Regulatory Work
C-TAC and its Regulatory Taskforce works closely with our partners at the Centers for Medicare & Medicaid Services (CMS) to submit comments on proposed rules regarding those with advanced illness and potential regulatory initiatives. Please see our collection of submitted comments below.
Comments on Hospice Payment Rate Rule
May 2021
View comments submitted by C-TAC in response to proposed rules out of the Centers for Medicare and Medicaid Services (CMS) regarding hospice payment rates, waivers, and reporting programs. C-TAC expresses strong support for making permanent the hospice waivers granted during the COVID-19 pandemic, suggests alterations to parts of the rule related to reporting programs, and answer questions related to the interoperability in post-acute care.
Comments on HIPAA Privacy Rule
View comments submitted by C-TAC in response to proposed modifications to the HIPAA Privacy Rule to support, and remove barriers to, coordinated care and individual engagement. C-TAC expressed strong support for multiple provisions in the rule, including steps that allow individuals to better access their health information and changes to facilitate value-based health care by modifying provisions that currently limit care coordination and case management communications. C-TAC did express concern that, while this rule allows more community organizations to access protected health information, it does not address the need for financial or capital investment for information management systems to facilitate doing so.
Comments to the VA on Expanding the Authority of Professional Practice
View comments submitted by C-TAC in response to a final rule from the U.S. Department of Veterans Affairs (VA). The rule 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 expressed strong support for this measure as a way to optimize the practice of every health care professional.
Comments on Fourth Interim COVID-19 Rule
View comments submitted by C-TAC in response to the fourth interim COVID-19 rule released by CMS. C-TAC expressed support for the overall goal of the rule, which is to clarify policies that are intended to support COVID-19 vaccine reimbursement and distribution. However, C-TAC did share concerns about the provisions related to vaccine coverage limitations and encouraged CMS to continue to develop transparent, evidence-based strategies to promote COVID-19 acceptance and 2 equitable and effective vaccine delivery.
Comments on Best Practices in Health Care in Response to the COVID–19 Pandemic
View comments submitted by C-TAC in response to a Request for Information issued by CMS regarding effective and innovative approaches to health care in response to the COVID-19 pandemic. C-TAC noted that there have been numerous efforts to leverage the telehealth flexibillities and waivers implemented during the public health emergency to support those with serious illness. C-TAC believes that with the appropriate telehealth policy changes such as allowing a patient’s home to serve as an eligible originating site and to continue to allow providers to use the advance care billing codes (99497 and 99498) for audio-only telehealth, such innovations could be scaled broadly and permanently.
Comments on Landscape Analysis to Leverage Novel Technologies for Chronic Disease Management for Aging Underserved Populations
View comments submitted by C-TAC in response to a Request for Information issued by CMS regarding a landscape analysis to leverage novel technologies for chronic disease management for aging underserved populations. C-TAC agrees that technology could help improve access and quality of care for this group, we are also concerned that such technology needs to address systemic and structural inequities in health care for this population. C-TAC also strongly encouraged CMS to include family caregivers into the group to consider for technology access and management.
Comments on Recommended Measure Set for Medicaid-Funded Home and Community-Based Services
View comments submitted by C-TAC in response to a Request for Information (RFI) released by CMS related to a recommended measure set for Medicaid-funded Home and Community-Based Services (HCBS). C-TAC expressed support for promoting the accessibility of and ensuring the quality of home and community-based services. We also support the inclusion of tested, validated measures and recommend prioritizing measures that are patient, or client-reported, and measure outcomes rather than just processes.
Comments on Proposed CY 2021 Physician Fee Schedule
View comments submitted by C-TAC on a proposed CMS rule that would update physician fee schedule (PFS) payments for calendar year (CY) 2021, and C-TAC submitted comments this week in response. C-TAC was pleased that the agency included several proposals that would increase telehealth and scope of practice flexibilities. However, we were concerned about the redistributive effect of CMS’s budget-neutral proposed increases in the payment rates for office/outpatient evaluation and management (E/M) visits.
Comments on Proposed Home Health Requirements
View comments that C-TAC submitted to the Center for Medicare & Medicaid Services regarding sections of a proposed rule related to the CY 2021 Home Health Prospective Payment System Rate Update, as well as the Home Health Quality Reporting Requirements and Home Infusion Therapy Services Requirements. We expressed support for the use of telehealth for people with advanced illness under the Medicare Home Health Benefit, although we recommended that the term "physician" be replaced with "non-physician" to reflect the full scope of providers delivering these services. We also asked for clarification that covered telehealth visits will include audio-only services, to be more inclusive of those who do not have access to smartphones or other technology needed for video conferencing.
Comments on Sections of Medicaid State Drug
Utilization Review (DUR) Proposed Rule
View comments that C-TAC submitted to the Center for Medicare & Medicaid Services regarding sections of a proposed rule related to the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) Act. We expressed concern that gives too much autonomy to states regarding setting initial fill days’ supply, duplicative and early refill limits, dosing limits, etc. We also recommended that those with sickle cell disease (SCD) also be excluded from the proposed rule's requirements.
Comments on Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency
View comments that C-TAC submitted to the Center for Medicare & Medicaid Services regarding additional policy and regulatory revisions proposed in response to the COVID-19 pandemic. C-TAC expressed support for the flexibilities included in this interim rule which enable providers to care for those with serious illness during the COVID-19 pandemic. Specifically, C-TAC supports the waiver allowing for telehealth services to be provided through audio-only technology and advocated for making the provision permanent.
Comments on Proposed FY 2021 Hospice Wage Index and Payment Rate Update
View comments that C-TAC submitted to the Center for Medicare & Medicaid Services regarding the proposed Hospice Wage Index and Payment Rate Update for the 2021 Fiscal Year. C-TAC proposed delaying implementation of this rule until October 2021 or the end of the COVID-19 pandemic. C-TAC also recommended that specific language be added to provide guidance to hospice providers on how to handle when a patient dies within five days of admission, as well as handling a patient or representative who refuses to sign the addendum.