November 14, 2024
Last night we sent you an article outlining some of the outstanding issues facing Congress before it adjourns for the year, to include whether or not to extend current Medicare telehealth flexibilities beyond the end of 2024.
Here in NY many of the telehealth flexibilities MH and SUD providers have been operating under since the beginning of the COVID-19 pandemic are set to expire in April 2025. This is a top priority for the NYS Council as we head into the next legislative session.
The incoming House and Senate will both be Republican led. The article below points to a potential bright spot for telehealth policies in terms of incoming leadership in the Senate where the new Majority Leader will be Sen. John Thune (R- South Dakota). Thune is apparently big on telehealth, rural hospitals, and increasing transparency for drug middlemen. Makes sense given the geography of his state. As the new Majority Leader, Thune will be in charge of coordinating the entire Republican policy agenda, and it’s not clear how health care will fit into the mix. However he represents a state that does not have much in the way of special interests in the healthcare industry beyond hospitals, doctors, and pharmacists. Let’s hope that’s a good thing.
A little (potential) good news is warranted right now so I thought I would share the article below.
STAT, 11/14
What the new Congress means for telehealth
As the Republican tilt of Congress for the next two years takes shape, so too do the prospects for important telehealth policy.
Here’s the good news for advocates: Newly elected Senate majority leader John Thune (R-S.D.) has a long history of supporting telehealth. As STAT’s John Wilkerson reports, Thune’s largely rural home state of South Dakota benefits from the expansion of virtual care services because people often live large distances from doctors.
In a key policy shift, lawmakers during the pandemic expanded the services people on Medicare could receive over telehealth. Those flexibilities are set to expire at the end of the year, and Thune supports making them permanent. There’s a bipartisan bill progressing through the House of Representatives that would extend the flexibilities for two years.
But the lame duck policy agenda is up in the air as lawmakers may choose to only pass a stopgap bill to fund the government into the next session. As John reports in another story on what to expect now that Republicans control both houses of Congress, it’s not clear what that would mean for extensions to expiring Medicare policies.
Sources in Washington over the last few months have told me this is one of the scenarios they feared might play out. By leaving telehealth extensions to the last second, the legislation was at risk of getting lost or modified in the lame duck shuffle. And this creates uncertainty for providers and Medicare enrollees who may be counting on telehealth access to services on Jan. 1 — 48 days from today. ——————————–
Information directly below pertains to Medicare:
The National Council has created section by section overviews of the CY2025 Physician Fee Schedule and Hospital Outpatient Prospective Payment System (OPPS) final rules along with a shorter summary of provisions in both rules.
You can access these documents through the links below:
- Short Summary of Overall Highlights
- Physician Fee Schedule Final Rule Highlights
- Hospital Outpatient Prospective Payment System Final Rule Highlights
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Trump selects RFK Jr. to head HHS
Modern Healthcare, 11/14
President-elect Donald Trump has selected Robert F. Kennedy Jr., to run the Department of Health and Human Services, a move that would elevate a prominent vaccine skeptic and pharmaceutical industry critic to a top role on federal health policy.
The move was first reported by Politico, which cited a person familiar with Trump’s plans. CNN reported that Trump has already offered the post to Kennedy.
Kennedy has espoused a number of unorthodox views on public health, most notably questioning the safety and efficacy of vaccines — statements which contradict guidance from the mainstream medical community.
During the Covid-19 pandemic, he called the shots a “crime against humanity” and compared them to the Nazi Holocaust. Those remarks drew widespread condemnation — including from his wife, the actress Cheryl Hines.
He also has said that he will work with Trump to remove fluoride from water systems — upending 80 years of public health consensus.
Kennedy’s selection would ignite a political firestorm. If confirmed by the US Senate, he would wield unprecedented influence over public health, drugs, food and nutrition — with the potential to disrupt related industries — as a member of an administration that has vowed to reshape the federal government.
Shares of vaccine makers dropped after the report from Politico on Thursday. Moderna Inc. shares fell 7%, Pfizer Inc. shares fell 3% and Novavax Inc. dropped as much as 5% after the report.
Trump transition spokeswoman Karoline Leavitt in an interview on Fox News earlier Thursday said Trump was looking to “find a place” for Kennedy in his second-term administration.
“RFK Jr. is a once-in-a-generation thought leader. He’s an independent mind, a critical thinker. We definitely need more of that in Washington, DC,” Leavitt said. “As for his specific position, I’ll let President Trump announce that, but RFK Jr. will focus in the Trump administration on making America healthy again.”
Kennedy is the scion of a prominent Democratic family but left the party to mount an independent presidential bid this cycle before eventually endorsing Trump. He criss-crossed the country to help elect the president-elect, appearing at rallies and events.
The appointment of Kennedy to the top health policy job in the administration would seal a political marriage of convenience between two former rivals. In the waning days of the campaign, Trump said he would let Kennedy “go wild” on health, adapting his signature campaign slogan to declare that he would “Make America Healthy Again.”
The week before the election, Kennedy said Trump had promised him “control of the public health agencies.”
Influential Post
As head of HHS, Kennedy would lead a sprawling federal department that entails more than 100 programs supporting medicine, public health and social services, including the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services and the Food and Drug Administration.
HHS was on the frontlines of the federal response to the Covid-19 pandemic, with Trump’s management of the outbreak during his first term drawing sharp criticism, including from those who accuse him of downplaying its severity.
Overseeing the agency would put Kennedy at the forefront of some of the most contentious policy debates surrounding the incoming administration — including abortion rights and health insurance.
On health care, Trump has floated seeking an alternative to the Affordable Care Act, popularly known as Obamacare. The president-elect has denied wanting to end the program but has not provided specifics on how he might revise or replace the law, saying during the debate that he had the “concepts of a plan.”
Trump’s HHS secretaries during his first term included among others, Tom Price, who resigned after criticism over taxpayer-funded air travel, and Alex Azar who split with Trump over the attack on the US Capitol on Jan. 6, 2021.
Scandalous Headlines
In addition to his controversial views, Kennedy’s presidential campaign was barraged by a series of scandalous tabloid headlines: The disposal of a bear carcass in New York City’s Central Park, an escapade involving a beached whale and a chainsaw.
Kennedy, 70, is the son of former Senator Robert F. Kennedy and the nephew of former President John F. Kennedy.
Both men were assassinated in the 1960s, and Trump has also promised a commission on presidential assassinations to re-open those cases.
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Biden-Harris Administration Announces Approvals in Five States That Will Keep Eligible Children and Adults Enrolled in Medicaid and CHIP
Building upon its commitment to expand health care coverage and ensure continuity of care, today the Biden-Harris Administration, through the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services (CMS), approved five section 1115 demonstration amendments. These amendments will authorize Colorado, Hawaii, Minnesota, New York, and Pennsylvania to provide additional years of continuous eligibility for children beyond the minimum 12 months required by law, and will newly provide continuous eligibility to individuals leaving incarceration in Colorado and Pennsylvania.
Providing eligible people with continuous eligibility ensures that people enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) can have peace of mind, knowing that they, or their children, will maintain uninterrupted access to care. Continuous eligibility means that individuals are assured that they are able to maintain health insurance, regardless of changes in circumstances that may make someone ineligible, such as a change in income. This continuous eligibility is especially critical for children to continue to receive health services they need, without interruption or having to renew their coverage frequently. Continuous eligibility also helps states by reducing the administrative burden on state agencies that conduct Medicaid and CHIP enrollment and renewals.
Specifically, today’s approvals include:
- In Colorado, continuous eligibility for children in Medicaid and CHIP until the child’s 3rd birthday, and 12 months of continuous eligibility for individuals aged 19 up through age 64 who are leaving incarceration.
- In Hawaii, continuous eligibility for children until the child’s 6th birthday, and 24 months of continuous eligibility for children aged six up to age 19.
- In Minnesota, continuous eligibility for children until the child’s 6th birthday, and 12 months of continuous eligibility for individuals aged 19 up to age 21.
- In New York, continuous eligibility for children in Medicaid and CHIP until the child’s 6th birthday.
- In Pennsylvania, continuous eligibility for children until the child’s 6th birthday, and 12 months of continuous eligibility for individuals aged 19 up through age 64 leaving incarceration, who meet certain high-risk criteria.
Over the last two years, CMS has approved broad expansions of continuous eligibility for different populations using section 1115 demonstrations to advance uninterrupted health coverage. These section 1115 demonstrations allow states to provide continuous eligibility for longer durations of time than they could under their Medicaid or CHIP state plans. CMS has previously approved nine other states’ requests for continuous eligibility for different populations: Kansas, Massachusetts, Montana, New Jersey, New Mexico, New York, Oregon, Utah, and Washington.
For additional information about each state’s section 1115 demonstration amendment approval, please visit the approvals on Medicaid.gov:
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(Note from DoH)Children’s Home and Community Based Service (HCBS) providers, Medicaid Managed Care Plans (MMCPs), Health Homes Serving Children (HHSC) and Care Management Agencies,
Based upon Stakeholder feedback, the New York State Department of Health will be holding a Collaborative Stakeholder Meeting on December 12th from 11am-1pm. An invitation with meeting details will be issued shortly. This meeting is an opportunity for all involved entities to collaboratively share information and work to solve any workflow barriers that may exist. We are seeking feedback on which topics will be most beneficial to discuss. To assist in agenda development, please complete the below survey by COB on 12/2/24:
SURVEY LINK: https://www.surveymonkey.com/r/ZRBXKTR
Each organization is requested to collaborate with their staff to submit one survey on behalf of their organization. Health Homes are requested to share this survey link with their care management agencies (CMAs) to request that each CMA also complete one survey.
Any questions on the survey or Stakeholder Collaborative Meeting can be sent to BH.Transition@health.ny.gov.
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On November 7th, 2024, NYS Office of Mental Health in partnership with MCTAC hosted a webinar with CMHRS & Unlicensed OMH designated Children and Family Treatment and Support Services (CFTSS) providers.
Participants had an opportunity to connect with fellow CFTSS providers as well as state and county government partners. This webinar also reviewed recent changes and revisions to CFTSS as reflected in the updated CFTSS manual.
This webinar was not recorded. However, presentation slides are available for review on the resource page below.Access the Slides Here