Blogs

Biden Administration Vaccine Mandates Include Health Center Staff

On Thursday afternoon, President Biden announced a sweeping six-pronged strategy to respond to the on-going COVID-19 pandemic.  The first prong entails imposing vaccine mandates in most workplaces – including health care settings such as community health centers (CHCs). The workplace mandates fall into three categories:  

• Workers in health care settings:
  • The requirement that all staff be vaccinated will go into effect sometime in October, when CMS issues an Interim Final Rule.  However, CMS has stated that “Facilities across the country should make efforts now to get health care staff vaccinated to make sure they are in compliance when the rule takes effect.”
  • Per the White House announcement, the mandate will apply to “clinical staff, individuals providing services under arrangements, volunteers, and staff who are not involved in direct patient, resident, or client care.” 
  • See below for more information about how this general requirement applies specifically to CHCs.
• Federal employees and contractors:  All federal employees and contractors will now be required to be vaccinated against COVID-19.  Until now, federal workers had the option of being tested regularly instead of getting vaccinated.
• Other workplaces with over 100 employees:  OSHA will soon publish a new Emergency Temporary Standard (ETS) requiring all employers with over 100 employees to ensure that all workers are either vaccinated or produce a negative test result on at least a weekly basis before coming to work.  (Note that weekly testing will not be an option for workers in health care settings or the Federal government.)  Businesses that ignore the mandate could face fines up to $14,000 per violation.

 Key points health centers should know about the impending the federal vaccine mandate:

• Health centers are explicitly listed as being subject to the vaccine mandate. (See the CMS announcement, which links to a list of list of facilities to which the mandate applies.)
• The mandate will apply to all health center employees, contractors, and volunteers – including those who have no direct contact with patients. 
• Individuals will not have the option to take weekly tests instead of getting vaccinated.
• While the mandate will be not become effective until sometime in October, CMS has stated that health care providers “should make efforts now to get health care staff vaccinated to make sure they are in compliance when the rule takes effect.”
• While no details have been provided yet, it is expected that staff will be eligible for medical or religious exemptions from the vaccine mandate.
• All employers must provide staff with paid time off to receive and recover from the vaccine.

Health Centers to Receive Millions of Free At-Home COVID Testing Kits

As part of the updated COVID strategy, the federal government will soon send 25 million free at-home rapid tests to health centers and food banks. At this time, there are no details on when shipments will arrive, how many each health center will receive, etc. Other new White House strategies to expands access to affordable rapid tests include:

• Invoking the Defense Production Act to spur the manufacture of more rapid coronavirus tests
• Getting Kroger, Walmart and Amazon to sell these tests at cost for a limited time.

 

Medicaid Expansion Enrollees Need to Select PCP

On September 7, the Oklahoma Health Care Authority (OHC) rule regarding Expansion Adults into SoonerCare Choice was signed and certified by the Governor. Members may pre-select a primary care provider (PCP) before October 1 by calling the SoonerCare Helpline at 1-800-987-7767. Members may find CHOICE providers by using the Provider Directory. After October 1, selections through the Soonercare helpline will be processed immediately based on the provider's age availability, and any selections made through agency view and or home view will continue to be processed overnight. Completed PCP action forms for Expansion Adult members will be held and processed after October 1, 2021. OHCA will be taking steps to align those adult members back to their previous PCMH/ PCP they had before transitioned to Expansion or to the family PCMH/PCP if that provider provides care to adults.

If your health center has questions or would like assistance with patient outreach to ensure recently enrolled Expansion adults select the health center as their PCP, contact Cassidy at cheit@okpca.org.

House Infrastructure Bill Includes Health Center Funding

The House of Representatives has included $10 billion for health center infrastructure (renovated, expanded, new facilities) and $6.3 billion for primary care workforce programs in the infrastructure bill. The bill is expected to be voted along party lines, but advocates can share their stories on social media and tag Democratic leadership in the House. Sample messages are available here.

Medicare Physician Fee Schedule Comment Templates

The Centers for Medicare and Medicaid Services is seeking comments on proposed changes to the Medicare Physician Fee Schedule. Comments must be submitted here by September 13 at 10:59 PM. The National Association of Community Health Centers (NACHC) has prepared a Medicare Physician Fee Schedule CY22 template comment letter. Below is a summary of the comments:

• CMS should amend the FQHC cost report and instructions to ensure FQHCs receive Medicare reimbursement at 100% of the reasonable costs for the COVID-19 vaccine and its administration, Monoclonal antibodies infusion, and Medicare Advantage enrollees’ vaccine administration.
• We encourage CMS to increase COVID-19 vaccine administration reimbursement for mass vaccination events that occur outside of the health center, to effectively reach vulnerable and underserved communities. 
• CMS should use its regulatory authority to permit FQHCs to provide remote services by revising the definition of medical and mental health FQHC visits to include services furnished using interactive, real-time, audio and video telecommunications, or audio-only interactions under defined circumstances.
• We encourage CMS to provide maximum flexibility for health centers implementing in-person service requirements for patients receiving virtual mental health services.
• CMS should use its authority to align FQHC patient choice with other Medicare beneficiaries by permitting patients to change their attending FQHC provider after they have made their initial election to receive hospice benefits.

Click here to download the template comment letter.