Neonatal Abstinence Syndrome Bill Sent to President
On Nov. 16, the Protecting Our Infants Act passed the House paving the way for the President's signature. This bill would require the Agency for Healthcare Research and Quality (AHRQ) to report on prenatal opioid abuse and neonatal abstinence syndrome (NAS); require the U.S. Department of Health and Human Services (HHS) to review its activities related to prenatal opioid use and NAS and develop a strategy to address gaps in research and programs; and require the Centers for Disease Control and Prevention (CDC) to provide technical assistance to states to improve neonatal abstinence syndrome surveillance and make surveillance data publicly available.
Congressional Caucus on Maternity Care Formed
A new bipartisan Congressional Caucus on Maternity Care was recently formed in the House of Representatives. Spearheaded by Reps. Jaime Herrera Beutler (R-WA) and Lucille Roybal-Allard (D-CA), the Caucus seeks to raise awareness about important and timely maternity care-related issues, and highlight challenges facing America's maternity care system. AMCHP staff members were invited to meet with the lead staff for the new caucus to discuss maternal health priority areas and look forward to opportunities to collaborate with the caucus in the future.
Health Reform Implementation
CMS to Grant $32 Million to Connect Kids to Coverage
The Centers for Medicare & Medicaid Services (CMS) announced $32 million in available funds to support state efforts to help eligible children sign-up for health coverage under Medicaid and the Children's Health Insurance Program (CHIP) and help them stay covered for as long as they qualify. Awardees will conduct activities aimed at alerting families to the availability of free or low-cost health coverage under Medicaid and CHIP, identifying children likely to be eligible, and assisting families with the application and renewal process. Click here for information on how to apply.
CMS Issues New Network Adequacy Regulations
On Nov. 20, CMS issued a notice of proposed rulemaking (NPRM) for its 2017 Benefit and Payment Parameters (BPP) rule. The NPRM includes a number of network adequacy regulations that are particularly relevant to MCH populations, including the imposition of various continuity-of-care requirements in the federally-facilitated Marketplace. The NPRM mandates that insurers would have to provide 30 days' notice (or notice as soon as practicable) to regular patients of providers who are being dropped from the plan's network. Where an enrollee is in active treatment (for example, the second or third trimester of pregnancy), the insurer would have to cover continuing care for up to 90 days or until treatment was completed. Insurers also are encouraged to inform enrollees of comparable in-network providers. This mandate holds insurers accountable for the continued coverage and care of vulnerable populations like pregnant women and CYSHCN. For more information on mandatory coverage benefits for MCH populations, check out the AMCHP coverage chart.
CMS Issues Clarification on 2016 New Essential Community Provider Payment Notice
On Nov. 20, CMS issued clarification on the final 2016 payment notice for Essential Community Providers (ECP). The clarification states that CMS will not be moving forward with efforts to support further ECP category disaggregation for children's hospitals, rural health clinics, free-standing cancer centers, community mental health centers, and hemophilia treatment centers at this time. CMS believes there are too few ECPs within these additional categories appearing on the HHS ECP list to afford issuers sufficient flexibility in their contracting. CMS may revisit this issue in the future, but for now stresses the importance for issuers to include these additional providers in their networks.