House Passes Build Back Better Act
On Friday, the U.S. House of Representatives voted along mostly party lines to pass the Build Back Better Act, the $1.75 trillion "soft infrastructure" package containing funding for paid leave, child tax credits, insulin caps, and Medicare hearing coverage. The bill will now go to the Senate, which is expected to amend the legislation. That will require the House to take up and pass the bill again before sending it to President Biden. The timeline to finish the legislation may be pushed to the end of this year as more immediate issues fill up the legislative schedule, such as the December 3, 2021 deadline to fund the government (likely through another continuing resolution) and a mid-December deadline to raise the debt limit.
Legislators Wrap Up Special Session
Oklahoma legislators quickly met and passed legislation to revise the state's congressional, state House, and state Senate district maps based on 2020 census data. The maps go now to Governor Stitt for his approval. Once signed, they will take effect for the 2022 election cycle.
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New Medicare Telehealth Mental Health Coverage
Beginning Saturday, January 1, 2022, Federally Qualified Health Center (FQHC) mental health visits with Medicare beneficiaries can be furnished using interactive, real-time telecommunications technology. CMS formalized this regulatory change through the Calendar Year 2022 Medicare Physician Fee Schedule final rule. It is not tied to the COVID-19 public health emergency and is permanent in the absence of further regulatory action. In the same way they currently do when visits take place in-person, health centers will be allowed to report and receive payment for mental health visits furnished via real-time telecommunication technology including audio-only visits when the beneficiary is not capable of, or does not consent to, the use of video technology.
An in-person, non-telehealth visit must be furnished at least every 12 months for these services; however, exceptions to the in-person visit requirement may be made based on beneficiary circumstances. Health centers will be reimbursed 80% of the lesser of their actual charges or the Prospective Payment System rate when these services are furnished to a Medicare beneficiary through telecommunication technology, including audio-only.
Additionally, beginning Saturday, January 1, 2022, FQHCs must add Modifier 95 (Synchronous Telemedicine Service Rendered via Real-Time Interactive Audio and Video Telecommunications System) to claims for mental health visits furnished via audio-video telecommunications and must add Modifier FQ (service provided using audio-only communication technology) to claims for mental health visits furnished via audio-only telecommunications.
Resources to Comply with the Vaccine Mandate
The Centers for Medicare and Medicaid Services (CMS) issued an emergency regulation earlier this month 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.