HealthCare Roundtable e-News – February 24, 2022

Health Providers “Disappointed” New HHS Health Fund Allocations Leave Out Requested $20B in Direct Relief

The Biden administration unveiled last week new allocations for another $30 billion in funds approved by Congress that will go towards HHS’ efforts to pay for more treatments and vaccines, sustain testing capacity and invest in next-generation vaccine research and development.

While providers are pleased that the bill will cover coronavirus care for the uninsured, some have expressed their dissatisfaction that the bill does not include the requested $20 billion for direct provider relief. Additionally, many have requested that lawmakers prioritize long-term care residents and staff when doling out additional COVID-19 relief.

“We’re pleased the administration wants $3 billion for the uninsured patient fund, but our hospitals need more support – especially to ease the severe staffing shortages they still face,” Beth Feldpush, America’s Essential Hospitals senior vice president of policy and advocacy. “We’ve asked Congress to appropriate at least $20 billion toward the workforce needs of essential hospitals and other providers during the public health emergency, and that remains a priority for us.” (InsideHealthPolicy)

Earlier this year, a coalition of more than 700 hospitals asked Congress to add $20 billion to the $178 billion Provider Relief Fund. Argentum, in particular, urged lawmakers to pass Reps. Lori Trahan’s (D-Mass.) and Brian Fitzpatrick’s (R-Pa.) bill that would provide $10 billion in targeted federal financial relief for assisted living facilities, which are in danger of closing after receiving relatively little in provider relief compared to other recipients. (InsideHealthPolicy)

CMS Seeks Comments on Race, Ethnicity Data for Exchange Quality Ratings in Draft 2022 Call Letter

CMS is requesting comments and other feedback on a draft 2022 call letter proposing changes to the qualified rating system (QRS) and qualified health plan (QHP) enrollee experience survey programs. According to the proposal published this month, the agency is also seeking feedback on provisions that would require plans to directly collect and report stratified race and ethnicity data on five measures starting in the 2024 rating year.

The agency is weighing plans to retain temporary rules implemented last year through the 2022 plan year that aim to mitigate the impact of the pandemic by preventing a rating from decreasing by more than one star from one year to the next. Starting in 2023, CMS will also seek to begin collecting and reporting stratified race and ethnicity data. Potential measures to be assessed include colorectal cancer screening, controlling high blood pressure, prenatal and postpartum care, and child and adolescent well-care visits. (InsideHealthPolicy)

Also proposed for the 2023 plan year is the inclusion of Kidney Health Evaluation for Patients with Diabetes to the QRS measure set, the temporary removal of the Initiation and Engagement of Substance Use Disorder Treatment measure from the 2023 rating year – a move that the agency says will give QHPs time to adapt to recent updates and reporting requirements – and the inclusion of optional Electronic Clinical Data System Reporting of measures.

The agency is encouraging all interested parties to submit their comments on the Draft 2022 QRS and QHP Enrollee Survey Call Letter to and reference “Marketplace Quality Initiatives (MQI)-Draft 2022 QRS and QHP Enrollee Survey Call Letter” in the subject line before the comment period deadline on March 9, 2022.

Schumer, Democrats Prioritizing Bill to Cap Insulin Costs

Senate Majority Leader Chuck Schumer (D-N.Y.) and fellow Democrats are rallying behind a bill from Sens. Raphael Warnock (D-Ga.) and Michael Bennet (D-Colo.) that will take aim at insulin costs by capping monthly out-of-pocket payments. During a Senate floor speech last Thursday (Feb. 17), Schumer said that his party “will continue focusing on lower costs for everyday Americans, including by taking aim at the costs of insulin.”

Warnock and Bennet’s bill seeks to require Medicare plans and private group or individual plans to cap monthly insulin costs at $35, similarly to the drug pricing provision previously included in President Biden’s Build Back Better bill, though talks around the package have since stalled. Known as the “Affordable Insulin Now Act,” the bill would also require Medicare plans to cap copays for preferred and nonpreferred products on plan formularies. The requirements would take effect Oct. 1 for Medicare plans and the beginning of next year for private health plans. (InsideHealthPolicy)

“It is unacceptable that the skyrocketing cost of prescription drugs like insulin forces Coloradans to make difficult financial decisions for themselves and their family,” said Bennet in a press announcement. “Our legislation will help ensure people with diabetes in Colorado never have to worry about whether or not they can afford their insulin. This is an important step to lower drug costs and reduce the economic burden Coloradans living with diabetes face every day.”

White House Considers Scaled Back Mask Requirements as U.S. Moves to New Phase of the COVID-19 Pandemic

As the total number of coronavirus cases continues to drop across much of the country, the White House is considering updating its mask guidance and scaling back response to the pandemic. During a White House press briefing last Wednesday (Feb. 16), COVID-19 response coordinator, Jeff Zients, told reporters that the administration is beginning to “look towards the future” as COVID-19 cases and hospitalizations continue to decline.

Data released from Johns Hopkins and the CDC show that new infections were down in many U.S. states in February, with cases largely decreasing since peaking in mid-January at more than 800,000 infections reported on average each day. But while case numbers are decreasing, deaths and hospitalizations are still high and steady enough to concern communities grappling with how to approach lifted mandates.

During the briefing, Zients said the Biden administration’s COVID-19 response team has been working with public health experts and local political and business leaders to help determine the administration’s next steps. Zients clarified that even though the government is including business leaders in pandemic discussions, all decisions will continue to be driven by science. (InsideHealthPolicy)