The arrival of the COVID-19 pandemic in early 2020 enabled telehealth to begin to play a more prominent role in dealing with this disease in ways that have affected both patients and caregivers significantly. This technology initially appeared in the 1960s and over time it gradually had a positive impact on the delivery of health care services in remote settings. More recently, COVID served as a prompt for the Centers for Medicare & Medicaid Services (CMS) to allow broader use of Medicare telehealth services. The declaration of a public health emergency made it possible under the National Emergencies Act to issue waivers and modifications under section 1135 of the Social Security Act affecting Medicare, Medicaid, and the Health Insurance Portability and Accountability Act (HIPAA). The Coronavirus Preparedness and Response Supplemental Appropriations Act on March 6, 2020 enabled the waiver of Medicare restrictions and requirements for telehealth services, which expanded outpatient telehealth reimbursement and access to services for Medicare fee-for-service beneficiaries.
Apart from funding provisions, the approval by Congress of the Consolidated Appropriations Act, 2022 (H.R. 2471) includes an extension of several Medicare telehealth waiver authorities. Examples are the expansion of originating sites and eligible practitioners, along with extending telehealth services to Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs). A temporary measure will allow employers to resume covering telehealth for employees with health savings accounts (HSAs) before annual deductibles are met. That kind of flexibility went into effect as a result of previous legislation, which expired at the end of 2021. The new provision will apply from April 1 to the end of 2022.
Advanced Research Projects Authority For Health (ARPA-H)
Senate Health, Education, Labor, and Pensions (HELP) Committee Chair, Senator Patty Murray (D-WA), and Ranking Member, Senator Richard Burr (R-NC), introduced the ARPA-H Act on March 10, 2022 to establish the Advanced Research Projects Authority for Health (ARPA-H), which would be housed in the National Institutes of Health and support cutting-edge, high-reward biomedical research. This new agency, originally proposed in President Biden’s fiscal year 2022 budget, and funded in the amount of $1 billion in the omnibus spending bill, would focus on transforming and advancing areas of biomedicine that cannot be accomplished readily through traditional research or commercial activity, and also developing transformative technologies in an effort to improve the prevention, diagnosis, mitigation, treatment, and cure of health conditions. The aim is to create an environment that remains concentrated on emerging new technologies and can help accelerate the development of those it deems most beneficial to advancing biomedicine and improving health. By working as an independent entity within the structure of the NIH, ARPA-H will have the ability to identify and invest in the best new ideas and technologies coming from the private sector and academia. The legislation would authorize such sums as may be necessary to carry out ARPA-H for each of fiscal years 2023 through 2027, and clarifies that the ARPA-H budget request must be separate from NIH budget requests.
Centers For Medicare & Medicaid Services (CMS) Recent Track Record
Since the start of 2021, CMS has been successful in expanding health care coverage to a record 14.5 million individuals through the Health Insurance Marketplaces. States around the nation were encouraged to extend Medicaid coverage for a full 12 months after childbirth. Access to home and community-based services for seniors and persons with disabilities also has increased. A new set of reforms, developed by and implemented through the Department of Health and Human Services (HHS), aims to improve the safety and quality of nursing home care, hold these facilities accountable for the care they provide, and make the quality of care and facility ownership more transparent so that potential residents and their loved ones can make informed decisions about care. Related initiatives entail having every nursing home provide a sufficient number of staff who are adequately trained to provide high quality care. CMS presently is striving to address provider shortages in Medicaid by building a larger and more diverse workforce that will ensure patients can obtain needed mental health services they need. A major objective is to achieve a dramatic expansion in the supply, diversity, and cultural competency of the mental health and substance use disorder workforce, from psychiatrists to psychologists, peers to paraprofessionals, and increase both opportunity and incentive for them to practice in areas of highest need.