Policy Round Up: Updated CDC guidance on boosters, fact sheet on insurance coverage of tests, input needed, and more

February 15, 2022
Vicki Gottlich, Director - Center for Policy and Evaluation

In this issue:

  • COVID-19 Updates:

    • New vaccination guidance for people who are immunocompromised

    • ICYMI:  HHS guidance for health care providers on civil rights protections for people with disabilities

    • ACL Fact Sheet: Insurance coverage for at-home COVID-19 tests

    • Coming soon:  Medicare coverage for at-home COVID-19 tests

    • CMS’ Updated toolkit for coverage and reimbursement of COVID-19 vaccines, vaccine administration and cost sharing under Medicaid, the Children’s Health Insurance Program, and the Basic Health Program

  • Input needed:

    • CMS Releases 2023 Medicare Advantage and Part D Advance Notice

    • Framework for the NIH-Wide Strategic Plan for Diversity, Equity, Inclusion, and Accessibility

Updated CDC vaccination guidance for people who are immunocompromised

CDC has updated its guidance for extra doses and boosters of the COVID-19 vaccine for people who are moderately or severely immunocompromised – boosters are now recommended three months after completing the primary series of mRNA vaccines and two months after completing the initial series of the J&J/Janssen vaccine, and additional doses are now also recommended for people who got the J&J/Janssen vaccine initially. When to get your additional doses and boosters, and which vaccine you should receive, depends on what you got initially.

If you are moderately or severely immunocompromised and:

  • You got two shots of the Pfizer-BioNTech vaccine:
    • You should get a third shot of Pfizer-BioNTech, at least four (4) weeks after the second
    • If you are 12 or older, you also should get a fourth shot of the Pfizer-BioNTech, at least three (3) months after your third shot.
  • You got two shots of the Moderna vaccine:
    • You should get a third shot of Moderna, at least four (4) weeks after the second
    • You also should get a fourth shot of the Moderna vaccine, at least  three (3) months after your third shot.
  • You got one shot of the J&J/Janssen vaccine:
    • You should get a second shot using either Pfizer-BioNTech or Moderna, at least four (4) weeks after your first shot
    • You also should get a third shot, using the same vaccine you got for your second, at least two (2) months after the second shot.  

ICYMI:  HHS’ New Guidance for Health Care Providers on Civil Rights Protections for People with Disabilities

On Feb. 4, the HHS Office for Civil Rights (OCR) issued guidance for health care providers on civil rights protections for people with disabilities under Section 504 of the Rehabilitation Act and Section 1557 of the Affordable Care Act. ACL collaborated with OCR on a number of topics included in the guidance, which addresses providers’ obligations to ensure people with disabilities are not discriminated against in accessing the healthcare they need during the continuing COVID-19 public health emergency.

This guidance responds to many of the concerns raised by disability and aging organizations throughout this pandemic, covering topics including:

  • How civil rights laws prohibit discrimination against people with disabilities in accessing scarce healthcare during emergencies, including Crisis Standards of Care (CSCs)
  • Our networks filed complaints with OCR about CSCs, including several that were resolved by OCR.
  • Reasonable modifications to visitation policies, including in hospitals and long-term care settings
  • Our networks also filed complaints with OCR about visitation policies, including at least one that was resolved by OCR.
  • Accessibility of vaccination, testing and contact-tracing programs.

New ACL Fact Sheet:  Insurance coverage of at-home COVID-19 tests

Along with vaccinations and sensible individual measures such as wearing masks, maintaining physical distance, and hand-washing, at-home COVID-19 tests are an important tool for stopping the spread of the virus. There now are several no-cost ways to get tested and to obtain at-home test kits to have on hand in case they’re needed. For people who need to purchase additional tests, health insurance may cover the cost (and assistance may be available for those who do not have insurance). We’ve pulled together the basic details in this fact sheet.

Coming soon: Medicare coverage of at-home COVID-19 tests

On February 3, the Centers for Medicare & Medicaid (CMS) announced a groundbreaking new program to allow Medicare beneficiaries to get up to eight at-home COVID-19 test kits at no cost to them. The program will launch early this spring and will provide critical support to help slow the spread of COVID-19 among older people and people with disabilities, who face higher risks from COVID. This program is one of the things included in our new fact sheet

Updates to CMS’ COVID-19 toolkit for Medicaid, CHIP and the Basic Health Program

Today (Feb. 14), CMS released updates to the toolkit on coverage and reimbursement of COVID-19 vaccines, vaccine administration, and cost sharing under Medicaid, the Children’s Health Insurance Program, and the Basic Health Program. These updates include information on the Food and Drug Administration and Centers for Disease Control and Prevention’s COVID-19 vaccine authorizations and recommendations, as well as updated information on current Public Readiness and Emergency Preparedness (PREP) Act amendments.

Input needed: CMS’ 2023 Medicare Advantage and Part D Advance Notice

The Centers for Medicare & Medicaid Services (CMS) is seeking input on proposed changes to its payment policies, particularly provisions intended to advance health equity, for Medicare Advantage and Part D drug programs. Changes would take effect in 2023.  Comments can be submitted online until March 4 at 6:00 PM (Eastern), and CMS will finalize the changes by April 4.

This CMS fact sheet summarizes the proposed changes. Changes that are of particular importance to ACL’s networks and about which the networks may want to comment include: 

  • The development of a health equity index to enhance Star Ratings of Medicare Advantage and Part D plans, which would include data on disability, beneficiaries receiving low-income subsidies that assist with Part D premiums and cost-sharing, and the dual eligible population;
  • Whether enhancements can be made to the CMS-HCC risk adjustment model (which adjusts payments based on populations enrolled in a plan) to address the impacts of social determinants of health on beneficiary health status, including what data CMS should focus on collecting and how data collection could be improved;
  • Whether a new measure related to COVID-19 vaccinations would be useful or feasible;
  • Changes to medication adherence measures to account for sociodemographic status, including age, gender, dual eligibility/low-income subsidy (LIS) status, and disability status;
  • Whether to include an additional measure addressing marketing misrepresentation complaints; and
  • The development of a measure that would ensure plans are screening enrollees for unmet food, housing and transportation needs.

Input needed:  NIH invites comments and suggestions on a framework for the NIH-Wide Strategic Plan for Diversity, Equity, Inclusion, and Accessibility

The National Institutes of Health (NIH) s published a request for information on its framework for the NIH-Wide Strategic Plan for Diversity, Equity, Inclusion, and Accessibility (DEIA). The plan will include activities NIH will undertake with the goal of embracing, integrating, and strengthening DEIA throughout the agency. Comments on the framework can be submitted online until April 3.

NIH seeks comments regarding the priorities outlined in the framework’s three main objectives, along with other priority areas for consideration. The framework’s three main objectives are:

  • Implement Organizational Practices to Center and Prioritize DEIA in the Workforce
  • Grow and Sustain DEIA through Structural and Cultural Change
  • Advance DEIA Through Research

 


Last modified on 02/15/2022


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