This Week’s Dose

The House is set to return from recess for a procedural vote on three major legislative measures. Biden requires vaccines for nursing home workers and announces boosters in September.

Congress

Speaker Pelosi Charted Out New Plan for Moving Infrastructure Packages

Last week, on the heels of passing a $1.2 trillion bipartisan infrastructure package, the Senate advanced the $3.5 trillion FY 2022 budget resolution for the partisan “human infrastructure package” on a party-line vote. The budget resolution is the framework that outlines the spending and savings numbers that the various House and Senate Committees are required to work within to develop the partisan “human infrastructure” legislation. For months, House Speaker Nancy Pelosi (D-CA) maintained that she would not hold a vote on the bipartisan infrastructure bill in the House until the Senate had also passed the partisan human infrastructure legislation to guarantee that Democratic priorities on childcare, education and healthcare were addressed. However, a group of nine moderate House Democrats complicated the Speaker’s strategy last week when they issued a statement that they would not vote on the partisan budget resolution until the House addressed the bipartisan infrastructure bill. The Speaker would be right to worry that if the bipartisan infrastructure bill is enacted, she and Senator Schumer will lose leverage viewed as necessary to advance the much bigger partisan package. With hardly any votes to spare, Speaker Pelosi has asked the House Committee on Rules to assess a new strategy using procedural votes to align the differences across her party. The Rules Committee will meet at 11:00 a.m. on Monday to make recommendations that could set up the House to have a full vote Tuesday on the partisan budget resolution. The Speaker is not expected to bring a vote for the bipartisan infrastructure package until significant progress is made on human infrastructure, which will likely not be until later this fall.

Administration

Centers for Medicare and Medicaid Services (CMS) Extended Window for Post-Public Health Emergency (PHE) Medicaid Eligibility Redeterminations

Medicaid and CHIP enrollment surged during the COVID-19 pandemic as Congress passed legislative provisions aimed at ensuring individuals could access and retain health insurance. These provisions included continuous eligibility requirements that prevented individuals from losing coverage through the duration of the PHE. Following a push from Medicaid advocates, a letter from Daniel Tsai, Director of the Center for Medicaid and CHIP Services, announced that states would now have up to 12 months to reassess their Medicaid enrollees for ongoing eligibility following the end of the PHE. This policy doubles the initial six-month window granted by the Trump Administration and seeks to support states and millions of new enrollees.

Biden Administration Mandated COVID-19 Vaccines for Nursing Homes and Recommended Boosters

As public health officials learn more about the Delta variant and the number of COVID-19 cases continue to increase, the Biden Administration announced this week that the Department of Health and Human Services would be issuing regulations that would condition nursing home participation in Medicare and Medicaid on having workers vaccinated. Nursing homes were hit especially hard by COVID-19 and their workforce represents about 1.6 million individuals, according to a White House fact sheet on the new vaccine policies. However, these facilities already struggle with staffing, and industry members are concerned this will exacerbate the existing labor shortages.

The nursing home mandate comes alongside an announcement that booster shots of the COVID-19 vaccine will be available beginning September 20. The Centers for Disease Control and Prevention announced that its Advisory Committee on Immunization Practices will meet soon to review the information and make a final recommendation on the administration of boosters. The White House stated that vaccine supply is not an issue for the booster shots and that it will continue to support global vaccine donations. The FDA has not yet granted full approval to any COVID-19 vaccine, though the agency is expected to do so for the Pfizer-BioNTech vaccine in early September.

Quick Hits

• After recently releasing the 2020 Merit-Based Incentive Payment System (MIPS) performance scores that impact 2022 payment adjustment, CMS said that, due to a technical error, it would be recalculating scores, a change that could impact some MIPS participants. The agency has also noted that due to COVID flexibilities many participants will be receiving a neutral payment adjustment for 2022.

• According to a Peterson-Kaiser Family Foundation Report, hospital admissions and spending remained below expectations in early 2021.

• Health Resources and Services and Administration distributed 36 grants to rural and underserved communities for telehealth investment, totaling $19 million.

• FDA issued the 2020 report on pharmaceutical quality following a year of delayed inspections.

• CMS leadership released “Innovation at The Centers For Medicare and Medicaid Services: A Vision For The Next 10 Years.”

• Center for Medicare and Medicaid Innovation (CMMI) released updated findings on the Bundled Payments for Care Improvement Models, finding reduced fee for service payments, but net losses overall under 2 of the 3 models.

• CMMI also published its Fourth Annual Evaluation of the Home Health Value-Based Purchasing Model, finding that the model continues to realize savings for Medicare.

• The Biden Administration increased Supplemental Nutrition Assistance Program benefits by about $36 per person, per month.

Next Week’s Diagnosis

The House returns next week to vote on a rule to advance the bipartisan infrastructure bill.