In this policy-round up:
- Input Needed
- CMS Revised 1915(c) HCBS Waiver Application and Technical Guide (comments due 11/13)
- Assessing mental health parity and addiction equity compliance in Medicaid and CHIP (comments due 12/4)
- ACF proposed rule on services and protections for unaccompanied children in its care (comments due 12/4)
- Coverage of over-the-counter preventative services (comments due 12/4)
- Census Bureau changes to American Community Survey and Puerto Rico Community Survey (comments due 12/19)
- HHS 504 proposed rule, stakeholder call recording now available (comments due 11/13)
- CMS releases new Medicaid Transportation Coverage Guide
- OCR resources for health care providers and patients on telehealth and protected health information
- HUD announces $212 million funding opportunity to expand affordable housing options for people with disabilities
Input needed: Revised CMS 1915(c) HCBS Waiver Application and Technical Guide
The Centers for Medicare and Medicaid Services (CMS) is seeking feedback on proposed revisions to the 1915(c) Home and Community-Based Services (HCBS) Waiver Application and the application’s Instructions, Technical Guide, and Review Criteria document.
The revisions to the application and technical guide aim to update outdated language, streamline the review process, and align with current CMS regulations and policies. Updates include incorporating HCBS Settings Rule requirements and adding the option of remote or telehealth delivery of services, which has become more common since the start of the COVID-19 pandemic.
Comments can be submitted online or by mail until November 13, 2023.
Input needed: Assessing mental health parity and addiction equity compliance in Medicaid and CHIP
CMS is seeking public comments on proposed processes for determining compliance with mental health parity and addiction equity requirements in Medicaid managed care arrangements, Medicaid alternative benefit plans (ABPs), and the Children’s Health Insurance Program (CHIP). These requirements seek to make mental health and substance use disorder (SUD) treatment as accessible as other types of medical treatment.
CMS is seeking this information in part due to concerns raised by advocates regarding barriers to accessing mental health and SUD treatment. CMS requests comments on a number of topics, including:
- Processes that should be considered in determining compliance with parity requirements
- Certain treatment limits that CMS should prioritize for review, such as pre-authorization requirements, fail first policies, or standards for a provider to be admitted in an insurer’s network
- If there are mental health conditions and substance use disorders that are more common among enrollees in Medicaid MCOs, Medicaid ABPs, and CHIP and what barriers exist to accessing treatment for these conditions
- If there are mental health conditions, SUDs, or types of treatment that are at risk of not being covered in compliance with parity requirements for Medicaid managed care arrangements, Medicaid ABPs, and CHIP
Comments can be submitted MedicaidandCHIP-Parity@cms.hhs.gov until December 4, 2023.
Input needed: ACF proposed rule on services and protections for unaccompanied children in its care
The HHS Administration for Children and Families (ACF) Office of Refugee Resettlement (ORR) released a proposed rule that would set clear standards for the care and treatment of unaccompanied children in ORR’s custody.
The proposed rule provides a number of protections for unaccompanied children with disabilities, including:
- Ensuring unaccompanied children with disabilities are not placed in secure facilities for youth deemed to need the strictest level of supervision if less restrictive alternative placements are available.
- Ensuring that information is effectively communicated to children with disabilities, including through auxiliary aids and services such as qualified sign language interpreters and braille and written materials.
- Ensuring that when children receive educational services, those services are appropriate to the child’s level of development, communication skills, and abilities
Comments on the proposed rule can be submitted online or to UCPolicy-RegulatoryAffairs@acf.hhs.gov until December 4, 2023.
Input needed: Coverage of over-the-counter preventive services
The Departments of Health and Human Services, Labor, and the Treasury are seeking public input on how best to ensure coverage and access to over-the-counter (OTC) preventive services, including requiring most health insurance plans to cover these services at no cost and without a prescription. Examples of OTC preventative services include contraceptives, tobacco smoking cessation products, folic acid during pregnancy, and breastfeeding supplies.
The request for information covers topics including how to ensure access to, and increase use of, OTC products and how increased access could impact health outcomes and quality of life.
Comments can be submitted online or by mail until 5:00 PM ET on December 4, 2023.
Input needed: Census Bureau changes to questions in the American Community Survey and Puerto Rico Community Survey
The Census Bureau is seeking input on proposed changes to the American Community Survey (ACS) and Puerto Rico Community Survey (PRCS) beginning in 2025. The ACS and PRCS are annual surveys conducted by the Census Bureau to provide current data on population changes happening around the country. These changes cover several topics, including disability.
The changes proposed are intended to reflect advances in how we think about disability, including using graded response categories (ie: “no difficulty with…”, “some difficulty with…”, “a lot of difficulty with…” etc.) instead of just “yes” or “no” questions. Additionally, a new question will ask about difficulty communicating.
Comments can be submitted online or to acso.pra@census.gov until December 19, 2023.
Input needed: HHS 504 proposed rule, stakeholder call recording now available
The HHS Office for Civil Rights is seeking comments on a proposed update to the HHS regulations implementing Section 504 of the Rehabilitation Act of 1973, which prohibits disability discrimination by recipients of federal funding.
This is the first comprehensive update to the regulations since they were first put in place more than 40 years ago. The proposed rule strengthens protections for people with disabilities and reflects the input and priorities of the disability community.
A recording is now available of a webinar in which OCR walked ACL stakeholders through key provisions of the proposed rule.
Comments can be submitted online or by mail until November 13, 2023.
Find more information and resources at acl.gov/504rule.
CMS releases new Medicaid Transportation Coverage Guide
CMS recently released a Medicaid Transportation Coverage Guide, which both highlights existing policies and includes new policies to address issues such as extended wait times and long-distance trips. It also addresses coverage of transportation for non-Medicaid eligible parents, family members, or other caregivers when required to participate in a Medicaid eligible child’s care.
Medicaid transportation is a critical service that assists beneficiaries with accessing covered Medicaid services and has a direct impact on health outcomes. This guide will help states understand the federal requirements for this service and flexibilities they can implement.
OCR resources for health care providers and patients on telehealth and protected health information
The HHS Office for Civil Rights (OCR) recently published two resource documents to help patients better understand the privacy and security risks to their protected health information (PHI) when using telehealth services and ways to reduce these risks.
The first resource is for health care providers; it provides suggestions for discussing telehealth privacy and security with their patients. Covered discussion topics include:
- Telehealth options offered
- Risks to PHI when using remote communications technologies
- Privacy and security practices of remote communication technology vendors
- Applicability of civil rights laws
The discussion of civil rights laws includes a reminder to take appropriate steps to ensure that communications with an individual with a disability about telehealth services are as effective as communications with others, including by providing appropriate aids and services where necessary.
The second resource, Telehealth Privacy and Security Tips for Patients, provides recommendations that patients can implement to protect and secure their health information such as:
- Conduct telehealth appointment in a private location
- Turn on multi-factor authentication if available
- Use encryption when available
- Avoid public Wi-Fi networks
HUD announces $212 million funding opportunity to expand affordable housing options for people with disabilities
The Department of Housing and Urban Development (HUD) announced that $212 million in funding is available to expand the supply of affordable housing and supportive services for people with disabilities.
The funding is available to participants in the Section 811 Supportive Housing for Persons with Disabilities program, which helps develop, subsidize, and provide supportive services in rental housing that meet the needs of people with disabilities.
People with disabilities, especially low-income people with disabilities, often have a hard time finding housing due to a shortage of accessible and affordable housing options.
Find more resources on accessible, affordable housing from the Housing and Services Resource Center.