Policy
Round Up: Evusheld authorization paused, HUD AFFH proposed
rule, Medicaid continuous enrollment, and more
By Vicki Gottlich, Director, Center for
Policy and Evaluation
In this policy round up:
- Evusheld authorization paused and
ways people who are immunocompromised can protect
themselves
- New CDC website helps locate free
COVID testing
- Public input opportunity: HUD
Affirmatively Furthering Fair Housing proposed rule
- HUD announces new funding for
affordable housing for people with disabilities
- CMS bulletin offers additional
information on continuous enrollment wind down
- Letter to states on CHIP and
Medicaid coverage for interpersonal consultations
- Correction to Medicare Special
Enrollment Periods guidance clarifies enrollment
timelines
- Public input opportunity: National
Coverage Determination Analysis for injectable PrEP
- Updates to the Nursing Home Care
Compare Website and Five Star Quality Rating System
Evusheld authorization
paused and ways people who are immunocompromised can
protect themselves
FDA has announced that Evusheld
is
not currently authorized for use
because it is unlikely to offer protection against the
COVID-19 variants that are common today. Since December
2021, Evusheld
has been an option for people who are moderately or
severely immunocompromised and people with a history of
severe adverse reaction to a COVID-19 vaccine or its
components.
If you’ve already received Evusheld, it’s
important to know that you may now have less protection
from developing COVID-19 if exposed to the variants circulating
today. However, there are many things you can do to
increase your protection against COVID-19 including staying
updated on vaccines, masking in public spaces, and
improving indoor ventilation. In addition, several
treatments, including Paxlovid and Veklury are available
for COVID-19. Timely treatment can reduce your risk of
getting very sick, being hospitalized, or dying as a result
of an infection.
This
resource from the Administration for Strategic Preparedness
and Response addresses questions about the change
in authorization for Evusheld, and how people who are
immunocompromised can protect themselves including staying
updated with vaccines, developing
In light of the FDA’s announcement, CDC’s
Morbidity and Mortality Weekly Report details a variety of
strategies that people who are immunocompromised
can use to protect themselves from the variants of COVID-19
currently circulating in the United States.
New CDC website helps
locate free COVID testing
CDC has launched the COVID-19
Testing Locator website, which allows consumers to
search for free COVID-19 testing sites near them. The
locator is part of the CDC Increasing Community Access to
Testing (ICATT) program, which provides access to COVID-19
testing, focusing on communities at a greater risk of being
impacted by the pandemic, people who do not have health
insurance, and surge testing in state and local
jurisdictions.
Public input opportunity:
HUD Affirmatively Furthering Fair Housing proposed rule
The U.S. Department of Housing and Urban
Development (HUD) took a major step towards rooting out
longstanding inequities in housing and fostering inclusive
communities by announcing
the “Affirmatively
Furthering Fair Housing (AFFH)" proposed rule.
This proposed rule would implement the Fair Housing Act's
affirmatively furthering fair housing mandate, which
directs the government to promote fair housing choice,
eliminate disparities in housing, and foster inclusive
communities.
This proposed rule seeks to simplify the
required fair housing analysis, emphasize goal-setting,
increase transparency for public review and comment, foster
local commitment to addressing fair housing issues, enhance
HUD technical assistance to local communities, and provide
mechanisms for regular program evaluation and greater
accountability, among other changes.
The proposed rule contains a number of
changes of particular note to the aging and disability
community, including:
- incorporating the housing needs of
people with disabilities into the definition of
“affordable opportunities;”
- defining “fair housing choice” for
persons with disabilities as providing “a realistic
opportunity to obtain and maintain housing with
accessibility features meeting the individual’s
disability-related needs, housing provided in the most
integrated setting appropriate to an individual’s
needs, and housing where community assets are
accessible to individuals with disabilities, including
voluntary disability-related services that an
individual needs to live in such housing;”
- requiring consultation with
organizations that advocate on behalf of individuals
with disabilities such as centers for independent
living, protection & advocacy agencies, aging and
disability resource centers, and councils on
developmental disabilities as a part of the community
engagement process jurisdictions must take as they
develop their Equity Plans; and
- restores previous references to the
Olmstead decision and the integration mandate of
Section 504 of the Rehabilitation Act.
HUD seeks public comments on this
proposed rule. The 60-day comment period will open once the
proposed rule is published in the Federal Register. HUD has
created
a guide to submitting comments. ACL networks and
stakeholders are encouraged to submit their views,
comments, and recommendations.
Additional fair housing resources: review the Affirmatively
Furthering Fair Housing (AFFH) Fact Sheet and Engaging
the Disability Community in Fair Housing Planning Webinar
Series.
HUD announces new funding
for affordable housing for people with disabilities
On January 4, HUD announced
that it would provide $24.7 million for permanent
affordable housing to people with disabilities. This award
allows local public housing authorities to house up to
2,210 additional families, and further support community
integration for persons with disabilities.
The assistance is provided through the HUD
Section 811 Mainstream Housing Choice Voucher Program,
which offers funding to housing agencies to assist
non-elderly people with disabilities who are transitioning
out of institutional or other isolated settings, at serious
risk of institutionalization, homeless, or at risk of
becoming homeless.
CMS bulletin offers additional
information on continuous enrollment wind down
As we discussed in our last
policy round up, the Consolidated Appropriations Act
(CAA) was signed into law last month. On January 5, the
Centers for Medicare & Medicaid Services (CMS) released
an informational
bulletin on changes the CAA made to Medicaid and
Children’s Health Insurance Program (CHIP) requirements.
Under this new law, states can end coverage for people who
no longer meet the requirements for Medicaid, CHIP, and the
Basic Health Program.
Stakeholders may want to work with their
State Medicaid agencies to ensure that older people and
people with disabilities who receive Medicaid are aware of
the resumption of Medicaid renewal reviews. They may also
want to work with individuals who may need assistance with
the renewal process. For more on how to prepare for these
changes, check out ACL’s April 2022 fact
sheet.
Letter to states on CHIP
and Medicaid coverage for interpersonal consultations
Earlier this month, CMS released a State
Health Official (SHO) letter that clarifies that states
may choose to cover interprofessional consultation under
Medicaid and the Children’s Health Insurance Program
(CHIP).
This change allows one provider to discuss a
Medicaid or CHIP beneficiary’s case with a specialist, with
or without the beneficiary present, and to pay the
specialist for their services directly.
The previous policy only allowed payment in
these cases if the provider seeking the consultation was
paid for the consulted provider’s services and then paid
the consulted provider directly. This change more directly
“links” routine care with specialty care, allowing more
people to benefit from providers with specialized
knowledge. This is especially important for improving
access to providers who specialize in child and adolescent
behavioral health.
Correction to Medicare
Special Enrollment Periods guidance clarifies enrollment
timelines
On December 30, CMS issued a notice
of correction to an important Medicare rule that establishes
special enrollment periods for Medicare for people in
certain circumstances, including after the loss of Medicaid
coverage. The establishment of these special enrollment
periods will help close some of the coverage gaps in
Medicare enrollment. The correction notice includes an
updated chart listing the Medicare effective dates for
people who enroll during certain time periods.
Public input opportunity:
National Coverage Determination Analysis for injectable
PrEP
Pre-exposure
Prophylaxis (PrEP) is a medication that is 99 percent
effective at stopping HIV transmission when taken
correctly. Medicare currently covers PrEP pills and is
considering covering the injectable form of the drug. It
just released a National Coverage Determination Analysis
for injectable PrEP- a review to determine if the
medication has sufficient research support to warrant
Medicare coverage.
Access to PrEP is particularly important for
LGBTQ+ Medicare beneficiaries and people of color who are
disproportionately impacted by HIV. Currently, in addition
to medication, people on PrEP must be tested for HIV every
3 months. Medicare only covers one HIV
screening per year for people 15-65 and those at
increased risk of HIV transmission, even if they are taking
oral PrEP. It is unclear whether that standard will change
if Medicare chooses to cover injectable PrEP.
You can read the National Coverage
Determination Analysis tracking sheet and comment here.
The comment period is open through February 11, 2023.
Updates to the Nursing
Home Care Compare Website and Five Star Quality Rating
System
On January 18, CMS released a memo
outlining updates to the Nursing Home Care Compare Website
and Five Star Quality Rating System to bring greater
transparency about nursing home citations to families and
to address concerns that some nursing homes have
inappropriately diagnosed residents with schizophrenia,
which can mask the facilities’ true rate of antipsychotic
medication use.
As part of these changes, CMS will conduct
offsite audits of schizophrenia coding and adjust the
quality measure star ratings for facilities whose audit
reveals inaccurate coding. This change will help improve
the accuracy of the quality information that is publicly
reported and the nursing home Five-Star Rating System. The
use of antipsychotic medications among nursing home
residents is an indicator of nursing home quality and used
in a nursing home’s Five-Star rating, however it excludes
residents with schizophrenia. If an audit identifies a
facility with a pattern of inaccurately coding residents as
having schizophrenia, the facility’s Five-Star Quality
Measure Rating on the Care Compare site will be negatively
impacted.
CMS will also publicly display survey
citations that facilities are disputing. Currently,
disputed citations are not posted to Care Compare until the
dispute process is complete. While these disputes are
usually resolved within 60 days, they sometimes take longer
and having that information can help people make more
informed choices when it comes to evaluating a nursing
home. While the citations will be publicly displayed, they
will not be included in the Five-Star Quality Rating
calculation until the dispute is complete.
|
No comments:
Post a Comment