NPAIHB Legislative & Policy Update
Monday, August 24, 2020

HHS Provider Relief Fund Medicaid targeted funds and Medicare phase 2 funds (APPLICATION DUE 8/28)
Announced 8/10/20
Provides an opportunity for additional funding from the U.S. Department of Health and Human Services (HHS) Provider Relief Fund. Applications are currently open for Phase 2 General Distribution funding for Medicaid, Medicaid managed care, CHIP, dental providers, and certain Medicare providers. This extended relief to further expand the eligibility, seems to be designed in response to concerns of tribes. Applicable providers include those who meet the following criteria:
  • Did not receive a Phase 1 payment that was equal to approximately 2% of their annual patient revenue (as reported in a provider's most recent tax filing). 
  • Received a Phase 1 payment but missed the deadline to submit revenue information. 
  • Received a Phase 1 payment, but the provider rejected the funds and is interested reapplying. 
  • Were held ineligible for a Phase 1 payment due to an ownership change or lack of Medicare fee-for-service revenue in 2019. 
All providers will receive funding of up to 2% of the reported total revenue from patient care. 

IHS DTLL -  Initiates tribal consultation on the use of approximately $30 million in offset and prior-year funds from the Special Diabetes Program for Indians (COMMENTS DUE 8/28)
Issued 7/2/20
Creates a new SDPI funding opportunity for approximately $30 millionth be used for purposes consistent with the statutory language for the use of funds. SDPI funds are available until expended and prior-year ("carryover") funds have accumulated over the years in many SDPI grants. IHS proposed options for the use of the $30 million in one-time funds include, but are not limited to a new grant opportunity for $10 million per year for three years for entities that do not currently have an SDPI grant, or one open to all eligible entities to apply to address diabetes-related risk factors (e.g. social determinants of health). 

HHS Region 10 Tribal Consultation (COMMENTS DUE 9/4)
Held 8/18/20
Requests written testimony in response to the annual consultation. The discussions throughout the consultation and the written testimonies will be used to draft a new Region 10 Top Tribal issues, which will be circulated for review in September, and monthly until the next consultation. 

CMS Proposal to expand tele-health benefits permanently for Medicare beneficiaries beyond COVID-19 (COMMENTS DUE 10/5)
Proposed 8/30/20
Releases a proposed rule for the 2021 Physician Fee Schedule, which contains new tele-health services covered under Medicare. As of March 30, CMS has allowed more than 135 additional services through tele-health during the public health emergency. Allows physicians to fulfill direct supervision requirements while remote, provided the physician is immediately able to engage via audio-video technology if needed. The change would be in effect through December 31, 2021 or end of the public health emergency, whichever is later. Allows HCPCS codes G2061 - G2063 to be billed by licensed clinical social workers, clinical psychologists, physical therapists, occupational therapists, and speech language pathologists.
CDC releases study showing American Indians and Alaska Natives are disproportionately affected by COVID-19
Released 8/19/20
Examines how COVID-19 is affecting American Indians and Alaska Natives. CDC found that in 23 states with adequate race/ethnicity data, the cumulative incidence of laboratory confirmed COVID-19 cases among AI/AN people were 3.5 times than of non-Hispanic whites. CDC highlighted that adequate health care and public health infrastructure resources are needed to support a culturally responsive public health effort that sustains the strengths of AI/AN communities. These resources would facilitate the collection and reporting of more complete case report data to support evidence-based public health efforts.

Executive Order on improving rural health and telehealth access
Issued 8/3/20
Orders increases in access to quality care through tele-health. the Executive Order includes the following initiatives: (1) launch a new payment model for rural health care; (2) development and implementation of a strategy to improve rural health care infrastructure; (3) creation of a report describing policy initiatives to improve rural health; and (4) proposes a regulation that would extend certain tele-health flexibilities.

CMS updates days on COVID-19 impacts on Medicare beneficiaries, which for the first time includes data specific to American Indian and Alaska Native beneficiaries
Updated 7/28/20
Provides a monthly update on the COVID-19 impacts on Medicare benefits. Specifically highlights new data showing American Indians and Alaska Native beneficiaries have the second highest rate of COVID-19 hospitalization among racial/ethnic groups. Confirms that the COVID-19 public health emergency disproportionately affects vulnerable populations due to higher rates of chronic health conditions. 

SAMHSA updates to confidentiality rules for substance use disorder (SUD) treatment
Finalized 7/15/20
Provides a final rule from earlier proposed revisions to the 42 CFR Part 2 regulations, governing confidentiality of SUD treatment information. Provisions become effective August 14, 2020. For example, the final provisions clarify that information verbally conveyed by a Part 2 program to another health care provider, who is not covered by Part 2 - does not become a "record" subject to Part 2 rule. The final rule also broadly allows patients to disclose information to an entity without having to name an individual recipient, even if the entity lacks a treating provider relationship with the patient. A new section was added to allow Part 2 programs to disclose dispensing and prescribing data to Prescription Drug Monitoring Programs (PDMPs). 

Appropriations Updates: 
10 of 12 Appropriations bills have passed the House. It is doubtful that these bills will move forward in the Senate before the end of the fiscal year on 9/30/2020. We anticipate that there will be a Continuing Resolution in September to provide funding, if this is the case, there will be a push to attach health extender programs like SDPI to the Continuing Resolution.  

S 4320: Coronavirus Response Additional Supplementation Appropriations Act  
(1 of 7 Senate Bills that comprise the HEALS Act) 
Brings an additional $605 million to direct service and self-gov tribes through contracts/compacts to remain available until September 30, 2021, to prevent, prepare for, and respond to coronavirus, domestically or internationally. And $1b to prevent, prepare for, and respond to coronavirus, domestically or internationally, including for the acquisition of sites, purchase and erection of modular buildings, and purchases of trailers, for provision of domestic and community sanitation facilities for Indians Funds available through 9/30/2021.  
For more information
 Laura Platero, Executive Director
Sarah Sullivan, Health Policy Analyst
(503) 228-4185