Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


President Takes Executive Action As Stimulus Talks Break Down

In the wake of Democratic leaders and White House officials failing to reach a deal on a new coronavirus relief package, President Trump released a slate of new executive actions over the weekend. The moves include a payroll tax deferral for Americans making less than $100,000 a year from September through December, the provision of $400 a week in jobless benefits, an expansion of a congressionally-approved eviction moratorium that expired in July, and relief for student borrowers. The actions have been panned by congressional Democrats and some Republicans as an infringement on Congress’s power of the purse, and the moves will likely face legal changes. Many have also raised concerns about the negative impact the President’s actions could have on negotiations on the next stimulus bill. The Senate will remain in session this week to continue talks on the coronavirus relief package, cutting short the chamber’s August recess, which was scheduled to start last weekend.

President Signs Additional Executive Orders on Telehealth, Domestic Manufacturing

The President signed an executive order last week that aims to increase access to telehealth and support rural hospitals. The order proposes a permanent extension of certain telehealth policies instituted in response to the COVID-19 pandemic, such as the expansion of which services can be provided virtually. The order also proposes to retool the way that rural hospitals get paid, using optional pilot projects to test new financial incentives for providers who deliver higher quality care. The order requires a report examining policies to reduce maternal mortality, improve mental health care and health care outcomes in rural communities, and eliminate regulations that limit the availability of health care providers.

President Trump also signed an order to encourage the production of more drugs and medical supplies in the U.S. The order encourages buyers to purchase American-made products and loosens federal drug-safety and environmental regulations that the White House argues put domestic producers at a disadvantage. As directed by the order, the Food and Drug Administration (FDA) will determine the list of essential products used to respond to a public health crisis that will be covered by the executive order. The U.S. Department of Health and Human Services (HHS), Department of Defense, and Department of Veterans’ Affairs will be required to buy the U.S.-made treatments. Exceptions to the order would be made if it is in the public interest, the drug or device is not produced in sufficient quantities in the U.S., or if it raises prices. Senate Finance Committee Chair Chuck Grassley (R-Iowa) praised the action but also argued that Congress should act to further encourage domestic manufacturing.

CMS Proposes to Expand Telehealth Benefits

The Centers for Medicare and Medicaid Services (CMS) is proposing to expand certain telehealth benefits for Medicare beneficiaries beyond the COVID-19 public health emergency (PHE) The proposal follows an Executive Order on Improving Rural and Telehealth Access signed by President Trump last week and is in keeping with the agency’s Patients Over Paperwork initiative. CMS is proposing to permanently allow some of the 135 services that were added to the list of services that could be paid for when delivered by telehealth during the PHE and is requesting comment on other services to permanently add to the telehealth list. The agency also proposes to temporarily extend payment for other telehealth services through the calendar year in which the PHE ends. CMS proposes to increase the value of services comparable to or including office/outpatient E/M visits in an effort to more appropriately recognize the value of care that requires face-to-face time with patients. CMS also proposes to make permanent certain changes to expand workforce capacity and bolster staffing levels in response to the pandemic. These changes include allowing nurse practitioners, clinical nurse specialists, physician assistants, and certified nurse-midwives (instead of only physicians) to supervise others performing diagnostic tests; clarifying that pharmacists can provide services as part of the professional services of a practitioner who bills Medicare; allowing physical and occupational therapy assistants (instead of only physical and occupational therapists) to provide maintenance therapy in outpatient settings; and allowing physical or occupational therapists, speech-language pathologists and other clinicians who directly bill Medicare to review and verify, rather than re-document, information already entered by other members of the clinical team into a patient’s medical record. Public comments on the proposed rules are due by October 5, 2020. CMS Administrator Seema Verma has acknowledged that Congress would need to pass legislation to permanently change which providers can use telehealth and where patients can access it.

Senate Passes Elder Abuse Legislation

The Senate passed the Promoting Alzheimer’s Awareness to Prevent Elder Abuse Act (S. 3703) by unanimous consent last week. The bill would amend the Elder Abuse Prevention and Prosecution Act to improve the prevention of elder abuse and exploitation of individuals with dementia. It would require the Department of Justice (DOJ) to develop training materials to assist professionals supporting victims of abuse living with Alzheimer’s and other dementias.

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