CMS Builds on Whole-of-Government COVID-19 Response with Vaccination Education, Offering, and Reporting
As part of the ongoing response to address the COVID-19 pandemic and to improve health care access and reduce the risk of severe illness and death from COVID-19, CMS issued a rule that will ensure long-term care facilities, and residential facilities serving clients with intellectual disabilities, educate and offer the COVID-19 vaccine to residents, clients, and staff. These requirements apply to Long-Term Care (LTC) facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID) and align with existing requirements for influenza and pneumococcal vaccines in LTC facilities.
The rule also requires LTC facilities to report weekly COVID-19 vaccination status data for both residents and staff. The new vaccination reporting requirement will not only assist in monitoring uptake amongst residents and staff but will also aid in identifying facilities that may be in need of additional resources and/or assistance to respond to the COVID-19 pandemic.
“These new requirements reinforce CMS’ commitment of ensuring equitable vaccine access for Medicare and Medicaid beneficiaries,” said Dr. Lee Fleisher, MD, CMS Chief Medical Officer and Director of CMS’ Center for Clinical Standards and Quality (CCSQ). “Today’s announcement directly aids nursing home residents and people with intellectual or developmental disabilities who have been disproportionately affected by COVID-19. Our goal is to increase COVID-19 vaccine confidence and acceptance among these individuals and the staff who serve them.”
To ensure LTC facilities receive support for COVID-19 vaccination efforts, they are now required to report weekly vaccination data of residents and staff to the CDC National Healthcare Safety Network (NHSN), the nation’s most widely used healthcare-associated infection tracking system. LTC facilities are already required to report COVID-19 testing, case, and mortality data to the NHSN for residents and staff but have not been required to report vaccination data. As data becomes available, CMS will post facility-specific vaccination status information reported to the NHSN for viewing by facilities, stakeholders, and the public on CMS’ COVID-19 Nursing Home Data website.
While this announcement is specific to LTC facilities and ICFs-IID, CMS is also seeking comment on opportunities to expand these policies to help encourage vaccine uptake and access in other congregate care settings, such as psychiatric residential treatment facilities, group homes, and assisted living facilities. By requiring vaccine education and offering within LTC facilities and ICFs-IIDs, CMS is improving health care access and reducing the risk of severe illness and death from COVID-19.
CMS Proposes to Enhance the Medical Workforce in Rural and Underserved Communities to Support COVID-19 Recovery and Beyond
Proposed rule would require hospitals to report vaccination rates among health care staff
On April 27, CMS issued a proposed rule (CMS-1752-P) for inpatient and long-term care hospitals that builds on the Biden Administration’s key priorities to close health care equity gaps and provide greater accessibility to care. Major provisions in the proposed rule would fund medical residency positions in hospitals in rural and underserved communities to address workforce shortages and require hospitals to report COVID-19 vaccination rates among their workers to contain the spread of the virus.
CMS recognizes the importance of encouraging more health professionals to work in rural hospitals and underserved areas and the need to retain and train high-quality physicians to help address access to health care in these communities. In accordance with the Consolidated Appropriations Act, 2021, CMS is proposing to distribute 1,000 additional physician residency slots to qualifying hospitals, phasing in 200 slots per year over five years. CMS estimates that the additional funding for these additional residency slots, once fully phased in, will total approximately $0.3 billion each year to fund medical residency positions in hospitals to address the workforce shortages.
“Hospitals are often the backbone of rural communities – but the COVID-19 pandemic has hit rural hospitals hard, and too many are struggling to stay afloat,” said HHS Secretary Xavier Becerra. “This rule will give hospitals more relief and additional tools to care for COVID-19 patients, and it will also bolster the health care workforce in rural and underserved communities. The Biden Administration is committed to expanding health equity in communities across the country, especially in rural America.”
Consistent with President Biden’s Executive Order 13985 on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, CMS is also committed to addressing significant and persistent inequities in health outcomes in the U.S. through improving data collection to better measure and analyze disparities across programs and policies. In this proposed rule, CMS is soliciting feedback on opportunities to leverage diverse sets of data (race, Medicare/Medicaid dual eligible status, disability status, LGTBQ+, socioeconomic status, etc.) and new methodological approaches to advance equity through the quality measurement and value-based purchasing programs.
The rule also proposes to implement section 9831 of the American Rescue Plan Act of 2021 to permanently reinstate the imputed floor-wage-index for all-urban States for FY 2022.
Additionally, the rule proposes to update Medicare Fee-for-Service payment rates and policies for acute care inpatient hospitals and long-term care hospitals for fiscal year 2022. CMS estimates total Medicare spending on acute care inpatient hospital services will increase by about $2.5 billion in fiscal year 2022.
Strengthening COVID-19 Ongoing Response
In November 2020, CMS established the New COVID-19 Treatments Add-on Payment (NCTAP) to mitigate any potential financial disincentives for hospitals to provide new COVID-19 treatments during the Public Health Emergency (PHE). The proposed rule would extend the NCTAP for certain eligible technologies through the end of the fiscal year in which the PHE ends.
In addition, the proposed rule seeks to strengthen the ongoing response to the PHE and future health threats by leveraging meaningful measures for quality programs. CMS is proposing the adoption of the COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) Measure to require hospitals to report COVID-19 vaccinations of workers in their facilities. This proposed measure is designed to assess whether hospitals are taking steps to limit the spread of COVID-19 among their workforce, reduce the risk of transmission within their facilities, help sustain the ability of hospitals to continue serving their communities through the PHE, and assess the nation’s long-term recovery and readiness efforts.
Additionally, CMS is proposing to modify the Promoting Interoperability program requirements for eligible hospitals and critical access hospitals to expand reporting within the Public Health and Clinical Data Exchange Objective. The proposal would require hospitals to report on all four of the following measures: Syndromic Surveillance Reporting, Immunization Registry Reporting, Electronic Case Reporting, and Electronic Reportable Laboratory Result Reporting.
Requiring hospitals to report these four measures would help to prepare public health agencies to respond to future health threats and a long-term COVID-19 recovery by strengthening public health functions, including early warning surveillance, case surveillance, and vaccine uptake, which will increase the information available to help hospitals better serve their patients. Requiring these measures would enable nationwide syndromic surveillance for early warning of emerging outbreaks and threats; automated case and laboratory reporting for rapid public health response; and local and national visibility on immunization uptake so public health can tailor vaccine distribution strategies.
Learn How to Build COVID-19 Vaccine Confidence
The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) will host a Building COVID-19 Vaccine Confidence webinar on Thursday, May 13 from 12:00-1:00 p.m. ET.
Dr. LaShawn McIver, Director of CMS OMH, will share information and resources to help you address vaccine hesitancy in your community. Dr. McIver will be joined by Dr. Peter Marks, Director of the Center for Biologics Evaluation and Research (CBER) at FDA, who will give an overview of vaccines and their safety. This webinar will equip you to speak persuasively about the COVID-19 vaccine.
Following the presentation, attendees will have the opportunity to ask questions and share ideas related to vaccine confidence.
Title: Building COVID-19 Vaccine Confidence
Dates and Time: Thursday, May 13, from 12:00-1:00 p.m. ET.
Please note: You will receive an email with login information from GoToWebinar upon registration. If you do not receive an email in a few days’ time, please contact CMSOMHTeam@ketchum.com
As part of the Biden-Harris Administration’s “We Can Do This” public education campaign to increase confidence in the COVID-19 vaccines and encourage vaccination, the Department of Health and Human Services (HHS) is launching a new initiative today to connect Americans with facts and information on vaccines from doctors, scientists, and health professionals through high-impact digital platforms. Read full news release
On Thursday 4/22, the White House is hosting an event that will focus on how faith and community organizations can help with COVID-19 vaccination efforts. We hope you can be there, please feel free to share with partner organizations who would be interested.
All In: Partnering with Community and Faith Organizations in COVID-19 Vaccination Efforts
Thursday, April 22 from 3:00-5:00 PM ET
The event will feature federal and state officials, vaccine providers, and faith and community leaders who are working together to meet this challenge.
This virtual White House event will highlight the ways that faith and community leaders can:
- Educate communities about the COVID-19 vaccine
- Engage communities to encourage vaccination
- Establish or support vaccination sites
Despite 90 percent of Americans now being eligible to receive a COVID vaccine and more than half of rural residents having gotten a dose, one in five say they will not get vaccinated. “If your doctor or nurse doesn’t want to take the vaccine, there’s no national campaign that’s going to overcome that,” says NRHA CEO Alan Morgan. In Maine, residents are traveling north to find appointments, which NRHA President John Gale says could indicate rural hesitancy. The CDC has advised providers to pause the use of the Johnson & Johnson vaccine until further review of the six reported U.S. cases of a rare type of blood clot. This vaccine had been considered a boon to rural areas where transportation is less accessible. When it comes to SDOH our health care system is not equipped to vaccinate rural communities. Going forward, we must invest in people and infrastructure. To advocate on behalf of rural health, participate in NRHA’s rural health advocacy campaigns. NRHA has teamed up with the Chartis Center for Rural Health to examine vaccinating rural hospital staff. Offer your perspective