CMS Funds Telehealth for Medical Centers, OIG Audits Medicare Advantage

September 29, 2021 - An influx of funding from the American Rescue Plan is earmarked by HRSA for medical centers in underserved communities. Additionally, the ONC is receiving funding from the plan for IT workforce development at minority institutions.

COVID-19 Pfizer boosters were approved by the FDA for certain groups, while healthcare workers in New York state face termination this week unless they are vaccinated. Meanwhile, the Investigator General has identified noncompliance with Medicare Advantage plans and opioid treatment facilities in Colorado.

HRSA Health Centers to Get $1B for Upgrades

The Health and Human Services Department’s Health Resources and Services Administration (HRSA) is leveraging $1 billion to improve the capabilities of around 1,200 health centers throughout the United States. Funds allocated from the American Rescue Plan will be used to increase telehealth capabilities and provide for underserved communities that were hurt by the pandemic. READ MORE

CMS Will Foot the Bill for COVID-19 Booster Shots

After the FDA’s recent approval of Pfizer booster shots, CMS announced that all booster shots will be free to beneficiaries covered by Medicare and Medicaid. For now, boosters are only approved for adults older than 65 and those younger than 65 with underlying health conditions or jobs that put them at high risk. It is recommended that patients wait to receive boosters until six months after their second vaccine dose. READ MORE

ONC Promotes Public Health IT Workforce Development, Diversity

To develop IT workforce, ONC allocated $73 million from the American Rescue Plan to underrepresented communities and institutes of higher education. The money aims to fund training for a diverse group of 4,000 individuals in public health IT. Programs created with the funding will be hosted at Historically Black Colleges and Universities (HBCUs), Hispanic Serving Institutions (HSIs), Asian American and Native American Pacific Islander-Serving Institutions (AANAPISIs), and other similar institutions. READ MORE

OIG: Medicare Advantage Plans Improperly Used Chart Reviews and HRAs

The Office of the Investigator General found billions of improper payments rendered in 2016 to a group of Medicare Advantage plans. The payments were issued without any proof of service and amounted to over $9 billion in risk-adjusted compensation. The investigation reviewed 162 Medicare Advantage companies and found 20 to be responsible for most of the incorrect payments. One of the organizations generated 40 percent of its risk-adjusted revenue through these types of fees. Recommendations to CMS from the Investigator General include stricter monitoring of health plans and payment verification. READ MORE

Medicaid Opioid Treatment Falls Short

After an audit of 100 opioid treatment programs (OTP) in Colorado, the Investigator General found that 79 programs did not meet federal and state requirements. The biennial state-run audit process in place was insufficient in scope and unable to ensure that accurate patient records were being kept. The Office of the Investigator General has recommended that a more robust record-keeping system be introduced to these federally funded treatment programs. Colorado responded to the findings with plans to introduce an automated central registry for these programs. READ MORE

New York May Tap National Guard to Replace Unvaccinated Healthcare Workers

New York State’s healthcare vaccination deadline arrived this week, with nearly 16 percent of workers remaining unvaccinated. Those employees who are unvaccinated face unpaid leave or termination under the law, which could contribute to a healthcare shortage in the state. Governor Kathy Hochul considered filling the gaps in care with National Guard replacements or out-of-state healthcare workers if healthcare systems become overstressed. READ MORE