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Policy Update 11/8/21

By Cassidy Heit posted 11-12-2021 17:32

  

Vaccine Mandate Rules Published

The Centers for Medicare and Medicaid Services (CMS) issued an emergency regulation last week requiring COVID-19 vaccines for health care workers. The Occupational Safety and Health Administration (OSHA) has also issued emergency guidance for federal workers, federal contractors, and anyone employed by a company with 100 or more employees.

Resources are available to help health centers comply with the CMS rule:

Importantly, the interim final rule requires that community health centers have a detailed set of policies and procedures relating to the federal vaccine mandate in place by December 6, 2021. Details of what must be addressed in the policies and procedures are laid out in the new regulatory language for health centers. Health center boards should approve of the policies. The rule also clarified that the mandate does not apply to CHC employees or contractors who exclusively provide telehealth or other services from outside of any CHC sites and never have direct contact with patients or other staff. The rule does apply, however, to volunteers including board members who set foot inside any health center site.

Upcoming deadlines:
  • By, December 6, 2021:
    • All staff must have:
      • received their first dose of the Pfizer or Moderna vaccine OR
      • received their only dose of the J&J vaccine OR
      • a temporary delay for medical reasons OR
      • requested a medical or religious exemption.  
    • Community health centers must have developed and implemented appropriate policies and procedures to comply with the vaccine mandate.  
  • By January 4, 2022:
    • All staff who got the Pfizer or Moderna vaccine must receive their second dose.
    • All unvaccinated staff must either:
      • have received approval for a medical or religious exemption, and be receiving accommodations that OR
      • have a CDC-supported reason for temporarily delaying getting a COVID vaccine.
    • Health centers must have implemented additional precautions to minimize the risk of transmission of COVID for accommodated individuals.
On 12:00 PM on Thursday, November 11, the National Association of Community Health Centers (NACHC) and Feldesman Tucker Leifer Fidell (FTLF) will be jointly hosting a webinar reviewing the vaccine mandate. Click here to register. If you cannot attend the event “live”, you can register to receive access to the recording directly from FTLF.
 

Policy & Advocacy

Infrastructure Bill Funding Passes House

The U.S. House of Representatives approved the scaled-back Infrastructure Investment and Jobs Act on Friday night, sending the $1.2 trillion infrastructure package to President Biden to sign. The bill, which passed with 13 Republicans voting in favor and 6 Democrats against, was approved 69-30 by the Senate in August. The "hard" infrastructure bill was passed without the social safety and health care funding it previously contained as conservative Democrats insisted on waiting for the larger package to be scored by the Congressional Budget Office. The larger Build Back Better Act contains many health care provisions and is expected to go to a vote the week of November 15.


CMS Issues Behavioral Health Telehealth Rule

The Centers for Medicare and Medicaid Services (CMS) issued a final rule that it says promotes wider use of telehealth in behavioral health. The CMS final rule on the Physician Fee Schedule for Medicare payments for calendar year 2022 eliminates restrictions on where patients can be when they seek mental health care via telehealth. Under the new final rule:
  • Medicare would allow for mental health telehealth visits to originate from within a patient’s home.
  • Geographic restrictions for mental health services offered via telehealth are eliminated.
  • Providers can do audio-only communications to diagnose and treat mental health disorders with established patients in their homes under certain circumstances—i.e., circumstances where a mental health provider could do a two-way video chat but the patient cannot use or refuses to consent to use the video chat system.
  • Providers are required to note that they were able to do an audio-only call but the patient wasn’t able to or didn’t want to use a video call.
  • The fact that mental health services include treatment for substance use disorder is clarified.
  • Medicare is permitted to pay rural health clinics (RHCs) and federally qualified health centers (FQHCs) for mental health services furnished via telehealth regardless of the public health emergency.
  • Similar rules about having patients come to an in-person appointment at least every 12 months apply to RHCs and FQHCs as well.
NACHC and OKPCA are reviewing the rule to evaluate whether other elements of it apply to health centers.
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