BCBJ Language Incorporated into House Reconciliation Package

Senator Casey, Chair of the Senate Aging Committee and sponsor of the Better Care Better Jobs Act, has compiled factsheets for every state on the impact of the Better Care Better Jobs Act (BCBJ), which can be found through the following link:

https://www.aging.senate.gov/press-releases/better-care-better-jobs-act-state-by-state-fact-sheets

Language from the original bill has unexpectedly been incorporated by Democrats into the Reconciliation package. See the package through the following link (BCBJ/HCBS starts on page 584):

https://docs.house.gov/meetings/BU/BU00/20210925/114090/BILLS-117pih-BuildBackBetterAct.pdf

CMS Getting Closer to Vaccination Guidance for Home Health Agencies, Other Medicare-Medicaid Providers

Home Health Care News / By Joyce Famakinwa

The Centers for Medicare & Medicaid Services (CMS) revealed last week that it was in the rulemaking stage of a collaboration with the Occupational Safety and Health Administration (OSHA) on the establishment of a federal vaccine mandate.
 
[Two Monday’s Ago] Dr. Lee Fleisher, CMS’ chief medical officer and director of the Center for Clinical Standards and Quality (CCSQ), confirmed that the agency is slated to release its guidelines in late October. Fleisher did so while appearing at the National Association for the Support of Long-Term Care’s (NASL) annual meeting.
 
This means that Medicare-certified home health providers should expect CMS to release guidance any day now.
 
“CMS will soon issue the emergency regulation requiring staff vaccinations within the nation’s more than 15,000 Medicare and Medicaid-participating nursing homes and Medicare and Medicaid-certified health care providers that are regulated under CMS regulations, but we cannot comment on the specifics of the pending regulations as we are in the active rulemaking process,” a CMS spokesperson told Home Health Care News in an email. “There will be a 60-day comment period that will begin when the regulation is published in the Federal Register for the public to share their feedback with CMS.”
 
The journey to a federal vaccine mandate officially began last month after President Joe Biden announced a six-pronged approach to his administration’s COVID-19 strategy, with plans explicitly mentioning home health providers. The approach also pushed for American workers to get vaccinated and called for increased COVID-19 testing.
 
At the time, CMS confirmed that vaccinations would be a condition for participating in the Medicare and Medicaid programs.
 
“The staff vaccination requirement would only apply to Medicare and Medicaid-certified provider and supplier types that are regulated under the Conditions of Participation,” the agency said. “If an entity is not regulated under the CoPs, then this requirement would not apply.”
 
For now, providers can only speculate on the potential details of the mandate and if any exceptions will be taken into consideration. When one comes out, CMS will need to keep several considerations in mind, according to National Association for Home Care & Hospice (NAHC) President William A. Dombi.
 
“First, any mandate must provide sufficient time for reasonable compliance,” Dombi told HHCN in an email. “That matters primarily because there is a high risk of interruption of patient services resulting from lost clinical staff. The vaccine mandates in health care settings that already have occurred have demonstrated that some staff leave their jobs. In home care and hospice, there is a current staff shortage such that even the loss of one staff member can cause difficulties in continuing to serve existing patients as well as taking on new patients.”
 
Secondly, a CMS mandate must provide for exceptions with clear standards for applying those exceptions, he noted.
 
Additionally, “to the extent possible,” a CMS vaccine mandate should be evenly applied across the health care sector, NAHC’s leader advised. On top of that, CMS should also consider the costs of a vaccine mandate, especially on newer home health and home care agencies.
 
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CMS Hopes to Support Home-Based Care with More Payment, Regulatory Flexibilities

Home Health Care News / By Robert Holly
 
Officials from the U.S. Centers for Medicare & Medicaid Services (CMS) and its main innovation hub touted a “strategy refresh” on Wednesday.
 
Among its key pillars, the refresh calls for greater payment and regulatory flexibilities supporting the provision of home- and community-based care.
 
CMS Administrator Chiquita Brooks-LaSure discussed the strategy reset during a Wednesday afternoon webinar. Brooks-LaSure was joined by CMS Innovation Center Director Liz Fowler, in addition to the center’s chief strategy officer, Purva Rawal.
 
“My vision for the future of the agency, our programs and the people we serve is straightforward: that CMS serves the public as a trusted partner and steward dedicated to advancing health equity, expanding coverage and improving health outcomes,” Brooks-LaSure said.
 
Ellen Lukens, group director of the CMS Innovation Center’s policies and programs group, was also on the webinar.
 
Contextually, the strategy refresh from CMS comes after a thorough review of the innovation center’s 10-year history.
 
Established in 2010 under the Affordable Care Act, the center’s overarching goal is to help move the U.S. health system toward value-based care across Medicare, Medicaid and the other major government health care programs. From 2018 to 2020 alone, CMS Innovation Center models affected over 528,000 health care providers and plans while also impacting nearly 28 million patients.
 
“Our vision is straightforward: a health system that achieves equitable outcomes through high-quality, affordable, person-centered care,” Fowler said during the webinar.
 
Paired with the webinar, CMS provided details of the refresh in a 32-page white paper, also released Wednesday. Driving accountable care, advancing health equity, supporting innovation, addressing affordability and partnering to achieve system transformation are the five key pillars of the refresh, the paper explains.

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Coronavirus (COVID-19) Update: FDA Takes Additional Actions on the Use of a Booster Dose for COVID-19 Vaccines

For Immediate Release: October 20, 2021

Today, the U.S. Food and Drug Administration took action to expand the use of a booster dose for COVID-19 vaccines in eligible populations. The agency is amending the emergency use authorizations (EUA) for COVID-19 vaccines to allow for the use of a single booster dose as follows:

• The use of a single booster dose of the Moderna COVID-19 Vaccine that may be administered at least 6 months after completion of the primary series to individuals:

• 65 years of age and older

• 18 through 64 years of age at high risk of severe COVID-19

• 18 through 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2

• The use of a single booster dose of the Janssen (Johnson and Johnson) COVID-19 Vaccine may be administered at least 2 months after completion of the single-dose primary regimen to individuals 18 years of age and older.

• The use of each of the available COVID-19 vaccines as a heterologous (or “mix and match”) booster dose in eligible individuals following completion of primary vaccination with a different available COVID-19 vaccine.

• To clarify that a single booster dose of the Pfizer-BioNTech COVID-19 Vaccine may be administered at least 6 months after completion of the primary series to individuals 18 through 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2.

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