CMS Updates Guidance on Resumption of Services After Public Health Emergency
The Centers for Medicare & Medicaid Services (CMS) released updated guidance to assist states in their planning efforts to resume routine Medicaid, Children’s Health Insurance Program (CHIP) and Basic Health Program (BHP) operations for the eventual end of the COVID-19 public health emergency (PHE). The updated guidance extends the timeframe for states to complete pending eligibility and enrollment work to up to 12 months after the PHE ends and requires states to complete a redetermination of eligibility after the PHE for all beneficiaries prior to taking any adverse action. In the coming months, CMS will provide additional detailed guidance on the updated policies described in the guidance. The updated guidance notes that while this letter will assist states in their planning efforts for the eventual end of the PHE, it does not signal nor confirm when the federal PHE declaration will end. The current PHE, signed by the Secretary of Health and Human Services, was effective July 20. The renewal remains in effect for 90 days and the Secretary may extend the declaration for subsequent 90-day periods for as long as the emergency continues. HHS previously indicated the declaration will be extended through at least the end of the calendar year. The available temporary 6.2 percentage point increase in the federal medical assistance percentage (FMAP) included in the Families First Coronavirus Response Act expires at the end of the quarter in which the public health emergency ends.
Update on COVID-19 Booster Shots
The Food and Drug Administration (FDA) amended the emergency use authorizations (EUAs) for the Pfizer and Moderna COVID-19 vaccines to allow for the use of an additional dose in certain immunocompromised individuals. The Director of the Centers for Disease Control and Prevention (CDC) signed the Advisory Committee on Immunization Practices’ recommendation endorsing the use of an additional dose for people with moderately to severely compromised immune systems after an initial two-dose vaccine series. Updated CDC guidance can be found here. The Centers for Medicare & Medicaid Services released information that Medicare recipients who qualify for an additional dose can receive it with no cost sharing. Yesterday, administration officials announced that beginning the week of September 20, Americans who received the Pfizer or Moderna COVID-19 vaccines should expect to be offered a booster shot eight months after their second dose. At that time, the individuals who were fully vaccinated earliest in the vaccination rollout, including many health care providers, nursing home residents, and other seniors, will likely be eligible for a booster. Officials concluded that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability.
Nursing Homes Receiving Medicare and Medicaid Funds Will Be Required to Vaccinate Their Staff
The President announced that nursing home and long-term care facilities must vaccinate their staff against COVID-19 to continue to receive federal Medicare and Medicaid funding. This action is in response to lagging vaccination rates and a surge of new cases from the Delta variant of the coronavirus. The Department of Health and Human Services (HHS) will develop new regulations requiring nursing homes to require that all their workers be fully vaccinated against COVID-19 as a condition of participating in the Medicare and Medicaid programs.
USDA and HHS Providing Funds for Rural Health Care and Telehealth
The U.S. Department of Agriculture (USDA) announced the availability of up to $500 million in grants to help rural health care facilities, Tribes and communities expand access to COVID-19 vaccines, health care services and nutrition assistance through creation of the Emergency Rural Health Care Grant Program. Funds will be allocated through Recovery Grants (approximately $350 million) and Impact Grants (approximately $125 million). In addition, the Department of Health and Human Services (HHS) is distributing $19 million to 36 award recipients to expand telehealth nationwide and improve health in rural and other underserved communities.
State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities
The National Governors Association (NGA) Center for Best Practices released a report, State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities. The report looks at examples of promising practices for governors, including building vaccine confidence, establishing pathways for individuals to access vaccines, and developing and streamlining ways to allocate and distribute vaccines to rural and frontier populations. NGA conducted interviews with state officials, national experts and rural community-based organizations and the report includes both short-term and long-term strategies and state examples.
National Trends in Medicaid and CHIP Enrollment
This data note by the Kaiser Family Foundation looks at national and state-by-state Medicaid and the Children’s Health Insurance Program (CHIP) enrollment data through March 2021. After declines in enrollment from 2017 through 2019 total Medicaid/CHIP enrollment grew to 81.7 million in March 2021, an increase of 10.5 million or 14.7 percent, from enrollment in February 2020, right before the pandemic. While enrollment has increased for 13 consecutive months, the monthly increases appear to be slowing compared to April through August 2020, when monthly increases were the largest. However, continued economic uncertainty and fallout from the more transmissible Delta variant could impact future Medicaid enrollment trends.