Weekly Health Care Policy Update - May 21, 2021

In this update:

Biden Administration Announces Updates on COVID-19 Response
White House Revokes Health Insurance Requirement for Visa Applicants
HHS Announces Behavioral Health Grant Funding, New Coordinating Council
HRSA Warns Drugmakers to Resume 340B Drug Sales to Contract Pharmacies
Anne Schuchat to Retire from CDC
CMS Releases Data on COVID-19 Impact on Medicaid and CHIP Service Utilization
IRS Releases Guidance on COBRA Premium Subsidies
HHS Announces Funding for Telehealth in Pediatric Mental Health Care
HRSA Issues FY 2022 FQHC Service Area Competition
Office of Minority Health Announces Diabetes Control Funding Opportunity
Supreme Court to Hear Abortion Case
Expert Panel Recommends Earlier Colon Cancer Screening
Congressional Hearings
OMH Proposes Rule to Establish Youth Assertive Community Treatment Services
OMH Updates Comprehensive Psychiatric Emergency Program Regulations
Governor Cuomo Announces Plans to Rejoin Federal Title X Program
UHF and GNYHA Issue Call for Presentations for Symposium on NY Health Care
Updated Guidance Documents

Administration Updates

Biden Administration Announces Updates on COVID-19 Response
This week, the Biden Administration announced new updates on the COVID-19 response:

On May 17^th, President Biden announced that the U.S. will begin sending at least 20 million additional doses of COVID-19 vaccine to countries battling the pandemic by the end of June. The new doses, donated from the U.S.’s excess supply, are in addition to the previously-committed 60 million doses of AstraZeneca vaccine, and will be distributed in coordination with COVID-19 Vaccines Global Access (COVAX).
Domestically, the Administration will distribute more than 27 million doses to vaccine providers this week. More than 60 percent of adults have received at least one dose, and for the first time, COVID-19 cases are down in all 50 states this year.
On May 20^th, President Biden signed S. 937, the COVID-19 Hate Crimes Act, into law. The law encourages the reporting of hate crimes and enables the Attorney General to make grants to community-based organizations to prevent or respond to hate crimes, including those related to or resulting from the COVID-19 pandemic.

White House Revokes Health Insurance Requirement for Visa Applicants
On May 14^th, President Biden issued a Proclamation that formally revokes a requirement for immigrants to obtain health insurance within 30 days of arrival in the country or to have the financial means to pay for their medical expenses. The requirement, issued by the Trump administration in an October 2019 Proclamation, never took effect; in November 2019, a federal judge granted a temporary restraining order preventing the proposal from moving forward. By revoking the Trump proclamation, the Biden administration has assured it will not take effect regardless of the outcome of the pending litigation.

Regulatory Updates

HHS Announces Behavioral Health Grant Funding, New Coordinating Council
On May 18^th, the Department of Health and Human Services (HHS) announced the award of a total of $3 billion, appropriated in the American Rescue Plan (ARP), for mental health and substance use block grants to states. These funds will be distributed by the Substance Abuse and Mental Health Services Administration (SAMHSA) through two programs, the Community Mental Health Services Block Grant (MHBG) Program and Substance Abuse Prevention and Treatment Block Grant Program (SABG). The funding is intended to enable states to provide comprehensive community mental health services and address needs and gaps in existing treatment services for those with severe mental illness, and implement and evaluate activities to prevent, treat, and help more people recover from substance use disorder.

New York will receive an additional $80 million through the MHBG and $90.5 million through the SABG. These amounts are in addition to an initial supplemental MHBG award of $46 million announced on March 11^th. More information on the New York State (NYS) allocation can be found on the NYS Office of Mental Health (OMH) website here. Other state funding allocations for the awards can be found here for the MHBG and here for the SABG.

HHS also announced that it would convene a new Behavioral Health Coordinating Council (BHCC), comprised of senior leadership from across HHS, to “facilitate collaborative, innovative, transparent, equitable, and action-oriented approaches to addressing the HHS’ behavioral health agenda.” The BHCC will be co-chaired by the Assistant Secretary for Health and the Assistant Secretary for Mental Health and Substance Use.

HRSA Warns Drugmakers to Resume 340B Drug Sales to Contract Pharmacies
On May 17^th, the Health Resources and Services Administration (HRSA) sent letters to six pharmaceutical companies warning that they are violating federal law by restricting safety net providers’ access to discounted drugs under the 340B program. The recipients of the letter included AstraZeneca, Eli Lilly, Novartis, Novo Nordisk, Sanofi, and United Therapeutics. The letter states that each company must “immediately begin offering its covered outpatient drugs at the 340B ceiling price to covered entities through their contract pharmacy arrangements.” Companies could face a $5,000 penalty for every violation. The American Hospital Association sued the federal government over this issue last year, arguing that the drug companies violated the federal statute that governs the 340B program. The letter demands an update from the companies by June 1^st. On May 20^th, Eli Lilly filed a lawsuit requesting an injunction against HRSA’s action and suggesting that the issue must be settled through litigation.

Anne Schuchat to Retire from CDC
On May 17^th, Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky announced that Dr. Anne Schuchat, the current principal deputy director of the CDC, is retiring from the agency. Dr. Schuchat, an internal medicine physician, will leave her post in the summer after 33 years at the agency. Her retirement follows the departure of Nancy Messonnier, who left CDC on May 14^th to be the executive director of the Skoll Foundation. Messonnier previously led the CDC’s response to the COVID-19 pandemic.

CMS Releases Data on COVID-19 Impact on Medicaid and CHIP Service Utilization
On May 14^th, the Centers for Medicare and Medicaid Services (CMS) released data showing that utilization of primary, preventive, and mental health care services dropped for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries from March through October 2020 compared to the same period in 2019. Of all services, mental health services have been the slowest to rebound to pre-pandemic levels. Children under age 19 experienced a 34% decline in mental health service utilization compared to the same period in 2019; adults experienced a 22% decline. Substance use disorder service utilization also fell by 13% compared to the same period in 2019. While primary and preventive service utilization has largely recovered to pre-pandemic levels, preliminary data for 2020 (inclusive of telehealth utilization) still shows 9% fewer childhood vaccinations for beneficiaries under age 2, 21% fewer child screening services, and 39% fewer dental services for children under age 19.

IRS Releases Guidance on COBRA Premium Subsidies
On May 18^th, the Internal Revenue Service issued lengthy subregulatory guidance on the enhanced COBRA premium subsidies available through September, as established in the ARP. The guidance consists of answers to more than 80 frequently asked questions IRS has received since the ARP’s enactment in March 2021.

Grant Updates

HHS Announces Funding for Telehealth in Pediatric Mental Health Care
On May 20^th, HRSA announced the availability of $14.2 million from the ARP to integrate tele-mental health services into pediatric primary care. This funding will be used to expand the Pediatric Mental Health Care Access (PMHCA) Program to new states and tribal areas across the nation. Today, 21 PMHCA state and regional networks provide teleconsults, training, technical assistance, and care coordination for pediatric primary care providers. HRSA expects to make 32 awards, with an award ceiling of $445,000.

Applications are due July 6^th. More information is available here.

HRSA Issues FY 2022 FQHC Service Area Competition
On May 13^th, HRSA posted the Service Area Competition (SAC) opportunity for fiscal year (FY) 2022. Through the SAC, organizations may apply to participate in the federally-qualified health center (FQHC) program in an existing service area. FQHCs are typically approved for a three-year period and, if they seek to renew, must reapply to the SAC. This year, there are two SACs open in Manhattan and several others in other areas of New York.

Applications are due July 12^th. More information is available here.

Office of Minority Health Announces Diabetes Control Funding Opportunity
On May 12^th, the Office of Minority Health at HHS announced a funding opportunity to identify family-centered factors that promote self-management and prevention of Type 2 diabetes. The program targets racial and ethnic minority families with a family member age 12 and older who has Type 2 diabetes. A total of $1.5 million is available, and HHS expects to make four awards, each with a ceiling of $500,000. Non-profit organizations as well as state, county, city, and tribal governments, are eligible to submit applications.

Applications are due July 13^th. More information is available here.

Other Updates

Supreme Court to Hear Abortion Case
On May 17^th, the U.S. Supreme Court agreed to hear a direct challenge to Roe v. Wade. The case, Dobbs v. Jackson Women’s Health Organization, concerns a 2018 Mississippi law that seeks to ban most abortions after 15 weeks of pregnancy. The law includes narrow exceptions for medical emergencies or severe fetal abnormalities. Lower courts have deemed the law unconstitutional under Roe’s “viability standard,” which is generally accepted to be about 24 weeks. Oral arguments are likely during the court’s next term which starts in October, with a potential decision in the spring or early summer of 2022.

Expert Panel Recommends Earlier Colon Cancer Screening
On May 18^th, the United States Preventive Services Task Force issued a final recommendation on screening for colon cancer, stating that screening should begin at age 45. The Task Force’s previous guidance, issued in 2016, recommended that colon cancer screening begin at age 50. The revision was driven by increasing rates of colon cancer in adults under age 50. Under the Affordable Care Act, the Task Force’s recommendations are used to determine which preventive items and services must be covered without cost-sharing. Once the new guidelines are finalized, following a four-week public comment period, colon cancer screening will be covered without cost-sharing for most insured adults aged 45 to 75.

Congressional Hearings

Tuesday, May 25^th:

At 10am, the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies will hold a hearing on the National Institutes of Health’s Fiscal Year 2022 Budget Request. More information is available here.

Wednesday, May 26^th:

At 10am, the House Committee on Small Business will hold a hearing on the implementation and effectiveness of the Small Business Administration’s COVID-19 economic relief programs. More information is available here.
At 10am, the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies will hold a hearing on the National Institutes of Health’s Fiscal Year 2022 Budget Request and the state of medical research. More information is available here.
At 11:30am, the Senate Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing entitled “A Shot at Normalcy: Building COVID-19 Vaccine Confidence.” More information is available here.

New York State Updates

OMH Proposes Rule to Establish Youth Assertive Community Treatment Services
On May 19^th, the New York State Office of Mental Health (OMH) published a notice of proposed rulemaking in the State Register (here) to establish a Youth Assertive Community Treatment (ACT) program. If approved, the amended regulations would allow children up to 21 years of age receive ACT services. Individuals ages 18-21 years would be able to receive either Youth ACT or Adult ACT services. ACT services are a comprehensive and integrated combination of treatment, rehabilitation, case management, and support services primarily provided in the client’s residence or other community locations by a mobile, multi-disciplinary mental health treatment team. Clients must have serious mental illness (or serious emotional disturbance under the proposed rule to include youth) and require services in order to remain in the community.

Children enrolled in Health Home Care Management or licensed day treatment programs would not be eligible for ACT services. However, a child would be able to receive both ACT services and Children and Family Treatment and Support Services (CFTSS) and/or Home and Community Based Services (HCBS) 30 days prior to discharge from Youth ACT only as a transition from Youth ACT to an alternate or lower level of care. Reimbursement for services provided to clients receiving both ACT and CFTSS, HCBS, or Personalized Recovery Oriented Services (PROS) would be limited to the partial step-down payment rate.

Comments on the proposed rule will be accepted until July 18^th.

OMH Updates Comprehensive Psychiatric Emergency Program Regulations
On May 19^th, OMH published a noticed of adoption in the State Register (here) of a rule that updates the regulations pertaining to the Comprehensive Psychiatric Emergency Program (CPEP). The final rule includes several technical and programmatic changes to the regulations, including but not limited to:

Clarifying the intent of CPEPs;
Removing, adding, and updating definitions;
Clarifying reimbursement for services; and
Establishing requirements related to incident review committees, patient screening, and use of PSYCKES and other databases, among other requirements.

Governor Cuomo Announces Plans to Rejoin Federal Title X Program
On May 18^th, Governor Cuomo announced that New York plans to rejoin the federal Title X program due to the Biden Administration’s proposed changes. In September 2019, New York State announced that due to the “gag rule” on Title X providers implemented by the Trump Administration, it would withdraw from the federal Title X program and continue supporting family planning with State funding. Under the current administration, HHS issued a proposed rule (available here) on April 15^th, which would revoke the gag rule and revert the program to the 2000 regulations, with limited revisions that would seek to clarify and expand the definition of family planning and expand access through new referral requirements, among others.

The Governor’s press release is available here.

UHF and GNYHA Issue Call for Presentations for Symposium on NY Health Care
On May 19^th, the United Hospital Fund (UHF) and Greater New York Hospital Association (GNYHA) issued a Call for Presentations for the 32^nd Annual Symposium on Health Care Services in New York. The annual symposium will be held virtually on October 25^th and will include a keynote address, a panel session, and presentations. The abstracts selected for presentation will highlight research or evaluation findings that are relevant to health care administrators, clinicians, researchers, and policymakers.

Presentation abstracts will be blindly evaluated by an expert selection committee that will choose 5-10 abstracts for presentation during the virtual symposium. Projects may consist of original research, syntheses of research, policy analyses, or model programs with evaluations, and may be applicable universally or to specific populations. Suggested presentation topics include, but are not limited to:

Clinical-Community Partnerships/Population Health
COVID-19
Financing
Public Health Issues
Service Delivery
Workforce Issues and Innovations

Additional information is available here. The deadline for the submission of presentation abstracts is July 2^nd. Applicants will be notified about acceptance in September. Questions may be sent to Hollis Holmes at hholmes@uhfnyc.org.

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