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Tags Posts tagged with "Medicare"

Medicare

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RCPA has signed onto a letter to Congressional leaders of the Ways and Means Committee and the Senate Committee on Finance, along with 244 other signatories, outlining the need for parity in addiction and mental health care under Medicare.

As the President’s 2023 Budget and Senate Finance Committee’s bipartisan report has highlighted, Medicare is not subject to the Mental Health Parity and Addiction Equity Act (Parity Act). As a result, Medicare beneficiaries do not have coverage of or access to the full range of mental health and substance use disorder benefits they need, and often lose access to treatment they were receiving prior to becoming eligible for Medicare. Although Congress has eliminated disparate financial requirements for Medicare beneficiaries, Medicare still imposes both quantitative (e.g. 190-day lifetime limitation on psychiatric hospital care) and non-quantitative treatment limitations that would violate the Parity Act. Applying the Parity Act to Medicare Parts A, B, C, and D is the critical next step to make mental health and substance use disorder services available and accessible to the millions of Medicare beneficiaries in need of treatment.

Read the full letter here.

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Medicare binary sign concept illustration design over black

The Centers for Medicare and Medicaid Services (CMS) is conducting interactive training webinars that cover Medicare basics today, June 14, 2022, and tomorrow, June 15, 2022, from 1:00 pm – 3:00 pm. The topics and registration links for both days are provided below:

Day 1 (June 14) — Topics will include Medicare enrollment and eligibility; SSA and CMS roles and responsibilities; cost and coverage under Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance); why enrolling on time is important; and an overview of Medicare Supplement Insurance (Medigap) policies.

Register for the Day 1 webinar here.

Day 2 (June 15) — Topics will include Medicare drug coverage (Part D); Medicare Advantage Plans; coordination of benefits; how to detect and report suspected Medicare fraud, waste, and abuse; and different resources to help you find answers to Medicare policy and coverage questions.

Register for the Day 2 webinar here.

These webinars will be recorded and posted to the National Training Program (NTP) website. You can view the recordings here.

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Source: The Center Square, June 1, 2022
By Anthony Hennen

After a months-long controversy over unionization language in Medicaid contracts that sparked a lawsuit, the Pennsylvania Department of Human Services has removed the provision in question, citing concerns about “misinformation” and “confusion.” …The language prompted the Hospital & Healthsystem Association of Pennsylvania to file a lawsuit against DHS in early May, alleging that DHS overstepped its authority and didn’t follow proper procedure for adding the unionization language.

On May 26, DHS confirmed that the work stoppage provision would be dropped from the Medicaid contracts.

View the full article here. If you have any questions, please contact your RCPA Policy Director.

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A message from Kevin Dressler, Bureau Director of the Office of Developmental Programs (ODP):

The CMS Interim Final Rule outlining the Vaccination Requirements for all staff and contractors providing services for Medicare and Medicaid certified providers published on 11-05-21 applies to Intermediate Care Facilities (ICFs). Below are several links outlining the Vaccine Requirements and Deadlines associated with the Interim Final Rule.

Please contact your ODP Regional Office liaison if you have concerns meeting the demands of the Vaccination Mandate.

Kevin Dressler | Bureau Director
Department of Human Services
Office of Developmental Programs
Bureau of State Operated Facilities
Room 508 Health & Welfare Bldg | Harrisburg, PA 17120
Office Phone: 717-425-5686
Cell Phone: 570-809-3759
Fax: 717.787.6583

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Photo by Markus Winkler on Unsplash

Mandatory Vaccination Update
Medicare and Medicaid Programs: Omnibus COVID-19 Health Care Staff Vaccination
OSHA Emergency Temporary Standard (ETS)  

RCPA continues to work for clarification with our State stakeholders from the Department of Human Services (DHS) and the Governor’s office as well as for guidance at the federal end through our National Councils.

The National Council on Mental Wellbeing has received several questions around the recent vaccine mandates released by the Biden Administration. The following links and summaries from the Council’s federal consultant group may answer some of your questions.

On November 4, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with comment (IFC), entitled “Medicare and Medicaid Programs: Omnibus COVID-19 Health Care Staff Vaccination” (Rule and Press Release).The FAQ provides excellent scenario-based guidance that may be applicable to your agency.

The IFC stipulates that all staff members of certain providers and suppliers participating in the Medicare and Medicaid programs, including those who perform their duties outside of a formal clinical setting, must be fully vaccinated against COVID-19 unless exempt. The definition of applicable facilities under the Medicare-certified providers and suppliers is listed under federal statute (for example, the current Medicare definition of CMHCs (there are 129 Medicare-certified CMHCs throughout the country), which is Section 4162 of the Omnibus Budget Reconciliation Act of 1990 (Pub. L. 101–508, enacted November 5, 1990) (OBRA 1990), which added sections 1861(ff) and 1832(a)(2)(J) to the Act, includes CMHCs as entities that are authorized to provide partial hospitalization services under Part B of the Medicare program).

However, the definition of Medicaid-certified providers and suppliers will vary by state. To that end RCPA, as part of its efforts, is seeking this clarification and to confirm determinations on which providers and suppliers are subject to the IFC. 

As noted in the summary below, the IFC does not allow for weekly testing in lieu of vaccination and maintains the employer’s right to require full vaccination of employees regardless of exemptions listed in the IFC. The final rule is expected to be published in The Federal Register on November 5, 2021, with an expected effective date of January 4, 2022. There will be the opportunity to comment on the IFC. Comments must be received no later than 60 days after the publication of the IFC in The Federal Register.

Also released was the Occupational Safety and Health Administration (OSHA) Emergency Temporary Standard (ETS) for COVID-19 Vaccination and Testing in the Workplace (Rule; Fact Sheet; Press Release). The ETS requires employees who are employed by private-sector employers with 100 or more employees to get vaccinated or test negative for the virus once per week and wear a mask indoors. It also requires employers to provide paid time off for employees to get vaccinated and recovery time from vaccination. The 28 states with OHSA-approved state plans must also adhere to the ETS.

The ETS mandates that employers determine the vaccination status of each employee, obtain acceptable proof of vaccination status from vaccinated employees, and maintain records and a roster of each employee’s vaccination status.

The testing requirement for unvaccinated workers is slated to begin on January 4, 2022, and employers must comply with all other requirements (i.e. providing paid time off for employees to get vaccinated and masking for unvaccinated workers) by December 5, 2021. Employees falling under the ETS rules will need to have their final vaccination dose by January 4, 2022.

OSHA has published a series of resources with respect to this ETS, including frequently asked questions, guidance materials, and reporting requirements.

RCPA will continue to update members on the status and any changes to the current information that has been published.

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