The Centers for Medicare and Medicaid Services (CMS) issued a final rule that it says promotes wider use of telehealth in behavioral health. The CMS final rule on the Physician Fee Schedule for Medicare payments for calendar year 2022 eliminates restrictions on where patients can be when they seek mental health care via telehealth. Under the new final rule:

• Medicare would allow for mental health telehealth visits to originate from within a patient’s home.
• Geographic restrictions for mental health services offered via telehealth are eliminated.
• Providers can do audio-only communications to diagnose and treat mental health disorders with established patients in their homes under certain circumstances—i.e., circumstances where a mental health provider could do a two-way video chat but the patient cannot use or refuses to consent to use the video chat system.
• Providers are required to note that they were able to do an audio-only call but the patient wasn’t able to or didn’t want to use a video call.
• The fact that mental health services include treatment for substance use disorder is clarified.
• Medicare is permitted to pay rural health clinics (RHCs) and federally qualified health centers (FQHCs) for mental health services furnished via telehealth regardless of the public health emergency.
• Similar rules about having patients come to an in-person appointment at least every 12 months apply to RHCs and FQHCs as well.

Members of Pennsylvania Governor Wolf’s Administration joined the Pennsylvania Harm Reduction Network (PAHRN), members of the General Assembly and other advocates and stakeholders in support of expanding access to life-saving harm reduction services for individuals struggling with a substance use disorder (SUD). Two bills that focus on harm reduction were discussed: Senate Bill 926, sponsored by Senators Pat Browne and Anthony Williams, and a forthcoming House Bill from Representatives Jim Struzzi and Ed Gainey that would legalize syringe services programs in Pennsylvania. “Syringe Services programs are a valuable tool in assisting people to enter treatment as well as helping to reduce HIV and HCV,” said Sen. Browne. “In addition, expanding these programs in Pennsylvania will save the commonwealth millions of dollars annually and reduce the burden on our health care system.” House Bill 1393, sponsored by Rep. Struzzi, and Senate Bill 845, sponsored by Sen. Tim Kearney, would legalize fentanyl test strips for personal use. “The rapid proliferation of fentanyl has been killing thousands of Pennsylvanians and destroying our families for years, and legalizing fentanyl test strips is a common sense change we can make to save lives,” said Sen. Kearney. “People cannot recover from addiction if they are dead – it’s time to get with the evidence and fight smart against addiction.”

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Over the past twenty months we have seen public health workers rise to the challenge and work tirelessly to protect their families, friends, neighbors, and communities during this pandemic. We are grateful for our staff here at the Department of Health, but we are also very thankful for everyone at county municipal health departments, local organizations, universities, and businesses who respond to the public health needs of Pennsylvanians every day. We encourage you to take this opportunity on Public Health Thank You Day on Monday November 22, 2021, to show our collective appreciation for all public health workers across the commonwealth, and in your community. There might have been specific individuals who have assisted you or your organization in a particular way that you want to publicly recognize.

There are many ways to participate in Public Health Thank You Day, as outlined in this toolkit. Please use and share the toolkit as appropriate.

Sincerely,

Denise A. Johnson, MD                  Alison V. Beam

Acting Physician General              Acting Secretary of Health

In keeping with President Biden’s Competition Executive Order, the Centers for Medicare & Medicaid Services (CMS) will be releasing a final rule that will further advance its commitment to increasing price transparency, holding hospitals accountable and ensuring consumers have the information they need to make fully informed decisions regarding their health care. The Calendar Year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule with Comment Period will strengthen enforcement of price transparency requirements for hospitals, and increase Medicare beneficiary quality and safety by halting the phased elimination of the Inpatient Only (IPO) list for surgical procedures.

“CMS is committed to promoting and driving price transparency, and we take seriously concerns we have heard from consumers that hospitals are not making clear, accessible pricing information available online, as they have been required to do since January 1, 2021,” said CMS Administrator Chiquita Brooks-LaSure.  “We are also taking actions to enhance patient safety and quality care.”

Price Transparency

Beginning January 1, 2022, CMS will increase the penalty for some hospitals that do not comply with the Hospital Price Transparency final rule. Specifically, CMS is setting a minimum civil monetary penalty of $300 per day that will apply to smaller hospitals with a bed count of 30 or fewer, and a penalty of $10 per bed per day for hospitals with a bed count greater than 30, not to exceed a maximum daily dollar amount of $5,500. Under this approach, for a full calendar year of noncompliance, the minimum total penalty amount would be $109,500 per hospital, and the maximum total penalty amount would be $2,007,500 per hospital.

Hospital price transparency helps people know what a hospital charges for the items and services they provide, an important factor given that health care costs can cause significant financial burdens for consumers. While enforcement activities are necessary to drive compliance with price transparency, CMS is also committed to working with hospitals to help them meet those requirements.

Enhancing Beneficiary Protections

CMS is also enhancing beneficiary protections by finalizing policies that will allow for a more evidence-based approach in determining whether procedures should be payable in the outpatient setting. In the CY 2021 OPPS/ASC final rule, CMS finalized a policy to eliminate the IPO list over a three-year period, removing 298 services in the first phase of the elimination. A large number of stakeholder comments opposed elimination of the list, primarily due to safety concerns with performing certain procedures in an outpatient setting.

For CY 2022, CMS is halting the elimination of the IPO list and, after review of the services removed from the list in CY 2021, CMS is adding all but a small number of procedures back to the list. CMS is also reinstating the ASC Covered Procedures List (CPL) criteria that were in effect in CY 2020 and adopting a process for stakeholders to nominate procedures they believe meet the requirements to be added to the ASC CPL.

Health Equity, Access to Emergency Care in Rural Areas and Lessons from COVID-19

In the OPPS/ASC Payment System proposed rule, CMS also issued Requests for Information (RFIs) and solicited comments on a number of potential proposals and actions to further the vision of advancing health equity, driving high-quality, person-centered care, and promoting affordability and sustainability. The comments will help inform future rulemaking around these topics. Future rulemaking will include additional opportunities for public comments.

• Health equity: CMS received input on ways to make reporting of health disparities based on social risk factors and race and ethnicity more comprehensive and actionable by including additional demographic data points (e.g., race, ethnicity, Medicare/Medicaid dual eligible status, disability status, LGBTQ+, and socioeconomic status).
• Access to emergency care in rural areas: the proposed rule included an RFI on Rural Emergency Hospitals (REHs). CMS received robust comments in response to this RFI and looks forward to taking each of those comments into consideration during the rulemaking process for the development of the REH requirements.
• Lessons from COVID-19: CMS solicited comments on the extent to which hospitals are using flexibilities offered during the COVID-19 public health emergency (PHE) to provide mental health services remotely and whether CMS should consider changes to account for shifting practice patterns. In addition, comments were received on the collection and reporting of COVID-19 vaccination status of hospital outpatient department and ASC staff, and making this information available to the public so consumers know how many workers are vaccinated in different health care settings.

For a fact sheet on the CY 2022 OPPS/ASC Payment System Final Rule (CMS-1753-F), please visit: https://www.cms.gov/newsroom/fact-sheets/cy-2022-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center-0

The OPPS/ASC Payment System Final Rule is displayed at the Federal Register, and can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/2021-24011/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment.

“Know your audience” is a mantra familiar to communicators everywhere. We think that’s the easy part – but is it? Communicating with your audience in a way that is accurate, respectful, and inclusive of everyone is more challenging.

Learn more about this invaluable resource from the CDC here:

Health Equity Guiding Principles for Inclusive Communication

The U.S. Cancer Statistics Data Visualization tool has been updated this year to make it easier to explore and use the latest cancer data. Check it out!

Data Visualization