Policy
Round Up:
OTC Hearing Aids, CDC’s Prescribing Guideline for Opioids,
Surgeon General’s Framework for Mental Health in the
Workplace, and more
- Last
chance: Comments due 12/6 on CMS RFI on Nat’l
Directory of Health Care Providers and Services
- Cheaper Hearing Aids Now in Stores
- CDC Releases Clinical Practice
Guideline for Prescribing Opioids
- U.S. Surgeon General Releases New
Framework for Mental Health & Well-Being in the
Workplace
- CMS Finalizes Policies to Simplify
Medicare Enrollment and Expand Access to Coverage for
Immunosuppressive Drugs
- CMS releases new resource for
states on ending Medicaid coverage in the optional
COVID-19 group
Last chance: Comments due 12/6 on CMS RFI on Nat’l
Directory of Health Care Providers and Services
CMS is seeking feedback on the
potential creation of a directory with information on
health care providers and services. Feedback can be
submitted by mail or online until tomorrow (December 6).
The directory could serve as a centralized data hub,
containing the most accurate, up-to-date, and validated
data in a publicly accessible index. This could help people
find and compare providers, as well as more easily identify
which providers meet their needs and preferences. This is
especially useful for older adults and people with
disabilities who often have accessibility and language
needs.
This would not replace current CMS-maintained data systems,
like Medicare Care Compare. Instead, the directory would be
a tool that works in combination with these systems to
streamline and improve the processes for collecting,
maintaining, and presenting information in a more
user-friendly manner.
The RFI seeks input on:
- Topics related to the establishment
of a national directory, including whether it would be
helpful to include data elements such as provider
languages spoken other than English, specific office
accessibility features for people with disabilities
and/or limited mobility, accessible examination or
medical diagnostic equipment, or a provider's cultural
competencies
- Key considerations related to data
submission and maintenance;
- Technical considerations;
- The current state of healthcare
provider directories and steps that could or should be
taken if CMS establishes a national directory;
- Feasibility of a phased approach to
implementation and potential opportunities to build
stakeholder trust and adoption along the way; and
- Risks, challenges, and
prerequisites associated with implementing such a
directory.
Cheaper Hearing Aids Now
in Stores
Last month, in response to an executive order issued by
President Biden, the Food and Drug Administration (FDA)
issued a final rule to lower the
cost of hearing aids for the nearly 30 million Americans
who have hearing loss.
The new rule allows adults with mild-to-moderate hearing
loss to buy hearing aids at a store or online without a
prescription, exam, or audiologist fitting. The FDA estimates this could lower
average costs by as much as $3,000 per pair. Eliminating
the need for these additional steps to obtain hearing aids
will also reduce not just cost, but barriers for those who
may not have access to an audiologist. Retailers across the
country, including CVS, Walgreens, Walmart, and others, are
now selling over-the-counter hearing aids. For more on the
options available, see this fact sheet.
CDC Releases Clinical Practice Guideline for Prescribing
Opioids
On November 4, the Centers for Disease Control and
Prevention (CDC) released an update to its
clinical practice guideline for prescribing opioids, which
was last issued in 2016. The
updated guideline provides more flexibility in its
recommendations, centering clinical judgment and
communication between clinicians and patients, a change the
disability community had strongly advocated for.
The update addresses management of subacute painful
conditions and clarifies recommendations that apply to
patients who are being considered for initial treatment
with prescription opioids and those who have already been
receiving opioids as part of their ongoing pain management
treatment.
The updated guideline also emphasizes the importance of
individualized person-centered care. It underscores that
pain management should include consideration of a person’s
physical health, behavioral health, long-term services and
supports, expected health outcomes and well-being needs.
Additionally, it recognizes that older adults can be at
risk for inadequate pain treatment and outlines best practices
when it comes to prescribing opioids to them, including
implementing interventions to mitigate common risks and
educating older adults receiving opioids to avoid
medication-related behaviors that increase risk, such as
saving unused medications.
U.S. Surgeon General Releases New Framework for Mental
Health & Well-Being in the Workplace
On October 20, the U.S. Surgeon General released a new Framework
for Mental Health & Well-Being in the Workplace.
The report outlines five essentials for workplace mental
health and well-being to help organizations develop,
institutionalize, and update policies, processes, and
practices that best support the mental health and
well-being of all workers.
Among those, the framework recommends making Diversity,
Equity, Inclusion, and Accessibility (DEIA) norms,
policies, and programs a priority. This includes considerations
for people with disabilities to ensure equitable access to
employment, as well as workplace participation,
accommodations, and modifications. To achieve this,
framework points to resources employers and current and
prospective employees can use, including the Job
Accommodation Network (JAN) and Administration for
Community Living’s Americans
with Disabilities Act National Network , which
provide free training and resources for employees,
employers, and job applicants.
CMS Finalizes Policies to Simplify Medicare Enrollment
and Expand Access to Coverage for Certain Immunosuppressive
Drugs
On October 28, the Centers for Medicare and Medicaid
Services (CMS) issued a final rule that will
simplify Medicare enrollment rules and extend coverage of
immunosuppressive drugs for certain beneficiaries.
CMS also published a fact sheet explaining
the key provisions of the rule. Among them:
- Reduced delays in coverage.
People who enroll during the general enrollment
period or during the last three months of their
initial enrollment period will now have Medicare
coverage beginning the month immediately after their
enrollment.
- New special enrollment periods,
which allow people to enroll in Medicare Part B
coverage without a late-enrollment penalty if they missed
a Medicare enrollment period due to:
- Emergency or disaster
- Health plans or employers
misrepresenting or providing incorrect information
- Incarceration
- Other exceptional conditions
- There also will now be a special
enrollment period to allow people to enroll in
Medicare after termination of Medicaid eligibility.
- Immunosuppressive drug coverage
will now be available indefinitely after a kidney
transplant for people who have Medicare coverage based
on End-Stage Renal Disease, if they do not have (or
plan to enroll in) other types of health coverage.
The rule simplifies state
administration of Medicare Savings Programs (MSPs), through
which states cover Medicare premiums and cost sharing for
low-income beneficiaries.
CMS releases new resource for states on ending Medicaid
coverage in the optional COVID-19 group
Last month, the Centers for Medicare & Medicaid
Services (CMS) released a new resource for states to
use as they prepare for the eventual end of the COVID-19
public health emergency (PHE).
During the PHE, some states expanded access to Medicaid
coverage through an optional COVID-19 eligibility group to
ensure people who would otherwise be uninsured could access
critical COVID-related services. When the PHE ends, this
special eligibility will end, as well. States will need to
redetermine eligibility for those beneficiaries to
determine if they’re eligible for Medicaid on another basis.
This resource provides states with strategies for doing so,
along with advice on planning for unwinding following the
PHE.
In a March a letter
to state health officials, CMS provided states
flexibility to prioritize work for certain populations and
distribute renewals across the unwinding period. That
letter recommends that states initiate no more than 1/9 of
their total caseload of Medicaid and CHIP renewals in a
given month during the unwinding period.
However, because coverage for the optional COVID-19 group
will end as of the last day of the PHE, CMS has advised
states in this new resource that they do not need to
include optional COVID-19 group beneficiaries in their
total caseload for purposes of ensuring they are initiating
renewals for no more than 1/9 of their total Medicaid and
CHIP caseload in a given month.
States also do not need to include the optional COVID-19
group in their baseline and monthly data eligibility and
enrollment unwinding data reports. CMS will track optional
COVID-19 group enrollment numbers and application
processing data through existing CMS data collection
efforts.
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