Health Policy Digest - May 2021

We are pleased to present the May issue of the ARN Health Policy Digest. This member benefit provides updates on health policy and legislative and regulatory developments that may be of interest to rehabilitation nurses.

CDC Unveils New Mask Guidance
In a significant update to federal safety guidelines, the Centers for Disease Control and Prevention (CDC) announced on May 13 that Americans who are fully vaccinated against the coronavirus may stop wearing masks or maintaining social distancing measures in most indoor and outdoor settings, regardless of capacity. The agency's recommendations stipulate that even vaccinated individuals must still cover their faces and physically distance when going to doctors, hospitals, nursing homes, or long-term care facilities; when traveling by bus, plane, train, or other modes of public transportation, or while in transportation hubs like airports and bus stations; and when in prisons, jails, or homeless shelters. Vaccinated Americans must also continue to abide by state, local, or tribal laws and regulations, and follow local rules for businesses and workplaces.

CMS Publishes IPPS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) issued its proposed rule governing fiscal year 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) reimbursement rates on April 27. The rule proposes updates to the Long Term Care Hospital Quality Reporting Program (QRP), including new reporting requirements relating to COVID-19 vaccination coverage and health outcome data on COVID-19 patients. The rule would also require state Medicaid provider enrollment systems to allow valid enrollments from Medicare providers serving certain Medicare-Medicaid dually eligible individuals for purposes of processing cost-sharing claims for services furnished to these individuals, to help reduce appeal and litigation costs for medical bills not covered by state Medicaid systems.

DRRC Backs "Triple A" Study Bills
On May 5, the Disability and Rehabilitation Research Coalition (DRRC), wrote to lawmakers expressing support for the bipartisan Assistive Technology and Devices for Americans Study Act legislation recently introduced as H.R.2461 by Reps. G.K. Butterfield (D-NC) and Brett Guthrie (R-KY), and as S.1089 by Sens. Tammy Duckworth (D-IL) and Marsha Blackburn (R-TN). Also known as the "Triple A" Study Act, the legislation would expand the knowledge base around access to assistive technologies and devices (AT) and lay the groundwork for improvements in care and policy solutions to support people with limb loss and limb difference.

Nursing Community Coalition Testifies to Labor-HHS Subcommittee
Executive Director of the Nursing Community Coalition (NCC) Rachel Stevenson provided testimony on May 6 to the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies. On behalf of 60 member organizations, the NCC has called for fiscal year 2022 appropriations of at least $530 million for the Nursing Workforce Development programs authorized under Title VIII of the Public Health Service Act (PHSA) and administered by the Health Resources and Services Administration (HRSA), and at least $193 million for the National Institute of Nursing Research (NINR). The coalition also sent a congratulatory letter to Secretary of Labor Marty Walsh following his March 23 swearing-in, pledging to work with the Department of Labor to improve the delivery of healthcare and expand the health workforce.

NAM Publishes Future of Nursing Report
On May 11, the National Academy of Medicine (NAM) released a comprehensive forward-looking survey on the evolution of nursing over the next decade, "The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity." Nursing in the next 10 years will demand a larger, more diversified workforce prepared to provide care in different settings to address the lasting effects of COVID-19, to break down structural racism and the root causes of poor health, and respond to future public health emergencies, says a new report from the National Academy of Medicine. By 2022, all state and federal policy changes in response to the COVID-19 pandemic that expanded the scope of practice should be made permanent, along with telehealth eligibility, insurance coverage, and equal payment for services provided by nurses says the report. Local, state, and federal governments should also prioritize funding and deployment of more school and public health nurses.

CMS to Require Nursing Home Vaccine Reporting
The CMS announced a new interim final rule on May 11 that will require long-term care facilities, including nursing homes and intermediate care facilities for individuals with intellectual disabilities (ICFs-IIDs), to report weekly COVID-19 vaccination data of both residents and staff to the CDC National Healthcare Safety Network (NHSN). Nursing homes are already required to report COVID-19 testing, case, and mortality data to NHSN for staff and residents. The interim final rule is intended to help monitor vaccine uptake and identify facilities in need of additional resources; early results from a CDC study of nursing home operators found that average vaccine uptake among staff has lagged that of residents. "Consistent vaccination reporting by LTC facilities via the NHSN will help to identify LTC facilities that have potential issues with vaccine confidence or slow uptake among either residents or staff or both," the CMS wrote. The agency also noted that because of high staff turnover at long-term care sites, COVID-19 vaccination will be an ongoing issue for skilled nursing facilities.

Care Organizations Support The Resetting the IMPACT Act (TRIA) of 2021
A group of post-acute care trade organizations including the American Health Care Association, American Medical Rehabilitation Providers Association, LeadingAge, National Association for Home Care & Hospice, and National Association of Long Term Hospitals have united in support of H.R.2455, a bill that would reset the statutory implementation timeline for the CMS to develop a unified post-acute care payment system. According to the 2014 statute, CMS must use at least two years of patient and quality measure data to inform the development of the new payment system, and the agency is currently planning to use data from 2017 through 2019 to develop its prototype payment model. However, the group says that a CMS changeover to new payment systems for most post-acute care providers since 2017 suggests the data the agency is relying on to create the payment prototype are outdated and do not reflect provider experiences during the COVID-19 public health emergency.

Advocacy 101: Effective Rehab Nurse Advocacy
Join ARN health policy expert, Jeremy Scott, on May 27 at 12 pm CT and learn how to make your voice heard at the federal level by engaging with Congress and the Administration. This webinar will provide an overview of the key issues on the ARN health policy agenda in 2021 to advance the rehabilitation nursing profession. ARN's new advocacy platform, Congress Plus, will be introduced. Scott will also provide a summary of the health care priorities expected to advance in the 117^th Congress and under the Biden Administration. Learn more.

If you haven't already, we recommend that you visit ARN's COVID-19 Resource page for the latest information and resources for rehabilitation nurses.

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