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NASPGHAN Leads Response to CMS Proposal that Puts Coverage of Medically Necessary Nutrition at Risk
Last week, NASPGHAN submitted comments in response to a proposed rule that includes potential changes to Essential Health Benefits (EHBs) offered by qualified health plans (QHPs) participating in the Affordable care Act (ACA) Marketplace.
The proposed rule reverses a 2025 policy, which would require states to defray the costs of any benefits they mandate as an EHB beyond federal requirements.
Consequently, continued coverage of medically necessary formulas and/or foods would be at risk in states where medical necessary nutrition has been incorporated into the EHB. The policy, if finalized, could also hamper future state actions to cover specialized formulas and foods.
The NASPGHAN-led letter, which was signed by 41 organizations, detailed the importance of specialized foods and formulas for those with GI and inherited metabolic disorders and called on the Administration to support the current treatment of state-required benefits within EHBs, as well as to expand medically necessary foods and formulas across all insured patient populations.
Judge Blocks Changes to Childhood Vaccine Recommendations
A federal judge in Massachusetts Monday granted public health groups’ request to stay Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.’s appointments to the Advisory Committee on Immunization Practices (ACIP) while their challenge to vaccine policy changes moves through the courts. Consequently, ACIP has canceled its meeting that was set to take place this week. The lawsuit is being led by the American Academy of Pediatrics (AAP) and other medical groups.
The judge also granted the AAP’s motion to block HHS from implementing its January 5 decision downgrading some childhood vaccines from “routine” recommendations to "shared clinical decision-making."
Read the AAP statement following the ruling here.
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