GBO NEWS: DC Elder Insider Blancato on Biden Admin & 117th Congress; Story Links on Trump Drugs Failure; COVID Hit on Nest Eggs; Hidden Hunger — PLUS Climate Change vs. Retirement; Nursing Homes’ Bad Biz Model; Arab American Elders in Pandemic; & MORE
GENERATIONS BEAT ONLINE NEWS
E-News of the Journalists Network on Generations – Starting Our 28th Year.
January 29, 2021 — Volume 28, Number 1
EDITOR’S NOTE: GBONews, e-news of the Journalists Network on Generations (JNG), publishes alerts for journalists, producers and authors covering generational issues. Send your news of important stories or books (by you and others), fellowships, awards or pertinent kvetches to GBO News Editor Paul Kleyman. To subscribe to GBONews.org at no charge, simply sending a request to Paul with your name, address, phone number and editorial affiliation or note that you freelance. For each issue, you’ll receive the table of contents in an e-mail, so just click through to the full issue at www.gbonews.org. GBONews does not provide its list to other entities.
In This Issue: Nobody’s Jumping Our Vaccine Line!
1. DC ELDER INSIDER BOB BLANCATO ON BIDEN ADMIN, New CONGRESS
2. THE STORYBOARD
*** “Trump Utterly Failed to Cut Drug Prices. Here’s How Biden Could Do Better,” by Michael Hiltzik, Los Angeles Times (Also, See U.S. GAO Report, “Department of Veterans Affairs Paid About Half as Much as Medicare Part D for Selected Drugs in 2017”;
*** “Some Seniors Face Shrinking Nest Eggs As They Care For Loved Ones During Pandemic,” by Sally Herships, NPR Morning Edition;
*** “Filing Suit for ‘Wrongful Life,’” by Paula Span, New York Times “New Old Age” column;
*** “Hidden Hunger: Elderly Hunger Is on the Rise During Covid,” by Cynthia McFadden, Emily R. Siegel and Kevin Monahan, NBC News;
*** “Budget Requests Boost Focus on Keeping Older Georgians Safe,” by Maya T. Prabhu, Atlanta Journal-Constitution;
*** “How Climate Change Is Ruining Retirement Across America,” by Craig Miller, MarketWatch;
*** “Nursing Homes’ Flawed Business Model Worsens COVID Crisis,” by Harris Meyer, AARP.
*** Nursing Homes Balance COVID-19 Prevention, Social Isolation,” by Cynthia McCormack, Cape Cod Times/Gannett;
*** “Study Seeks to Understand Arab American Health During COVID-19,” by Hassan Abbas, Arab American News
3. RELIABLE SOURCES: *** Generations SmartBrief business news produced for the American Society on Aging (ASA); *** “Ongoing Regulatory Changes to Medicare in Response to COVID-19,” Commonwealth Fund “To the Point” blog.
1. ELDER ADVOCATE BOB BLANCATO ON NEW BIDEN ADMIN, CONGRESS
A belated Happy New Year, everyone. Has anything happened since our December issue? What’s that? Democracy survived (barely and, sad to say, fatally for five people); the movers got Trump out without lashing him to a dolly, although Speaker Nancy Pelosi is doing what she can to keep Disgruntled President Movers from ever returning; the Biden-Harris administration now rules the West Wing, and Mitch McConnell has given up control of the Senate and the filibuster – to conservative Democrats, who pledged not to preserve it, to Mitch’s delight? Your move Majority Leader Schumer.
So much change so fast. Still, nobody’s getting any younger. President Joe Biden took fast action, of course, signing twice the executive orders as his predecessor did in his first week, about a third of them reversing those enacted by Trump. Cabinet, subcabinet officials and lower department heads are rapidly moving in. Democrats’ children are filling Zoom squares in Washington-area virtual classes, and older Americans and reporters who cover the generations beat are, well, waiting patiently, as usual. That issues in aging, central as ever in America’s life, tend to draw belated presidential attention weeks, or even months into a new administration, has long been the White House MO.
That noted, who will oversee what authorities on aging in the Biden administration and key committees in the 117thCongress is taking shape. At this early stage, reporters covering elder issues should be aware of important changes to date. To get an authoritative scorecard of who will sit where, GBO’s editor decided to take his own advice from our last issue and consult veteran Washington mover-shaker on aging, Robert “Bob” Blancato.
With over 35 years of experience in and around Capitol Hill, he is ostensibly President of Matz, Blancato and Associates, National Coordinator of the Elder Justice Coalition and Executive Director of the National Association of Nutrition and Aging Services Programs (such as Meals on Wheels). He also served as President Bill Clinton’sExecutive Director of the 1995 White House Conference on Aging.
Blancato said in an e-mail interview, “Broadly speaking for reporters on the generations beat, President Biden identifies four simultaneous crises to deal with: the pandemic, economic collapse, racial injustice and climate change. Dealing with these at various degrees of speed will dominate the early agenda for Biden and Congress.”
Journalists, he said, will need to keep their eye on how any policy activity on aging will interact with these concerns. Of course, the effect of February’s planned impeachment trial of the former president on the new administration’s pace in dealing with these issues remains to be seen.
Blancato continued, “There should be plenty of material in the health care space, including a number of last-minute executive orders and regulatory actions, such as those regarding prescription drugs. Also worth following would be immigration measures to undo actions that the Trump administration used to restrict access to the Supplemental Nutrition Assistance Program (SNAP, or food-stamps), during this time of increasing food insecurity among people of all ages.”
He went on, “Reporters on aging should also watch the Biden administration’s key cabinet and subcabinet choices,” which initially have revolved around three criteria: experience, familiarity with Biden and multicultural diversity. Those chosen on the front end reflect the president’s recognition that his agencies have to hit the ground running. He knows he will be judged politically on what gets done in the first 100 days. Reporters should monitor how long these appointees remain — and at overlooked groups who will have candidates ready to step in to vacancies.”
Blancato emphasized, “Key to generational impact will be Biden’s choice of Janet Yellin as Treasury Secretary. Watch for how she addresses Social Security after the next program’s annual Trustees report comes out in April. It will likely show a grim forecast of the program’s future solvency. Also when issues related to tax reform come up — will Biden’s ambitious caregiver plan make it in?”
HHS Hearings, Appointments Signal Debates
Biden’s choice of former California Attorney General Xavier Becerra as Secretary of Health and Human Services (HHS) has triggered an undercurrent of concern about his lack of health care experience during this critical period of confronting the pandemic. Assuming the Senate approves Becerra quickly, Blancato suggests that reporters pay attention to concerns raised in his confirmation hearings before two committees, the Senate Health, Education, Labor and Pensions (HELP) and Finance bodies.
The issues voiced prominently in these hearings should tip the media not only to his focus on seniors – such as the high proportion of COVID-19 deaths in nursing homes. Also, as Becerra take the helm of HHS, the senators’ questions may signal the coming political focus and partisan lines of debate.
“Within HHS,” Blancato said, “who gets tapped to run the Centers for Medicare and Medicaid Services (CMS), will be one of the most important agencies for the journalists on the generations beat. Among several prime CMS issues in the Biden-Harris platform will be Biden’s proposals to expand Medicare for more people, such as adding pre- or early-retirees ages 60-64?”
Another issue in the wings, he said, “is ending waiting lists for home and community-based services under Medicaid. The future of the agency’s Center for Innovation and different payment models should be a prime focus for health policy reporters in the coming months. And how the president’s CMS nominee answers questions on lowering health care costs, especially on prescription drugs, should make the confirmation hearing well worth watching.”
Older Americans Act Programs
Further, Blancato said, “Who will get tapped to run the Administration on Community Living (ACL) the department within HHS focused on aging and disability? Will the lead official come from the aging or disability community? And how long will it take for the Biden administration make a permanent appointment? On his first day, Biden appointed as acting administrator, Alison Barkoff, a strong disability advocate.”
Also important to watch, he noted, is “how will the agency be located within HHS. Does it gain stature?”
In terms of the agencies administration of the 1965 Older Americans Act, which covers a range of needs, such as meals, senior centers and protections against elder abuse, federal funding has stagnated at low levels through administrations and congresses headed by both parties.
As GBONews reported recently, Blancato has long been involved with efforts to combat elder abuse and both drafted and lobbied for the Elder Justice Act (EJA), passed as part of the 2010 Affordable Care Act–a full seven years after it was first introduced in Congress. Even then it’s programs, such as for research, didn’t even get funded for years. Now EJA up for congressional renewal, and Blancato suggested that reporters eye the level of White House support for its passage as one indicator of the ACL agency’s focus on senior issues.
Another prime question ahead, said Blancato, is, “Can the Older Americans Act be recast into a program that addresses both social isolation and social determinants of health and gain more resources?”
He explained, “The reality is the Act has programs providing nutrition, transportation, preventive health, employment and caregiver support services. Each of these addresses elements of either social isolation or social determinants of health [race, gender, income, etc.], yet it is still treated as a series of separate funding silos when instead the Act should be looked at more holistically. If social isolation among older adults is part of public health emergency funding for the nutrition programs, which help to alleviate this, they should be mandatory and not discretionary.”
Also worth watching, Blancato said, is whether Neera Tanden is confirmed to run the Office of Management and Budget (OMB). He observed, “She is the most partisan appointment to date. She is president of Center for American Progress, the most political think tank there is. OMB is a hugely powerful agency; is Tanden a surprise gift to the progressive wing of the Democratic Party. Will her policies reflect that if she is confirmed?”
He added, “OMB according to Politico, is the ‘nerve center of the White House, the department through which Biden’s fiscal and regulatory agenda must pass.’
Tanden may work to advance a more progressive climate change proposal tied to infrastructure and also impact the focus of the first COVID relief package to ensure its relief is especially targeted to those most in need.”
The 107th Congress
On the House side, Blancato said, “There’s not a lot of drama” around support for program in aging. In the overall Democratic leadership, he said it’s especially worth watching South Carolina Rep. James E. Clyburn, “the most direct tie to Biden in Congress—and top African American,” who support was crucial for the new president’s winning the Democratic nomination.
And if California’s Nancy Pelosi is, as she’s said, in her last term as Speaker, and “will she avoid being regarded as a lame duck?” asked Blancato. And what will be the influence of the Dem’s progressive wing.
Also worth following, he suggested, are Connecticut Rep. Rosa DeLauro as new chair of the House Appropriations Committee, and Georgia Rep. David Scott, the new Chair of Agriculture Committee and first African American in that position. How will the address the aging of America’s family farmers?
For more drama, he said, one need only look to the Senate, Blancato continued, and its 50/50 power-sharing arrangement, but Democrats in majority, as Vice President Kamala Harris is also President of the Senate – and the tie breaker.
“Watch the Senate moderates,” Blancato urged. Look at those who did the last stimulus package. Key will be Republicans Susan Collins of Maine, long a supporter of programs for family caregiving, and Mitt Romney of Utah. When the GOP’s 2012 presidential nominee was the governor of Massachusetts, he led enactment of “Romneycare,” the model for “Obamacare.”
Swinging more conservatively on the Dem side are West Virginia’s Joe Manchin, already a factor in supporting continuation of the filibuster, and Virginia’s Mark Warner.
Other prime-time players to watch will be new chairs of key Senate committees with critical positions for programs on aging. Now leading the Senate Finance Committee is Oregon’s Ron Wyden. Washington State’s Patty Murray now chairs Health, Education, Labor and Pensions (HELP). (She’ll also head the Education Committee.)
Pennsylvania’s Bob Casey will now lead the Senate Special Committee on Aging.
“Perhaps the most interesting of all,” noted Blancato, Bernie Sanders will place his handcrafted Vermont mittens atop the wheel of the powerful Budget Committee.
2. THE STORYBOARD
*** “Trump Utterly Failed to Cut Drug Prices. Here’s How Biden Could Do Better,” by Michael Hiltzik, Los Angeles Times (January 19, 2021): The Pulitzer-prize winning business columnist wrote, “As a sort of sour welcome for the Biden administration and a final slap in the face for Donald Trump, America’s drug companies jacked up prices on hundreds of prescription drugs, including some of their top sellers, at the very start of this year. Market analysts say the median price hike was 4.8%, a tad below last year’s level, but once you’ve said that you’ve said everything.”
Hiltzik explains the flaws in key Trump executive orders, especially one that “tied U.S. prices to those paid in other developed countries, known as granting the U.S. so-called most-favored-nation status in the worldwide pharmaceutical market.”
He added, “Trump’s approach to drug prices has been, from the inception, all talk and no action. ‘This has been a rhetorical success but a practical failure,” says Rachel Sachs, an expert on food and drug regulation at Washington University in St. Louis.’” Sachs went on that the report, does give the Trump White House credit for having “’succeeded in normalizing the ideas . . . ,’ even if its ham-handed treatment of the administrative requirements and its delays in making the rules final hobbled their chances of success.”
The new administration, Hiltzik urged, should note that “Biden also has a useful template to work with in the form of HR 3, the “Elijah E. Cummings Lower Drug Costs Now Act,” which was passed by the Democratic-controlled House in December 2019 and stifled by the Republican-controlled Senate. With the Senate now under Democratic control, the Cummings Act has a solid chance of enactment.”
He continued that the Cummings Act, named for the late Democratic congressional member from Maryland, “would mandate the use of an international price index as a benchmark for the government to negotiate drug prices for Medicare and Medicaid. Those negotiated prices could then be used by private insurers.” Also, “The Act would also allow Medicare to negotiate drug prices with manufacturers for the first time.”
* See Related GAO Report, “Department of Veterans Affairs Paid About Half as Much as Medicare Part D for Selected Drugs in 2017,” U.S. Government Accountability Office (GAO-21-111), January 14, 2021: “Medicare and the Department of Veterans Affairs covered prescription drugs for about 52 million people in 2017. In our sample of 399 brand-name and generic prescription drugs, the VA paid an average of 54% less per unit than Medicare, even after taking into account rebates and discounts. The programs pay for drugs differently. Medicare reimburses the Part D plan sponsors to pay pharmacies, but the VA buys drugs directly from manufacturers. The VA may be able to get lower prices because it can:
1) Negotiate as a single health system with a unified list of covered drugs, and
2) Use discounts defined by law that Medicare doesn’t have.
*** “Some Seniors Face Shrinking Nest Eggs As They Care For Loved Ones During Pandemic,” by Sally Herships, NPR Morning Edition (Jan. 25, 2021), 4 min. audio, or read story: “Senior citizens are increasingly finding themselves with new responsibilities and a lot of hard choices because of the coronavirus pandemic. Those who have savings have to decide if they should dip into their accounts early, potentially eating away at funds they’d earmarked for later. Others are having to calculate how starting to receive their Social Security payments earlier than planned could reduce their checks in the future.
‘Who can even think about it — your retirement? If you’re struggling to put food on the table today, you’re going to do whatever you have to do that’s legal to be able to maintain yourself and your family,’ says Beth Finkel with AARP New York. And in New York state, 2.5 million seniors are taking care of others, according to Finkel.”
*** “Filing Suit for ‘Wrongful Life,’” by Paula Span, New York Times “New Old Age” column (Jan. 22, 2021): “Subhead: More Americans are writing end-of-life instructions as the pandemic renders such decisions less abstract. But are medical providers listening?”
She wrote, “Lawsuits charging negligence or malpractice by hospitals and doctors typically claim that they have failed to save patients’ lives. More recently, though, some families have sued if providers failed to heed patients’ documented wishes and prevented death from occurring. “In the past, people have said, ‘How have we harmed you if we kept you alive?’” said Thaddeus Pope, a professor at the Mitchell Hamline School of Law in St. Paul, Minn., who follows end-of-life legal cases. “Now, courts have said this is a compensable injury.”
Span added, “The campaign to persuade people to document end-of-life instructions goes back decades, but it remains an uphill battle. A 2017 analysis of 150 studies, involving nearly 800,000 Americans, found that among those over 65, only 45.6 percent had completed an advance directive, including barely half of nursing home residents.”
*** "Hidden Hunger: Elderly Hunger Is on the Rise During Covid," by Cynthia McFadden, Emily R. Siegel and Kevin Monahan, NBC News (January 17, 2021): “Prior to the pandemic, one in 10 older New Yorkers was food insecure, but now that number has soared to one in five, according to a study by FoodBank NYC.”
*** "Budget Requests Boost Focus on Keeping Older Georgians Safe," by Maya T. Prabhu, Atlanta Journal-Constitution (January 21, 2021): “Months after the General Assembly passed sweeping legislation to improve staffing, training and accountability in Georgia’s senior care homes, agencies are seeking to beef up the ranks of those tasked with making sure the state’s elderly are safe.
*** “Despite opposition, Health Care Authority moves forward with $2B plan to privatize Medicaid,” by Carmen Forman, The Oklahoman (Jan. 27, 2021):
“A split Oklahoma Health Care Authority board on Tuesday signed off on plans for the agency to spend up to $2.2 billion to privatize the state’s Medicaid program. After a lengthy debate where efforts to table the controversial agenda items failed, the board did not approve specific contracts with for-profit companies to manage the program’s spending, but gave the agency approval to move forward with overhauling Medicaid.”
Forman reports that Gov. Kevin Stitt, a Republican, urged the Health Care Authority “to contract with outside entities to manage medical care for roughly 700,000 of Oklahoma’s Medicaid recipients through what is often referred to as a managed-care model.”
She explained, “Managed care is an approach to health insurance coverage that seeks to maximize health care quality while stabilizing or cutting costs. Opponents of managed care argue that health care cannot be improved when costs are cut. . . . Representatives from five major Oklahoma health care associations begged members of the Health Care Authority board to oppose funding for managed care contracts. Although much research has been done on managed care, there are no definitive conclusions that hiring for-profit companies to manage care improves health outcomes for patients, said Debra Billingsley, executive director of the Oklahoma Pharmacists Association.”
*** “How climate change is ruining retirement across America,” by Craig Miller, MarketWatch (January 13, 2021): Miller reports on older victims of fires and floods from Northern California to the Carolinas. He wrote, ““The trends are all going the wrong way,” says Adam Smith, an applied climatologist at the National Centers for Environmental Information. Regional climate impacts have become so commonplace that lists of ‘best retirement destinations’ are beginning to take them into account.”
Under the subhead, “Grassroots Efforts Aim to Wake Up Government Leaders,” he added, “State and local government officials are starting to feel the heat from some residents concerned about climate change’s effects where they live.” One effort in South Carolina, Groundswell Charleston, to bring her concerns to city officials. It was slow going at first. ‘The powers that be here were just ignoring it,’ she recalls. ‘It was absolutely not discussed.’ The torpid response from local officials is not unusual, according to A.R. Siders, an assistant professor at the Disaster Research Center at the University of Delaware’s Biden School of Public Policy. ‘This is incredibly difficult because it doesn’t fall under disasters,”’ says Siders, of chronic coastal flooding. ‘It’s not a big, one-time event, it’s this slow-onset creep.’”
*** “Nursing Homes’ Flawed Business Model Worsens COVID Crisis,” by Harris Meyer, AARP (Dec. 7, 2020): Subhead: “To understand the industry’s shortcomings, look at laws going back 85 years.” The veteran health policy reporter writes, “Private equity (PE) firms pool cash from individual investors to buy businesses from which they hope to extract greater profits or reorganize to sell pieces of the business at a profit. These firms often borrow heavily to fund acquisitions. And, as noted, PE firms have gotten deeply involved in the nursing home industry.”
Harris follows up on an unusual 2017 study showing “how PE takeovers of nursing homes affect their operations and finances because the new owners are, well, private.” He goes on, “In 2006, the PE firm Fillmore Capital acquired Beverly Enterprises, a publicly traded operator of more than 300 nursing homes and assisted living facilities in 21 states. Along with renaming the company Golden Living, here are some of the changes the new owners made, according to coauthors Aline Bos and Charlene Harrington, a University of California, San Francisco, professor emerita who has studied nursing homes for decades.”
Golden Living split company operations into a separate pharmacy and other entities, a common practice aimed at maximizing profits in different sectors. Additionally, the company “divided the nursing home chain into individual limited liability companies for each of the properties.” That’s a standard private equity maneuver that, among other advantages, makes it difficult for elders or families to aim legal action at the corporation.
And the firm “significantly reduced per-resident staffing hours to lower-than-industry levels in its California nursing homes, cutting hours for licensed practical nurses and nursing assistants. Subsequent staff increases didn’t keep pace with national trends.” They also Increased the amount of local managers’ compensation based on “financial performance and clinical excellence” rather than base pay. “They can almost double their salary,” said Neil Kurtz, M.D., who is still Golden Living’s CEO.
Meyer went on, “To its credit, the researchers found, Golden Living increased staffing hours for registered nurses, boosted employee training and benefits, and accelerated investments in information and communication technology. But, the researchers wrote, ‘the private equity-owned company did not improve quality of care.’”
The story notes, “After the takeover, Golden Living faced numerous legal and regulatory actions in different states alleging problems with its facilities.”
*** “Nursing Homes Balance COVID-19 Prevention, Social Isolation,” by Cynthia McCormack, Cape Cod Times/Gannett (Jan. 4, 2021): “As the spiraling cases of COVID-19 shut Cape nursing homes . . . to indoor visitors, fears of a return to the social isolation experienced during the spring pandemic peak loom in the minds of residents and their families. Social isolation can be a threat to physical and mental well-being, according to experts in elder health care.”
McCormack continued, “The community spread of COVID-19 is forcing public health officials and nursing home operators to strike an uneasy balance between protecting the state’s most vulnerable residents from infection while attempting to meet their social and mental health needs. Long-term care residents have borne the brunt of the pandemic, making up about 60% of statewide fatalities from COVID-19, with most of the deaths occurring this past spring.
The piece went on, “’Nursing home visitor suspensions constitute a second epidemic — a silent epidemic of social isolation, said Joanne Lynn, MD, [head of Medicaring at the Altarum Institute and] health and aging policy fellow in the office of Congressman Thomas Suozzi. “We did not ask, as a country,” what elderly people thought of being isolated by virtue of their age and susceptibility to the disease of coronavirus, Lynn said. ‘Even if the outcome wouldn’t be any different, it is important to include elderly people in the conversation,’ she said . . . . Lynn wrote a report released in November titled Elder Care and the End of Life in the U.S. that said COVID-19 has made end of life even grimmer for many.”
*** “Study Seeks to Understand Arab American Health During COVID-19,” by Hassan Abbas, Arab American News (Dec. 24, 2020): “New research seeks a better understanding of how social and behavioral aspects of everyday life affect the health and wellness of those aged 65 and older in Metro Detroit. Led by Prof. Kristine Ajrouch, PhD, who heads the University of Michigan’s Center for Contextual Factors in Alzheimer’s Disease, the study is examining the social components of health among older Arab Americans, often overlooked in research. . . . The survey will collect data from Arab Americans, Blacks and Whites living in Metro Detroit. The survey will be the first for which the University of Michigan is hiring all Arab Americans to conduct the interviews, something Ajrouch is excited about. She said underrepresentation of Arab Americans in census data has been a past barrier to research. “There is a difficulty in identifying Arab Americans, just because Arab Americans are considered White,” Ajrouch said.
3. RELIABLE SOURCES
*** Generations SmartBrief is a thrice-weekly e-newsletter from the Washington, D.C. based SmartBrief business news company in partnership with the American Society on Aging (ASA). Sharply designed and crisply cribbed items are aggregated from major and specialized media outlets, summarizing and linking to newly released commercial and noncommercial or government reports on aging.
For instance, the issue for Jan. 20, 2021, features a study by Boston College’s Center for Retirement Research showing the number of household unable to maintain their standard of living in retirement has risen to 51%, with links on it to the Wall Street Journal and the insurance-industry pub, “Plan Sponsor Online.” Another item highlighted a new investigation by the U.S. A Government Accountability Office (GAO) on the lack of data on the costs of financial exploitation of older adults, connecting with the Forbes story. Others in the issue reported on a study of Alzheimer’s disease, from the Seoul-based Korea Herald; decreasing suicides among U.S. cancer patients, in HealthDay News; and a story from McKnight’s Senior Living online on a Pew Research survey showing 68% of adults 65-plus often get their news from TV, while 48% say they use smartphones and other devices.
GBONews mentions the range of professional and trade links because they offer reporters a glimpse of specialized media sources serving the aging enterprise. An occasional glance at some of these can suggest experts and industry leaders sought by insiders for their views and sometimes their political influence. The can offer inside-out views of where the business end of aging is pointing.
*** “Ongoing Regulatory Changes to Medicare in Response to COVID-19” by Jennifer Podulka, Commonwealth Fund “To the Point” blog (January 21, 2021): “Early in 2020, the COVID-19 pandemic prompted Congress and the Trump administration to rapidly waive or change existing Medicare regulations, providing unprecedented flexibility to help health care providers, Medicare Advantage plans, and Part D [prescription drug] plans respond to the public health emergency. Between January 1 and July 24, more than 200 Medicare legislative and regulatory changes were made in response to the pandemic, under various policy rationales, such as patient safety or preventing fraud and abuse. Some of these changes have had a significant impact on the Medicare program and may continue to do so even after the pandemic ends. For example, more services can now be provided via telehealth, and many of the rules governing telehealth have been waived.”
However, they wrote, “Because of the urgency of the situation, nearly all the early actions were taken outside of the established notice-and-comment rulemaking process . . . . While the majority of COVID-19-related regulatory changes were declared temporary when they were announced, the Trump administration indicated plans to make some permanent and had the opportunity to revisit changes through regular rulemaking.”
The report notes further, “The Biden administration has inherited this slate of temporary COVID-related Medicare regulatory changes and will have to decide whether and how to extend these policies given the state of the pandemic and its impact on health care providers. As the new administration addresses the ongoing pandemic with the new phase of vaccinations underway, it is likely that regulatory and subregulatory changes will continue to be introduced and modified to reflect the administration’s COVID and Medicare policies.”
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