Policy Round-Up: EV Charging Stations, Medicaid Renewals, Open Enrollment, and More

In this Policy Round-Up:

• Input Needed: Proposed Rule on Accessibility of EV Charging Stations (Comments due 11/4)
• CMS Informational Bulletin on Medicaid Renewal Requirements
• Medicare Updates
  • Medicare Open Enrollment Begins
  • CMS Announces Coverage for PrEP
  • CMS Finalizes Guidance for Second Cycle of Drug Price Negotiation Program
  • CMS Announces Cost Savings for 54 Prescription Drugs
• CMS Releases Memo Regarding Nursing Home Residents' Right to Vote
• Issue Brief on Diagnostic Errors and Older Adults
• HRSA Awards To Expand Access to Mental Health and Substance Use Disorder Services at Community Health Centers

Input Needed: Proposed Rule on Accessibility of EV Charging Stations

The Architectural and Transportation Barriers Compliance Board, better known as the Access Board, seeks comments on a proposed rule that would amend the accessibility guidelines for certain buildings and facilities to specifically address the accessibility of electric vehicle (EV) charging stations, covered by the Americans with Disabilities Act of 1990 (ADA) and the Architectural Barriers Act of 1968 (ABA).

The proposed rule would set minimum guidelines to ensure that people with disabilities can access and use EV charging stations, including both physical access to the EV charging station and access to the interface to operate and pay for the charging session.

The Board is seeking public comment on topics including the alternative "use last" model versus reserved spaces for people with disabilities, particularly enforcement and wait times for people with disabilities attempting to use the accessible spaces. The "use last" model would require more EV charging spaces to be designed with accessible mobility features but would not require that the charging spaces be reserved exclusively for people with disability placards. Rather, people without disability placards could use accessible EV charging spaces when all others are occupied.

Comments can be submitted online, by email, or by mail until November 4.

CMS Informational Bulletin on Medicaid Renewal Requirements

As we've discussed before, with the end of the COVID-19 public health emergency, all states are resuming their regular processes for renewing individuals' Medicaid coverage.

The Centers for Medicare & Medicaid Services (CMS) recently released an informational bulletin to provide states with updated information on timing and expectations for reaching compliance with federal renewal requirements. All states are required to submit a plan outlining steps and milestones for addressing identified areas of non-compliance to CMS by December 31, 2024. Compliance plans will detail how states will achieve compliance by December 31, 2026.

For more information, check out this slide deck.

Medicare Updates: Open Enrollment Begins

Medicare's Open Enrollment period has begun and will run through December 7. During this period, people can make certain changes to their Medicare coverage, including adding, dropping, or changing their Medicare Advantage or Part D coverage. Any changes made take effect January 1.

State Health Insurance Assistance Programs (SHIPs) are available to provide help, compare options, or make changes. SHIPs provide local, in-depth, and objective insurance counseling and assistance to Medicare-eligible individuals, their families, and caregivers. To find a local SHIP, use the online SHIP Locator or call 877-839-2675. 

You also can go directly to Medicare to compare options and enroll in some plans by calling 1-800-MEDICARE or visiting www.Medicare.gov. Anyone who wants to make changes can also contact plans directly to learn more about the coverage they provide and to enroll.

To learn more, check out this blog on Open Enrollment.

Medicare Updates: CMS Announces Coverage for PrEP

CMS has released a national coverage determination (which we discussed when it was proposed) to cover pre-exposure prophylaxis (PrEP) using FDA-approved antiretroviral drugs to prevent HIV infection in individuals at increased risk. In addition, Medicare will now cover up to eight individual HIV risk-related counseling visits annually, additional HIV screenings up to eight times annually, and a single screening for hepatitis B virus.

PrEP involves the use of antiretroviral drugs on an ongoing basis or before and after potential HIV exposure. When taken as directed, it is highly effective at preventing HIV. Under the national coverage determination, both oral and injectable forms of the medication will now be covered under Part B as an "additional preventive service" without cost-sharing and are required to be covered by Medicare Advantage plans without cost-sharing at in-network providers.

For more information, check out the following resources:

• Fact sheet
• One-pager for consumers
• FAQs webpage
• Technical FAQs for pharmacies

Medicare Updates: CMS Finalizes Guidance for Second Cycle of Drug Price Negotiation Program

CMS has published final guidance for the second cycle of negotiations under the Medicare Drug Price Negotiation Program. As we've discussed before, this program could reduce drug costs for some older people and people with disabilities who have Medicare coverage.

The guidance outlines the process for the second cycle of negotiations under the Medicare Drug Price Negotiation Program. It also explains how CMS will help ensure people with Medicare can access drugs at the negotiated prices from the first and second cycles when those prices take effect in 2026 and 2027, respectively.

For the second cycle of negotiations, CMS will select up to 15 additional drugs for negotiation. The second set of drugs will be announced by February 1, 2025, and any negotiated maximum fair prices for this second set of drugs will take effect starting January 1, 2027.

For more information on the guidance and the Medicare Drug Price Negotiation Program, check out this fact sheet.

Medicare Updates: CMS Announces Cost Savings for 54 Prescription Drugs

As we've discussed before, the Inflation Reduction Act requires drug companies to pay rebates to Medicare when their prices for certain prescription drugs increase faster than the rate of inflation. Rebates paid by drug companies will be used to help ensure the long-term sustainability of the Medicare program.

Under that program, coinsurance may be lower for 54 drugs paid for under Part B between October 1 and the end of the year. More information on the program is available on CMS' website.

CMS Releases Memo Regarding Nursing Home Residents' Right to Vote

CMS recently released a memo reinforcing the regulatory expectations that Medicare and Medicaid-certified long-term care facilities affirm and support the right of residents to vote. The memo reminds states that nursing homes should have a plan to ensure residents can exercise their right to vote, whether in person, by mail, by absentee ballot, or through another authorized process. It also includes information on how residents can report violations.

Issue Brief on Diagnostic Errors and Older Adults

The Agency for Healthcare Research and Quality (AHRQ) released an issue brief that addresses the issues impacting diagnostic errors in older adults.

Older adults are at higher risk for diagnostic errors than younger adults for multiple reasons. They are more likely to have multiple coexisting conditions or take multiple medications that can impact how other conditions present. The issue brief also notes that stereotypes about aging and communication barriers play a role in diagnostic errors for older adults.

The issue brief provides several recommendations for reducing older adults' risk of diagnostic error, including enhancing training in geriatrics for health care professionals and researchers and funding research that focuses on diagnostic errors in older adults. It also underscores the critical role of caregivers in the diagnostic process, recognizing the valuable insights they contribute because of their role maintaining the health and care needs of their loved ones on a daily basis.

HRSA Awards To Expand Access to Mental Health and Substance Use Disorder Services at Community Health Centers

HRSA announced $240 million in awards to launch and expand mental health and substance use disorder services in more than 400 community health centers across the country. Community health centers are a primary source of care for individuals across the country who are uninsured, underinsured, or enrolled in Medicaid - making them well-positioned to respond to the urgent need for high quality, stigma-free, culturally competent, and readily accessible behavioral health services.

A list of awardees is available on HRSA's website.

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