This Week on the Hill
The House and Senate are adjourned until the week of November 14.
DOT Accepting Applications for $850 Million in FASTLANE Grants
The U.S. Department of Transportation (DOT) announced a call for applications for up to $850 million in Fostering Advancements in Shipping and Transportation for the Long-Term Achievement of National Efficiencies (FASTLANE) grants. The FASTLANE program was established in the Fixing America’s Surface Transportation (FAST) Act to fund critical freight and highway projects across the country. The FAST Act authorized the program at $4.5 billion for fiscal years 2016 through 2020, including $850 million for fiscal year 2017. DOT received 212 applications for fiscal year 2016 awards totaling nearly $9.8 billion and awarded just over $750 million to 18 projects. The deadline for submitting applications for the second round of funding is December 15.
CMS Releases Final Outpatient Payment Rule for Medicare, Addresses Opioid Overprescribing
The Centers for Medicare and Medicaid Services (CMS) announced the finalized updated payment rates and policy changes for hospital outpatient care and ambulatory surgical center care for calendar year 2017. CMS estimates the updates in the final rule would increase Hospital Outpatient Prospective Payment System payments by 1.7 percent and Ambulatory Surgical Center Payment System payments by 1.9 percent in 2017. The final rule also addresses physicians’ and other health care providers’ concerns that patient survey questions about pain management unduly influence prescribing practices; CMS is removing pain management questions from the customer satisfaction survey for hospital patients (known as the Hospital Consumer Assessment of Healthcare Providers and Systems). The final rule can be found here and a fact sheet on the rule can be found here.
USDA Announces Grants in 39 States for Rural Water Infrastructure Projects
Last week the U.S. Department of Agriculture (USDA) announced an investment of $331 million in 85 projects that will improve water and wastewater infrastructure in rural areas in 39 states and American Samoa. USDA is providing $264 million in loans and $67 million in grants through Rural Development’s Water and Environmental programs, which provide assistance and financing to develop drinking water and waste disposal systems for communities with 10,000 or fewer residents. According to the announcement, funding for each project is contingent upon the recipient meeting the terms of the loan, grant, or loan/grant agreement. Since 2009, USDA Rural Development has invested $13.9 billion for 5,825 water and waste infrastructure projects benefiting 19.5 million rural residents. A list of projects can be found here and additional information on the Rural Development program can be found here.
CMS Releases 2017 Medicaid Managed Care Rate Development Guide
The Centers for Medicare and Medicaid Services (CMS) released the 2017 Medicaid Managed Care Rate Development Guide for use in setting rates for rating periods starting January 1, 2017 and June 30, 2017. The guide outlines federal standards for rate development and describes information that CMS expects states and their actuaries to provide when developing actuarial rate certifications. CMS notes that one of the lessons learned from implementation of previous rate development guidance was that the guidance needed to be more detailed to get more consistent and complete documentation included in the rate certifications. The new guide includes three sections: the first section applies to all Medicaid managed care capitation rates; the second section outlines specific concepts that states and their actuaries must consider when developing rates that include long-term services and supports; and the third section focuses on issues specific to new adult group capitation rates.
Administration Announces Actions to Deploy Electric Vehicles and Charging Stations
As part of the administration’s efforts to combat climate change, last week the White House announced the establishment of 48 national electric vehicle charging corridors on highways, covering nearly 25,000 miles in 35 states. In addition, 28 states, utilities, vehicle manufacturers and other organizations are committing to accelerate the deployment of electric vehicle charging infrastructure on the corridors while 24 state and local governments are committing to partner with the administration and increase the procurement of electric vehicles in their fleets. The “alternative fuel” corridors include 55 interstates that will serve as the basis for a national network spanning 35 states plus the District of Columbia; 48 of these routes are designated as electric vehicle charging corridors and certain states are authorized to use signs developed by the U.S. Department of Transportation that identify electric vehicle charging stations, similar to signs that currently identify gas stations, food and lodging.
Mental Health and Substance Use Disorder Parity Task Force Final Report
The Mental Health and Substance Use Disorder Parity Task Force released its final report that offers recommendations to advance parity in mental health and substance use disorder health benefits. The report notes that states play an important role in implementing and enforcing parity with respect to the individual and small group markets and that some states have developed promising practices that would provide a useful model for other states to follow. A report prepared by the Substance Abuse and Mental Health Services Administration outlines promising practices from California, Connecticut, Maryland, Massachusetts, New York, Oregon, and Rhode Island.
DOT Announces Pilot Program to Deliver Transportation Aid Directly to Local Governments
The U.S. Department of Transportation (DOT) Federal Highway Administration issued a notice announcing a pilot program to permit, on an experimental basis, direct delivery of federal funding of up to five local public agencies (LPAs). According to the notice, these LPAs will be subject to federal oversight and the state transportation department will be relieved of direct oversight and accountability for projects funded under the pilot program; the program is named the Local Empowerment for Accelerating Projects (LEAP) pilot program. The pilot will be carried out for a period of five years, but may be extended. The Federal Highway Administration cites two goals in launching the LEAP pilot program: to evaluate the impact of direct federal aid funding on effectiveness, efficiency, and expediency of projects delivered by LPAs; and to assess the cost and benefit of direct federal aid funding of LPAs as well as the highway administration’s ability, administrative costs, and resources needed to oversee an expanded base of direct aid recipients by using various approaches to oversight. Applicants must agree to a voluntary contribution from non-federal funds in an amount equal to one percent of the funds transferred from the highway administration. Applications must be received by November 25.
Labor Awards $30 Million to State Workforce Agencies to Improve UI Program Operations
The U.S. Department of Labor (DOL) recently announced awards totaling approximately $30.4 million to 39 workforce agencies nationwide for initiatives to improve the delivery and management of state unemployment programs. The funds will support efforts to improve unemployment insurance (UI) program operations, better assist those eligible for the program, prevent and detect fraud, and modernize outdated information technology systems to ensure program efficiency. The awards were made to 35 state workforce agencies and four multi-state consortium projects.
Recently Released Reports
Opioid Addiction: Laws, Regulations, and Other Factors Can Affect Medication-Assisted Treatment Access, U.S. Government Accountability Office
Family Options Study: Three-Year Impacts of Housing and Services Interventions for Homeless Families, U.S. Department of Housing and Urban Development
State Child Care Assistance Policies 2016, National Women’s Law Center
The Future of Youth Justice: A Community-Based Alternative to the Youth Prison Model, Harvard Kennedy School/National Institute of Justice
Declines in Opioid Prescribing After a Private Insurer Policy Change - Massachusetts, 2011-2015, Centers for Disease Control and Prevention
Economic News
Economy Adds 161,000 Jobs in October
New data released last week by the U.S. Bureau of Labor Statistics showed that total nonfarm payroll employment increased by 161,000 in October and the unemployment rate was little changed at 4.9 percent (compared to 5.0 percent the previous month). Over the past three months, job growth has averaged about 176,000 a month. The data also shows that in October there were 7.8 million unemployed persons, down slightly from 7.9 million in September. The number of long-term unemployed (jobless for 27 weeks or more) was unchanged at 2.0 million, accounting for 25.2 percent of the total unemployed. The labor force participation rate was essentially unchanged at 62.8 percent. In October, job gains occurred in health care (31,000), professional and business services (43,000) and financial activities (14,000). Mining jobs were unchanged in October, and employment saw little change for construction, wholesale trade, retail trade, government and manufacturing. The average hourly earnings for all employees increased by 10 cents to $25.92 in October, following an increase of 8 cents in September. Over the year, average hourly earnings have risen by 2.8 percent.
Federal Reserve Holds Interest Rates Steady for Now, Increase Expected in December
At its November meeting, the Federal Open Market Committee voted 8-2 to maintain the target range for the federal funds rate at .25 to .50 percent. The committee noted information received since the September meeting indicates that the labor market has continued to strengthen and that growth of economic activity has picked up from the modest pace seen in the first half of this year. Although there has been little change in the unemployment rate, job gains have been solid. Household spending has been growing moderately but business fixed investment has remained soft; also inflation has increased somewhat since earlier this year but is still below the Committee’s 2 percent longer-run objective. Looking at future possible adjustments, the statement says that “the case for an increase in the federal funds rate has continued to strengthen but the Committee has decided, for the time being, to wait for further evidence of continued progress towards its objectives.” The two members who voted for raising the federal funds rate preferred to raise the target range to .50 to .75 percent. An increase is widely expected at the December meeting.