• The CIB offers reporting templates and a new technical assistance toolkit to help states improve their overall monitoring and oversight of managed care. The managed care reporting templates will provide a standard format for states to report managed care medical loss ratios (a measure that helps encourage health plans to provide value to enrollees) and network adequacy (a measure of how well a plan delivers its actual benefits) to CMS.

• To promote transparency in Medicaid and CHIP, the CIB also reminds states of the requirement to post their Network Adequacy and Access Assurances reports on a state website for each program they operate. CMS will make all reports submitted through Managed Care Reporting available after an initial review of reports are complete. CMS will be creating a webpage on Medicaid.gov where states will be able to review the reports. Reports are currently available upon request.

• As an additional step to aid states and the individuals many Medicaid and CHIP programs serve, CMS also released a toolkit to support program monitoring for Medicaid enrollees in Managed Long-Term Services and Supports (MLTSS) —specific managed care programs that can help ensure more people with long-term care needs transition from institutions to home and community-based settings. The toolkit, “Promoting Access in Medicaid and CHIP Managed Care: Managed Long-Term Services and Supports Access Monitoring Toolkit,” was developed in response to MLTSS growth and federal oversight concerns about access to services and quality of care.

• To begin helping address the staffing issue while the rulemaking process is underway, CMS added new requirements for surveyors to incorporate the use of Payroll Based Journal staffing data for their inspections. This will help better identify potential noncompliance with CMS’s nurse staffing requirements, such as lack of a registered nurse for eight hours each day, or lack of licensed nursing for 24 hours a day. This guidance will help to uncover instances of insufficient staffing and yield higher quality care. 

• Using lessons learned from the pandemic, CMS is providing further guidance requiring each facility to have an Infection Preventionist (IP) who has specialized training to effectively oversee the facility’s infection prevention and control program—in accord with President Biden’s campaign commitment to ensure facilities have sufficient on-site IPs.

• CMS has highlighted the benefits of reducing the number of residents in each room for preventing infections and the importance of residents’ rights to privacy and home-like environment. The pandemic has further proven the risk of contracting infectious diseases in rooms with several residents. CMS is urging providers to consider making changes to their settings to allow for a maximum of double occupancy in each room and encouraging facilities to explore ways to allow for more single occupancy rooms for nursing home residents.

• The updates also contain improvements to CMS guidance for mental health and substance use disorder, and builds upon the agency’s Behavioral Health Strategy to better meet the unique needs of LTC facility residents with mental health and substance use challenges. CMS also clarified the minimum level of knowledge and skills of facility staff to ensure that the policies and practices do not conflict with resident rights or other participation requirements.

• Each order now includes 12 rapid-antigen tests that are more accessible for people who are blind or have low vision. These will ship in six separate packages, each with two tests. Each package will have a separate tracking number.
• Orders will ship free, while supplies last.

• Ordering tests.
• Understanding instructions for test administration and test results.
• Providing alternative instructions for traditional at-home tests for people who are unable to access, read, or understand the manufacturer’s version.
• For those who cannot use an at-home test, DIAL operators can:
• Assist with ordering “swab and send” kits to collect a sample and mail it back for results.
• Connect callers to local organizations for assistance locating other testing options in their community, including in-home testing programs or transportation or companion support to visit a community-based testing site.

• Allie Cannington, Manager of Advocacy & Organizing The Kelsey
• Sandra Conley, Intern, American Association of People with Disabilities 
• Carlean Ponder, Director of Disability Rights and Housing, The Arc of The United States
• Sarah Malaier, Senior Advisor, Public Policy and Research, American Foundation For The Blind

• Georgina Peacock, MD, MPH, Director, Immunization Services Division, Centers for Disease Control and Prevention National Center for Immunization and Respiratory Diseases
• Stefanie Costello, Office of Communications, Partner Relations Group, Centers for Medicare & Medicaid Services
• Emily Roller, Health Insurance Program Manager, Virginia Health Care Foundation
• Porter Novelli Public Services, Outreach Contractor, Connecting Kids to Coverage National Campaign 

• Engage in discussion and solution building with international leaders regarding accessible transportation globally.
• Participate in research forums to exchange ideas and data regarding accessible transportation solutions.
• Hear state-of-the-art strategies and solutions to address international mobility and transportation challenges.