Pfizer/BioNTech Vaccine Safe for More Teens; AHA Challenging CMS Over Site-Neutral Payments
Positive developments for the Pfizer/BioNTech mean good news for younger teens. Meanwhile, CMS is facing a challenge from AHA over Medicare reimbursement rates.
Source: Getty Images
By - As the vaccine rollout moves forward for American adults and older teens, new research shows that the Pfizer/BioNTech vaccine is safe and effective for younger teens. AHA is pushing back against a move by CMS to reduce Medicare reimbursement around site-neutral payments.
Pfizer/BioNTech Vaccine Effective for Teens
Pfizer and BioNTech recently announced that its COVID-19 vaccine, BNT162b2, demonstrated 100 percent efficacy and robust antibody responses in adolescents with or without prior SARS-CoV-2 infection. The Phase 3 trial enrolled 2,260 adolescents 12 to 15 years of age in the US. In the trial, 18 cases of COVID-19 were observed in the placebo group versus none in the vaccinated group.
“The initial results we have seen in the adolescent studies suggest that children are particularly well protected by vaccination, which is very encouraging given the trends we have seen in recent weeks regarding the spread of the B.1.1.7 UK variant,” says Ugur Sahin, CEO and Cc-founder of BioNTech. READ MORE
Aetna, CVS Seeking Hybrid Approach to Mental Healthcare
During the lockdown, payers and members naturally turned to digital platforms in order to address the swell of mental healthcare needs. However, with the pandemic becoming more manageable and the country preparing to emerge from the public health emergency, payers have to consider how to transition these solutions into the new normal. Aetna and CVS Health aim to provide an omnichannel approach to mental healthcare by mirroring their in-person HealthHUB options with a virtual care option.
“The pandemic is having a large effect on the totality of people's mental health wellbeing. The number of people that we know go undiagnosed, especially in populations of color, is far too high,” says Cara McNulty, president of behavioral health and the Employee Assistance Program at Aetna.
AHA Challenges Site-Neutral Payment Denials
The American Hospital Association is calling on CMS to rescind recent audit determinations that lowered Medicare reimbursement to site-neutral payment rates for certain off-campus provider-based departments per the 21st Century Cures Act. The group now claims that CMS is too late with completing audit activities authorized by the law and, as a result, the mid-build exception denials “inappropriately reduced payment rates for items and services furnished by certain off-campus provider-based departments (PBDs) that first billed Medicare for services furnished on or after Nov. 2, 2015.” READ MORE
Chronic Disease Proving Fatal for Black Community
Black individuals in rural parts of the US have experienced higher chronic disease death rates than whites in the last 20 years, reflecting significant racial disparities and gaps in care. In a research letter written by a team from Beth Israel Deaconess Medical Center, the group stated that black adults living in rural areas had higher mortality rates due to diabetes, high blood pressure, heart disease, and stroke compared to white adults. Researchers noted that racial disparities improved only minimally in rural areas over the last 20 years, while there were larger improvements in urban areas. READ MORE
Positive Trend for Vaccinations of Black Population
The number of Black people expressing COVID-19 vaccine hesitancy has gone down by 14 percentage points since February, according to Kaiser Family Foundation (KFF) data, marking a big win on the public health messaging front. Overall, 55 percent of Black people included in KFF’s Vaccine Monitor poll said they have already gotten the vaccine or plan to do so as soon as possible. This finding comes as healthcare experts across the country have called for strong public health messaging and community health partnership as part of health equity efforts. READ MORE
New Lobby Group Pressuring CMS on Telehealth Coverage
The Alliance for Connected Care is leading a new lobbying effort to include telehealth in a Medicare-funded diabetes prevention program. The organization is lining up supporters behind a letter that asks HHS Secretary Xavier Becerra to include virtual visits in the Medicare Diabetes Prevention Program for the rest of the public health emergency created by the coronavirus pandemic, and to “work on longer-term reforms” that would make connected health a permanent part of the program. READ MORE
