Morning Briefing
Summaries of health policy coverage from major news organizations
CMS Does Not Have To Collect 2021 Data For Medicare Star Ratings: Judge
Three Medicare Advantage plans lost their fight to require CMS to collect data on patient care and satisfaction during the COVID-19 pandemic, with a federal judge ruling that the agency did not need to ask Congress before deciding to suspend collection. The U.S. District Court for the District of Columbia on Tuesday granted HHS' motion for summary judgment. The case stems from an April 2020 interim final rule that said CMS would rely on 2020 information with regard to the Healthcare Effectiveness Data and Information Set, or HEDIS, and the Consumer Assessment of Healthcare Providers and Systems, or CAHPS, when calculating Star ratings for the plans. The rule was made "because data collection was unsafe and would divert resources from patients" during the pandemic, according to the opinion. (Tepper, 6/3)
CMS' Center for Medicare and Medicaid Innovation could mandate more participation in its models, CMMI Director Liz Fowler said during a Health Affairs event on Thursday. The agency wants to ensure that its experiments prioritize patients' needs and support the transformation of the healthcare delivery system鈥攐bjectives consistent with the Biden administration's greater emphasis on improving health equity and quality. But they also signal that CMMI will fight against the entrenched interests of a healthcare industry under increasing pressure to change the way it does business. (Brady, 6/3)
In other Medicare news 鈥
Seniors in states that invested in their health systems enjoy a higher quality of overall care, a聽new聽50-state ranking聽shows. Researchers compared health care in 24 categories聽for Medicare recipients聽in聽all 50 states and Washington D.C.聽related to cost, quality and access. The data,聽taken from publicly available databases, was weighed equally against each other before being averaged out, giving each state an overall score.聽The analysis,聽conducted by insurance technology company MedicareGuide.com, ranked Minnesota first with North Dakota close behind. Massachusetts and California followed in the third and fourth spots. Nebraska ranked fifth, and Hawaii followed in sixth. (Avery, 6/3)
Throughout the pandemic, long-term care facilities have struggled to find staff. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL), which represents more than 14,000 long-term care providers, now calls the workforce shortage "a legitimate crisis." The problem is a nuanced one: Workers have left an industry that was hit hard by COVID-19 cases and deaths during the pandemic, seeking out higher paying and potentially less dangerous jobs. And employers have struggled to remain operational as volumes fell and costs rose, strapped by what they characterize as inadequate Medicaid reimbursement rates. Nursing homes lost nearly 19,000 jobs in April, the biggest loss in the healthcare sector, according to figures from the the U.S. Bureau of Labor Statistics. (Christ, 6/3)
And from state Medicaid programs 鈥
The U.S. is the only industrialized nation in which the maternal death rate has been rising. Each year, about 700 deaths are due to pregnancy, childbirth or subsequent complications, according to the Centers for Disease Control and Prevention. When someone dies while pregnant or within a year of childbirth in Illinois, that鈥檚 considered a maternal death. Karen Tabb Dina is a maternal health researcher at the University of Illinois at Urbana-Champaign who serves on a state-level committee that鈥檚 trying to figure out what鈥檚 killing these mothers. (Herman, 6/3)
The Louisiana Senate Finance Committee killed legislation Thursday that would have allowed people who were pregnant to stay on Medicaid for a year postpartum. The federal government would have had to sign off on the approval before it went into effect.聽Currently, people who use Medicaid during their pregnancy lose their health care coverage two months post-pregnancy 鈥 unless they qualify for Medicaid in another way. (O'Donoghue, 6/3)
State officials are dropping plans for a two-tier system to cover voter-approved Medicaid expansion in Nebraska. The Nebraska Department of Health and Human Services announced Tuesday that all Nebraskans covered by the expansion will get a full range of benefits starting Oct. 1, the Omaha World-Herald reported. The announcement is a change from the earlier plans of Gov. Pete Ricketts鈥 administration to offer a two-tier system that would include a 鈥渂asic鈥 plan covering physical and behavioral health care services and a 鈥減rime鈥 plan that would also cover dental, vision and over-the-counter drugs. (6/2)
The Oklahoma Supreme Court ruled Gov. Kevin Stitt鈥檚 plan to privatize much of the state鈥檚 Medicaid program is unconstitutional. In a 6-3 ruling Tuesday, the court determined the Oklahoma Health Care Authority did not have the legislative approval to move forward with the plan, dubbed SoonerSelect. (6/2)
The state鈥檚 first-ever Medicaid open enrollment period ended this month. Consumers and advocates say there may be challenges ahead. (Engel-Smith, 6/4)
A record number of Montanans are enrolled in the state鈥檚 Medicaid expansion program, which provides health insurance for low-income adults, according to the state health department. Nearly 99,000 people were being served by the program in April, which is 18,300 more than the nearly 80,500 enrolled a year earlier, according to state data. (6/3)
