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Advancing Care through Innovation, Observation and Collaboration.

On Jan. 7, the U.S. Department of Health and Human Services (HHS) extended the COVID-19 Public Health Emergency (PHE) to April 22, 2021. This is the fourth time the declaration has been renewed and the first since early October.

The extended PHE is important  for the seriously ill population, as regulatory flexibilities such as those broadening access to telehealth and audio-only advance care planning will continue for the extended 90 days. These flexibilities continue to support providers’ ability to serve those with serious illness as the COVID-19 pandemic continues. In addition to those mentioned above, CMS and HHS have authorized numerous pandemic-related allowances for providers of all kinds, including a host of waivers to standard oversight and reporting requirements.

C-TAC supports the PHE extension, and will continue to work with Administration officials to ensure the needs of those with serious illness are addressed through COVID-19 regulatory action.

A complete inventory of all HHS COVID-19 regulatory waivers and guidance can be found here.

Other Updates:

C-TAC Submits Comments to the VA on Extending Authority of Professional Practice

The Department of Veterans Affairs (VA) recently sought comment on an interim final rule that would allow health care professionals within the VA to practice consistent with their national scope and training regardless of state license, registration, certification, or other requirements that unduly interfere with their practice. C-TAC has long advocated, and so strongly supports this move as a way to optimize the practice of every health care professional. Allowing them to practice across state lines and to the fullest extent of their training and certification will set an important example for other health care organizations and will indeed enhance beneficiaries’ access to critical health care services, especially those veterans living with serious illness. The VA is to be congratulated for taking this important step.

See our full comment letter here.

CMS Releases Roadmap for States to Address SDOH

On Jan. 7, CMS released a roadmap for states to address the social determinants of health (SDOH) in the Medicaid and Children’s Health Insurance Program (CHIP). SDOH encompasses the range of social, environmental, and economic factors that can influence health status. The new guidance describes how states can leverage existing flexibilities under federal law to address adverse health outcomes that can be impacted by SDOH and supports states with designing programs, benefits, and services that can improve population health. While states have flexibility to design a number of different services to address SDOH, the guidance focuses on a set of services and supports that states can cover under current law, including housing-related services and supports, non-medical transportation, home-delivered meals, educational services, and employment supports. C-TAC supports the continued movement towards addressing SDOH, creating more opportunities for high-quality care and addressing inequities in services for the seriously ill population. In addition to guidance like this that clarifies exiting SDOH policy pathways, C-TAC urges policymakers to devote additional funding and resources to these programs to ensure broader access to the important non-medical services that are delivered under their banner.

HHS Announces Expansion of Home Health Value-Based Purchasing (HHVBP) Model

On Jan. 8, HHS approved the national expansion of the Home Health Value-Based Purchasing (HHVBP) Model. Tested by the CMS Innovation Center, the HHVBP Model began its first performance year in 2016 and will be expanded by early 2022. The model has demonstrated important quality and cost-saving benefits, and its expansion could serve to improve the quality of care for more Medicare home health beneficiaries, without denying or limiting coverage or the provision of appropriate benefits. C-TAC supports this expansion as a way to boost value-based care in home and community settings, which is especially important for those living with serious illness.

More information on the HHVBP model can be found here.

CMS Innovation Center 2020 Year-In-Review

On Jan. 11, The Center for Medicare and Medicaid Innovation (CMMI) released a Year-in-Review reflection on its alternative payment model (APM) activities and achievements during 2020. Specific examples called out in the piece that are relevant to the serious illness stakeholder community include the announcement of new models such as the Direct Contracting “Geo” Model, The Community Health Access and Rural Transformation (CHART) Model, The End-Stage Renal Disease (ESRD) Treatment Choices Model, and The Radiation Oncology Model. CMMI also announced the expansion of some models nationwide, including the Home Health Value-Based Purchasing (HHVBP) Model. Finally, the reflection highlights design modifications CMMI made both to a few care model demonstrations, as well as to internal CMMI process and operational protocols. C-TAC will continue to work with CMMI and CMS to develop and expand models that improve the care of those with serious illness.

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