Budget Blog

September 10, 2020 - Health Care Issues Update

By Stacey Mazer posted 09-10-2020 12:00 AM


HHS Announces Incentive Payments for Nursing Homes

The Department of Health and Human Services (HHS) announced the details of a $2 billion Provider Relief Fund performance-based incentive payment distribution to nursing homes. This is the latest update in the previously announced $5 billion in planned support, which included $2.5 billion in upfront payments. HHS will measure nursing homes against a baseline level of infection in the community where a given facility is located and facilities will have their performance measured on two outcomes: ability to keep new infection rates low among residents and ability to keep mortality low among residents. There will be four scheduled performance periods, lasting a month each with $500 million available each period.


CMS Issues Guidance on Contract Language for Managed Care Contracts  

The Centers for Medicare & Medicaid Services (CMS) issued guidance on contract language for inclusion in states’ Medicaid and Children’s Health Insurance Program (CHIP) managed care plan contracts. States should execute contract amendments to include the additional language in managed care plan contracts no later than December 31, 2020. CMS expects states to include language in their managed care plan contracts that will help to ensure that CMS is not matching expenditures on unauthorized programs or activities.


Administration Announces Rural Telehealth Initiative and Rural Action Plan

The Federal Communications Commission (FCC), Department of Health and Human Services (HHS) and U.S. Department of Agriculture (USDA) announced the signing of a Memorandum of Understanding (MOU) on a Rural Telehealth Initiative. The initiative is a joint effort to collaborate and share information to address health disparities, resolve service provider challenges, and promote broadband services and technology to rural areas. Additionally, HHS released the Rural Action Plan, the first HHS-wide assessment of rural healthcare efforts. Efforts that will be undertaken in fiscal 2020 include nine new rural-focused administrative or regulatory actions, three new rural-focused technical assistance efforts, 14 new rural research efforts, and five new rural program efforts.


CDC Releases Early Estimates for Health Insurance Coverage in 2019

The Centers for Disease Control and Prevention (CDC) released the report of health insurance coverage for the U.S. population based on data from the January–December 2019 National Health Interview Survey. In 2019, 33.2 million or 10.3 percent of individuals were uninsured at the time of the interview. In the second half of 2019, 35.7 million individuals or 11.0 percent were uninsured, significantly higher than the first 6 months of 2019 when 30.7 million individuals or 9.5 percent were uninsured. This is also higher than the 30.4 million individuals, or 9.4 percent, who were uninsured in 2018.


CMS Releases Bulletin to States on Treating Neonatal Abstinence Syndrome

The Centers for Medicare and Medicaid Services (CMS) released an informational bulletin on Guidance to Improve Care for Infants with Neonatal Abstinence Syndrome (NAS) and Their Families. Legislation required the guidance for states regarding opportunities to improve care for infants with NAS, addressing topics such as best practices for innovative payment models, recommendations on financial opportunities through Medicaid and the Children’s Health Insurance Program (CHIP), guidance and technical assistance to state Medicaid agencies on additional flexibilities and incentives, and guidance for suggested terminology and codes.


Directed Payments in Medicaid Managed Care

This issue brief by the Medicaid Payment and Access Commission (MACPAC) examines the use of directed payments. The Centers for Medicare & Medicaid Services (CMS) 2016 Medicaid managed care rule created a new option for states to require managed care plans to pay providers according to specific rates or methods, referred to as directed payments. Common types of directed payment arrangements include those that establish minimum payment rates for certain types of providers and those that require participation in value-based payment arrangements that advance the state’s quality and access goals.