MHA Today | Sepember 2, 2022

Staff Contact: Kara Amann-Kale or Keri Barclay

Following the recommendation of the Advisory Committee on Immunization Practices, the CDC recommends the use of updated mRNA COVID-19 boosters that include bivalent strains of the SARS-CoV-2 virus in individuals ages 12 and older – specifically, Moderna’s booster for those 18 years and older, and Pfizer BioNTech’s booster for those 12 years and older. These actions followed emergency use authorization of these boosters from the FDA. This authorization also revoked use of monovalent mRNA COVID-19 booster doses for individuals 12 years of age and older. DHSS is expected to provide standing orders that will be available on their website.

These changes will prevent hospitals from administering on-hand monovalent boosters to patients awaiting discharge to LTCFs that require residents to be up to date with their COVID-19 vaccines. As a result, hospitals should consider ordering boosters now through the DHSS portal for delivery expected around Monday, Sept. 12. Hospitals that have or will receive preordered bivalent boosters over the next several days should consider prioritizing their initial allocation for LTC discharges.

Staff Contact: Brian Kinkade

CMS is preparing to file rules that will remove barriers to and streamline the Medicaid application submission process and enrollment. The rules will eliminate steps that can prevent or delay eligible elderly and disabled individuals from becoming covered, and mitigate states’ administrative practices that can cause individuals to inappropriately lose coverage when eligibility is being reevaluated. CMS also will update and standardize requirements for state recordkeeping and program integrity activities. The proposed rules will be published in the Federal Register on Sept. 7. Public comments will be accepted for 60 days. MHA has prepared an issue brief on the proposed rule.

Staff Contact: Brian Kinkade

CMS released its report of states’ performance in processing Medicaid applications for the first quarter of 2022. The report reflects the struggles DSS has had keeping up with the influx of applications associated with Medicaid expansion. The department’s performance led CMS to impose a “mitigation plan,” which gives the state opportunities to expedite processing and requires the state to get its average processing time for Medicaid applications within the 45-day standard set by federal regulation by Friday, Sept. 30. Recent reports from the department indicate that processing performance is improving and that it expects to meet the CMS-imposed timeliness goal.

Staff Contact: Brian Kinkade

Missouri Medicaid covers nursing facility care for non-disabled adult participants. MO HealthNet adults who are enrolled in managed care and need skilled nursing care will remain in the managed care program until a skilled nursing placement is arranged or 60 days, whichever occurs first. Once placed, the participant will be disenrolled from managed care and enrolled in the fee-for-service program.

Staff Contact: Sherry Buschjost

CMS selected up to 500 hospitals for validation of chart-abstracted measures for the CY 2024 annual payment update determination. The quarters included in the outpatient data validation efforts are 1Q2022, 2Q2022, 3Q2022 and 4Q2022. The list of hospitals selected for CY 2024 validation, as well as validation resources, are available on QualityNet.