The Blog to Transform Advanced Care
Advancing Care through Innovation, Observation and Collaboration.
Each week, C-TAC compiles the latest legislative and regulatory updates affecting the serious illness care field, combined with insider analysis from our policy experts. Here’s what you need to know for the week ahead:
- CMMI Announces Indefinite Delay of Primary Care First Seriously Ill Population Model
- CDC Releases New Guidance for Those Who Have Received COVID-19 Vaccine
- MedPAC likely to recommend an effective cut in Medicare Advantage spending
- House Health Leader Rep. Anna Eshoo Calls for Permanent Medicare Telehealth Expansions
CMMI Announces Indefinite Delay of Primary Care First Seriously Ill Population Model
The Center for Medicare and Medicaid Innovation (CMMI) has announced that the Primary Care First Seriously Ill Population (PCF-SIP) model will not be implemented on April 1, 2021. The model has been placed “under review,” per an announcement at the top of the model page on the CMMI website. This decision to delay SIP comes as CMMI has taken similar actions recently on other demonstrations, such as pausing applications for the Geographic track of Direct Contracting and delaying the start of the Kidney Care Choices model. The model review activity is happening as the new CMMI Director, Elizabeth Fowler, starts her new leadership role at the Center. With a new Administration, it is not unusual for a new Director to review the model portfolio and make modifications that align with their and the Administration’s overall care delivery reform strategy.
C-TAC has already engaged with CMMI to learn more about the SIP delay and will continue to do so. We will monitor the situation as it develops and keep our members and partners updated.
CDC Releases New Guidance for Those Who Have Received COVID-19 Vaccine
During a briefing on March 8, the Centers for Disease Control & Prevention (CDC) released guidance on safe behavior for people who have received the COVID-19 vaccine. People are considered fully vaccinated two weeks after their second dose in a two-dose series (like the Pfizer or Moderna vaccines) or two weeks after a single-dose vaccine like the Johnson & Johnson vaccine. The CDC has stated that vaccinated people can gather indoors with other fully vaccinated people without wearing a mask. They can also gather indoors with unvaccinated people from one other household without masks, unless anyone in the household has an increased risk for serious illness from COVID-19.
Apart from these exceptions, safety precautions like as mask-wearing and social distancing remain in place under the new guidance. The full guidance is now available on the CDC website.
MedPAC likely to recommend an effective cut in Medicare Advantage spending
According to a Medicare Payment Advisory Commission (MedPAC) meeting last week, the commission will recommend a new benchmark policy for Medicare Advantage (MA) at its April meeting. Modern Healthcare reported that the changes would adjust how CMS ties MA payments to fee-for-service spending, increase the rebate to at least 75% and adopt a discount rate of at least 2%. Commission staff said the changes would lower Medicare spending without limiting beneficiaries’ access to plans. But beneficiaries would likely get fewer additional benefits because MA plans would receive lower payments from the federal government, causing plans to cut costs. To learn more, click here.
House Health Leader Rep. Anna Eshoo Calls for Permanent Medicare Telehealth Expansions
During a Committee on Energy and Commerce health subcommittee hearing yesterday, Rep. Anna Eshoo (D-CA) said it’s time to make telehealth flexibilities enacted during the COVID-19 pandemic permanent. The Centers for Medicare & Medicaid Services has waived many telehealth payment policies in response to the COVID-19 pandemic, boosting access to virtual care at a time when many people were sheltering in place. The recently introduced Telehealth Modernization Act (S. 368), would make permanent many of the most foundational pandemic-related flexibilities, including the removal of Medicare telehealth’s restrictive originating site and geographic limitations.
C-TAC has also called for making certain telehealth flexibilities permanent, highlighting that remote care has long been crucial for people with serious illness and the waivers will continue to benefit this population after the pandemic. Learn more about the flexibilities that we believe should be made permanent, including audio-only advance care planning and the elimination of patient cost-sharing for telehealth services, in a blog post on the C-TAC website. Learn more about Rep. Eshoo’s remarks in a report from Fierce Healthcare.