{"id":3275,"date":"2021-08-23T16:40:39","date_gmt":"2021-08-23T16:40:39","guid":{"rendered":"https:\/\/thornrun.com\/health-policy-report-200\/"},"modified":"2021-08-23T16:40:39","modified_gmt":"2021-08-23T16:40:39","slug":"health-policy-report-200","status":"publish","type":"post","link":"https:\/\/thornrun.com\/health-policy-report-200\/","title":{"rendered":"Health Policy Report"},"content":{"rendered":"\n

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

The House will convene for a brief legislative session this week as lawmakers eye action on the Senate-passed budget resolution for fiscal year (FY) 2022. Members will vote today on a rule that will set up debate on the budget resolution<\/a>, voting rights legislation<\/a>, and the bipartisan infrastructure deal<\/a>. While the budget resolution and John Lewis Voting Rights Act (H.R. 4<\/a>) are both slated for final up-or-down votes tomorrow, the bipartisan infrastructure deal is not expected to be taken up until later in the fall after a budget reconciliation package has been clinched. Nearly a dozen moderate Democrats are continuing to press for a vote on the infrastructure package as soon as possible, however, with some threatening to vote against the budget resolution absent a vote on Biden-endorsed legislation. Meanwhile, Speaker Pelosi doubled down her position in a “Dear Colleague” letter<\/a> last week that emphasized the importance of triggering the reconciliation process, while taking a swipe at the Senate’s infrastructure bill for “not [being] reflective of the totality of Democrats’ vision.” <\/p>\n\n\n\n\n\n\n\n

CMS to Revisit\nMedicaid Beneficiary Eligibility Post Pandemic <\/strong><\/p>\n\n\n\n

The Centers for\nMedicare and Medicaid Services (CMS) sent a letter to state health officials\noutlining Medicaid redetermination after the pandemic ends. The guidance comes\nafter CMS Administrator Chiquita Brooks-LaSure said that the agency is focused\non ensuring that beneficiaries do not lose coverage gained during the public\nhealth emergency (PHE). The Trump administration initially laid out a plan that\ngave states six months after the PHE to remove ineligible beneficiaries\nfollowing the pandemic, allowing ten days for beneficiaries to respond to\ndetermination forms. The new guidance alters these regulations, providing\nstates with a year to resume eligibility analyses and offering at least 30 days\nto respond to redetermination forms. Additionally, the Biden administration is\nrequiring that states cannot remove beneficiaries from Medicaid until they have\ncompleted a new redetermination at the end of the PHE. The administration\nmaintained Trump-era guidance giving states four months to begin processing\napplications.<\/p>\n\n\n\n

States must keep\nMedicaid beneficiaries enrolled through the PHE to receive federal funding.\nHowever, some experts estimate that up to 30 percent of beneficiaries could\nlose coverage during the redetermination process. States worry that the\nredetermination process cannot be completed during the PHE, leading to unfair\ndeterminations to remove beneficiaries from their Medicaid plans and a buildup\nof redeterminations that could last for years. To comply with changes to the\nTrump-era guidance, CMS is encouraging states to review their risk-based\napproaches to guide their redetermination work. Health care advocates generally\nsee the Biden administration\u2019s tweaks to the guidance as a step in the right\ndirection, though concerns remain. Some stakeholders are hoping that higher\nrates of electronic data utilization can ease the burden of the redetermination\nprocess, and others are calling for more detailed public reporting of\nredetermination statistics. <\/p>\n\n\n\n

CDC Gears Up for\nBooster Shots Amidst New Data <\/strong><\/p>\n\n\n\n

After reviewing new\ndata from the Centers for Disease Control (CDC), top Biden administration\nofficials determined last week that Americans will need COVID booster shots.\nCDC officials presented data to White House Covid-19 task force officials last\nSunday that had been compiled over the last several months. The data confirmed\ngrowing speculation that initial vaccination protections wane over time. The\nadministration had been preparing for this possibility as the booster debate\noccupied health officials and the media since Pfizer submitted an application\nfor its booster shot to the Food and Drug Administration (FDA) earlier this\nmonth. The FDA approved both Pfizer and\nModerna\u2019s two-shot vaccines<\/a> for immunocompromised\nindividuals two weeks ago. <\/p>\n\n\n\n

The Biden\nadministration is expected to roll out a formal booster strategy shortly. The\nplan will rely on about 100 million doses of Pfizer and Moderna shots that are\ncurrently available, as well as a new contract for 400 million doses to be\nadministered as needed. FDA still needs to authorize the booster shots, and CDC\nmust formally recommend that people obtain a booster eight months after their\nfirst vaccine series. The CDC\u2019s vaccine advisory committee has its next booster\nmeeting the week of August 30th<\/sup>. Federal officials are still waiting on a\nJohnson & Johnson booster study to make a determination regarding the\nnecessity of a second shot of the drug maker\u2019s vaccine. <\/p>\n\n\n\n

Despite the\nadministration\u2019s determination, The World Health Organization (WHO) has been\nurging developed nations to hold off on booster shots until developing nations\nhave access to sufficient supply to provide initial vaccinations. Infectious\ndisease experts worry that prioritizing boosters over providing initial doses\nfor other nations will make the world vulnerable to new variants. However, if\ndrug companies apply for booster shot approval and the FDA deems the treatment\neffective, it will be incredibly difficult to stop Americans from seeking the\nadditional dose. <\/p>\n\n\n\n

In 2020, Overdoses Decrease\nin Part D<\/strong><\/p>\n\n\n\n

The Department of\nHealth and Human Services (HHS) Office of the Inspector General (OIG) released\nits Opioid Overdoses in Part D\nBeneficiaries Decreased In 2020<\/em><\/a>report. This report\noffers a different analysis from the CDC\u2019s Provisional Drug Overdose Death\nCounts for 2020<\/em><\/a> <\/em>report in July, whichindicated a spike in overdose deaths. According to the new HHS report, over\n43,000 Medicare Part D beneficiaries overdosed in 2020 despite a decrease in\nopioid prescriptions. An average of 4,000 Part D beneficiaries were treated for\noverdoses per month in 2020, with a peak in June and July. Twenty-four percent of\nbeneficiaries received at least one prescription for an opioid, down from 26\npercent in 2019 and 29 percent in 2018. OIG said that the decline is likely due\nto a steep decrease in short-term opioid prescriptions since most elective\nsurgeries were postponed during the pandemic. As a result, Part D paid out $2.7\nbillion for opioid prescriptions, less than in previous years. <\/p>\n\n\n\n

Rates of\nmedication-assisted treatment (MAT) utilization increased by eight percent in\n2020. While this data continues to show that MAT utilization amongst Part D\nbeneficiaries continues to grow, the rate of growth for 2020 is slower than\nprevious years. OIG attributed the slower increase of MAT utilization to the\npandemic. Regardless, over 225,000 beneficiaries used MAT during the year\naccording to the report, bringing the overall utilization rate to about 13\npercent. The report noted that utilization rates are lower than desired, and\nOIG was also concerned with a decrease in naloxone usage to treat overdoses\namongst the Part D population. <\/p>\n\n\n\n

While overdoses\ndecreased as a whole for the Part D population, the data was not entirely\npositive. OIG encouraged CMS to continue educating beneficiaries about MAT and\nnaloxone and to closely monitor utilization rates. The agency also recommended\nthat prescribers offer beneficiaries ample opportunity to reevaluate their\nutilization of high-dose opioids and actively look into decreasing dosage. OIG\nfound that beneficiaries at risk for overdose and misuse were likely receiving\nvery high dosages or were \u201cdoctor-shopping\u201d to obtain higher doses. In response\nto that finding, OIG also encouraged prescribers to utilize state databases to\ncheck a patient\u2019s opioid history. <\/p>\n\n\n\n

CMS Ushers in New\nVaccination Requirements in Nursing Homes<\/strong><\/p>\n\n\n\n

On Wednesday, CMS and CDC issued an emergency regulation requiring the nation\u2019s 15,000 nursing homes to require staff vaccinations. The \u201cno-jab, no-job\u201d order poses new challenges for nursing homes. Most notably, non-compliance with the rule would result in halting Medicare and Medicaid reimbursements. Nationally, about 62 percent of nursing home staff are vaccinated (compared to 83 percent of residents), with state vaccination rates amongst nursing home workers ranging from 44 to 88 percent. In June, cases of the Delta variant were at a low of 319, though cases have since spiked to 2,696 reported cases at the beginning of August. Over 2,000 nursing home staff members and 130,000 residents have died of COVID. <\/p>\n\n\n\n

Throughout the pandemic, high infection and death rates in nursing homes have been partially attributed to staff shortages, among other factors. Proponents of the guidance argue that requiring staff vaccinations will encourage some who left the industry due to safety concerns to return to work.\u00a0 <\/p>\n","protected":false},"excerpt":{"rendered":"

Capitol Hill Update The House will convene for a brief legislative session this week as lawmakers eye action on the Senate-passed budget resolution for fiscal year (FY) 2022. Members will vote today on a rule that will set up debate on the budget resolution, voting rights legislation, and the bipartisan infrastructure deal. While the budget […]<\/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 - 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-200\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Health Policy Report - thornrun\" \/>\n<meta property=\"og:description\" content=\"Capitol Hill Update The House will convene for a brief legislative session this week as lawmakers eye action on the Senate-passed budget resolution for fiscal year (FY) 2022. 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