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Policy Round Up: CDC vaccine guidance, NIH input needed, new CMS data, and more

May 3, 2023
Vicki Gottlich, Deputy Administrator for Policy and Evaluation

In this policy round up:

  • CDC now allows additional COVID-19 shots for older adults and immunocompromised adults
  • Input needed: NIH Office of Disease Prevention Strategic Plan
  • Ownership Data for All Medicare-Certified Hospice and Home Health Agencies Now Publicly Available
  • Update on ACA Preventive Care Litigation (Braidwood v. Becerra)
  • Settlement Agreement Extends Appeal Period for SSI Recipients
  • New Surgeon General’s Advisory on Loneliness and Isolation
  • ICYMI: Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers

CDC now allows additional COVID-19 shots for older adults and immunocompromised adults

Because the protection provided by the COVID-19 vaccine fades much more quickly for people 65 and older and people who are immunocompromised, the Centers for Disease Control and Prevention (CDC) updated its COVID-19 vaccine recommendations to allow an additional an dose of the updated (bivalent) vaccine for these populations.

CDC also simplified its vaccination recommendations for everyone else. Everyone six and older should to get one shot of the updated bivalent vaccine, regardless of whether they completed the original vaccination series.

Not sure if you need one?

  • No matter how older you are, if you have not gotten a shot since September, you definitely need one!
  • If you are 65 or older or if you are moderately or severely immunocompromised, it may be a good idea for you to get an extra dose of the bivalent vaccine. Talk to your healthcare provider or pharmacist to decide whether it makes sense for you.

Getting vaccinated and staying up to date continues to be the best way to prevent serious illness and death due to COVID-19. CDC’s website has more details on current recommendations.

Input needed: NIH Office of Disease Prevention Strategic Plan

The National Institutes of Health (NIH) Office of Disease Prevention (ODP) is seeking comments on its Strategic Plan for Fiscal Years 2024–2028. ODP works to develop, coordinate, and implement prevention research. Feedback can be submitted online until May 22.

The office is seeking feedback on the priorities it has outlined in its draft plan, including these two, which are particularly important to ACL’s networks:

  • To promote and coordinate prevention research that addresses health disparities; and
  • To improve the availability and visibility of information about prevention research, inform diverse audiences about the scope and impact of disease prevention research, and engage with ODP’s partners to enhance and support ODP’s mission.

ODP also seeks any additional feedback that could help ODP accelerate prevention research.

Ownership Data for All Medicare-Certified Hospice and Home Health Agencies Now Publicly Available

Detailed information about the ownership of all Medicare-certified hospice and home health agencies is now available on the Centers for Medicare & Medicaid Services (CMS) website. This information will help patients and their loved ones make more informed decisions about their care.

Publication of this information builds on prior CMS efforts to increase transparency.

  • In April 2022, CMS released data  on mergers, acquisitions, consolidations, and changes of ownership from 2016-2022 for hospitals and nursing homes enrolled in Medicare.
  • In September 2022, CMS released additional data on the ownership of approximately 15,000 nursing homes certified as a Medicare Skilled Nursing Facility, including providing more detailed information about organizational owners of nursing homes.
  • In December, CMS released detailed information on the ownership of more than 7,000 hospitals certified to participate in the Medicare program.

Update on ACA Preventive Care Litigation (Braidwood v. Becerra)

The Biden-Harris Administration is seeking a stay to prevent a recent ruling in the Braidwood v. Becerra lawsuit from taking effect.

Braidwood v. Becerra is a lawsuit filed in 2020 that challenges the Affordable Care Act’s requirement for insurers to provide coverage for preventive care services. On March 30, the judge in that case ruled that health plans can’t be required to cover services the U.S. Preventive Services Task Force recommended or updated on or after March 23, 2010. The judge also ruled that health plans can’t be required to cover PrEP medications for HIV prevention.

The federal government is appealing this decision. A stay would prevent the ruling from being enforced while the case works its way through the courts.

If the ruling were to go into effect, any services recommended by the task force prior to March 23, 2010 would still be covered, as would vaccines recommended by the CDC’s Advisory Committee on Immunization Practices and women’s preventive services care recommended by the Health Resources and Services Administration. The ruling would, however, limit access to crucial preventive care, including cancer screenings, preventive medications, health counseling, and prenatal care.

Settlement Agreement Extends Appeal Period for SSI Recipients

Earlier this month, a settlement was reached in a case addressing the Social Security Administration’s appeals process.  Plaintiffs in the argued that the process causes low-income older adults and disabled people of all ages who receive Supplemental Security Income (SSI) to lose access to benefits. The settlement extends the appeal period, during which an SSI recipient can continue receiving benefits, from 10 days to 60 days. This ensures people don’t lose access to their benefits while they’re waiting for a decision on their appeal.

Justice in Aging put together a fact sheet on the settlement.

New Surgeon General’s Advisory on Loneliness and Isolation

This week, U.S. Surgeon General Dr. Vivek Murthy released a new advisory to warn the American public about loneliness, isolation, and disconnection. Loneliness and isolation are widespread, with approximately half of U.S. adults experiencing loneliness. The advisory notes that older adults and people with disabilities are among the populations with the highest prevalence of loneliness and isolation. Such disconnection can have profound effects on mental, physical, and societal health.

The advisory lays out a National Strategy to Advance Social Connection and includes recommendations that individuals, governments, workplaces, health systems, and community organizations can take to increase connection in their lives, communities, and across the country.

ICYMI: Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers

Earlier this month, President Biden signed the Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers. This Executive Order uses a broad definition of “care” that incorporates both high-quality long-term care provided both by workers and by family caregivers, as well as early care and education for children (together referred to simply as “care”) and provides support for workers and family caregivers. The Executive Order seeks to address barriers to accessing care as well as the underlying causes of direct care workforce crisis. 

This Executive Order creates new momentum for ACL’s work to strengthen the care infrastructure that helps people with disabilities and older adults live and fully participate in their communities, including our work leading the National Strategy to Support Family Caregivers and to strengthen and expand the direct care workforce, our partnership with the Veterans Health Administration on the Veteran-Directed Care program, and more.

This fact sheet was also released explaining describes the highlights from of the executive order and its importance.

The Executive Order will support family caregivers and the long-term care workforce and improve access to long-term care by:

  • Directing the Department of Health and Human Services (HHS) to consider rulemaking to improve access to home and community-based services (HCBS) under Medicaid, including taking steps to support provider participation in Medicaid HCBS programs.
  • Directing HHS to consider issuing several regulations and guidance to improve the quality of home care jobs. These include actions to:
    • Ensure there are enough home care workers to provide care to older adults and people with disabilities enrolled in Medicaid;
    • Build on the minimum staffing standards for nursing homes; and
    • Condition a portion of Medicare payments on how well a nursing home retains workers.
  • Directing federal agencies to identify which of their grant programs can support child-care and long-term care for individuals working on federal projects and consider requiring applicants seeking federal job-creating funds to expand access to care for their workers.
  • Improving access to home-based care for veterans who require support with activities of daily living, like bathing and getting dressed, by giving them more decision-making power over who delivers that care and when. The Department of Veterans Affairs (VA) will do this by expanding its Veteran Directed Care program, which provides veterans with a budget to hire for personal care assistance. The veteran can use this budget to select and hire caregivers, including from family members. The Executive Order also directs the VA to consider:
    • Piloting a new self-directed care program in no fewer than five new sites called a “Co-Employer Option” that provides veterans with a budget for personal care assistance while reducing administration burdens related to managing care by connecting veterans with a third-party agency that would help coordinate administrative tasks and act as an intermediary between veterans and their home health workers; and
    • Adding 75 new interdisciplinary teams to its Home-Based Primary Care program which provides in-home services to veterans. Those additional teams would allow the VA to serve an additional 5,600 veterans in their homes.
  • Directing the VA to consider expanding access to the Program of Comprehensive Assistance for Family Caregivers, which provides support for caregivers of veterans, and provide more mental health support for caregivers enrolled in that program.
  • Directing HHS to consider testing a new dementia care model that will include support for respite care (short-term help to give a primary family caregiver a break) and make it easier for family caregivers to access their family member’s Medicare information and provide more support during the hospital discharge planning process.

The Executive Order also recognizes the importance of stakeholder engagement in creating these solutions. Under the executive order, the Departments of the Treasury, Defense, Agriculture, Labor, Health and Human Services, Education, and Veterans Affairs must engage with stakeholders, including parents, guardians, and other relatives with care responsibilities; individuals receiving long-term care; state and local care experts; care providers and workers; employers; and labor unions in order to better support access to high quality care.


Last modified on 05/03/2023


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