{"id":2021,"date":"2021-01-11T17:44:04","date_gmt":"2021-01-11T17:44:04","guid":{"rendered":"https:\/\/thornrun.com\/health-policy-report-1-11\/"},"modified":"2023-08-08T21:25:27","modified_gmt":"2023-08-08T21:25:27","slug":"health-policy-report-1-11","status":"publish","type":"post","link":"https:\/\/thornrun.com\/health-policy-report-1-11\/","title":{"rendered":"Health Policy Report (1\/11)"},"content":{"rendered":"\n

Capitol Hill Update<\/strong><\/p>\n\n\n\n

Congress formally certified President-elect Joe Biden as the winner of the 2020 presidential election following a chaotic day on Capitol Hill. The process was delayed after rioters broke into the Capitol building, forcing an hours-long lockdown that pushed the certification process into the early morning hours. Despite repeatedly stating that he will not concede the election and supported GOP lawmakers’ efforts to overturn results in several states, President Donald Trump issued a statement after the certification saying “there will be an orderly transition” to the incoming Biden administration. The President-elect will be sworn into office on Wednesday, January 20.<\/p>\n\n\n\n\n\n\n\n

Meanwhile, lawmakers are\nleft with lingering questions and repercussions regarding the security of the\nCapitol complex, as well as the future of President Donald Trump. There have\nbeen growing calls among Democratic leadership and rank-and-file Members \u2014 as\nwell as some industry leaders \u2014 to remove President Trump from office by way of\nthe 25th Amendment or impeachment for his role in last Wednesday’s events. In a\n\u201cdear colleague\u201d letter<\/a> to Members over the weekend, Speaker Nancy\nPelosi (D-CA) urged lawmakers to \u201cbe prepared to return to Washington this\nweek\u201d as House Democratic leadership formulates its plans for another round of\nimpeachment against President Trump. <\/p>\n\n\n\n

Biden to Release Nearly\nAll Remaining COVID-19 Vaccine Doses <\/strong><\/p>\n\n\n\n

President-elect Joe\nBiden\u2019s transition team announced last Friday he would seek to release nearly\nall available COVID-19 vaccine does in an effort to accelerate distribution. TJ\nDucklo, spokesman for the Biden transition team, noted that the\npresident-elect\u2019s plan will ensure the Americans who need it most get it as\nsoon as possible. Additional details about the plan are expected to be\nannounced this week. The Trump administration has been holding back around half\nof the remaining vaccination doses for second shots, and only 2.8 million of\nthe 12 million vaccine does from Moderna and Pfizer that have been shipped had\nbeen administered as of January 1. Last week, the Food and Drug Administration\n(FDA) reported delaying the second vaccine dose for both the Moderna and Pfizer\nvaccines would be potentially detrimental to public health. The Biden\ntransition team has said they are confident the manufacturers can produce\nenough additional vaccines to deliver second doses in a timely manner and\nstated the president-elect will use the Defense Production Act to boost supply.\n<\/p>\n\n\n\n

Democratic Control of\nSenate Could Change Health Policy Agenda <\/strong><\/p>\n\n\n\n

The Democratic Party is\nset to enjoy a unified government for the next two years after their victories\nin both Georgia Senate runoff elections. Democrat Jon Ossoff was declared the\nwinner over incumbent Sen. David Perdue (R-GA), and Rev. Raphael Warnock\ndefeated Sen. Kelly Loeffler (R-GA). With this 50-50 split in the upper chamber\nand Vice President-elect Kamala Harris serving as tiebreaker, Democrats will\nhave additional opportunity to pursue their health care agenda. Additionally,\nthe budget reconciliation process in Congress presents Democrats with a\nsignificant opportunity to pass sweeping legislation with a simple majority \u2014\npreviously used by Democrats to pass a significant portion of the Affordable\nCare Act (ACA) in 2010. While the odds are improved, Democrats couldn’t afford\nto lose a single vote in the Senate on a budget reconciliation measure and\nwould have to unify a narrow, ideologically diverse House majority. <\/p>\n\n\n\n

Although health care\nreform legislation isn\u2019t likely to be the first item on Congress\u2019 agenda,\nDemocrats could choose to pursue a host of wish-list items in the 117th<\/sup> Congress.\nIt\u2019s unlikely the Democrats would be able to pass a public insurance option\nwith such narrow majority, but Democrats could expand coverage by beefing up\nsubsidies on Affordable Care Act exchanges and offering incentives for states\nto expand Medicaid. Democrats could look to lower the Medicare eligibility age\nto 60 through the budget reconciliation process, one of Biden\u2019s campaign\npromises. A Democratic majority will also make it easier for President-elect\nBiden to nominate individuals who lack Republican support to key health care\npositions requiring Senate confirmation. Furthermore, a simple Democratic\nmajority in the Senate now allow Democrats to overturn major health care rules\npromulgated by the Trump administration within its last 60 legislative days via\nthe Congressional Review Act. <\/p>\n\n\n\n

CMS Issues Guidance\nOutlining Authorities for Addressing Social Determinants<\/strong><\/p>\n\n\n\n

Last Thursday, the\nCenters for Medicare and Medicaid Services (CMS) sent a letter<\/a> (press release<\/a>) to states outlining existing authorities that\ncan be used to address social determinants of health (SDOH) through Medicaid\nand CHIP. The State Health Official (SHO) letter enumerated state plan and\nwaiver authorities that states may employ to address housing, education, food\nsecurity, and more with the goal of improving beneficiary health and reducing\nprogram costs. CMS did not announce any new authority, either through\nregulation or through new interpretation of existing statute or regulation.\nInstead, the letter serves as a one-stop shop for states considering the use of\nthese authorities and to encourage SHOs to adopt them to address SDOH. <\/p>\n\n\n\n

The letter lays out four\noverarching principles to which states must adhere when providing services to\naddress SDOH: (1) services must be based on individual assessments of need; (2)\nMedicaid is frequently but not always the payer of last resort, and states must\nassess all available public and private funding streams; (3) utilization and\npayment must be consistent with efficiency, economy, and quality of care; and\n(4) services must be sufficient in amount, duration, and scope to reasonably\nachieve their purposes. All four principles are rooted in statute or\nregulation. <\/p>\n\n\n\n

CMS encouraged states to\nuse existing authorities and to pursue demonstration projects that would help\naddress SDOH. However, it noted that any state proposals for demonstration\nprograms should be grounded in evidence and be accompanied by a rigorous\nevaluation plan. The agency also stressed that many of the services outlined\nmay be provided using telehealth in addition to in person visits. As such, CMS\nencouraged states to assess their telehealth frameworks to determine if there\nare unnecessary restrictions preventing maximum utilization of telehealth for\nthe services.<\/p>\n\n\n\n

The letter enumerates\nauthorities that CMS has identified that may be used to address the social\ndeterminants of health. An appendix to the letter lays these out in tabular\nform. In the body of the letter itself, CMS also identified the authorities and\nprovides discussion, including extant examples of the authorities in action. It\nalso highlighted services that may be covered using the authorities. <\/p>\n\n\n\n

CMS Offers Guidance on\nEnd-of-Pandemic Medicaid Changes<\/strong><\/p>\n\n\n\n

On December 22, the\nCenters for Medicare and Medicaid Services (CMS) sent a letter<\/a> to state health officials on preparations to\nreturn to normal operations after the conclusion of the COVID-19 pandemic. When\nthe public health emergency (PHE) associated with the pandemic ends, several\ntemporary authorities will expire, continuous enrollment requirements will end,\nand additional federal medical assistance percentage (FMAP) will revert to\nnormal. The letter describes the authorities that will expire and provides\nguidance on planning for the eventual return to normal operations. <\/p>\n\n\n\n

The state health\nofficial (SHO) letter went to officials overseeing Medicaid, CHIP, and Basic\nHealth Programs (BHP) who were charged with overseeing the state-level\nimplementation of PHE flexibilities and new requirements and authorities\ncreated by COVID-19-related legislation in Spring 2020. This included\nrequirements to maintain eligibility for currently enrolled beneficiaries\nthrough the end of the PHE mandated coverage without cost sharing of COVID-19\ntesting and treatment. In exchange, states received an extra 6.2 percent in\nmedical FMAP through the end of the calendar quarter in which the PHE ends.\nOther measures existed and were triggered by the declaration of the PHE,\nincluding 1135 waivers.\n\nCMS encouraged states\nto examine all the flexibilities and temporary policies that were made\navailable at the beginning of the pandemic and to decide whether they should be\nterminated early, terminated at the end of the PHE, or maintained on a\ntemporary or permanent basis, if possible. Flexibilities that could be\nterminated early, CMS says, include exceptions to meeting federal timeliness\nstandards for processing applications and redeterminations. The agency\nrecommended returning to normal operations on applications and redeterminations\nas soon as possible to ensure that they are able to comply with timeliness\nstandards when the PHE ends. On the other hand, CMS said that flexibilities such\nas allowing the use of telehealth in 1915(c) waiver populations could be\nextended through a state plan amendment (SPA) or a modified 1915(c) waiver.\nSuch modifications to benefits could be permanently extended, though it would\nrequire state action\n\n\n\n<\/p>\n","protected":false},"excerpt":{"rendered":"

Capitol Hill Update Congress formally certified President-elect Joe Biden as the winner of the 2020 presidential election following a chaotic day on Capitol Hill. The process was delayed after rioters broke into the Capitol building, forcing an hours-long lockdown that pushed the certification process into the early morning hours. Despite repeatedly stating that he will […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,7],"tags":[],"acf":[],"yoast_head":"\nHealth Policy Report (1\/11) - thornrun<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/thornrun.com\/health-policy-report-1-11\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Health Policy Report (1\/11) - thornrun\" \/>\n<meta property=\"og:description\" content=\"Capitol Hill Update Congress formally certified President-elect Joe Biden as the winner of the 2020 presidential election following a chaotic day on Capitol Hill. 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