May 11, 2021

Volume XI, Number 131

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May 10, 2021

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McDermottPlus Check-Up: April 9, 2021

This Week’s Dose

Congress is out of session this week, but the Senate Parliamentarian reportedly ruled that lawmakers may pursue an additional reconciliation package for fiscal year (FY) 2021, a decision that is likely to shape legislative efforts for the remainder of the year. The Centers for Medicare and Medicaid Services (CMS) released annual payment rules, including the FY 2022 proposed payment rule for inpatient rehabilitation facilities (IRFs).

Administration

CMS Released Proposed FY 2022 IRF Rule

CMS estimates that the proposed rule would increase payments to IRFs by 1.8%, or approximately $160 million, nationwide in FY 2022 over FY 2021. The rule also proposes adjustment to the IRF quality reporting program, including modifying the number of quarters used to report on certain quality measures due to the public health emergency. In line with the President’s Executive Order on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, the proposed rule also includes a request for information seeking comments on revising measure development and the collection of Standardized Patient Assessment Data Elements to address health equity in IRFs. More information on the proposed changes is available here. The proposed rule is scheduled to be published in the Federal Register on April 12 and comments are due on June 7, 2021.  

CMS Announced Direct Contracting Participants and Halted 2022 Applications

The agency provided an updated list of 53 participants for the performance year that began April 1, 2021, along with updated Frequently Asked Questions and Financial Frequently Asked Questions. The agency also announced that it would not be accepting new applications for January 1, 2022. Entities that previously applied, were accepted and deferred will be permitted to begin in January 2022. CMS is likely to face significant pushback from stakeholders who had planned to apply for 2022.

CDC Awarded $3 Billion to Expand COVID-19 Vaccine Programs

The funds from the Centers for Disease Control and Prevention (CDC) will support local efforts to increase vaccine uptake by expanding COVID-19 vaccine programs and ensuring greater equity and access to vaccines by those disproportionately impacted by COVID-19. The funding was made available through the American Rescue Plan and the Coronavirus Response and Relief Supplemental Appropriations Act. To ensure that the funds are used to advance health equity and expand access to COVID-19 vaccines in communities disproportionality impacted by the pandemic, CDC is requiring that 75% be focused on racial and ethnic minorities and 60% must go to support local health departments, community-based organizations and community health centers. Details on where funds will be distributed are available here.

Medicaid Work Requirements Rescinded

The Biden Administration reversed Trump-era Section 1115 waivers in Michigan and Wisconsin that required some Medicaid beneficiaries to work or participate in related activities to be eligible for benefits.  Last month, CMS sent letters to the 10 states that had implemented, or sought to implement, Medicaid work requirements, saying the Administration does not believe work requirements promote Medicaid objectives. The Democratic governors in Michigan and Wisconsin inherited the work requirement waivers from their Republican predecessors and were not expected to defend the policy. However, the Administration may face legal challenges from the remaining Republican-led states as it continues the rollback. 

Quick Hits

  • The White House released an outline of the President’s discretionary budget request for FY 2022, which includes $131.7 billion for the US Department of Health and Human Services (HHS), a 23.5% increase over the 2021 enacted level.

  • The Democratic leaders of the congressional health committees sent a letter urging HHS to create a Special Enrollment Period for laid-off Americans when their employer-based coverage expires.

  • CMS released the FY 2022 proposed payment rules for hospice and Skilled Nursing Facilities (SNFs). The agency estimates that the rules would increase payments to hospice providers by $530 million and to SNFs by $444 million. Public comments on both rules are due June 7, 2021.

  • CMS updated the list of approved hospitals and health systems for the Acute Hospital Care at Home Demonstration.

  • The Medicaid and CHIP Payment and Access Commission held its April Public Meeting on April 8 and 9. 

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© 2021 McDermott Will & EmeryNational Law Review, Volume XI, Number 99
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Mara McDermott, McDermott Law Firm, Washington DC, HealthCare Law Executive

Mara is an accomplished health care executive with a deep understanding of federal health care law and policy, including delivery system reform, physician payment and Medicare payment models.

Most recently Mara served as the senior vice president of federal affairs at America’s Physician Groups (formerly the California Association of Physician Groups, CAPG), a professional association representing medical groups and independent practice associations practicing in capitated, coordinated care models. As head of the Washington, DC, office, Mara...

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Kristen O’Brien Healthcare Executive McDermott Consulting
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Kristen O’Brien is an accomplished healthcare executive with a deep understanding of regulatory advocacy and healthcare policy efforts.

Kristen offers a strong background and a keen eye for solutions to barriers and challenges impacting healthcare clients. With more than 10 years of experience, her work focuses on implementing new laws through the rulemaking process, as well as working with relevant agency officials to develop and improve agency guidance.

Kristen recently served as Principal of the Health Industry Policy and Regulatory Practice Group at a law and lobbying...

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Katie Waldo Healthcare Attorney

Katie is an experienced government relations strategist who helps clients navigate the complex issues surrounding Medicare, Medicaid and the healthcare marketplace.

Katie works with clients to represent their needs before the US Congress and the US Department of Health and Human Services (HHS) and its agencies by relying on extensive experience as a policy advisor on the Medicaid and Medicare programs, as well as the 340B program and other aspects of the Public Health Service Act. She anticipates the effects of state and federal policymaking on issues impacting their businesses and...

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Government Relations Professional and Registered Lobbyist

Emma is a government relations professional and registered lobbyist who supports clients on a range of health policy issues.

As a policy consultant, Emma lobbies and consults with legislators and congressional staff on issues relating to Medicare, Medicaid payment and regulation, and the 340B Drug Pricing Program. She provides analysis of the federal political and regulatory environment, and routinely monitors pertinent Hill activities including congressional hearings, bill markups and think tank events.

Emma graduated...

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