Weekly Health Care Policy Update - April 2, 2021

In this update:

President Biden Announces Updates on Combatting COVID-19
Biden Administration Announces “American Jobs Plan” Infrastructure Proposal
Biden Administration Announces Drug Policy Priorities
President Biden Signs PPP Extension Act of 2021
CMS Instructs MACs to Temporarily Hold Medicare Claims
HHS Announces Implementation of Enhanced Premium Tax Credits for HealthCare.gov Coverage
CMMI Delays CHART Model ACO Transformation Track RFA
Governor Cuomo Issues Executive Order 202.99
CMS Approves OPWDD HCBS Waiver Appendix K Extension
Governor Cuomo Launches Broadband Portal and Telehealth Provider Training Portal
Updated Guidance Documents

Administration Updates

President Biden Announces Updates on Combatting COVID-19
This week, the Biden Administration announced new steps to combat the COVID-19 pandemic:

The Administration has set a goal that 90 percent of adults will be eligible for a COVID-19 vaccine by April 19^th, and live within five miles of a vaccination site. This will be achieved by increasing the number of vaccination sites from 50,000 to 70,000, primarily by increasing the number of pharmacies administering vaccinations to 40,000. The federal government will also open at least 12 new mass vaccination sites.
The Administration launched the COVID-19 Community Corps (announced here), a national network of community leaders and groups to encourage vaccinations. There are over 275 founding members, including public health and medical organizations, sports and entertainment figures, rural groups, unions, and others.
The Department of Health and Human Services (HHS) will provide close to $100 million to increase vaccinations among older adults and people with disabilities through the Administration for Community Living (ACL). This includes about $93 million for aging and disability networks in each state and territory, such as state units on aging, aging and disability resource centers, and state councils on developmental disabilities. It also includes $5 million for national hotlines to help these populations register. More details are available here.

Biden Administration Announces “American Jobs Plan” Infrastructure Proposal
On March 31^st, President Biden announced his $2 trillion proposal for investments in the United States’s infrastructure and workforce, the American Jobs Plan. Among other investments in transportation, power, water, Internet, buildings, and other infrastructure, as well as job opportunities and infrastructure, the Plan also includes some specific health care-related initiatives. These include:

$400 billion for the expansion of access to home and community-based services (HCBS) are for older adults and people with disabilities. This would include:
- The expansion of HCBS within Medicaid programs;
- The extension of the Money Follows the Person (MFP) demonstration; and
- Initiatives to increase pay and benefits for direct care workers, including supporting the option for unionization.
$18 billion into buildings of the Department of Veterans Affairs (VA), including hospitals, clinics and federal buildings.
$50 billion for the National Science Foundation (NSF), focusing on fields including biotechnology.
$30 billion for new investments in medical countermeasures manufacturing, research and development, and biopreparedness and biosecurity.

The official press release and fact sheet is available here.

Biden Administration Announces Drug Policy Priorities
On March 31^st, the President’s Office of National Drug Control Policy released a document outlining drug policy priorities for the first year of the Biden Administration. This statement is statutorily due to Congress by April 1^st in the inaugural year. The Administration’s listed priorities are:

Expanding access to evidence-based treatment;
Advancing racial equity issues in the approach to drug policy;
Enhancing evidence-based harm reduction efforts;
Supporting evidence-based prevention efforts to reduce youth substance use;
Reducing the supply of illicit substances;
Advancing recovery-ready workplaces and expanding the addiction workforce; and
Expanding access to recovery support services.

The full document is available here.

Legislative Updates

President Biden Signs PPP Extension Act of 2021
On March 30^th, President Biden officially signed the Paycheck Protection Program (PPP) Extension Act of 2021 into law, which extends the loan application period for the PPP program, which was originally set to expire on March 31^st, through May 31^st. Furthermore, the SBA will continue to process existing applications through June 30^th.

SPG distributed a primer on the PPP last week, available here.

Regulatory Updates

CMS Instructs MACs to Temporarily Hold Medicare Claims
On March 30^th, the Centers for Medicare & Medicaid (CMS) directed Medicare Administrative Contractors (MACs) to hold payment for all Medicare claims dated April 1^st or later, because of expected legislation that would delay the reinstatement of Medicare sequestration. The Senate passed this legislation on March 25^th, but owing to amendments, the House will need to pass the bill again when it returns from recess on April 13^th. CMS expects that the hold will last for “a short period without affecting providers’ cash flow.”

The CMS notice is available here. The full text of the bill is available here.

HHS Announces Implementation of Enhanced Premium Tax Credits for HealthCare.gov Coverage
On April 1^st, HHS announced that the enhanced premium tax credits and lowered maximum premiums established by the American Rescue Plan (ARP) are now available for consumers enrolling in insurance plans in any of the 36 States using a federally-facilitated exchange through HealthCare.gov. A Special Enrollment Period (SEP) due to COVID-19 is currently available through August 15^th.

In order to receive enhanced credits, current enrollees should resubmit their HealthCare.gov applications, and may either select a new plan or reselect their current plan. New enrollees will automatically receive enhanced credits. Consumers who take action in April will begin receiving savings on their May premiums.

The ARP’s temporary enhancements include:

All families, including those with income above 400% of the federal poverty line (FPL) are now eligible for individual insurance market subsidies;
Households with income below 150% of FPL will pay no premiums for a silver plan;
Households with income of 400% of FPL or higher will pay no more than 8.5% of their income; and
Individuals who receive unemployment benefits for any period during 2021 will receive benefits as if they had income of 133% of FPL for one year.

HHS also announced that it would spend an additional $50 million in advertising to promote the availability of the SEP.

The full CMS press release is available here.

CMMI Delays CHART Model ACO Transformation Track RFA
On March 30^th, the CMS Innovation Center (CMMI) announced that it would delay the issuance of a Request for Applications (RFA) for the Community Health Access and Rural Transformation (CHART) Model’s Accountable Care Organization (ACO) Transformation Track. CMMI now expects to issue the RFA in spring 2022. The CHART ACO model, as proposed, would provide upfront funding and an enhanced prospective per beneficiary per month (PBPM) payment to up to 20 rural-focused ACOs.

Additionally, CMMI has extended the deadline for the CHART model’s other component, the Community Transformation Track, to May 11^th. This model offers funding to eligible organizations to coordinate care delivery transformations within a rural service area.

More information on the CHART Model is available here.

Congressional Hearings

The House and Senate are in recess. The House will be back in session on April 13^th and the Senate will return on April 12^th. Select Senate committees will proceed with confirmation hearings for President Biden’s nominees.

New York State Updates

Governor Cuomo Issues Executive Order 202.99
On March 26^th, Governor Cuomo signed Executive Order 202.99 (available here), which extends all disaster emergency provisions outlined in Executive Order 202 and its successors that have not been otherwise superseded, modified, or expired through April 25^th. The Order also modifies previous directives to require pharmacies to prioritize the following groups for COVID-19 vaccinations:

Individuals who are age eligible;
P-12 public or non-public school teachers, substitute teachers, or student teachers; and
Individuals with comorbidities.

CMS Approves OPWDD HCBS Waiver Appendix K Waiver Extension
On April 1^st, the Office for People with Developmental Disabilities (OPWDD) announced that CMS has approved an extension of Appendix K emergency modifications to the OPWDD 1915(c) HCBS Waiver. Under this extension, the Appendix K flexibilities will expire six months after the end of the federal COVID-19 public health emergency. Flexibilities for OPWDD providers under the Appendix K authority include the ability to deliver services using remote technology and in alternate settings.

Governor Cuomo Launches Broadband Portal and Telehealth Provider Training Portal
On March 31^st, Governor Cuomo announced three new initiatives informed by the Reimagine New York Commission’s action plan (available here), which includes recommendations for New York State related to connectivity, telehealth, and work. The three new initiatives include:

An broadband portal (here) to help New Yorkers access:
- Affordable broadband programs in their area;
- Information about the Federal Communications Commission (FCC) Emergency Broadband Benefit Program ($50/month subsidy for broadband service, plus a one-time discount of up to $100 on computers and tablets); and
- Consumer surveys.
An open-access telehealth training program (here) to support medical and behavioral health providers in developing, improving, and maintaining telehealth competencies.
The Reimagine Mental Health Outreach Campaign (here), a partnership between the Office of Mental Health and private organizations statewide that will support communities that disproportionately face unmet mental health needs.

Updated Guidance Documents
Recently released New York State and City COVID-19 guidance documents are listed below.

This Week’s SPG Updates

Please find below links to updated SPG resource documents.

Directory of COVID-19 Guidance Documents (4.1.21)
NYS COVID-19 Waiver Timeline Tracker (3.31.21)