medicaid disproportionate share hospital funding.

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policy

The document details payment features of Medicare fee-for-service Hospital Global Budgets under the States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD).

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policy

The collaborative will bring together providers, community partners, and other experts to explore challenges facing postpartum populations and solutions to improve postpartum mortality.

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policy

The rule finalizes a 2021 statutory requirement that hospitals, when calculating a Medicaid DSH cap, include only the costs and payments for patients for whom Medicaid is the primary payer or who are uninsured.

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policy

The agency proposes to increase oversight of organizations that accredit Medicare facilities, reduce conflicts of interest, and make surveys more consistent.

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policy

The accelerator will provide technical assistance to states implementing health-related social needs services through Medicaid and the Children's Health Insurance Program.

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policy

Patients now can give a single consent for all uses and disclosures for substance use disorder treatment, payment, and health care operations.

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policy

The Internal Revenue Service will hold office hours Feb. 6 and Feb. 9, from 1–2 pm ET, to assist with the prefiling registration process for elective payment of clean energy credits.

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policy

Paxlovid will no longer be authorized for emergency use after March 8; V-safe, the CDC's vaccine safety monitoring system, is once again open.

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policy

The FAQ clarify what constitutes full benefits for states extending Medicaid and Children's Health Insurance Program coverage for 12 months postpartum.

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policy

The FAQ include guidance for hospitals, long term care facilities, and critical access hospitals on enforcing and communicating visitation policies.

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policy

HHS and CMS will share training materials, convene hospital and provider associations to discuss best practices and challenges, and establish a team of experts to support hospitals.

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policy

The Administration for Strategic Preparedness and Response designed the goals in response to common attack vectors against hospitals identified in the 2023 Hospital Cyber Resiliency Landscape Analysis.

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policy

Hospitals have until March 31 to apply for the third round of Section 126 awards, which will implement 200 new Medicare-funded residency slots.

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policy

The rule requires payers to create application programming interfaces to facilitate payer-to-provider data sharing.

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policy

Comments on the Federal Independent Dispute Resolution Operations proposed rule now are due Feb. 5.

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policy

CMS will select eight organizations to test the eight-year behavioral health care integration model; applications will open in spring 2024.

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policy

The website provides tailored outreach and engagement resources for partners helping people with Medicaid and Children's Health Insurance Program renewals.

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policy

America’s Essential Hospitals urged HHS to withdraw its proposed information blocking disincentives for health care providers.

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policy

Comments on the rule, aims to improve the independent dispute resolution process for surprise medical bills, originally were due Jan. 2.

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policy

CDC reports no clear link between COVID-19 oral antiviral treatment and reduced risk of infection rebound as JN.1 cases rise; COVAX comes to an end after distributing nearly 2 billion COVID-19 vaccine doses.

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policy

The association supports provisions that will expand coverage for non–modified adjusted gross income populations and align open enrollment periods across all marketplaces.

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policy

The Transforming Maternal Health Model supports a whole-person approach to pregnancy, childbirth, and postpartum care for Medicaid and Children's Health Insurance Program patients.

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policy

HHS finalizes fees associated with the federal independent dispute resolution process for out-of-network services.

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policy

CMS shares strategies to ensure continuity of coverage amid a decline in Medicaid and CHIP enrollment among youth after the end of continuous enrollment.

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policy

GAO identifies weaknesses in CMS' policies and procedures for approving payments and makes recommendations to improve fiscal guardrails and transparency.

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policy

Effective Jan. 1, 2024, Medicare will cover marriage and family therapists, mental health counselors, and intensive outpatient services.

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policy

The rule establishes nationwide transparency requirements for artificial intelligence and algorithms used in health information technology.

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policy

HHS reopened the federal independent dispute resolution portal for all surprise billing disputes and will grant extensions for disputes affected by the portal’s closure.

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policy

Building on the National Cybersecurity Strategy, the department's strategy includes resources for hospitals to implement cybersecurity initiatives.

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policy

States that fail to meet reporting requirements must submit a corrective action plan that reinstates coverage for those affected or suspends procedural disenrollments.

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policy

The Office of Climate Change and Health Equity will host national and targeted webinars to help hospitals take advantage of funding for climate projects made available through the Inflation Reduction Act.

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policy

The CDC launched the National Wastewater Surveillance Program to detect traces of infectious diseases as COVID-19 hospitalizations increase for the third week in a row.

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policy

The FAQ instruct independent dispute resolution entities on how to process batched disputes and air ambulance disputes.

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policy

CMS released guidance outlining opportunities under Medicaid and CHIP for supporting efforts to address health-related social needs.

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policy

The proposed rule aligns state and federal marketplace requirements and includes several Medicaid provisions.

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policy

Missouri has extended postpartum coverage from 60 days to 12 months through the state plan authority established by the American Rescue Plan Act in 2021.

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policy

CMS outlines tools for states to monitor Medicaid and CHIP managed care, along with new submission requirements for Medicaid managed care contracts.

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policy

CMS advises state Medicaid programs on adding questions about sexual orientation and gender identity to Medicaid and CHIP applications.

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policy

Essential hospitals that serve primarily Black patients in the southeastern United States are invited to participate in a hypertension management program.

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policy

A CDC advisory committee recommends providers wear masks during routine check-ups to prevent the spread of respiratory infections; FDA advises providers to ensure they administer the correct vaccination dosage to youth.

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policy

The rule covers Part B payment to 340B hospitals, site-neutral payment policies, price transparency requirements, and outpatient quality reporting.

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policy

To certify, hospitals must provide data for three greenhouse gas emission sources and an action plan to reduce emissions.

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policy

In the Nov. 2 rule, the Centers for Medicare & Medicaid Services finalized its plan to make one-time, lump-sum payments totaling $9 billion to repay hospitals in the 340B Drug Pricing Program for nearly five years of illegal cuts to Part B drug reimbursements.

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policy

The proposed rule sets disincentives for health care providers to interfere with the access, exchange, or use of electronic health information.

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policy

The executive order calls for the formation of a Department of Health and Human Services Artificial Intelligence (AI) Task Force and tracking of AI-related clinical errors.

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policy

CMS answers FAQ about separate CHIP programs, enrollment fees, and unpaid premiums related to a Consolidated Appropriations Act, 2023 provision requiring continuous enrollment for children in Medicaid and CHIP.

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policy

Health care provider resources include strategies for talking with patients about flu, COVID-19, and respiratory syncytial virus vaccines.

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policy

A new program will help organizations use tax credits, grants, and other support structures in the Inflation Reduction Act to invest in climate projects.

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policy

Under the state plan amendments, states can provide 24/7 Medicaid services to eligible individuals experiencing a behavioral health or substance use crisis.

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policy

Two new resources educate health care providers and patients about privacy and security of protected health information in telehealth.

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policy

This extension authorizes practitioners to prescribe schedule II–V controlled medications via telemedicine through Dec. 31, 2024.

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policy

HHS will offer $600 million in funding for the production of new at-home COVID-19 tests and $45 million in grants to support long COVID-19 clinics; FDA amended the emergency use authorization of the Novavax COVID-19 vaccine to include its updated vaccine that targets XBB.1.5.

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policy

The independent dispute resolution portal is open for new billing disputes; HHS also issued guidance about qualifying payment amount calculation.

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policy

HHS announces $103 million to support obstetric care, forms the Task Force on Maternal Mental Health, and supports a postpartum depression campaign.

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policy

The Center for Medicaid & CHIP Services seeks information on assessing mental health and addiction equity parity compliance in Medicaid and CHIP; comments are due Dec. 4.

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policy

Effective Jan. 1, 2024, states must provide 12 months of continuous eligibility for children younger than age 19 in Medicaid and CHIP.

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policy

The guide covers federal and state policies and includes updated guidance on nonemergency medical transportation.

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policy

The portal combines monthly heat, wildfire, and drought outlooks with county-level data on risk factors for negative health outcomes from climate hazards.

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policy

CMS requires 29 states and Washington, D.C. to pause procedural renewals after system issues improperly disenrolled eligible beneficiaries from Medicaid.

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policy

America's Essential Hospitals called on CMS to provide an adequate annual payment update to cover the effects of inflation and rising workforce costs.

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policy

In its response to the Centers for Medicare & Medicaid Services, America's Essential Hospitals comments on policies for telehealth services, advanced diagnostic imaging, social determinants of health, and other Physician Fee Schedule proposals.

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policy

Effective Oct. 5, the State Department’s regulations will revert to the narrower definition of public charge in a 1997 State Department rule.

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policy

FDA approves Moderna and Pfizer-BioNTech's updated COVID-19 vaccines, and HHS announces $1.4 billion for Project NextGen.

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policy

The President’s Council of Advisors on Science and Technology outlines strategies to improve patient safety and reduce health care–associated injuries.

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policy

The association supports changes to the definition and duration of short-term, limited-duration insurance and requests clarification in application notices.

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Essential Insights

The Ohio State University Wexner Medical Center promotes sustainability through energy conservation, construction of efficient buildings, and intentional partnerships.

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policy

The States Advancing All-Payer Health Equity Approaches and Development Model focuses on chronic condition treatment and behavioral health.

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quality

Health care providers should send suspected isolates to a public health laboratory and promptly initiate antibiotic therapy or surgical intervention.

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policy

CMS urges states to review their Medicaid renewal processes to ensure eligible individuals are not disenrolled erroneously through ex parte renewals at the household level.

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policy

America’s Essential Hospitals urged CMS to swiftly finalize a remedy to repay 340B hospitals for five years of Medicare Part B drug payment cuts.

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quality

Ahead of Sepsis Awareness Month in September, CDC provides seven core elements to guide the creation of hospital sepsis management programs.

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policy

The Centers for Medicare & Medicaid Services is exploring a new model to promote health equity, with the goal of enhancing access to patient-centered care for underserved groups and including them in value-based care systems.

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policy

HHS will host the Aug. 24 webinar to gather input from a variety of health care stakeholders on hospital preparedness before, during, and after emergencies.

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cdc, cms, hhs
policy

The National Maternal Mental Health Hotline has provided support to nearly 13,400 people in its first year.

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policy

The administrative fee returns from $350 to $50 after an Aug. 3 court decision, but the independent dispute resolution portal remains closed to new disputes.

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policy

HHS announced the formation of the Office of Long COVID Research and Practice to lead the long COVID response as EG.5 subvariant cases increase.

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policy

The funding supports a program to help licensed practical nurses become registered nurses, the Nurse Faculty Loan Program, and other nurse training programs.

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policy

The National Action Alliance to Advance Patient Safety webinar, on Aug. 22, will highlight how leadership engagement can foster a culture of safety.

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policy

CMS has developed a three-step guide for state Medicaid programs to develop a claiming methodology for the differential match rate.

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policy

The letters review the state's May 2023 Medicaid unwinding metrics and compliance with federal requirements in three categories.

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policy

The toolkit aims to help states increase postpartum care access, quality, and equity by maximizing existing Medicaid authorities.

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policy

CMS suspended the independent dispute resolution process for certain surprise billing disputes due to an Aug. 3 court decision.

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policy

The rule includes changes to the calculation of Medicare disproportionate share hospital payments and payment and quality reporting provisions.

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policy

The rule aims to reinforce a law requiring that consumers have the same access to mental health and SUD benefits as they do physical health benefits.

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policy

CMS will release state Medicaid and Children's Health Insurance Program renewal data on a monthly, two-part basis due to data availability. 

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policy

Hospitals have until Sept. 11 to complete recertification for the 340B Drug Pricing Program through the Office of Pharmacy Affairs Information System.

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policy

CMS outlines three strategies to improve treatment and support for Medicaid and CHIP enrollees with mental health and substance use disorder conditions.

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policy

An August webinar series will provide strategies for reaching out to diverse communities to share information about Medicaid and CHIP renewals.

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policy

The states will implement mitigation strategies before starting procedural terminations for Medicaid beneficiaries who have not renewed.

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policy

In California and Kentucky, mobile teams can provide Medicaid services to individuals experiencing a behavioral health or substance use crisis.

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policy

A new letter warns health systems and telehealth providers that online web tracking technologies can send sensitive information to third parties.

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policy

CMS released a request for information to aid the design of a future episode-based payment model to be implemented no later than 2026.

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cms
policy

The proposed rule would clarify and reaffirm the prohibition on discrimination on the basis of sexual orientation and gender identity in certain statutes.

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policy

The CDC Bridge Access Program will provide no-cost COVID-19 vaccines to uninsured and underinsured adults following the end of the COVID-19 Vaccine Distribution Program; the GAO released a new report outlining recommendations for future public health emergency preparedness.

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policy

The rule revises site-neutral payment policies, updates price transparency requirements, and changes outpatient quality reporting, among other provisions.

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policy

The proposed rule includes provisions for Medicare reimbursement of telehealth services, quality programs, and social determinants of health data collection.

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policy

HHS proposes to modify the definition of short-term, limited-duration insurance and conditions surrounding hospital or other fixed indemnity insurance.

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policy

The FAQ respond to concerns about the definition of cost sharing and facility fees in the No Surprises Act and Affordable Care Act.

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policy

CDC reports that roughly three-fourths of all Americans aged 16 and older had contracted COVID-19 by the end of 2022; the agency also reports new data showing the disproportionate effect of COVID-19 on the lowest-income communities.

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policy

CMS proposes to remedy five years of unlawful cuts to Medicare Part B reimbursement for separately payable drugs with lump-sum payments expected in late 2023 or early 2024.

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policy

CMS is publishing all approved state directed payment preprints on its website, along with preprint addendum tables in Excel workbook format.

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policy

The FAQ clarify the new enforcement authority in the Consolidated Appropriations Act, 2023 related to states' federal medical assistance percentage.

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policy

Starting Oct. 1, Medicaid and the Children’s Health Insurance Program will cover only COVID-19 vaccines that have been fully approved by the Food and Drug and Administration.

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policy

The association urged CMS to ensure sufficient payment rates in the Medicaid managed care and fee-for-service programs for providers in hospital settings.

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policy

The association urged an appeals court to restore an Affordable Care Act requirement that most health plans cover certain preventive services.

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policy

Moderna seeks FDA authorization for an updated vaccine, Invivyd announces a pathway to potential emergency use authorization for the monoclonal antibody adintrevimab, and the CDC tracks a new subvariant, EU.1.1.

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policy

The Medicaid and CHIP Payment and Access Commission's June report to Congress includes recommendations on countercyclical disproportionate share hospital policy and explores health care challenges faced by adults leaving incarceration.

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policy

The FDA's Vaccines and Related Biological Products Advisory Committee advises manufacturers to develop a monovalent vaccine targeting XBB, the globally dominant subvariant, in time for the fall.

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policy

A proposed rule allows certain entities exempt from federal tax, including hospitals, to 12 clean energy tax credits through the Inflation Reduction Act.

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policy

HHS offers flexible options states can adopt to ensure smooth transitions of coverage during the Medicaid redetermination process.

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policy

From July 2024 through 2034, CMMI will pilot in eight states the Making Care Primary Model, which will support value-based primary care.

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policy

The final rule retroactively affects the calculation of Medicare disproportionate share hospital payments from fiscal years 2005 to 2013.

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policy

The association urged CMS to increase the proposed annual hospital payment update and adopt a safety net hospital definition and related payment policies.

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policy

A CDC study confirms that a third mRNA vaccine is safe for children; FDA grants marketing authorization for the Cue at-home COVID-19 test.

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quality

The National Action Alliance to Advance Patient Safety will host three webinars on patient safety and violence prevention in health care settings.

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policy

The new group, comprising two divisions from existing groups, will monitor and provide technical assistance to state and territory managed care programs.

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policy

Two CDC studies indicate that adults who have not received a bivalent mRNA booster vaccine have little remaining protection against COVID-19–associated hospitalization and that half of Americans aged 16 and up have hybrid immunity against the virus.

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policy

CMS says the withdrawal of the mandate, effective immediately, aligns with the agency's approach to other infectious diseases.

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policy

The Food and Drug Administration approves Paxlovid to treat COVID-19 in adults; a National Institutes of Health study sheds new light on long COVID-19.

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policy

The proposed rule targets drug misclassification, along with drug pricing and product data misreporting, by manufacturers.

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policy

The report summarizes HHS' progress, barriers, and future plans to improve access to services for individuals with limited English proficiency.

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policy

A World Health Organization advisory group recommends using the XBB subvariant in future vaccines; the National Institute for Occupational Safety and Health recalls eight respirators.

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policy

A new guide provides educational and referral strategies for health care providers to mitigate health issues related to climate change.

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policy

The FAQ guide state Medicaid and Children's Health Insurance Program agencies as they begin terminating enrollment for those who no longer qualify.

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policy

An HHS fact sheet details policy changes with the end of the COVID-19 public health emergency; ASPR announces Project NextGen; CDC says the Johnson & Johnson vaccine no longer is available in the United States.

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policy

The letter expressed concern with reports that HRSA no longer will allow hospitals to administer 340B drugs in offsite outpatient locations that have not yet appeared on a filed Medicare cost report.

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policy

Health care providers will be able to prescribe controlled medication without requiring an initial in-person visit through Nov. 11.

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policy

The World Health Organization has ended the COVID-19 global health emergency designation, and the CDC will use hospitalization data to track COVID-19 spread.

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policy

The brief urges an appeals court to restore an Affordable Care Act requirement that most health plans cover certain preventive services.

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policy

After receiving record comments on proposals to limit the prescription of controlled substances via telemedicine, the DEA will extend this COVID-era flexibility.

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policy

The six new members will review Medicaid and CHIP access and payment policies and make recommendations to Congress, the administration, and states.

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policy

Hospitals have until June 1 to preview their Overall Hospital Quality Star Rating, measure group score, individual measure results, and peer grouping.

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policy

FDA amends the Pfizer vaccine authorization for immunocompromised children aged 6 months to 4 years old, while the Biden administration ends its vaccine requirement for federal employees.

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policy

The May 5 webinar will feature CMS experts sharing how the end of the PHE will affect current health care waivers and flexible policies.

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policy

Two proposed rules establish access standards and standardize review and assessment of Medicaid payment rates across states; comments are due to CMS July 3.

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policy

The association urged CMS to withdraw its proposal to exclude patient days related to uncompensated care pools from the Medicare disproportionate share hospital funding calculation.

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policy

To increase compliance with the hospital price transparency rule, CMS has set new compliance timelines and no longer will issue warning notices.

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policy

In a letter to hospital and provider associations, Secretary Becerra emphasized health care providers' legal duties to provide emergency care.

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policy

A new webinar series will share government resources for health care stakeholders to reduce emissions and build resilience.

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policy

The rule updates essential community provider requirements for qualified health plans and adds a special enrollment period for those losing Medicaid or CHIP coverage.

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policy

The rule would allow DACA recipients to be eligible for health care coverage through the Affordable Care Act marketplace, Medicaid, and the Children's Health Insurance Program.

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policy

The new tool from the federal Office of Climate Change and Health Equity explains opportunities in the Inflation Reduction Act for tax credits and other support for climate mitigation work.

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policy

The association urged CMS to work with Congress to avoid unintended cuts to Medicaid disproportionate share hospital payments imposed by Section 203.

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policy

CDC simplifies vaccine recommendations for all age groups; a new HHS program supports COVID-19 vaccines and treatments for uninsured Americans.

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policy

The Supporting Safety Net Hospitals Act would eliminate devastating cuts to Medicaid disproportionate share hospital funding in fiscal years 2024 and 2025.

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policy

Individuals ages 65 and older are eligible for a second bivalent dose; HHS will end vaccine administration flexibility granted during the public health emergency.

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policy

A new Section 1115 demonstration will support service delivery systems that facilitate reentry transitions for Medicaid-eligible individuals leaving prisons and jails.

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policy

In honor of Black Maternal Health Week, CMS shares recent work and resources focused on advancing equity in obstetric outcomes.

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policy

President Biden signs a bill ending the COVID-19 national emergency; FDA grants emergency use authorization to a vilobelimab treatment.

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policy

The proposed fiscal year 2024 Inpatient Prospective Payment System rule includes a request for feedback on defining safety net hospitals; CMS will accept comments until June 9.

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quality

Amid two international outbreaks of the rare but highly fatal viral hemorrhagic fever, CDC provides virus identification and biosafety recommendations.

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policy

A new categorical waiver allows health care facilities to use alternate power sources other than a generator or battery system.

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policy

Both the CDC and World Health Organization now recommend just one bivalent booster dose for healthy adults and children with no immunocompromising conditions.

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policy

The upcoming end of the COVID-19 national emergency will not affect policies enacted during the public health emergency issued under a separate declaration.

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policy

The report includes recommendations for therapeutic practices for youth of diverse sexual orientation and gender identity.

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policy

The state has extended postpartum coverage from 60 days to 12 months through the state plan authority established by the American Rescue Plan Act in 2021.

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policy

FDA releases guidance on transitioning to normal operations for medical device authorization after the public health emergency ends and continues to monitor the effect of viral mutation on test performance.

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quality

The agency calls the rapid rise and geographic spread of Candida auris concerning and emphasizes the need for surveillance, expanded lab capacity, quicker diagnostic testing, and adherence to infection prevention and control.

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policy

FDA announces that children aged 6 months through 4 years old who completed primary monovalent COVID-19 vaccination are now eligible to receive a bivalent booster dose, while agency advisers vote in favor of full Paxlovid approval.

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quality

The agency shared resources for protecting patients and providers from infectious disease threats, such as antimicrobial resistance.

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policy

To exclude 340B drugs from Medicare Part B inflation rebates required by the Inflation Reduction Act, providers must identify 340B drugs on Medicare claims. 

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policy

The decision comes after HHS halted payment determinations following a February court ruling vacating certain provisions of the No Surprises Act.

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policy

The guide tailors the 2018 National Institute of Standards and Technology Framework for Improving Critical Infrastructure Cybersecurity to the health sector.

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policy

The report reviews how COVID-19 public health emergency policies affected hospital finances and includes state-specific projections for the Medicaid disproportionate share hospital funding cuts scheduled to take effect Oct. 1.

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policy

Per the Inflation Reduction Act, drug manufacturers that increase prices faster than the inflation rate will be required to pay rebates to Medicare.

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policy

FDA announced March 10 that it will withdraw and revise several COVID-19 guidance documents, including emergency use authorization of surgical masks, as circumstances surrounding the virus evolve.

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policy

The updated guidance highlights the importance of sustaining a QAPI program over time and increasing engagement by the hospital’s governing body.

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policy

The voluntary pledge asks institutions to commit to reducing emissions, taking inventory of scope 3 emissions, and developing climate resilience plans.

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policy

A bivalent vaccine that protects against SARS-CoV-2 and influenza will not be available this year, while a CDC advisory committee says there is not enough evidence to recommend more than one annual COVID-19 booster for immunocompromised people.

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policy

Two proposed rules would extend many flexible provisions enacted during the COVID-19 public health emergency for prescribing controlled substances.

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policy

States may start initiating Medicaid renewals between February and April and terminating enrollment for individuals who no longer qualify as early as April 1.

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policy

Applications close May 31 for the two-year extension of the Bundled Payments for Care Improvement Advanced voluntary payment model.

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policy

CMS proposes to limit the types of Medicaid Section 1115 waiver days that can be included when calculating a hospital’s disproportionate patient percentage.

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quality

Shigella infections caused by extensively drug-resistant strains comprise about 5 percent of Shigella infections reported to CDC.

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policy

FDA authorizes the first at-home nasal test that detects influenza A and B as well as COVID-19; Moderna reaches a $400 million agreement with the National Institutes of Health.

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policy

The proposed rule implements Section 203, which alters the process for calculating the Medicaid disproportionate share hospital uncompensated care limit.

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policy

The order instructs agencies to produce an annual public equity action plan, build agency equity teams, and improve community engagement.

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policy

The bulletin advises that arrangements among providers to redistribute Medicaid payments violate the hold harmless provisions of the law.

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policy

National Institutes of Health research finds that Black and Hispanic Americans face greater long COVID-19 risks, the CDC says that primary series vaccination protects children ages 3–5 for four months, and Novavax will deliver an additional 1.5 million doses.

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policy

The association asked that CMS swiftly make 340B hospitals whole for reduced Medicare Part B reimbursement from 2018 to fall 2022, plus applicable interest.

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policy

HHS instructed federal independent dispute resolution entities not to issue new payment determinations in out-of-network billing payment disputes.

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policy

The CDC updated the 2023 immunization schedule for children and adolescents to include the COVID-19 primary vaccine series, and the FDA cleared for commercial distribution a device that detects 15 respiratory viral and bacterial infections.

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policy

The roadmap outlines which policies implemented under the COVID-19 public health emergency (PHE) will be affected when the PHE ends May 11.

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policy

Drug manufacturers that increase prices faster than the inflation rate must pay rebates to Medicare; comments on this policy are due to CMS March 11.

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policy

Following the agenda's release, HHS on Feb. 10 requested information on promising practices for advancing health equity for intersex individuals.

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quality

A CDC report finds that patients receiving dialysis treatment for end-stage kidney disease, especially Hispanic patients, are at an increased risk of contracting Staphylococcus aureus bloodstream infections.

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policy

FDA no longer requires a positive COVID-19 test to receive a Paxlovid or Lagevrio prescription; CDC reports that bivalent boosters protect against XBB and XBB.1.5 SARS-Co-V-2 subvariants.

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policy

The updated fact sheets share when specific waivers will end and whether they will continue after the public health emergency's end on May 11.

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policy

The guidance informs states how to maintain the temporary increased federal medical assistance percentage while returning to normal Medicaid operations.

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policy

Qualified individuals and their families who lose Medicaid or CHIP eligibility once the continuous enrollment requirement ends can apply for marketplace coverage between March 31, 2023, and July 31, 2024.

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policy

The Biden administration announced that the COVID-19 public health emergency, initially declared Jan. 27, 2020, will end May 11.

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policy

FDA's Vaccines and Related Biological Products Advisory Committee votes to replace the original monovalent COVID-19 vaccine, Evusheld no longer is authorized under emergency use, and the CDC launches a COVID-19 testing locator.

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policy

The Drug Enforcement Administration no longer will require additional registration for prescribers to prescribe buprenorphine.

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policy

CMS reports that open enrollment through the health insurance marketplaces for 2023 totals 16.3 million people, a 13 percent increase from 2022.

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policy

An FDA committee will vote on the future of the COVID-19 vaccine, while CDC unveils two trackers for COVID-19, flu, and RSV–related hospital and emergency department visits.

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policy

The association supports HHS' work to align the rule more closely with HIPAA regulations, which will improve care coordination and mitigate discrimination.

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policy

In a new podcast series by a physician at association member NYC Health + Hospitals, Beth Feldpush, DrPH, the association's senior vice president of policy and advocacy, unpacks the complex patchwork of payments that keep essential hospitals afloat. 

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policy

The National Institutes of Health launches the Home Test to Treat program; FDA and CDC report a COVID-19 vaccine safety concern for those ages 65 and older.

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policy

America's Essential Hospitals and other plaintiffs had asked the judge to order an immediate repayment in full for five years of underpayments to 340B hospitals.

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policy

A CMS letter to state Medicaid directors clarifies how in lieu of services (ILOS) can be used to mitigate health disparities, limits ILOS expenditures, and adopts documentation and review requirements.

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policy

The association supports CMS' work to simplify enrollment and asks the agency to ensure equitable access to beneficiaries’ preferred health care providers.

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policy

Prioritizing hospitals in health professional shortage areas, CMS awarded residency slots to 100 hospitals, including 27 essential hospitals.

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policy

Effective Jan. 11, Health and Human Services Secretary Xavier Becerra renewed the COVID-19 public health emergency determination.

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policy

FDA and CDC say Evusheld is unlikely to neutralize the XBB.1.5 subvariant, and a CDC report indicates COVID-19 vaccination in children and adolescents is highest among Asian and Hispanic youth. 

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policy

After the omnibus bill decoupled Medicaid redeterminations from the end of the COVID-19 public health emergency, CMS updates key redetermination dates.

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policy

Medicaid and CHIP coverage of interprofessional consultation is permissible as long as the consultation is for the beneficiary's direct benefit.

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policy

FDA approves the use of Actemra, a monoclonal antibody treatment, as COVID-19 cases caused by the XBB.1.5 subvariant of SARS-CoV-2 spike.

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policy

The report summarizes responses to a 2022 request for information, which focus on eligibility and enrollment, access to hospital services, and payment.

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policy

The proposed rule updates essential community provider requirements for qualified health plans and adds a special enrollment period for those disenrolled from Medicaid or CHIP.

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policy

Americans again can request four no-cost, at-home COVID-⁠19 tests per address; FDA's vaccine committee will meet in January to develop a long-term strategy.

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policy

A proposed rule will make permanent a temporary policy to allow providers to initiate buprenorphine prescriptions for new patients through telehealth.

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policy

The dashboard tracks nonfatal opioid overdoses by state and county and will help service providers target substance use disorder interventions and treatment.

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policy

CDC expands its recommendation for bivalent COVID-19 vaccines for children ages 6 months to 5 years old as health agencies confront low vaccination rates among children.

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policy

The proposed rule leverages application programming interfaces to exchange health information and automate the provider prior authorization process.

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policy

FDA pauses its emergency use authorization of bebtelovimab, which does not protect against prevalent SARS-CoV-2 subvariants; CDC updates its guidance for managing COVID-19 in congregate living settings to align with previous guidance.

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policy

The agency will not enforce a surprise billing requirement that requires good faith estimates to include cost estimates from co-providers and co-facilities.

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policy

The proposed administrative dispute resolution process delegates the majority of decision-making authority to Office of Pharmacy Affairs staff and has no minimum monetary threshold for claims.

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policy

The proposed rule aims to align Part 2 more closely with HIPAA, improve care coordination, and increase anti-discrimination protections for patients with substance use disorder.

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policy

New COVID-19 vaccine initiatives seek to address access inequalities, and NIH launches a website where Americans can self-report COVID-19 test results anonymously to provide data to public health departments.

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policy

The memo reviews regulatory obligations to care for patients in a safe environment, including the need to identify patients at risk for intentional harm to themselves or others.

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policy

Pfizer-BioNTech and Moderna data indicate that bivalent vaccines provide greater protection than the original monovalent vaccine against the emerging BQ.1.1 omicron subvariant, while the CDC reports low COVID-19 vaccination numbers among children.

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quality

At a Nov. 14 listening session, HHS leaders announced plans to launch in 2023 a learning community focused on patient and health care worker safety.

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quality

The agency shares toolkits to help acute-care, long-term care, and ambulatory care facilities adopt the Four Moments of Antibiotic Decision Making framework.

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policy

The agency shared three sample formats to help hospital staff build machine readable files to comply with the Hospital Price Transparency Rule.

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policy

A JAMA Network open study highlights disparities in access to Test-to-Treat sites; the Biden administration holds a White House COVID-19 Equity Summit.

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policy

The CMS Innovation Center shares a progress report on its 10-year strategy and a blog post announcing plans to improve integrated specialty care.

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policy

A new report from the Department of Veterans Affairs indicates that Paxlovid can reduce risk of long COVID-19; new data show Pfizer bivalent COVID-19 booster vaccines substantially increase immune responses compared with monovalent vaccines.

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policy

The association urges CMS to educate and provide funding for essential hospital staff to conduct Medicaid and CHIP eligibility and enrollment activities.

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policy

The Medicare Outpatient Prospective Payment System final rule for calendar year 2023 reverses cuts to hospitals in the 340B Drug Pricing Program and delays developing a remedy for cuts to 340B hospitals that have been in place since 2018.

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policy

The rule finalizes the conversion factor and includes reimbursement provisions for telehealth and behavioral health services, the Quality Payment Program, and the Medicare Shared Savings Program.

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policy

President Joe Biden urges Americans to get their updated COVID-19 vaccine, which protects against the original SARS-CoV-2 variant and BA.4 and BA.5 subvariants.

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policy

Financial, educational, and workplace challenges pose obstacles to recruiting and retaining a diverse behavioral health workforce.

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policy

Currently, 26 states have extended Medicaid and Children's Health Insurance Program coverage from 60 days to 12 months postpartum.

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policy

A CDC committee recommends the inclusion of COVID-19 vaccines in the 2023 immunization schedule; the administration releases a biodefense strategy.

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policy

CDC recommends for younger age groups updated Pfizer and Moderna COVID-19 booster vaccines that target the BA.4 and BA.5 subvariants of SARS-CoV-2.

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quality

International Infection Prevention Week, Oct. 16–22, highlights infection preventionists' role in protecting public health through education.

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policy

The decision to revert to the full payment rate is in compliance with a recent federal district court decision in favor of America’s Essential Hospitals.

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policy

CMS extends for two years the Bundled Payments for Care Improvement Advanced Model and alters the accounting process for beneficiaries with COVID-19.

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policy

Effective Oct. 13, Health and Human Services Secretary Xavier Becerra renewed the COVID-19 public health emergency determination.

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policy

HHS links COVID-19 vaccinations to fewer COVID-19 hospitalizations and deaths, and NIH details its plan to study long COVID-19 effects.

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policy

CDC issued a health advisory reminding health care providers to remain aware of a patient’s international travel history.

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policy

FDA now urges COVID-19 test developers to take traditional premarket review pathways, and HHS will cover the cost of 60,000 bebtelovimab doses.

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policy

In a new Forefront commentary, the association's current, immediate past, and incoming board chairs say essential hospitals’ indispensable role, unique characteristics, and financial fragility argue for recognizing them as a distinct class in public health and policymaking.

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policy

America's Essential Hospitals urges HHS to codify a nondiscrimination standard and establish nondiscrimination training for all health care workers.

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policy

A federal district court ruled that HHS must pay hospitals in the 340B Drug Pricing Program the full Medicare Part B drug payment rate for the remainder of calendar year 2022.

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policy

CDC updates guidance on infection control for health care personnel and staff shortages, as well as its global pandemic response strategy.

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policy

AHRQ published a primer detailing how hospitals and health systems can reduce their carbon footprint and protect communities from climate threats.

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policy

The roadmap implements the three pillars of the President's March 2022 Strategy to Address our National Mental Health Crisis.

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policy

CDC reports lower in-hospital mortality rates from the omicron variant, providers have until Sept. 30 to report period 3 Provider Relief Fund spending.

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policy

HHS seeks input on the No Surprises Act's advanced explanation of benefits and good faith estimate requirements for insured individuals; comments are due Nov. 15.

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policy

America's Essential Hospitals urges CMS to swiftly restore full Medicare Part B drug payment rates for hospitals in the 340B Drug Pricing Program and define a select group of hospitals with a safety net mission.

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policy

The Biden administration encourages organizations to commit to working toward its goal of ending hunger and increasing healthy eating and physical activity by 2030.

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policy

The Biden administration's fall plan to manage the COVID-19 pandemic includes securing millions of updated vaccines and additional at-home, rapid tests; ensuring vaccine access for higher-risk Americans; and fostering community conversations about updated vaccines.

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policy

The agency requests information on health care access and equity, provider experiences, and the effect of policies introduced in response to COVID-19.

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policy

The association urged CMS to adequately reimburse off-campus, provider-based departments; refine physician quality reporting; and codify a definition of essential hospitals.

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policy

A September continuing resolution provides a potential legislative vehicle for health policy provisions. We summarize key workforce priorities and actions from Congress, the administration, and the association.

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policy

CDC recommends updated Pfizer and Moderna COVID-19 booster vaccines that target the BA.4 and BA.5 subvariants of SARS-CoV-2.

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policy

An Aug. 31 CMS proposed rule aims to streamline Medicaid and CHIP enrollment and ensure continuous coverage throughout the renewal process.

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policy

CMS on Aug. 29 finalized its decision to delay indefinitely implementation of the Radiation Oncology Model, which was scheduled to start Jan. 1, 2023.

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policy

No-cost, at-home COVID-19 tests no longer will be offered through the United States Postal Service, CDC releases a fall vaccination plan, and FDA warns prescribers about Paxlovid drug interactions.

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policy

The Department of Homeland Security finalized a rule codifying the Deferred Action for Childhood Arrivals program with some limited changes.

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policy

The annual 340B Drug Pricing Program recertification period for hospitals began Aug. 24. Hospitals will have until Sept. 19 to complete the process.

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policy

Pfizer applies for emergency use authorization for its omicron-specific booster vaccine, the National Healthcare Safety Network will take over hospital data reporting, and CMS tells hospitals to brace for the public health emergency's end.

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policy

The rule finalizes disclosure requirements for the qualifying payment amount and select provisions for the related independent dispute resolution process.

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policy

CDC updated its COVID-19 safety guidelines, FDA warned of false negative test risks, and bebtelovimab will transition to the commercial marketplace.

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policy

HHS releases two new reports on long COVID-19 research and support, while the Administration for Strategic Preparedness & Response shares guidance on Paxlovid efficacy and eligibility.

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policy

The proposed rule expands the definition of discrimination "on the basis of sex" and explicitly includes telehealth services in nondiscrimination policies.

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policy

The declaration enables HHS to modify Medicare and Medicaid program requirements and could lead to more emergency funding for virus prevention and vaccines.

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policy

Health care providers have until Aug. 30 to download their preview reports before CMS shares quality data publicly in October.

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policy

The regulation contains payment and quality reporting provisions, a new designation to identify “birthing-friendly” hospitals, and a 4.3 percent increase in operating payment rates for general acute-care hospitals, compared with a proposed 3.2 percent update.

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policy

This is the second star ratings update since the agency updated its methodology in 2020 to include the use of peer grouping.

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policy

HHS agreed to purchase 66 million Moderna bivalent COVID-19 vaccine doses, while the CDC reported fewer vaccine reactions for those older than 50 who receive a second mRNA booster shot.

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policy

As the World Health Organization declares monkeypox a global health emergency, CDC updates clinical guidance, and HHS plans to allocate additional vaccine doses.

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policy

CDC recommends the Novavax COVID-19 vaccine for adults and reports that additional mRNA COVID-19 vaccine booster doses increase protection against moderate and severe COVID-19.

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policy

The Aug. 22 webinar will complement other federal resources on the annual 340B Drug Pricing Program recertification period for hospitals, open from Aug. 24 to Sept. 19.

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policy

The Department seeks comment on Public Service Loan Forgiveness program eligibility policies for physicians at nonprofit hospitals.

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policy

CMS seeks feedback at a July 21 listening session on the 5 percent lump sum Alternative Payment Model Incentive Payment, set to expire at the end of 2022. 

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policy

FDA approves the Novavax COVID-19 vaccine for those 18 and older as the Biden-Harris administration releases an action plan to take on the BA.5 subvariant.

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policy

The Medicare Outpatient Prospective Payment System proposed rule for calendar year 2023 reverses cuts to 340B Drug Pricing Program hospitals and seeks comment on remedying existing cuts to 340B hospitals.

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policy

Effective July 15, Health and Human Services Secretary Xavier Becerra renewed the COVID-19 public health emergency determination.

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policy

CMS proposes to decrease the conversion factor determining physician payment rates for specific services by $1.53. The proposed rule also includes provisions related to Medicare reimbursement of telehealth services, vaccine administration, and the Medicare Shared Savings Program.

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policy

FDA approves the Pfizer COVID-19 vaccine for use in individuals ages 12 to 15 and authorizes state-licensed pharmacists to prescribe Paxlovid.

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policy

Certain providers who returned Provider Relief Fund payments because they were unable to meet the period 1 reporting deadline can apply for reissuance of these funds.

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policy

The document outlines five priority goals to improve maternal health and outcomes and, for each, actions the federal government will take.

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policy

The GAO reviewed recent and planned actions to enhance oversight of state directed payments and found the effectiveness of these actions is unknown and information gaps remain.

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policy

The strategy aims to deploy vaccines rapidly in the most affected communities, facilitate testing, and engage stakeholders to mitigate spread.

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policy

The HHS Office of Climate Change and Health Equity announced a climate change webinar series, beginning July 14, and shared a companion resource compendium.

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policy

FDA advises vaccine manufacturers to incorporate an omicron variant component into booster doses; Pfizer requests FDA approval of antiviral pill Paxlovid.

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policy

CDC recommends the Moderna vaccine for kids ages 6 to 17; an FDA committee will consider modifying COVID-19 vaccine composition to reflect virus mutations.

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policy

CDC recommends that children ages 6 months to 5 years receive a COVID-19 vaccine; Pfizer study data shows Paxlovid failed to alleviate COVID-19 symptoms.

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policy

In a resounding victory for essential hospitals, the U.S. Supreme Court unanimously ruled in favor of America’s Essential Hospitals in its years-long legal challenge to restore full Medicare payment rates for 340B Drug Pricing Program hospitals.

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policy

The order instructs the HHS Secretary to use the agency's authorities to protect LGBTQI+ individuals' access to medically necessary care.

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policy

In its June report to Congress, the Medicaid and CHIP Payment and Access Commission considers oversight of managed care directed payments and examines Medicaid's role in advancing health equity.

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policy

The commission's June report to Congress includes illustrative policies about defining and supporting Medicare safety net providers and aligning payments across outpatient settings, among other topics of interest to essential hospitals.

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policy

The Supreme Court’s dismissal of the appeal does not touch on the legality of the public charge rule but only on the ability of the 13 states to intervene in defense of the rule.

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policy

America's Essential Hospitals commented on several policy proposals of interest to essential hospitals and responded to requests for information on maternal health, equity, and climate change.

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policy

The tool compiles existing guidance to help states prepare to return to regular Medicaid operations after the COVID-19 public health emergency ends.

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policy

CDC no longer requires a negative COVID-19 test or proof of COVID-19 recovery from travelers to the United States; an FDA advisory committee recommends the Novavax vaccine.

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policy

The National Steering Committee for Patient Safety calls on health care providers to put its 2020 Action Plan into practice.

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policy

Hospitals have until June 16 to preview their Overall Hospital Quality Star Rating, measure group score, and individual measure results, along with peer grouping.

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policy

An FDA advisory committee deliberates the safety of Novavax's COVID-19 vaccine and will consider amendments to Pfizer's and Moderna's authorization requests later this month.

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policy

The agency's strategy to strengthen behavioral health care focuses on improving access, equity, quality, and data integration.

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policy

FDA extended the shelf life of select lots of bebtelovimab and updated the authorization for Evusheld to include information about hypersensitivity risks.

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policy

CMS on May 25 approved proposals in four states to extend postpartum Medicaid coverage from 60 days to one year after birth.

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policy

A new advisory from U.S. Surgeon General Vivek Murthy, MD, MBA, calls for a whole-of-society approach to protect and support health workers facing burnout.

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policy

The webpage includes renewal instructions for eligible beneficiaries and guidance for ineligible beneficiaries to secure insurance through the marketplaces.

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policy

CDC is tracking monkeypox, a virus endemic to west and central Africa, after confirming a case in a Massachusetts resident who recently traveled to Canada.

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policy

A new CMS resource highlights federal requirements for program renewals, verifications, applications, and oversight amid the anticipated COVID-19 public health emergency unwinding.

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policy

Pfizer and BioNTech release promising data on a three-dose COVID-19 vaccine for children six months to younger than 5; CDC expands booster shot eligibility to include everyone 5 years old and older.

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policy

The current National Suicide Prevention Lifeline number, 1.800.273.8255, will transition to 988 on all devices on July 16.

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policy

The association urged HHS to provide funding, educate stakeholders, and build capacity to execute the 2022 Environmental Justice Strategy and Implementation Plan.

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policy

HHS urges governors to start planning for the end of the COVID-19 public health emergency; FDA authorizes a Pfizer booster vaccine for children ages 5 to 11.

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policy

New HHS initiatives focus on climate change, health equity, and the role health care stakeholders can play in promoting climate resilience.

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policy

FDA limits authorized use of the Janssen COVID-19 vaccine after reports of thrombosis with thrombocytopenia syndrome following vaccination; a new analysis estimates vaccines are associated with $2.6 million in savings due to a reduction in Medicare hospitalizations.

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policy

A new omicron subvariant, BA.2.12.1, constitutes more than 30 percent of U.S. genomic sequences; Moderna files for emergency use authorization for a vaccine for children younger than 6.

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policy

The association thanked the administration for taking steps to reverse the damaging 2019 broadened definition of public charge and made recommendations for developing and implementing a new definition.

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policy

The final rule raises the essential community provider threshold from 20 to 35 percent and uses wait time standards to evaluate qualified health plans for network adequacy.

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policy

In a white paper, the association encourages CMS to develop policies that reduce disparities and incorporate equity into waiver approval and evaluation processes.

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policy

Moderna releases promising preliminary data on its variant-specific COVID-19 booster shot; CDC launches a Center for Forecasting and Outbreak Analytics.

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policy

The Accreditation Council for Graduate Medical Education introduced two rural track program designations to accredited residency programs and seeks members for an advisory group on health care access for medically underserved areas and populations.

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policy

Hospitals and other industry stakeholders are invited to pledge by June 3 to reduce greenhouse gas emissions and increase their climate resilience.

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policy

America's Essential Hospitals generally supports the tool, as it will direct investments to target several social determinants of health, but recommended the tool show aggregate data at the state and county levels.

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policy

The action plan includes goals to close gaps in health care access, quality, and outcomes through data collection, outreach, and community engagement.

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policy

The proposed fiscal year 2023 Inpatient Prospective Payment System rule would increase operating payment rates by 3.2 percent and make other changes to Medicare payment and quality reporting policies. CMS is accepting comments on the proposed rule until June 17.

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policy

The independent dispute resolution process can be initiated to resolve payment disputes between health care providers and issuers.

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policy

The association made recommendations on payment rates, workforce development, eligibility and enrollment policies, and measuring access to hospital services.

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policy

A federal judge in Florida ruled against the Centers for Disease Control and Prevention (CDC) travel mask requirement, ending the Transportation Security Administration's enforcement of the mandate. But the CDC continues to recommend masking during traveling.

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policy

Effective April 16, Health and Human Services Secretary Xavier Becerra renewed the public health emergency determination related to the continued effects of COVID-19; the determination has been in place since Jan. 27, 2020, and has been renewed every three months.

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policy

President Joe Biden announces a national research plan on prolonged illness developed after COVID-19; FDA limits authorization of sotrovimab to treat COVID-19.

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policy

Two new documents provide guidance for health care providers on No Surprises Act compliance and good faith estimates for uninsured or self-pay patients.

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policy

CMS shares tools to mitigate an anticipated increase in Medicaid fair hearing requests and resume normal operations after the COVID-19 public health emergency ends.

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policy

Recommendations for Medicare and Medicaid equity measures under development focus on standardized data collection and opportunities for testing and feedback.

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policy

CDC recommends an additional COVID-19 booster for older and immunocompromised adults; COVID.gov aggregates COVID-19 prevention and treatment tools; CDC data show threats to youth mental health during the pandemic.

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policy

FDA authorizes a second vaccine booster for older and immunocompromised individuals; OSHA reopens the comment period for its emergency temporary standard.

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quality

The fact sheet highlights CDC goals of expanding collection of disparities and equity data; supporting infection control and patient safety efforts; addressing educational needs that impact diverse health care workers’ ability to protect themselves and their patients from infections; and more.

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policy

Research shows mRNA vaccines effectively prevent ventilation and death from COVID-19; Pfizer and Moderna seek authorization for an additional booster dose.

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policy

In its March report to Congress, the Medicaid and CHIP Payment and Access Commission examines the relationship between Medicaid disproportionate share hospital (DSH) allotments, uncompensated care costs, and services for low-income, uninsured populations.

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policy

Citing a depletion of funds for the HRSA COVID-19 Uninsured Program, the agency says the last day for providers to submit claims for testing and treatment is March 22 and the last day to submit vaccine administration claims is April 5.

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policy

The Transportation Security Administration extends to April 18 its public transit mask mandate; HHS shares a fact sheet on the COVID-19 Test-to-Treat initiative.

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policy

A State Health Official letter includes guidance for states to prepare for the COVID-19 public health emergency unwinding and return to regular Medicaid program operations.

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policy

The court ruled the qualifying payment amount should not be the main factor in determining payment for out-of-network services in independent dispute resolution.

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policy

President Joe Biden unveils a new COVID-19 National Preparedness Plan; FEMA extends its 100 percent federal cost share for COVID-19 efforts.

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policy

Coupled with the $11 billion previously distributed, this brings total phase 4 payments to about $11.5 billion, leaving less than $6 billion in pledged funds. These new funds will reach more than 4,000 providers across the United States this week.

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policy

CDC announces a new community-level framework that assesses COVID-19 risk; the Biden administration unveils a new COVID-19 mitigation plan for people with disabilities.

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policy

The Centers for Medicare & Medicaid Services outlines the application process for 1,000 new graduate medical education slots created by the Consolidated Appropriations Act of 2021. Applications for the first round of slots are due March 31, 2022, and CMS intends to award slots July 1, 2023.

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cms, gme
policy

The Center for Medicare & Medicaid Innovation will release a request for applications for the Realizing Equity, Access, and Community Health accountable care organization model, which will focus on promoting health equity and mitigating health disparities for underserved communities.

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policy

National emergency extended; new study highlights conditions and symptoms developed after COVID-19 infection; CDC updates vaccine guidance with clarifications for immunocompromised people.

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policy

Through a request for information, the Centers for Medicare & Medicaid Services hopes to better understand enrollees' barriers to coverage and access to care to inform future policies and regulatory actions. A 60-day public comment period began Feb. 17.

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policy

Authorization for the Pfizer COVID-19 vaccine for children six months to four years old is delayed; FDA authorizes the monoclonal antibody bebtelovimab.

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policy

Due to a calculation error in measure results used for calendar year 2021 public reporting, the Centers for Medicare & Medicaid Services has delayed until July the overall hospital star ratings update originally scheduled for April.

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policy

The Department of Health and Human Services will distribute $19.2 million in American Rescue Plan Act funds to help train primary care residents to provide quality care to diverse populations and communities, particularly in underserved and rural areas.

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policy

Pfizer and BioNTech apply for emergency use authorization for their pediatric COVID-19 vaccine; CDC recommends the Moderna COVID-19 vaccine; Medicare will cover over-the-counter COVID-19 tests.

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policy

FDA approves the Moderna COVID-19 vaccine and limits a monoclonal antibody authorization; OSHA withdraws its vaccine mandate emergency temporary standard.

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policy

An estimated 5.8 million people newly gained coverage during this open enrollment period; 32 percent of consumers using the federal marketplace selected a plan that costs them $10 or less per month. Enrollment remains open through Jan. 31 in five states and the District of Columbia.

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policy

Each awardee will receive up to $1.5 million for a three-year period to reduce the number of uninsured children by advancing Medicaid and Children's Health Insurance Program enrollment and retention. Grant applications are due March 28.

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policy

The funds will reach more than 7,600 providers across the country this week; $6 billion in pledged phase 4 funds remain undistributed.

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policy

The Biden administration will distribute 400 million no-cost N95 masks; CDC studies highlight the importance of boosters in protecting against COVID-19.

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policy

HHS awarded $103 million to improve health care worker retention by reducing staff burnout and promoting mental wellness. Several essential hospitals were among the awardees, including the University of New Mexico, Virginia Commonwealth University, and the University of Utah.

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policy

In response to the proposed rule for the 2023 plan year, the association urged the Department of Health and Human Services to ensure equitable access, finalize nondiscrimination policies, standardize collection of Z codes, and prorate premiums and advanced premium tax credits.

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quality

The revised site reflects new information, partner feedback, and industry best practices and includes fact sheets on the agency's AR Laboratory Network and innovative investments to respond to AR globally.

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policy

The U.S. Supreme Court upheld CMS' vaccine mandate but struck down the Occupational Safety and Health Administration's mandate; President Joe Biden announced new initiatives to expand testing access.

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policy

Effective Jan. 14, Health and Human Services Secretary Xavier Becerra renewed the public health emergency determination related to the continued effects of COVID-19; the determination has been in place since Jan. 27, 2020, and has been renewed every three months.

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policy

CDC shortens the time between primary vaccine series and booster shot and recommends a Pfizer booster for adolescents; the Supreme Court hears oral arguments on two vaccine mandates; HHS requires coverage of at-home COVID-19 tests, effective Jan. 15.

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policy

The Centers for Medicare & Medicaid Services released guidance and example templates for good faith estimates and the surprise billing patient-provider dispute resolution process.

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policy

The Medicare Part B drug model, also known as the most favored nation model, would have phased-in reduced payment rates for 50 Part B drugs over four years. America's Essential Hospitals previously called on CMS to withdraw the model.

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policy

The guidance results in a net reduction of about 30 percent of data fields; it adds questions on pediatric data, as well as makes mandatory certain influenza fields. The HHS guidance does not satisfy the requirements of a CMS quality measure on health care personnel vaccination rates.

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policy

FDA expands authorization for the Pfizer COVID-19 booster; FDA authorizes two antiviral pills; CMS updates guidance on vaccine mandate compliance.

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policy

New guidance from the Centers for Medicare & Medicaid Services reviews the timeline for open negotiations and initiating the federal independent dispute resolution process under the No Surprises Act.

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policy

The new document explains various provisions under part II surprise billing regulations, including that all financial assistance should be reflected in the good faith estimate regardless of the amount or type of discount. The new regulations take effect Jan. 1, 2022.

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policy

In the new rule, the agency finalizes proposals on direct and indirect graduate medical education (GME) policies in response to the COVID-19 pandemic and solicits comments on other GME issues to inform future policymaking.

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policy

The association asked that CMS provide additional time for hospitals to comply with the requirements, especially given the uncertain outcome of pending litigation regarding the administration's vaccine mandate.

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policy

CDC recommends mRNA COVID-19 vaccines be given clinical preference over the Janssen vaccine; the CMS vaccine mandate rule is revived in 25 states.

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policy

In a new white paper, America's Essential Hospitals discusses essential hospitals' role in value-based payment models and makes recommendations to the Center for Medicare and Medicaid Innovation on improving equity through broader model participation.

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policy

Providers now have until Dec. 20 to report lost revenue and expense information related to the receipt of Provider Relief Fund payments.

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policy

FDA authorizes the Pfizer COVID-19 vaccine booster for individuals as young as 16; the agency also authorizes a monoclonal antibody for COVID-19 prevention.

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policy

A Centers for Medicare & Medicaid Services letter to state Medicaid directors outlines new supplemental payment reporting and Medicaid disproportionate share hospital requirements under the Consolidated Appropriations Act.

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policy

The Substance Abuse and Mental Health Services Administration will ask grant recipients to develop or expand evidence-based services that may include the provision of sterile syringes, safe-sex kits, prevention education, overdose prevention kits, and more. Applications are due Feb. 7, 2022.

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policy

The advisory aims to combat the youth mental health crisis that worsened due to the COVID-19 pandemic. Specifically, the surgeon general recommends health care professionals focus on prevention and trauma-informed care principles, routinely screen children for mental health risk factors, and more.

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policy

In its comments to the Agency for Healthcare Research and Quality, the association stressed the importance of considering hospital physical infrastructure and financial status in developing research and practice improvement strategies.

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policy

As part of Vice President Kamala Harris' call to reduce maternal mortality and morbidity, a Department of Health and Human Services report highlights the impact of extending postpartum Medicaid coverage. In addition, CMS intends to propose a "Birthing-Friendly" hospital designation.

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policy

Vice President Kamala Harris hosted the first federal Maternal Health Day of Action. Coinciding with the event, America's Essential Hospitals announced 12 member hospitals will participate in a new CVS Health Foundation–funded learning collaborative to improve maternal health.

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policy

America’s Essential Hospitals commented on the second interim final rule implementing the No Surprises Act. The association urged HHS to revise good faith estimate requirements and create an IDR process that does not favor payers over providers.

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policy

As the omicron SARS-CoV-2 variant reaches the United States, President Joe Biden releases a new plan to combat COVID-19; CMS will not enforce its health care worker vaccine mandate amid legal challenges.

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policy

CMS released guidance to help states maintain Medicaid and Children's Health Insurance Program coverage as they return to normal operations when the COVID-19 public health emergency ends. Many strategies in the documents require support from outside organizations that work with beneficiaries.

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policy

A new Department of Health and Human Services report finds the share of Medicare visits conducted via telehealth increased from about 840,000 in 2019 to 52.7 million in 2020. In particular, telehealth was helpful in offsetting potential foregone behavioral health care during the COVID-19 pandemic.

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policy

The World Health Organization Nov. 26 classified a new COVID-19 variant, B.1.1.529, referred to as omicron. The variant was first reported in South Africa. To date, no cases have been identified in the United States.

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policy

The Department of Health and Human Services announced a $1.5 billion investment to help grow and diversify the nation's health care workforce through loan repayment and scholarship programs.

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policy

The proposed rule aims to strengthen and preserve the Deferred Action for Childhood Arrivals policy, which is critical to the nation's health care workforce. The association urges the Department of Homeland Security to formally add the policy through the notice-and-comment rulemaking process.

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policy

FDA and CDC endorse expanded eligibility for Pfizer and Moderna COVID-19 booster vaccine doses; Pfizer seeks authorization for its COVID-19 antiviral pill.

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policy

The Department of Health and Human Services released a fourth interim final rule to implement the No Surprises Act. The agency aims to enhance transparency and provide insight into how prescription drugs contribute to the growth of health care spending and the cost of health coverage.

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policy

CMS released final guidance for compliance with Medicare conditions of participation related to co-location, which occurs when two Medicare-certified hospitals or a Medicare-certified hospital and another health care entity are on the same campus or in the same building and share resources.

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policy

The Presidential Health Equity Task Force released recommendations for equitable disbursement of COVID-19 relief funds and culturally aligned communication to people of color and other underserved populations. Meanwhile, the White House announced $785 million in new investments to improve on equity.

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policy

Pfizer and BioNTech ask the FDA to authorize their COVID-19 booster vaccine for everyone age 18 and older; FEMA COVID-19 funding will continue until April 2022.

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policy

The letter from America’s Essential Hospitals to the Senate Committee on Finance responded to the panel’s request for information on improving access to and enhancing mental and behavioral health care.

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policy

CDC recommends the Pfizer COVID-19 vaccine for children ages 5 to 11; CMS holds a stakeholder call on its vaccine mandate for health care workers. Pfizer says its investigational novel COVID-19 oral antiviral candidate significantly reduces hospitalization and death.

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policy

CMS announced phased vaccination requirements as a condition of participating in Medicare and Medicaid; vaccination must be completed by Jan. 4, 2022. A new Occupational Safety and Health Administration emergency temporary standard promotes vaccination for businesses with 100 or more employees.

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policy

The rule adjusts the conversion factor used to determine physician payment rates and includes provisions related to appropriate use criteria, Medicare reimbursement for telehealth services, vaccine payment rates, the Quality Payment Program, and the Medicare Shared Savings Program.

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policy

The Medicare Outpatient Prospective Payment System final rule for calendar year 2022 continues cuts to hospitals in the 340B Drug Pricing Program and pauses elimination of the inpatient-only list. The rule also includes provisions on price transparency, rural emergency hospitals, and health equity.

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Essential Insights

Even during the COVID-19 pandemic, essential hospitals continued to act as models in the industry for sustainability practices.

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policy

FDA authorizes the Pfizer COVID-19 vaccine for use in children ages 5 to 11 and delays approval of the Moderna vaccine in adolescents ages 12 to 17. The agency recommends providers avoid purchasing or using imported medical gloves from certain companies that might be in violation of laws and rules.

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policy

The new strategy from the Department of Health and Human Services expands the scope of crisis response beyond opioids to include other substances often involved in overdoses. It focuses on four priority areas: primary prevention, harm reduction, evidence-based treatment, and recovery support.

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policy

The plan — required by the Coronavirus Aid, Relief, and Economic Security Act — focuses on increasing the health workforce in rural and underserved areas and better preparing for the health care needs of the future. HHS will issue a report to Congress on implementation.

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policy

Consumers now can preview health plans and prices on healthcare.gov ahead of open enrollment, which runs Nov. 1, 2020, through Jan. 15, 2021.

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policy

FDA and CDC recommend Moderna and Janssen booster vaccines, along with heterologous booster doses; the Biden administration releases a plan to vaccinate children.

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policy

America's Essential Hospitals submitted comments on the Department of Homeland Security advanced notice of proposed rulemaking on the public charge ground of inadmissibility. Following feedback, the agency plans to engage in the rulemaking process to issue an updated public charge regulation.

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policy

America's Essential Hospitals urged CMS to finalize withdrawal of the Trump administration's Most Favored Nation Model, citing procedural deficiencies, ongoing legal challenges, and significant reduction in provider payment rates.

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policy

A new Center for Medicare and Medicaid Innovation white paper outlines a strategy to advance health system transformation. The goal is to achieve equitable outcomes by driving accountable care, advancing health equity, supporting innovation, addressing affordability, and creating partnerships.

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policy

CMS will require states to cover COVID-19 treatment with no cost-sharing for Medicaid and Children's Health Insurance Program beneficiaries. Further, states in some circumstances must cover treatments for conditions that might seriously complicate the treatment of COVID-19.

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policy

In a letter to congressional leaders, America's Essential Hospitals advocates for strengthening the health care workforce in the wake of COVID-19, including through more funding in public health emergencies, prioritized visas for foreign clinicians, and increased graduate medical education slots.

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policy

The Vaccines and Related Biological Products Advisory Committee endorses booster shots of the Moderna and Janssen COVID-19 vaccines. Meanwhile, FDA delays authorization of the Moderna COVID-19 vaccine for emergency use in adolescents ages 12 to 17 after reports of cardiac side effects.

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policy

Money from the American Rescue Plan will fund up to 50 awards through the Health Resources and Services Administration's State Loan Repayment Program for state-run programs that support, recruit, and retain primary care clinicians who work in underserved communities.

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policy

Effective Oct. 18, Health and Human Services Secretary Xavier Becerra renewed the public health emergency (PHE) determination related to the continued effects of COVID-19. The PHE determination has been in place since Jan. 31, 2020.

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policy

A new analysis finds annual clinical labor costs in the emergency department and intensive care unit and among nursing staff increased by $24 billion due to the COVID-19 pandemic, translating to about $17 million in additional expenses for the average 500-bed facility.

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policy

The Department of Homeland Security will use the notice-and-comment rulemaking process to codify the Deferred Action for Childhood Arrivals program.

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policy

HHS released a Spanish version of QuestionBuilder, an app that helps patients and caregivers prepare for their in-person or telehealth appointments, along with a report on Latino patients' access to care.

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policy

The use of Z codes to document social determinants of health in Medicare fee-for-service beneficiaries increased slightly from 2017 to 2019 but remains low.

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policy

An HHS report shows the COVID-19 vaccine prevented hospitalization and death in Medicare beneficiaries; Pfizer applies for emergency use authorization for its vaccine in children age 5 to 11.

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policy

HHS guidance clarifies how HIPAA applies to COVID-19 vaccination status requests; CDC urges pregnant people to get vaccinated amid a surge in hospitalizations.

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policy

The departments of Health and Human Services (HHS), Treasury, and Labor and the Office of Personnel Management issued Part II of the No Surprises Act interim final rule with comment period.

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policy

FDA on Sept. 22 authorized a third booster dose of the Pfizer-BioNTech COVID-19 vaccine for select groups. A CDC panel subsequently recommended the booster shots, and CMS announced coverage for all Medicare beneficiaries and nearly all Medicaid and Children's Health Insurance Program beneficiaries.

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policy

In a Sept. 20 letter, America's Essential Hospitals welcomes the announcement of additional COVID-19 relief funding but notes the methodology falls short of adequate support for safety net providers. The association urges HHS to issue another targeted safety net distribution, among other requests.

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policy

An FDA advisory committee recommends a Pfizer COVID-19 vaccine booster for a limited population; CDC announces $2.1 billion dedicated to infection control and prevention.

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policy

The rule, released by the Department of Health and Human Service and the Department of Treasury, extends open enrollment, adds a new special enrollment period, expands navigator responsibilities, and modifies Section 1332 innovation waivers.

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aca, hhs
policy

The calendar year 2022 Physician Fee Schedule proposed rule includes provisions on Medicare payment for telehealth services, the Quality Payment Program, and more. The association also responded to a request for information on improving health equity through data collection.

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policy

In response to the calendar year 2022 Outpatient Prospective Payment System proposed rule, America's Essential Hospitals urged CMS to halt elimination of the inpatient-only list and to restore adequate payment to hospitals in the 340B program and to off-campus provider-based departments.

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policy

In this first white paper of a new series, America's Essential Hospitals discusses the chronic underfunding of Medicaid as a form of structural racism and provides recommendations to ensure the program is an effective tool to improve equity.

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policy

The comprehensive plan includes potential legislative and administrative actions that could be used to lower drug prices. The plan also notes the importance of the 340B Drug Pricing Program and its role in supporting the health care safety net.

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policy

The president's newly announced "Path out of the Pandemic" plan includes action steps for increasing vaccinations, further protecting those who are vaccinated, keeping schools safely open, testing and mask requirements, and economic recovery. CDC updates its infection control guidance.

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policy

Hospitals have until Sept. 13 to complete 340B Drug Pricing Program recertification through the Office of Pharmacy Affairs Information System.

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policy

An FDA committee will review Pfizer's COVID-19 vaccine booster application; Moderna is applying for booster approval. CDC data show COVID-19 hospitalizations on the rise among children.

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policy

In a letter to the Centers for Medicare & Medicaid Services, America's Essential Hospitals commented on the first interim final rule implementing the No Surprises Act. The association urged HHS to delay implementation until after the COVID-19 public health emergency, among other requests.

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policy

In a letter to Democratic congressional leadership, the association urges consideration of essential hospital priorities — including funding for critical workforce and hospital infrastructure needs and protecting the 340B Drug Pricing Program — in forthcoming budget reconciliation legislation.

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policy

A CDC advisory committee voted Aug. 30 to recommend the Pfizer-BioNTech COVID-19 vaccine; the agency warns against using ivermectin to treat or prevent COVID-19.

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policy

In a letter to HHS Secretary Xavier Becerra, America's Essential Hospitals urges the agency to swiftly allocate and target remaining PRF funds, take steps to ensure adequate hospital staffing, expedite full approval of COVID-19 vaccines, and protect the nation's supply chain.

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policy

The Department of Homeland Security released an advance notice of proposed rulemaking to gather data and feedback on the public charge ground of inadmissibility. Public comments are due Oct. 22; DHS will host public listening sessions on Sept. 14 and Oct. 5.

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policy

FDA approves the Pfizer-BioNTech COVID-19 vaccine. HHS plans to promote a booster shot of the mRNA vaccines beginning in September. CMS and CDC work to develop an emergency regulation requiring COVID-19 vaccination for nursing home staff.

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policy

The Office of the National Coordinator for Health Information Technology will host a series of webinars to discuss information sharing requirements finalized in a 2020 rule. The first webinar, focused on clinicians, will be Sept. 14, from 1–2 pm ET. 

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policy

America's Essential Hospitals sent CMS recommendations for implementing the new Medicaid supplemental payment reporting system under the Consolidated Appropriations Act of 2020. The association noted the importance of accuracy and avoiding duplicate data collection.

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policy

America's Essential Hospitals outlines concerns with the timeline for implementation and the scope of the Occupational Safety and Health Administration's emergency temporary standard (ETS) for occupational exposure to COVID-19.

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policy

FDA and CDC recommend a third mRNA COVID-19 vaccine dose for immunocompromised people; CDC recommends COVID-19 vaccines for pregnant and breastfeeding people.

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policy

In an Aug. 13 letter to state health officials, the Centers for Medicare & Medicaid Services updates its guidance regarding the resumption of normal state Medicaid, Children’s Health Insurance Program, and Basic Health Program operations when the COVID-19 public health emergency ends.

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policy

The White House COVID-19 Response Team will host an Aug. 23 virtual conversation on increasing vaccination in an equitable way. The event is open to health system leaders and health care providers.

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policy

Two CDC studies highlight the effectiveness of the COVID-19 vaccines in preventing reinfection and hospitalization; CDC extends the eviction moratorium.

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policy

CMS proposes to rescind the Trump administration’s Most Favored Nation model interim final rule, which aimed to reduce payment for 50 Medicare Part B drugs. America’s Essential Hospitals previously urged the agency to withdraw the model due to substantive and procedural issues.

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policy

CMS on Aug. 2 released its fiscal year 2022 Inpatient Prospective Payment System final rule, which includes payment and quality reporting provisions. The rule does not finalize provisions related to new residency slots, organ acquisition costs, or Section 1115 waiver days. 

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policy

The annual 340B Drug Pricing Program recertification period for hospitals will begin Aug. 16. Hospitals will have until Sept. 13 to complete the process.

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policy

CDC recommends everyone, even those who are fully vaccinated, wear a mask indoors in public in areas with substantial and high COVID-19 transmission.

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policy

Effective Jan. 1, 2021, hospitals are required to publish standard charges, including negotiated rates, for all services in a machine-readable format. The Centers for Medicare & Medicaid Services will host a webinar on Aug. 11 for hospitals to learn about posting standard charge information.

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policy

As COVID-19 cases rise, the association calls on members to require employee vaccination; CDC urges immunocompromised people to continue wearing masks.

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policy

CMS released an advisory alerting certain qualifying participants in alternative payment models that the agency does not have billing information needed to disburse incentive payments. Participants who anticipated but have not received an incentive payment should submit the necessary form by Nov. 1.

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policy

Effective July 20, Health and Human Services Secretary Xavier Becerra renewed the public health emergency (PHE) determination related to the continued effects of COVID-19. The PHE determination has been in place since Jan. 31, 2020, and has been renewed every three months since.

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policy

The administration has created a new website, StopRansomware.gov, to help government agencies and the private sector understand the threat of ransomware, mitigate risk, and learn how to respond to a ransomware attack.

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policy

A bulletin from the Center for Medicaid and CHIP Services notes the withdrawal of the 2019 public charge rule and addresses states' role in safeguarding applicant and beneficiary information. The public charge rule was vacated and is no longer in effect, retroactive to March 2, 2021.

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policy

The OPPS proposed rule would continue cuts to hospitals in the 340B Drug Pricing Program and off-campus provider-based departments, pause the elimination of the inpatient-only list, and increase penalties for failing to report standard charges.

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policy

HRSA announced $103 million in American Rescue Plan funding over three years to help reduce burnout and promote mental health among the health care workforce.

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policy

The U.S. Surgeon General issues a health misinformation advisory; CDC and the Office of Minority Health develop a Minority Health Social Vulnerability Index.

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policy

CMS announces $15 million for state Medicaid agencies to launch mobile crisis intervention services, as authorized by the American Rescue Plan.

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policy

The rule includes provisions related to telehealth, vaccine payment rates, the Quality Payment Program, and the Medicare Shared Savings Program; comments are due to CMS by Sept. 13.

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policy

The Aug. 11 webinar will complement other federal resources on the annual 340B Drug Pricing Program recertification period for hospitals, which is scheduled to start Aug. 16. Hospitals will have until Sept. 13 to complete the process.

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policy

Notable to essential hospitals, the Biden administration's July 9 executive order includes health care items related to prescription drugs, price transparency, hospital consolidation, and health insurance.

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policy

The Occupational Safety and Health Administration extends to Aug. 20 the comment period for the COVID-19 health care emergency temporary standard. The Centers for Disease Control and Prevention and the Food and Drug Administration say fully vaccinated individuals do not need COVID-19 booster shots.

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policy

The Department of Health and Human Services announced $250 million in grant awards to 73 local governments as part of a new initiative to identify and implement best practices for improving health literacy to enhance COVID-19 vaccination among underserved populations.

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policy

On July 1, the Biden administration released part 1 of the No Surprises Act interim final rule. Passed as part of the Consolidated Appropriations Act of 2021, the rule establishes new patient protections from balanced billing and excessive cost-sharing, known as surprise billing.

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policy

The Supreme Court’s decision to review the case marks a significant step in the association’s efforts to overturn harmful Medicare Part B cuts to hospitals in the 340B Drug Pricing Program. The Supreme Court will hear oral arguments in the case in its next term, with a decision likely in 2022.

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policy

Providers who received Provider Relief Fund dollars and are required to document their use during reporting period 1 (April 10–June 30, 2020) have until Sept. 30 to access the portal and submit the information.

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policy

The departments of the Treasury and Health and Human Services proposed extending open enrollment in the Affordable Care Act marketplaces, adding a new special enrollment period, expanding navigator responsibilities, and modifying Section 1332 innovation waivers.

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policy

America's Essential Hospitals commented on several policy proposals of interest to essential hospitals in the Inpatient Prospective Payment System rule and responded to a request for information on closing the health equity gap in hospital quality programs.

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policy

CDC extends to July 31 the eviction moratorium to protect people unable to make rental payments due to the COVID-19 public health emergency. Distribution of bamlanivimab and etesevimab is paused after tests find they are ineffective against some COVID-19 variants.

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policy

America's Essential Hospitals urged the agency to ensure essential hospitals receive much-needed relief and are equipped for their central role in the continued response to the pandemic, including allocating remaining Provider Relief Fund dollars and revising guidance on the use of these funds.

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policy

In its June report to Congress, the Medicare Payment Advisory Commission issues recommendations on issues of importance to essential hospitals, including payment for Part B drugs, alternative payment models, indirect medical education payments, and Medicare coverage of vaccines, among other topics.

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policy

The Biden administration proposes to rescind a Trump-era final rule requiring federally qualified health centers to charge certain low-income patients no more than the 340B Drug Pricing Program price for insulin and injectable epinephrine. Comments on the proposed rule are due July 16.

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policy

The interim guidance covers physical and mental health conditions present four or more weeks after some COVID-19 infections, including by patients who initially had mild or asymptomatic acute infections.

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Essential Insights

For 40 years, America’s Essential Hospitals and its members have championed care for underserved communities, including LGBTQ people. As we celebrate Pride Month, the association reflects on members’ efforts to improve care for this population and recent administration actions to support this goal.

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policy

The lawsuit, brought by individual plaintiffs and 18 Republican-led states, argued the ACA’s individual mandate was unconstitutional and that the entire ACA had to be dismantled as a result. The court's decision was made on procedural grounds and did not rule on the underlying merits of the case.

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policy

Novavax's COVID-19 vaccine demonstrated 90.4 percent efficacy in clinical trials; CDC urges vaccination upon hospital discharge.

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policy

The new timeline for spending and reporting on Provider Relief Fund (PRF) dollars depends on when a provider received the payments. The PRF reporting portal, which so far has been open only for registration, will open July 1 for providers to begin reporting on the use of their PRF payments.

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policy

America's Essential Hospitals and 11 additional national groups sent a letter to the Centers for Medicare & Medicaid Services urging the agency to partner with stakeholders who can offer technical expertise and context in developing the supplemental payment reporting system.

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policy

The emergency temporary standard aims to protect those working in health care settings where suspected or confirmed COVID-19 patients are treated.

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policy

The Centers for Medicare & Medicaid Services is issuing $80 million in grant funding for navigators in states using the federal insurance marketplace for the 2022 plan year.

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policy

President Biden announces a National Month of Action to vaccinate 70 percent of U.S. adults by July 4; Moderna applies for FDA approval of its vaccine.

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policy

WHO announces new names for SARS-CoV-2 variants of concern; two NIH studies show that mRNA vaccines are safe for pregnant people.

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policy

FDA lengthens the refrigerator storage time for the Pfizer COVID-19 vaccine. A new CDC site aggregates state and local COVID-19 funding opportunities. The Department of Health and Human Services allocates $4.8 billion to the HRSA COVID-19 Uninsured Program.

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policy

The interpretive guidance includes information on hospital admission, discharge, and transfer notification requirements outlined in CMS' May 2020 interoperability and patient access final rule.

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policy

The Department of Treasury released an interim final rule related to the distribution and allocation of $350 billion in funding for state, local, metropolitan city, and tribal governments; the funding was included in the American Rescue Plan Act.

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policy

New CDC recommendations no longer require people who are fully vaccinated against COVID-19 to wear a mask or physically distance.

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policy

HHS will interpret and enforce the Affordable Care Act's prohibition on discrimination "on the basis of sex" to include sexual orientation and gender identity. The change comes in response to a Trump administration rule in June 2020 that removed protections for transgender and LGBTQ individuals.

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policy

The agency seeks input, information, and recommendations from stakeholders on equity assessments and strategies, barrier and burden reduction, procurement and contracting processes, financial assistance, and stakeholder and community engagement.

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policy

In a letter to the HHS Office of Civil Rights (OCR), America's Essential Hospitals responds to proposed changes to privacy rules under the Health Insurance Portability and Accountability Act. OCR outlined the changes in a Jan. 21 proposed rule aiming to improve the transition to value-based care.

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policy

A CDC brief updates transmission methods; Pfizer applies for FDA approval of its vaccine; CMS increases the Medicare payment for monoclonal antibodies.

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policy

In a new interim final rule with comment period, the Centers for Medicare & Medicaid Services revises the rules for certain hospitals seeking a wage index reclassification with the Medicare Geographic Classification Review Board.

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policy

New CDC guidelines walk back outdoor mask regulations for fully vaccinated people; two research studies examine adverse reactions to the Janssen COVID-19 vaccine.

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policy

The Office of Minority Health page includes tools for data collection and analysis, developing language access plans, and strategic plan creation.

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policy

The Centers for Medicare & Medicaid Services published updated overall hospital quality star ratings on its Care Compare website; the ratings were last updated in January 2020. America's Essential Hospitals has expressed continued concern about the fairness and reliability of the ratings.

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policy

Effective April 28, HHS expanded the group of providers eligible to prescribe buprenorphine, a drug used to treat opioid use disorder, and removed some barriers to its use.

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policy

The Department of Health and Human Services announced $80 million in grants to increase access to marketplace enrollment assistance for consumers. The agency's 2021 open enrollment report shows more than 12 million consumers selected a marketplace plan during the 2021 open enrollment period.

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policy

The Centers for Medicare & Medicaid Services’ proposed fiscal year 2022 Inpatient Prospective Payment System rule would increase operating payment rates by 2.8 percent, repeal market-based data collection, and add 1,000 new graduate medical education teaching slots, among other provisions.

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policy

CDC and FDA lift the pause on Janssen vaccine administration after blood clot reports. Data show COVID-19 patients have long-term health needs.

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policy

The COVID-19 public health emergency (PHE) determination has been renewed effective April 21. The PHE determination initially was made Jan. 31, 2020, and has been renewed a total of five times.

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policy

Everyone in the United States ages 16 and older is now eligible for a COVID-19 vaccine; CDC's advisory committee will meet April 23 to discuss the Janssen vaccine pause.

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policy

The FCC announced the filing window for the second round of applications for the COVID-19 Telehealth Program will open at noon ET on April 29. The agency plans to award funding in two phases so applicants have the opportunity to provide supplemental information if they initially are denied funding.

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policy

The waiver makes Illinois the first state to provide continuity of full Medicaid benefit coverage for mothers by extending eligibility during the entire first year after delivery.

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policy

CDC and FDA recommend pausing Janssen COVID-19 vaccine administration after six U.S. reports of blood clots; HHS expands the Health Center Vaccine Program.

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policy

CDC Director Rochelle Walensky declared racism a serious public health threat and outlined agency efforts to mitigate the impact of racism on public health. The association applauds Walensky's clear statement on systemic racism.

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policy

HHS and CDC launch a nationwide grassroots vaccine promotion network; CDC issues new guidance on travel, cleaning, and disinfection.

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policy

The Office of National Drug Control Policy outlines the Biden administration's drug policy priorities for 2021, including expanding access to evidence-based treatment and prevention services, advancing racial equity, reducing supply of illicit substances, and advancing recovery-ready workplaces.

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policy

In a newly issued report and order, the Federal Communications Commission provided more information on the application and evaluation process for the second round of the COVID-19 Telehealth Program. The application window will open within 30 days of the order.

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policy

President Joe Biden announced initiatives to expand COVID-19 vaccine access; a CDC study shows mRNA vaccines are highly effective in preventing SARS-CoV-2 infection.

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policy

In light of the COVID-19 public health emergency, CMS updated its guidance document to expand on best practices, lessons, and planning considerations for emerging infectious diseases. 

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policy

In a new HHS Office of Inspector General report, hospitals highlight challenges associated with the public health emergency — including barriers to care delivery and vaccination, staff burnout, supply shortages, and declining revenue — that have strained the nation's health care delivery system.

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policy

The Centers for Medicare & Medicaid Services is extending until Aug. 15 the special enrollment period for 36 states using the federal health insurance marketplace, giving consumers more time to view new options under the American Rescue Plan, including lower premiums and plan upgrades.

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policy

FDA alerts providers about monoclonal antibody–resistant SARS-CoV-2 variants; a new study examines vaccine rates in counties where residents experience a high number of social risk factors.

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policy

In an annual report to Congress, the Medicaid and CHIP Payment and Access Commission finds an increase from 2018 to 2019 in the number of uninsured and in charity care and bad debt. The report includes state-specific projections of the Medicaid disproportionate share hospital allotment.

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policy

In its March report to Congress, the Medicare Payment Advisory Commission recommends payment updates in fee-for-service payment systems, including for hospital inpatient and outpatient services. The panel also outlines Medicare coverage of telehealth services during the pandemic and beyond.

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policy

In response to an executive order, a new issue brief reviews four policy areas under Section 1115 demonstrations and their impact on Medicaid coverage and access to care. The brief notes all examined areas create barriers to enrollment and reduce coverage, leading to adverse health effects.

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policy

The Occupational Safety and Health Administration updated its COVID-19 enforcement plan; CDC updates infection control guidance for vaccinated people in health care facilities.

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policy

The association will convene its virtual spring Policy Assembly March 16. Whether or not you join us, these resources are available to encourage your legislators to protect access to care.

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policy

In accordance with the presidential regulatory freeze, HHS proposes to further delay until July 20 a final rule requiring federally qualified health centers to charge certain low-income patients no more than the 340B Drug Pricing Program price for insulin and injectable epinephrine. 

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policy

A new White House Gender Policy Council, established via executive order, will coordinate efforts to advance gender equity and equality across executive departments and agencies.

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policy

A federal court vacated several policies in the Trump Administration’s 2019 health insurance marketplace rule for violating federal law, including provisions related to review of network adequacy, standardized options, income verification requirements, and reducing medical loss ratio rebates.

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policy

In a March 9 letter, America's Essential Hospitals asked the administration to ensure adequate vaccine supplies reach essential hospitals, emphasizing the critical role they play in vaccinating the health care workforce and the broader population.

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policy

The guidance clarifies how hospitals receiving Medicaid disproportionate share hospital payments can use Provider Relief Fund general and targeted distribution payments.

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policy

The $1.9 trillion package temporarily increases Medicaid disproportionate share hospital allotments to ensure essential hospitals receive the same level of payments as they would have expected absent the pandemic. The package returns to the House for a final vote, expected as early as Tuesday.

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policy

CDC releases public health guidelines for fully vaccinated people; CMS invites hospitals to pilot a COVID-19 learning series.

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policy

CDC warns health care providers to stay vigilant amid Ebola outbreaks in the Democratic Republic of the Congo and Guinea.

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policy

In a letter, America's Essential Hospitals urges swift allocation of the remaining funds in the $178 billion Provider Relief Fund and calls for another targeted distribution to hospitals omitted from the first two safety-net distributions, among other requests.

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policy

FDA granted an emergency use authorization for the one-dose Janssen COVID-19 vaccine and an at-home COVID test; a multi-agency FAQ document addresses COVID-19 health coverage.

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policy

A CDC report shows promising COVID-19 vaccine safety profiles; the federal COVID-19 task force expands support for vaccination and testing.

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policy

CDC provides new vaccine demographic data and guidelines for ensuring close-fitting face masks; President Biden appoints two essential hospital leaders to a health equity task force.

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policy

America's Essential Hospitals sent a letter to President Joe Biden and his administration detailing key priorities for essential hospitals, including issues related to structural racism, COVID-19, Medicaid, the 340B Drug Pricing Program, site-neutral payment policies, immigration, and other topics.

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policy

The special enrollment period, intended to ensure access to health coverage amid the the COVID-19 pandemic, will continue through May 15. The enrollment period applies to consumers in the 36 states that use the federal marketplace platform.

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policy

The Joint Commission's latest Quick Safety newsletter offers recommendations to ensure equitable care during the COVID-19 pandemic.

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policy

Janssen applied for emergency use authorization of its COVID-19 vaccine; a CDC report shows reporting gaps in ethnic and racial data of vaccine recipients.

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policy

A new executive order calls on agencies to review public charge rules enacted under the Trump administration. Two other executive orders establish an interagency task force to reunite immigrant families and create a comprehensive regional framework to address the causes of migration.

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policy

Hospitals have 30 days to review their reports before public reporting to Care Compare.

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policy

A new CDC order requires mask use on public transportation; a PREP Act amendment expands the provider groups authorized to administer vaccines.

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policy

President Biden released an executive order to strengthen Medicaid and the Affordable Care Act. The order calls for a special enrollment period on the federally facilitated exchange for uninsured or underinsured individuals — particularly those hardest hit by the COVID-19 pandemic.

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policy

In his first week in office, President Biden released multiple executive orders of note to essential hospitals, including those related to COVID-19, health equity and nondiscrimination, and immigration.

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policy

The regulatory freeze could affect rules directing health clinics to pass certain drug discounts on to patients, establishing minimum standards in Medicaid state drug utilization review, and modifying Health Insurance Portability and Accountability Act privacy arrangements.

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policy

CDC requires a negative test or travel clearance from a health care professional to enter the country; President Biden issues COVID-19 national strategy and complementary executive orders.

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policy

The document outlines acceptable approaches to calculate and report median payer-specific negotiated charges by Medicare Severity Diagnosis Related Group for reporting periods ending on or after Jan. 1, 2021.

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policy

As a highly transmissible SARS-CoV-2 variant spreads across the country, CDC issues two new vaccination toolkits; HHS alters its Provider Relief Fund reporting timeline.

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policy

The Centers for Medicare & Medicaid Services will begin reprocessing outpatient claims to excepted off-campus provider-based departments at the lower site neutral payment rate it established in the calendar year 2019 Outpatient Prospective Payment System final rule.

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policy

The website contains FAQs on the administrative dispute resolution (ADR) panel and board, the monetary threshold for filing an ADR claim, the types of documentation stakeholders must provide as part of the ADR process, and other information.

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policy

A new notice encourages states to improve health outcomes, reduce disparities, and lower costs within Medicaid and the Children's Health Insurance Program. It describes how states might address social determinants of health using flexibility available under current law.

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policy

CDC shares information about two highly contagious SARS-CoV-2 variants, allergic reactions in Pfizer vaccine recipients, and vaccines for pregnant people.

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policy

Managed care organizations can participate in direct contracting for their populations dually eligible for Medicare and Medicaid. The model builds on direct contracting opportunities that test risk-sharing arrangements to reduce Medicare expenditures while preserving or enhancing quality of care.

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policy

A new Centers for Medicare & Medicaid Services final rule addresses minimum standards in Medicaid State Drug Utilization Review, creates value-based purchasing arrangements with manufacturers, and outlines minimum standards to reduce opioid prescribing–related fraud and abuse.

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policy

Health and Human Services Secretary Alex Azar extended, effective Jan. 21, the COVID-19 public health emergency (PHE) determination. The PHE determination has been in place since Jan. 31, 2020; it was set to expire Jan. 20, 2021.

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policy

The rule, currently on hold due to a regulatory freeze, requires federally qualified health centers to pass 340B Drug Pricing Program discounts on to certain low-income patients as a condition of receiving federal grant funding; it applies to insulin and injectable epinephrine.

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policy

The proposed rule builds on a CMS final rule on interoperability and patient access; it would leverage application programming interfaces to improve patients’ access to their electronic health information and reduce burden on providers related to prior authorization.

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policy

CDC announces target groups for phases 1b and 1c of COVID-19 vaccine allocation; a new brief recommends strategies for building vaccine trust.

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policy

Two federal courts halted implementation of the Centers for Medicare & Medicaid Services' most favored nation model interim final rule. The seven-year model was set to begin Jan. 1, 2021, phasing in a reduced payment rate for 50 Medicare Part B drugs.

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policy

The Office of Management and Budget (OMB) provides additional direction to auditors on COVID-19 payments. OMB delays by three months the deadline for single-audit reports for entities that received COVID-19 funding and had original audit report due dates from Oct. 1, 2020, to June 3, 2021.

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policy

The next phase of the Maternal and Infant Health Initiative (MIHI) includes a new focus on postpartum care visits, well-child visits, and decreasing rates of cesarean-section births in low-risk pregnancies. A work group developed a set of recommendations and a report on next steps for the MIHI.

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policy

FDA issues an emergency use authorization for the Moderna vaccine and an at-home antigen test; a CDC committee votes on allocation recommendations.

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policy

On Dec. 16, the Health Resources and Services Administration completed its review of Phase 3 applications for Provider Relief Fund money and will distribute $24.5 billion to more than 70,000 providers.

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policy

FDA authorizes the Pfizer COVID-19 vaccine for emergency use; HHS expands hospital COVID-19 data reporting requirements to include therapeutic data.

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policy

The Department of Health and Human Services’ Office of Civil Rights proposed modifications to the Health Insurance Portability and Accountability Act privacy rule as part of the agency's regulatory sprint to coordinated care.

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policy

The Health Resources and Services Administration finalized a rule creating a 340B Drug Pricing Program administrative dispute resolution process for covered entities and drug manufacturers; the rule marks a long-delayed implementation of an Affordable Care Act requirement.

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policy

CDC recommends groups to prioritize in vaccine distribution and revises antigen testing guidance.

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policy

The Department of Health and Human Services released a detailed action plan on maternal health and announced a public-private partnership to reduce maternal mortality and morbidity. The surgeon general simultaneously announced a call to action to improve maternal health, complementing HHS' plan.

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policy

The Medicare Outpatient Prospective Payment System final rule for calendar year 2021 continues cuts to hospitals in the 340B Drug Pricing Program and off-campus provider-based departments, and updates the overall hospital star ratings methodology.

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policy

CMS establishes a conversion factor of $32.41 — a decrease of $3.68 from CY 2020. The final rule also includes provisions related to Medicare reimbursement for telehealth services, the Quality Payment Program, and the Medicare Shared Savings Program.

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policy

In a notice of proposed information collection, the Centers for Medicare & Medicaid Services announced its intention to make changes to the Medicare cost report and accompanying instructions.

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policy

Moderna applied for emergency use authorization for its COVID-19 vaccine; CDC issued ethical vaccine application principles and updated face mask guidance for health care workers.

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policy

The Centers for Medicare & Medicaid Services announced the Acute Hospital Care at Home program to further increase hospital capacity during the COVID-19 crisis, in response to a rising number of hospitalizations nationwide. The program builds on the Hospitals Without Walls initiative.

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policy

The Dec. 8 webcast will offer hospitals information and resources to prepare for publishing standard charges, including negotiated rates, for all services in a machine-readable format and display prices of shoppable services in a consumer-friendly format.

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policy

FDA Commissioner Stephen Hahn, MD, says drug and biological product centers will publicly post reviews of the data and information supporting emergency use authorizations (EUAs) for all drug and biological products, including vaccines, as part of the agency's COVID-19 response.

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policy

The Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) finalized rules in conjunction with HHS' regulatory sprint to coordinated care. The OIG rule modifies safe harbor protections; CMS’ rule targets undue burden of the physician self-referral law, or Stark law.

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policy

In an interim final rule with comment period, CMS announces a seven-year mandatory payment model set to go into effect Jan. 1. The Most Favored Nation rule builds on an International Pricing Index model; by issuing an interim final rule, the agency bypasses releasing a proposed rule.

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quality

The Centers for Disease Control and Prevention marks U.S. Antibiotics Awareness Week with a new Antibiotic Use Option Report that synthesizes National Healthcare Safety Network data.

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policy

The Centers for Medicare & Medicaid Services (CMS) on Dec. 1 will retire its original Hospital Compare tools, encouraging users to visit Medicare.gov’s new Care Compare tool to find and compare health care providers. CMS will not update the overall hospital quality star ratings in January 2021.

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policy

In its first letter to President-elect Joseph Biden and his transition team, America's Essential Hospitals noted a desire to work together to stabilize the nation's health care safety net and described several administrative policy priorities and paths of partnership.

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policy

An interim analysis of Moderna Inc.'s COVID-19 vaccine shows promising results; CDC guidance highlights that wearing a mask can protect the wearer.

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policy

The Medicaid and Children's Health Insurance Plan managed care final rule includes provisions to help reach Medicaid goals, increase network adequacy for managed care plans, and align quality rating approaches.

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policy

FDA grants emergency use authorization for an Eli Lilly antibody treatment; a Pfizer vaccine has promising early results; President-elect Biden names a COVID-19 advisory board.

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policy

In mid-September, CMS Administrator Seema Verma withdrew the Medicaid Fiscal Accountability Regulation (MFAR) via a tweet, citing stakeholder concerns. America's Essential Hospitals asserts formally withdrawing MFAR would be the best course of action both for CMS and stakeholders.

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policy

Operation Warp Speed (OWS), a joint effort by the departments of Defense and Health and Human Services, on a stakeholder call discussed principles for allocation and distribution of therapeutics, specifically monoclonal antibodies. OWS also released a draft pre-emergency use authorization playbook.

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policy

The decision of the U.S. District Court for the Northern District of Illinois marks the first time a court ruled in favor of the plaintiffs on the merits of the legal challenges to the public charge rule. DHS immediately appealed the case, allowing continued enforcement while the appeal is pending.

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policy

The rule sets content elements a plan or issuer must disclose for a covered item or service. The rule also finalizes changes to the medical loss ratio program to allow issuers offering group or individual health coverage to receive credit for certain savings they share with enrollees.

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policy

In a letter to the Department of Homeland Security, America’s Essential Hospitals called on the department to withdraw a proposal that could affect the ability of essential hospitals to hire and retain international medical graduates in residency programs.

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policy

The threat involved malicious actors using Trickbot malware to compromise information technology systems, including by engaging in ransomware attacks, data theft, and the disruption of health care services.

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policy

The Office of the National Coordinator for Health Information Technology has pushed back the starting date for compliance with information blocking provisions from Nov. 2, 2020, to April 5, 2021.

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policy

The new FAQs specify that a provider may use PRF payments to cover the distribution of a COVID-19 vaccine licensed by the Food and Drug Administration. Providers also may use PRF funds to prepare for the distribution of a vaccine before it becomes available.

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