ARN Health Policy Digest – July 2021

We are pleased to present the July 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.

Joint Statement Supporting Vaccine Mandates for Health Care Workers
On July 23, ARN joined several health care organizations and societies to advocate that all health care and long-term care employers require their workers to receive the COVID-19 vaccine. ARN stands with the growing number of experts and institutions that support the requirement for universal vaccination of health workers. While we recognize some workers cannot be vaccinated because of identified medical reasons and should be exempted from a mandate, they constitute a small minority of all workers. Employers should consider any applicable state laws on a case-by-case basis. To learn more, read the statement and accompanying Washington Post article.

Fiscal Year 2022 Appropriations
The House Appropriations Committee voted 33-25 on July 15 to approve the fiscal year 2022 Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) funding bill. The Labor-HHS bill appropriates $253.8 billion, an increase of $55.2 billion (28 percent) above the fiscal year 2021 enacted level. Please see the chart for more details on individual agency appropriations. The full House of Representatives will vote on Labor-HHS funding next week as part of a larger government funding bill. The Senate Appropriations Committee has delayed consideration of Labor-HHS funding priorities until September.

CMS Updates Physician Fee Schedule
On July 13, the Centers for Medicare & Medicaid Services (CMS) released the proposed Medicare Physician Fee Schedule. Among other proposals, CMS proposes to recognize COVID-19 as a qualifying condition for pulmonary rehabilitation, in certain circumstances. The rule also proposes to extend telehealth flexibilities for certain services through the end of 2023, although telehealth waivers for many services will continue to lapse at the end of the COVID-19 public health emergency. Any comments on the proposed rule are due no later than 5:00 PM on September 13, 2021.

PCORI National Priorities for Health
The Patient Centered Outcomes Research Institute (PCORI) Board of Governors voted in June to release for public comment five proposed National Priorities for Health, a collection of broad principles intended to guide PCORI's research agenda development, stakeholder engagement, and scientific communications over the next decade. Developed in consultation with an array of health experts and policy advisors, the board's proposed priorities are: Increase Evidence for Existing Interventions and Emerging Innovations in Health; Enhance Infrastructure to Accelerate Patient-Centered Outcomes Research; Advance the Science of Dissemination, Implementation, and Health Communication; Achieve Health Equity; and Accelerate Progress Toward an Integrated Learning Health System.

After a 60-day public comment period from June 28 to August 27, PCORI will revise the proposed National Priorities for Health and expects to finalize them in Fall 2021. The PCORI Research Agenda is also expected to be available for public comment in Fall 2021.

Public Health Emergency Extended
On July 19, Secretary of Health and Human Services Xavier Becerra extended the COVID-19 public health emergency (PHE) for an additional 90 days. The public health emergency has been in effect since January 31, 2020. The extension of the public health emergency allows for the continuation of pandemic-related regulatory flexibilities, including telehealth waivers and certain state licensing requirements and conditions of participation. The extension of the public health emergency also permits the continued distribution of COVID-19 vaccines that have received emergency use authorization.

CDC Drafts "Long COVID" Guidance
The Centers for Disease Control and Prevention (CDC) released interim guidance on evaluating and treating patients for post-COVID-19 conditions, commonly known as "long COVID." The guidance outlines the wide range of symptoms experienced by patients after the acute phase of COVID-19 disease, the varying length of those symptoms from weeks to months post-infection, and strategies for healthcare providers to identify and manage symptoms to achieve the best possible patient outcomes. Stressing that such longer-term symptoms and clinical findings can occur even in patients who suffered only mild or asymptomatic illness, the CDC recommends providers follow up promptly with recovering COVID-19 patients and carefully assess any symptoms present after four weeks. The CDC also cautions that research into long-term COVID-19 physical and mental health consequences is still in its early stages, and clinical recommendations are likely to change as additional studies are completed.

ARN Submits Comments on Inpatient Rule
On June 28, 2021, ARN submitted comments to CMS on the 2022 Hospital Inpatient Prospective Payment System (IPPS) rule. ARN responded to a request for information within the IPPS rule on health equity. In that response, ARN emphasized that rehabilitation nurses play an integral role in reducing health disparities among Medicare beneficiaries and urged CMS to pursue discrete, targeted interventions that can deliver better outcomes for patients

ARN Submits Comments on Cures 2.0
On July 13, ARN provided comments to Congresswoman Diana DeGette and Congressman Fred Upton on the recently-released 21st Century Cures 2.0 draft legislation. Section 101 of Cures 2.0 proposes to convene a long-COVID learning collaborative to understand the impacts of long-COVID and how to best care for patients with this still poorly understood condition. ARN applauded the inclusion of this learning collaborative in the Cures 2.0 legislation and emphasized the importance of rehabilitation services, and rehabilitation nursing services specifically, in helping patients recover from long-COVID.

ARN Joins Coalition to Preserve Rehabilitation Letter on Post-Acute Payment System
ARN joined the Coalition to Preserve Rehabilitation in a response to the June 20201 Technical Expert Panel on a unified post-acute care prospective payment system (unified PAC PPS). The letter raised concerns about the timing of a PAC PPS, given the ongoing public health emergency; the viability of combining widely disparate patient populations and settings within a PAC PPS; and the potential of a PAC PPS to limit access to maintenance therapy.