Policy Round-Up: COVID updates, No Surprises Act info, and 3 things that need your input

January 31, 2022

Our first Policy Roundup for 2022 includes:

  • COVID-19 updates:
    • EEOC: When COVID-19 may be considered a disability
    • DOJ: COVID-19 and the ADA
  • Input needed:
    • CMS: Coverage of monoclonal antibodies in Alzheimer’s research (due 4/11)
    • CMS proposed rule change: Medicare Advantage and prescription drug plans (due 3/7)
    • White House RFI: Strengthening community health through technology (due 2/28)
  • CMS fact sheet: No Surprises Act 

COVID-19 Updates 

EEOC: When COVID-19 may be considered a disability; impact on employment

The Equal Employment Opportunity Commission (EEOC) has added a new section to its COVID-19-related technical assistance to clarify when COVID-19 may be considered a disability and what that means for employers, employees, and job applicants. 

This new addition provides examples to illustrate when COVID-19 or disabilities arising from conditions that were caused or worsened by COVID-19 may meet the definition of disability under Title I of the Americans with Disabilities Act (ADA) or Section 501 of the Rehabilitation Act, which the EEOC enforces, and when employees or job applicants may be entitled to reasonable accommodations at work as a result. It also addresses nondiscrimination protections provided to employees and job applicants under the ADA and the Rehabilitation Act and clarifies that certain ADA protections apply to all job applicants and employees, regardless of whether they have a disability.

This update follows the “Guidance on ‘Long COVID’ as a Disability Under the ADA, Section 504, and Section 1557”, issued in July by the Department of Justice (DOJ) and the Department of Health and Human Services (HHS). That guidance focused on long COVID and did not address disability concerns related to employment.

DOJ Guidance on visitation in medical facilities and accessibility of outdoor retail/dining

On January 5, the Department of Justice updated its “Common Questions About COVID and the ADA” to address visitation in medical facilities and accessibility of outdoor dining and retail spaces. 

The guidance clarifies that the ADA requires medical facilities to allow visitors if they are needed to ensure equal access to care for people with disabilities and provides examples of situations to which this requirement may apply. It also clarifies that outdoor retail and dining spaces (sometimes called “streateries”) must be accessible to people with disabilities and provides examples of how those establishments and local governments can ensure accessibility. 

CDC Updates Consumer Mask Webpage

The Centers for Disease Control and Prevention (CDC) has updated its webpage describing the types of masks and respirators used to prevent transmission of COVID-19 to help people determine which options are best for them. The updated page lays out the protection provided by available masks and respirators, noting that some types of masks and respirators provide better protection than others. 

Input needed

CMS Proposes to Add Beneficiary Protections to Medicare Advantage and Prescription Drug Plan Rules

The Centers for Medicare & Medicaid Services (CMS) has published a proposed rule to lower out-of-pocket Medicare Part D prescription drug costs and improve consumer protections, reduce disparities, and improve health equity in MA and Part D programs. A fact sheet summarizing the proposed changes is available here. Comments can be submitted by mail or online until March 7.

The rule includes several provisions important to ACL’s networks. For example, it would: 

  • Revise marketing and communications requirements to help ensure that beneficiaries get accurate and accessible information about Medicare coverage;
  • Reduce beneficiary cost-sharing for prescription drugs by redefining how the cost of a drug is determined;
  • Revise regulations for dual-eligible special needs plans (D-SNPs), and in some cases other special needs plans, related to enrollee advisory committees, health risk assessments, and ways to improve integration of Medicare and Medicaid;
  • Revise criteria used to review applications for new or expanded MA and Part D plans;
  • Revise quality ratings for MA and Part D plans;
  • Revise provider network adequacy requirements; and
  • Revise timeframes and standards for MA programs associated with disasters and emergencies.

CMS: Proposed coverage of monoclonal antibodies directed against amyloid for Alzheimer’s patients enrolled in approved trials  

CMS has released a proposal to cover monoclonal antibodies directed against amyloid for the treatment of Alzheimer’s disease for Medicare beneficiaries who have mild cognitive impairment due to Alzheimer’s or mild Alzheimer’s dementia and who are enrolled in approved medical trials. 

The memo lays out the criteria for CMS-approved trials, which must include a diverse group of participants that are representative of the Medicare population. Comments surrounding the criteria for approving trials, particularly around ensuring diversity, are encouraged.

Comments can be submitted until February 10. CMS expects to issue a final decision regarding coverage on or before April 11.

White House seeks input on strengthening community health through technology

The White House Office of Science and Technology Policy (OSTP) has published a request for information (RFI) soliciting information on how digital health technologies are used, or could be used in the future, to transform community health, individual wellness, and health equity. Comments are due by 5:00 PM ET on February 28 and can be submitted via email to connectedhealth@ostp.eop.gov or via phone at 202-456-3030. 

The RFI specifically requests input on several areas of interest to ACL’s networks, including:

  • Barriers to the use of digital health technologies in community-based settings faced by individuals or organizations;
  • How the use of digital health technologies (including telemedicine) has changed during the pandemic;
  • How digital health technologies could be better designed with the user experience in mind;
  • How digital health technologies have been used, or could be used, in community-based settings to drive towards a reduction in health disparities or achieving health equity; and
  • Opportunities for the federal government to support the transformation of community health settings through the uptake of innovative digital health technologies and telemedicine at the community level.

CMS Fact Sheet: No Surprises Act

On January 1, the No Surprises Act went into effect, establishing protections against surprise billing and excessive cost-sharing for people who are covered by commercial health plans. CMS has published this fact sheet and updated this webpage to help people understand these protections. 

As we have discussed previously, Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, and TRICARE already provide protections against surprise billing and excessive cost-sharing. Now, people with commercial health plans will also be protected from surprise bills for most emergency care and many instances of non-emergency care. The bill also ensures that no one can be charged for out-of-network costs without notice. That notice must be accessible to people with disabilities and people with limited English proficiency. The No Surprises Act also establishes important protections for uninsured or self-paying patients, including requiring most providers to give a “good faith estimate” of costs before providing non-emergency care.

Last modified on 02/01/2022

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