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U.S. Sen. Manchin Kills Hope for Broad Reconciliation Bill But Supports Drug Pricing Provisions
Last week, Sen. Joe Manchin (D-WV) told Senate leadership that he will only support a narrow budget reconciliation package before Labor Day if it does not include new spending to fight climate change or taxes on wealthy individuals or corporations, saying the only provisions he is willing to support are those to lower prescription drug prices and a two-year extension of higher ACA subsidies enacted under the American Rescue Plan. It is not clear whether a package may include closing the coverage gap for states that have not expanded Medicaid.
FY23 U.S. Appropriations Update: House Moving Forward, Senate Outlook Much Murkier
The FY23 appropriations process is moving forward in the House. The Appropriations Committee passed each of its 12 FY2023 appropriations bills last month, and Committee Chairwoman hopes to get all 12 bills through the House floor by the end of the month. The FY23 Labor-HHS bill is expected to go to the House floor during the final week of July.
On the Senate side, negotiations between Democrats and Republicans over top-line numbers stalled last month, and no committee mark-up schedule has been announced yet. It is unlikely that the Senate will make significant progress on FY23 Appropriations until November.
Annual Physician Fee Schedule Includes Dental, Hearing, and ACO Expansions But No Long-Term FQHC Medicare Telehealth Fix
After last year’s Physician Fee Schedule rule allowed FQHCs to be reimbursed by Medicare on a permanent basis at PPS for behavioral health visits provided via telehealth, FQHCs were disappointed by CMS’ recently published proposed CY2023 PFS regulation for not doing the same for medical services provided via telehealth. Given that CMS did not include this proposal, FQHCs’ ability to be reimbursed for medical telehealth visits will now end 152 days after the COVID Public Health Emergency ends unless Congress intervenes before then.
On a brighter note, the proposed rule offers several provisions that will benefit FQHC patients. These include:
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An expansion in the list of dental services that are considered “medically necessary” and therefore covered by Medicare.
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Allowing patients to see an audiologist once a year without receiving an order from a doctor or NPP.
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Health equity incentives for ACOs.
Bipartisan 340B Letter Delivered with 181 House Rep. Signatures
In a letter sent to HHS Secretary Xavier Becerra, Rep. Spanberger (VA-7) and 180 additional U.S. House Representatives - including Reps. Adams (NC-12), Butterfield (NC-1), and Manning (NC-6) from N.C. - called on HHS to penalize drug manufacturers that refuse to comply with their 340B obligations under law.
“We urge the Department of Health and Human Services (HHS) and its Office of the Inspector General (OIG) to use current statutory authority to impose civil monetary penalties against all drug manufacturers who have unlawfully overcharged safety net health care providers,” said Spanberger and her colleagues.
Additionally, they emphasized how recent changes have negatively impacted patients, pharmacists, and healthcare providers across the country.
Annual Essential Community Provider (ECP) Petitions Submission
Deadline: August 17th for inclusion in the final Plan Year 2024 ECP List.
The Essential Community Provider petition submission is an annual process that works prospectively. HHS updates this ECP list annually to assist issuers with identifying providers that qualify for inclusion in an issuer's plan network toward satisfaction of the ECP standard under 45 CFR 156.235.
Per CMS, “For ongoing provider updates, the ECP petition process remains open year-round. Provider petitions submitted between August 19, 2021, and August 17, 2022, will be reviewed for inclusion on the final Plan Year 2024 ECP List. Provider petitions submitted after August 17, 2022, will be reviewed for inclusion on the final Plan Year 2025 ECP List.
Click here to download a detailed memo with important reminders and instructions.
Click here to visit the CMS website to view all sites currently associated with your organization and submit a petition for each of your facilities. All FQHCs should submit a petition for each of their facilities even if they do not see errors or omissions that require correction.
Questions? Contact Chaundra Cureton, Member Management Specialist, curetonc@ncchca.org.
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Please finalize your NHCW event plans this week and 
2021 UDS data will be released on August 8, via the BPHC UDS webpage. There will be a webinar on August 9 from 1:00-2:00 p.m. to review trends; 
Building Bridges to Better Health is a national competition with a total of $1 million in cash prizes to encourage innovation through technical assistance to health centers. Competition participants will accelerate the development of low-cost, scalable solutions to help HRSA-supported community health centers improve patient access to primary care and strengthen the link between health care and social services.
As most of you already know, HPET (Health Professions Education and Training) Plans have been a core focus of the NCCHCA Workforce Workgroup this year, and much of last. As we move towards finalizing drafts, here are some resources to support you:
