CMS Proposes Better Home Health, Access; Telehealth Bills Target Rural Health, Diabetes

Two proposed rules from CMS target better home health and access to health insurance exchanges, while proposed telehealth bills aim to improve rural health access and diabetes prevention.

By Emily Sokol, MPH

June 30, 2021 – CMS issued two proposed bills that would expand home healthcare and access to health insurance exchanges. Meanwhile, Congress continues to push for telehealth bills that would increase rural access to care and promote diabetes prevention programs.

HOUSE COMMITTEE HEARING LOOKS TO SOCIAL DETERMINANTS OF HEALTH

Last week, the House Committee on Energy & Commerce held a hearing on the Social Determinants of Health Accelerator Act. Cosponsored by Congresswoman Cheri Bustos (IL-17), the bill would allocate money directly to state, local, and Tribal governments to develop social determinants of health interventions. “You think of people who, because of where they are born and raised, and if it happens to be, for instance, in this zip code, they’re faced with immediate challenges on the day that they come onto this planet. That’s just wrong,” Bustos told PatientEngagementHIT.

73 LOCAL GOVERNMENTS RECEIVE HHS AID FOR HEALTH LITERACY, VACCINATION EFFORTS

On June 28, HHS announced $250 million in grant funding for 73 local governments. The funding will go toward improving health literacy in these communities to enhance COVID-19 vaccination rates and other preventive health measures. As a part of the Biden Administration’s Advancing Health Literacy to Enhance Equitable Community Responses to COVID-19 initiative, the local agencies will have two years to identify and implement best practices for advancing health literacy and vaccine education.

INTEROPERABILITY AND PATIENT ACCESS FINAL RULE ENFORCEMENT BEGINS JULY 1

Enforcement of the Interoperability and Patient Access final rule under the 21st Century Cures Act is set to begin July 1. Under the rule, in effect since January 1, healthcare providers must give patients access to their personal health information. The goal is for increased interoperability to also improve patient care, as a patient’s provider can have access to her entire medical history to make more informed clinical decisions.

SUPREME COURT DECLINES SITE-NEUTRAL PAYMENT CASE, MAINTAINS CDC EVICTION MORATORIUM

The Supreme Court dismissed a case filed by the American Hospital Association (AHA) regarding site-neutral payment options. The original lawsuit was filed in May, arguing that the 2019 Outpatient Prospective Payment System rule limited hospital outpatient access. Twice, lower courts sided with AHA and other hospital plaintiffs saying HHS surpassed its statutory authority when it reduced Medicare rates for some services delivered off-site at provider-based departments. A three-judge appeals panel reversed the decision last July and AHA brought the case to the Supreme Court in February.

Yesterday, the Supreme Court also refused to lift the CDC eviction moratorium. The Alabama Association of Realtors challenged the CDC decision to pause all evictions because of the COVID-19 public health emergency, but a 5-to-4 vote by the justices upheld the moratorium until its original deadline of July 31.

TELEHEALTH BILLS PUSH FOR RURAL HEALTH ACCESS, DIABETES PREVENTION PROGRAMS

A bipartisan group of senators is promoting the Rural and Telehealth Expansion Act. The proposed bill would increase the Federal Medical Assistance Percentage by five percent for telehealth services in frontier states and those with limited broadband access. The bill also aims to expand access to connected health technologies—including audio-only telehealth services—where access to care is limited or accessibility of telehealth is limited by unreliable broadband connection.

Several senators also re-introduced the Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act, otherwise known as the PREVENT DIABETES Act. The proposed bill would allow the Medicaid Diabetes Prevention Program’s Expanded Model to include virtual programs such as telehealth.

CMS PROPOSES EXPANDING HOME HEALTH, INCREASING ACCESS TO CARE

In an effort to improve home health services to Medicare beneficiaries, CMS proposed the expansion of the Home Health Value-Based Purchasing (HHVBP) Model. Currently, nine states are participating in the model and have saved Medicare over $141 million. The goal is to test if payment incentives can change healthcare provider behavior and improve the quality of care. The proposed rule would expand the model nation-wide in calendar year 2022. It also includes increased payments to home health agencies and proposes updated payment rates for home infusion therapy services.

In the third installment of the payment notice for 2022, CMS proposed a rule that would expand access to health insurance on the federal insurance marketplace. The rule has three key factors:

  • Increasing the annual enrollment period by 30 days
  • Creating a special enrollment period for certain low-income members
  • Expanding responsibilities of federally-facilitated exchange navigators or patient navigators

All three propositions aim to increase access to health insurance coverage for millions of Americans who rely on the federal health insurance exchange for coverage.