NOW AVAILABLE IN iQIES - Preview Reports and Star Rating Preview Reports for the April 2023 Refresh

For this refresh, Home Health (HH) Outcome and Assessment Information Set (OASIS) will be based on the standard number of quarters. Due to the COVID-19 reporting exceptions, the claims-based measures have been calculated excluding Q1 and Q2 2020 data from measure calculations. For additional information, please see the HH QRP COVID-19 Public Reporting Tip Sheet in the downloads section of the HH Quality Reporting Training webpage and the Home Health Data Submission Deadlines webpage. 

HHS Offers States Flexibility to Better Address Medicaid Enrollees’ Needs

Home Care Association of America

Recently, the U.S. Department of Health and Human Services (HHS) and CMS released guidance to help states expand access to health care services and address health-related social needs for people with Medicaid coverage. The option of “in lieu of services and settings” in Medicaid managed care will help state offer alternative benefits to address unmet health-related social needs, such as housing instability and food insecurity.

​Provided via a state Medicaid director letter, the guidance establishes requirements that states must meet to ensure the services are cost effective, medically appropriate, preserve enrollee rights and protections, and fulfill the objectives of the Medicaid program.
 
For more information or to read the state Medicaid director letter in its entirety, visit Medicaid.gov. 

https://www.medicaid.gov/federal-policy-guidance/downloads/smd23001.pdf

Medicare Advantage, Telehealth Expansion Allies to Helm Key House Panels

Fierce Healthcare | By Robert King
 
The new leaders of the influential House Ways and Means Committee and the House Energy and Commerce Committee have previously been fierce advocates for extending telehealth services as well as preserving Medicare Advantage (MA).
 
Rep. Cathy McMorris Rodgers, R-Washington, was selected Tuesday as the head of Energy and Commerce. Rep. Jason Smith, Missouri, will helm the House Ways and Means Committee. Both panels have major jurisdiction over healthcare issues in Congress.
 
It remains unclear what the exact priorities for both lawmakers will be in the new congressional session. 
 
McMorris Rodgers has served as the ranking member of Energy and Commerce in the last Congress and has been critical of the Biden administration’s response to the COVID-19 pandemic. She has called for information and records from the National Institutes of Health on the origins of the COVID-19 pandemic, which will likely be the source of hearings across multiple committees in the coming years.
 
She is also likely to be a sharp critic of Centers for Medicare & Medicaid Services (CMS) policies on Medicaid and the Affordable Care Act.
 
McMorris Rodgers slammed CMS for approving a waiver by Washington state to enable undocumented immigrants to get subsidized coverage. Rodgers said in a statement last month that the waiver granted by CMS to Washington was a “misuse of taxpayer dollars.”
 
Both McMorris Rodgers and Smith are aligned on a key issue of how to keep around telehealth flexibilities. Smith told Axios that a big focus of his chairmanship will be on extending telehealth and improving access to healthcare in rural areas. 
 
McMorris Rodgers has also been a big proponent of the expansion of telehealth flexibilities created at the onset of the pandemic. 
 
Both lawmakers will likely play a pivotal role in the future of telehealth. At the start of the pandemic, CMS expanded the flexibility for providers to get Medicare reimbursement for telehealth. 
 
Congress passed legislation at the tail end of 2022 that extends those benefits through 2024. It may be up to Congress again to pass another extension or to decide which flexibilities should become permanent. 

Telehealth Continues

NIHCM

Telehealth emerged as a strong care delivery system during the pandemic. The US Department of Health and Human Services shared new insights on how telehealth programs could be strengthened. Congress expanded COVID-era telehealth flexibilities through 2024.

• Mental Health: A large study found telehealth to be as effective for treating anxiety and depression as in-person visits. Many schools are turning to telehealth to support students’ mental health needs. 
• Rural Health: Telehealth is connecting rural patients to sexual assault nurses, when before they had to travel to a hospital in another county for care. There is also emerging evidence of telerehabilitation in rural areas. 
• Substance Use: The Substance Abuse and Mental Health Services Administration proposes to expand access to opioid use disorder treatment by using telehealth to initiate buprenorphine at opioid treatment programs.

Resources & Initiatives:

• A recent study found that telehealth enabled mental health care for an increasing number of patients.
• Horizon Blue Cross Blue Shield of New Jersey shares information on when telehealth is the right choice for care.