From: ACL <xxxxxx@connect.hhs.gov>
Sent: Monday, September 27, 2021 6:45 PM
To: Robin Troutman <xxxxxx@nacdd.org>
Subject: Policy Roundup: CDC booster guidance, comments needed, and more

On Friday, CDC announced recommendations for boosters of the Pfizer COVID-19 vaccine

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[Blue banner with white text: Policy Round-Up]<https://click.connect.hhs.gov/?qs=aad005818604684f93fbbd5cb4f6ec32c7d8809182a0c3bfdca5f8e6cc4a3f564200e245aca08f3b14762756a94349a528ce932364dfec63>
Policy Roundup: CDC booster guidance, comments needed, and more<https://click.connect.hhs.gov/?qs=aad005818604684ff7e7e7359e10946cacdc4ce22a0d4229f6af2690b08e5f6afc13c02d614ba8a52d039674cfc58715d3817c0f35e53504>

On Friday, CDC announced recommendations for boosters of the Pfizer COVID-19 vaccine for people who: are 65 and older, live in long-term care settings, are at high risk for severe illness, or work in a high-risk job. Today’s Policy Roundup includes those details, along with the following:

  *   CMS guidance: ARP Act funding for Medicaid and CHIP (Coverage of habilitation services, COVID-19 testing and vaccination, and more).
  *   Input needed: Medicare drug pricing rule
  *   Input Needed: NQF Rural Telehealth and Healthcare System Readiness Measurement Framework
  *   Medicare.gov Tool to Compare Nursing Home Vaccination Rates

CDC recommendations for COVID-19 vaccine boosters

On Friday, the CDC recommended booster shots of the Pfizer COVID-19 vaccine for people at highest risk of serious illness and those in high risk occupational and institutional settings. Specifically, CDC guidance<https://click.connect.hhs.gov/?qs=aad005818604684ff4b2e18a65603e6c296a26080e8b13c68fec3b9074136f97213a0b8eb1447a30b0349a5f98480a1883227e70e9d181cf> now states that people who received their second shot at least six months ago:

Should receive a booster shot if they are:

  *   65 years old or older
  *   18 years old or older and live in a long-term care setting
  *   aged 50–64 years and have underlying medical conditions<https://click.connect.hhs.gov/?qs=aad005818604684f3d9ea3252f9551d6d1c2ad4b63cf41ac728d208c872e8c9a787ffce78f05e929892b704241b6dcf90a9fb0d8d206761f>

May receive a booster shot, based on their individual benefits and risks, if they are:

  *   18–49 years old and have underlying medical conditions<https://click.connect.hhs.gov/?qs=aad005818604684f3d9ea3252f9551d6d1c2ad4b63cf41ac728d208c872e8c9a787ffce78f05e929892b704241b6dcf90a9fb0d8d206761f>
  *   18–64 years year old, and at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting. The CDC website includes a complete list<https://click.connect.hhs.gov/?qs=aad005818604684f0b2e40162d21575c9cb1f8f06dc703e1fbc3a8daabcd1939d4b22b7d66a893d7d7c99a9bc54c109c27a117dfdba0cffa>, but it includes front line healthcare workers and congregate care staff.

CDC will evaluate available data in the coming weeks to swiftly make additional recommendations for other populations, as well as for people who received the Moderna or Johnson & Johnson vaccines.

CMS Guidance on Medicaid and CHIP: COVID-19 testing, habilitation services, FMAP increase

In two letters to state health officials, CMS recently provided guidance on Medicaid and CHIP requirements and flexibilities established by the American Rescue Plan Act (ARP). These include coverage of habilitation services for students with disabilities, COVID-19 testing and vaccination, and more. Some highlights:

  *   Remote learning has made it challenging for children with disabilities who receive Medicaid-covered services at school to get the services they need. As of August 30, states now can cover habilitation services<https://click.connect.hhs.gov/?qs=aad005818604684f41059aa5f40ba8f447b76e3d0ca9bf29fb0efc7505320574532f44105d6d79edabf4b812ed3a06661d5953ff0342ad3e> for students who are enrolled in a section 1915(c) waiver and/or 1915(i) program who are also learning remotely all or part of the time, if schools are unable to provide those services.
  *   COVID-19 testing<https://click.connect.hhs.gov/?qs=aad005818604684f41059aa5f40ba8f447b76e3d0ca9bf29fb0efc7505320574532f44105d6d79edabf4b812ed3a06661d5953ff0342ad3e> must be covered for Medicaid and CHIP beneficiaries, without any cost sharing. This applies both to tests used to diagnose COVID-19 and tests to screen someone for COVID-19 so they can return to school or work or meet requirements for travel. All types of tests approved by FDA are covered under this requirement, including at-home tests, whether those tests are sent to a laboratory to get results or not.
  *   The ARP included a temporary increase in the federal funding provided to states for a number of different services for Medicaid and CHIP participants<https://click.connect.hhs.gov/?qs=aad005818604684f7b81780a9bf8b543d43a040ca2bc1d2e99c30ef7281716125ab1e1feef2c417f45c81f7a2f45f1b144f723027e98a3af>.

Read more.<https://click.connect.hhs.gov/?qs=aad005818604684f18a1bb4ea008d5e59d68693fbd1410ea284db2da91dad0fa6c6d6a181f6f8734f1010056ed41a6dea14ca4a086e48510>

Input Needed: “Most Favored Nation” Medicare Drug Pricing Rule

Bottom line: The Centers for Medicare and Medicaid Services is seeking comment<https://click.connect.hhs.gov/?qs=aad005818604684fb8363a3e25184682de6060e76110dddf374312ec394ec9e3d84c5e91e0f18fa2a183194a3263b7e67f1419225de0179a> on its proposal to rescind the rule published in November 2020<https://click.connect.hhs.gov/?qs=aad005818604684f902d3083bf6c41ef446267f1a9f156b2060febd742a1bbae0c73baa926345ecd8ac4a2fb0ff70dcd5388aa67a16f6182> to establish a Most Favored Nation (MFN) Model for setting Medicare payment rates for some Part B drugs.

The MFN model<https://click.connect.hhs.gov/?qs=aad005818604684f96d0f40821ed643641e09149cadc288086fca12a9fef16d1b6cbe59a8052305073f179009e43e46a34ea0f749293b60a> proposed to lower Medicare spending on Part B drugs by basing Medicare payments on prices paid by other countries, several of which use Quality-Adjusted Life Years (QALYs) to determine whether to cover medical treatments (include medicines). Aspects of the rule itself and the rulemaking process were challenged in lawsuits, which has prevented the rule from being implemented.

The proposed rule to rescind the MFN -- currently open for comment --would permanently prevent the policy from taking effect. Because of the significant impact of this rule on older adults and people with disabilities, we strongly encourage the aging and disability networks to provide comments<https://click.connect.hhs.gov/?qs=aad005818604684fb8363a3e25184682de6060e76110dddf374312ec394ec9e3d84c5e91e0f18fa2a183194a3263b7e67f1419225de0179a> and encourage the people you serve to do the same. Comments are due Oct. 12, 2021.

Advocates for older adults and people with disabilities strongly objected<https://click.connect.hhs.gov/?qs=aad005818604684f9a5b83c95277da20cfea52c17727a67789e541f678b555665156d6ba2c7375856da0e0de910542555d196d06cdcfc03b> to the rule for several reasons.

Read more.<https://click.connect.hhs.gov/?qs=aad005818604684fc933172b92c41585ef4f77e0f4f7d7a8e628ba6cf507fc99d10dc399e75d0913e2d8845e88aeff2553aae0759d78f8c3>

Input Needed: NQF Rural Telehealth and Healthcare System Readiness Measurement Framework

Bottom Line: The National Quality Forum (NQF) is seeking input on the Rural Telehealth and Healthcare System Readiness Measurement Framework<https://click.connect.hhs.gov/?qs=aad005818604684fa7352c2620e31cf30ddc3df19ac7bed4b7c2805e14f92e8c528e09e629cb3c98b7d0d8c25f00ca62a9476502e7678be5>. Comments may be submitted through the project page<https://click.connect.hhs.gov/?qs=aad005818604684f5beb71c9b4f8d3c0a942a06c542b064d7d2731f1f33afb246db6b986e6d932738c1970cb282b6b98d4e62341987030b1> through Friday, October 8 at 6:00 PM ET.

Why this is important: Rural communities commonly face shortages in healthcare professionals, lack of transportation options and other challenges to accessing health care, and these issues have been exacerbated by the COVID-19 pandemic. Telehealth has the potential to increase access to care and improve quality of care in rural communities, particularly during emergencies.

Read more.<https://click.connect.hhs.gov/?qs=aad005818604684f32d19ae116bea3c1933b407a8fb1d74b5792b56d4c48b5d6238e6b5912e034e2400c0e8f5c12c6c99bca3ce2acfb3b63>

Medicare.gov adds vaccination rates to nursing home details

Last week, CMS launched a new feature on Medicare.gov to make it easier to check COVID-19 vaccination rates for nursing home staff and residents. When users search for information about nursing homes using Medicare.gov’s “Find and Compare” tool<https://click.connect.hhs.gov/?qs=aad005818604684fa5dff201a5665f917dc3f81cb12ab3deaf4817bb05915948f25b11a81686752f8d0918fb63cb17db9bba6fead1a3c311>, they will now find the percentage of residents and staff who are vaccinated for COVID-19, along with the state and national rates for each.
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