Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.
Despite ongoing pressure from some members of Congress, the public health emergency declared at the onset of the COVID-19 pandemic is expected to stay in place for the first quarter of 2023.
This declaration — and when it may end — is significant because of its impact on Florida’s mammoth Medicaid program.
The Biden administration promised to give states 60-day notice if the administration plans to lift the designation, which must be renewed every 90 days. The current declaration is due to expire Jan. 11, meaning the notification deadline was Nov. 11.
The Senate this week voted 62-36 in favor of a resolution that would end the overall national emergency declared due to COVID-19. Both Florida Senators — Rick Scott and Marco Rubio — voted to end the emergency, but the Biden administration has vowed to veto the legislation should it reach his desk.
In a statement, the administration said that “while COVID-19 is no longer the disruptive threat that it once was, and we have made tremendous progress in combating the virus, the virus continues to pose a risk to the American people and our health care system.”
The continuation of a public health emergency related to COVID-19 will affect overall state spending on Medicaid since Florida is receiving a higher share of federal reimbursement right now. But that comes with a requirement that people be allowed to remain enrolled in Medicaid. Medicaid enrollment is expected to peak at 5.35 million people during the current fiscal year.
State economists had forecast last August that the overall enrollment would begin to drop once the public health emergency is dropped and the state can start to remove people from the rolls.
Because of the uncertainty, the National Association of Medicaid Directors sent a letter Thursday asking that Congress step in and provide clear direction on the “unwinding” of the public health emergency. The group asked for at least a 120-day notice before states should start redetermining if someone is eligible for Medicaid and provide a phased-out approach to when the extra federal aid now flowing into the state will stop.
“With the lack of an announcement from the U.S. Department of Human Services that the national COVID-19 Public Health Emergency (PHE) will end in January 2023, states are now assuming the PHE will extend into April 2023,” the letter read. “This extension of the PHE — which would be the 12th such extension — exacerbates the uncertainties for state planning to resume normal Medicaid operations. This, in turn, increases the risk of unnecessary losses of health insurance coverage for Medicaid members.”
The letter added the uncertainty around the fate of the public health emergency is “untenable.”
Diagnosis will be off next week in honor of Thanksgiving but will return for publication Dec. 1.
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— Time passages —
Florida’s Medicaid managed care program is the most expensive procurement in the state, and all eyes are on the upcoming bid.
The multiyear contracts are worth billions of dollars to the winning Medicaid managed care plans, and health plans that aren’t chosen to participate in the program will be shut out of Florida’s Medicaid market for six years unless they merge with or buy a managed care plan that did submit a winning bid.
The Agency for Health Care Administration (AHCA) repeatedly has said it expects the procurement to begin sometime during the fourth quarter of the calendar year 2022.
AHCA can still make its self-imposed timetable if it marks the beginning of the procurement cycle with the publication of what’s known as the Medicaid Data Book.
The data book is the Holy Grail of re-procurement. It holds all the information about the state’s Medicaid program that a managed care plan wants or needs to know about the safety net program that serves the poor, elderly and disabled before deciding whether it wants to compete for a contract.
The information book must be published at least 90 days before AHCA publishes its Invitation to Negotiate (ITN).
To date, AHCA has not published the Medicaid Data Book (though the Governor’s office allegedly has the information and is reviewing it.)
Even if the book were to be published tomorrow, the agency wouldn’t be able to post its ITN until the beginning of February.
— Far out —
Can a drug compound made from tomatoes restore age-related muscle loss?
Siobhan Malany, Ph.D., an associate professor of pharmacodynamics at the University of Florida College of Pharmacy, can’t wait to find out.
The Falcon 9 rocket is slated to launch from the Kennedy Space Center in Cape Canaveral next week. On the rocket will be a tiny laboratory that Malany and other UF scientists have built that plugs into the Space Station. The experiment will allow scientists to understand how microgravity affects human muscle biology.
The findings could lead to new therapies for age-related muscle loss on Earth.
“Scientists have turned to space to study the effects of aging because microgravity can accelerate muscle mass changes,” Matany said. “If we can take what we learn in space and apply it to drug development on Earth, then we’re taking a big step forward in developing new therapies for muscle loss in older adults.”
Muscle loss in older adults leads to a decline in mobility, which leads to scores of other problems including falls and fractures.
The UF-built lab features an automated tissue chip system, which feeds nutrients to 3D muscle bundles every six hours. The chips have electrodes that will allow scientists to study muscle contractions. The laboratory also has a microscope camera system that will capture images.
While other chip-based experiments performed on the International Space Station can take weeks of crew time, the UF experiment is fully automated and doesn’t require work from the Space Station crew.
Moreover, the experiment also tests advances in the automation of human tissue-chip technology via miniaturized labs. According to UF, the long-term goal is to, among other things, replace the use of animal models.
The National Institutes of Health and the National Center for Advancing Translational Sciences funded the research. It is also supported by AdventHealth Orlando, Micro-gRx Inc., Micro Aerospace Solutions Inc., Space Tango and the UF Department of Biomedical Engineering.
— Apprentice opportunities —
The Florida Behavioral Health Association (FBHA) developed the first behavioral health apprenticeship model in Florida after receiving a grant from the Florida Department of Education last year.
Dubbed Health Quest, FBHA President and CEO Melanie Brown-Woofter said the program’s goal is to bolster employment in the behavioral health field by supporting recruitment and retention efforts and encouraging more individuals to consider entering the field.
People are given three apprenticeship tracts to choose from: addictions counselor, behavioral health technician and peer specialist.
Since it’s National Apprenticeship Week, there’s no time like the present to tout its success.
According to the FBHA, nearly one dozen professionals have enrolled in the program since its launch. Forty-seven-year-old Charli Cole, a special projects director at STEPS in Orlando, was one of those enrollees.
She said the opportunity was a life changer.
“The apprentice program gave me the opportunity for on-the-job training and experience to help me advance my education and job skills while maintaining my employment. Thanks to full support from my employer, pursuing the certification for the Addictions Counselor gave me more confidence,” Cole said in a prepared release. “It also encouraged me to go back to school and further my education, knowing that I had such a supportive work environment.”
This article originally appeared here and was republished with permission.