CMS Round Up
CMS Roundup (June. 16, 2023)
Today, the Centers for Medicare & Medicaid Services (CMS) is providing an at-a-glance summary of news from around the agency.
CMS Posts Resources Addressing the Needs of Adults with Intellectual & Developmental Disabilities and Their Caregivers
June 2: As part of its commitment to advancing health equity and access to care for underserved populations, CMS released a set of resources addressing the needs of adults with intellectual and developmental disabilities (I/DD) living with and cared for by aging parents or guardians. The release includes resources for state Medicaid and partner agencies to provide new or additional support to adults living with I/DD and their caregivers as they age and experience life transitions.
CMS Seeking Charter Members to New Air Ambulance Advisory Committee
June 2: CMS is seeking nominations for charter members of its first Air Ambulance Advisory Committee. HHS and the Department of Transportation established the Advisory Committee on Air Ambulance Quality and Patient Safety to review options to develop quality, patient safety, and clinical capability standards for each clinical capability level of air ambulances. Currently, there are no Medicare standards of care or quality requirements for air ambulance agencies providing life-saving services to the most critically ill and injured patients. The committee is required to hold its first meeting within 90 days of enactment and submit a report to Congress within 180 days of the first meeting. The member nomination period is open for 21 days, and information can be found here.
With the Addition of South Dakota and New York, Postpartum Coverage Under Medicaid/CHIP Expands to 35 States & D.C.
June 5: South Dakota received approval to extend postpartum coverage for a full year for individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). Here is the link to the Medicaid approval; here is the link to the CHIP approval.
On June 13, New York became the 35th state, including D.C., to extend postpartum Medicaid/CHIP coverage to a full year. Here is the link to the Medicaid approval; here is the link to the CHIP approval. Details are in the press release link below. CMS’ approval of the South Dakota and New York state plan amendments allowing the postpartum coverage extension was made possible by the American Rescue Plan.
CMS Issues Guidance on Hospital Discharges to Post-Acute Care Providers
June 6: As part of its continuing commitment to protecting patient health and safety of patients when they are discharged from hospitals to post-acute providers, CMS issued guidance reminding state agencies, accrediting organizations, and hospitals of the requirements for discharges and transfers to post-acute care, including the provision of appropriate patient information to the post-acute care provider and caregivers. The guidance identifies areas of concern related to missing or inaccurate patient information and offers recommendations hospitals can leverage to improve and protect patients’ health and safety during the discharge and transfer process. A copy of the guidance is available here.
Newly Released Data Briefs Detail Medicaid/CHIP Enrollee Demographic Characteristics
June 7: CMS released a series of data briefs detailing various demographic characteristics of Medicaid and Children’s Health Insurance Program (CHIP) enrollees for the first time. The four data briefs focus on the race and ethnicity, rural residency, primary language, and disability-related eligibility of the national Medicaid and CHIP populations. Collectively, the Medicaid and CHIP programs provide essential coverage to one in five Americans, including low-income adults, children, and people with disabilities, and the release of these data briefs is a major step toward sharing public data on some of the nation’s largest and most important health coverage programs and the individuals they serve.
CMS Outlines the Innovation Center’s Primary Care Strategy
June 9: CMS' Center for Medicare and Medicaid Innovation (Innovation Center) outlined its primary care strategy in a blog that discusses CMS’ commitment to creating more opportunities for primary care to move from fee-for-service to value-based payment approaches that are more reliable, more supportive of thoughtful clinician practice and patient engagement, and provide a better foundation for supporting whole-person care, which includes relationships with specialty care and addressing health-related social needs. The blog describes the Innovation Center’s approach to supporting primary care under the dimensions of financing, equity, and sustainability through an overview of the newly-announced Making Care Primary Model that will be tested in eight states and outlines additional pathways the Innovation Center is exploring.
CMS Issues Update to Critical Access Hospital Annual 96-Hour Patient Length of Stay Calculations Post Public Health Emergency (PHE)
June 9: CMS issued guidance that Medicare Administrative Contractors will resume standard practice for evaluating the annual average 96-hour patient length of stay requirement for Critical Access Hospitals (CAHs), which was waived during the PHE. Medicare-certified CAHs are required to meet the annual 96-hour average patient length of stay standard for acute inpatient care under the CAH Conditions of Participation (CoPs). CMS waived the requirement that CAHs limit the annual average patient length of stay to 96 hours during the PHE, which ended May 11, 2023. The purpose of the guidance is to alert state agencies of a one-time change to the CAH 96-hour patient length of stay calculation to account for the time period of the PHE. The guidance can be found here.
CMS Releases Additional Materials on Medicaid Unwinding
June 12: CMS announced the release of additional materials related to Medicaid unwinding, including strategies states may use to help Medicaid enrollees complete renewals or connect to other coverage, as appropriate. At the same time, the Department of Health and Human Services (HHS) released a letter to the nation’s governors urging them to adopt policies that help individuals and families keep their health coverage. The materials can be found here.
CMS Releases New Data to Raise Awareness of Extra Help Available to Low-Income Seniors with Medicare Prescription Drug Coverage
June 12: CMS released new national data on people with Medicare Part D living in the community who benefit from the Low-Income Subsidy program (a.k.a. Extra Help), those who are likely eligible for Extra Help but not enrolled, and those who stand to save more on prescription drugs thanks to the program’s forthcoming expansion in 2024 under the Inflation Reduction Act. This data includes key demographic information, like gender, age, race and ethnicity, metro status, and limited English proficiency. This release is part of the Administration’s ongoing efforts to raise awareness of the Extra Help program. A link to the public-use files is available here. Outreach information and resources to increase awareness of Extra Help can be found here.
New Web Pages to Help Consumers Understand their Rights and Protections Against Unexpected Medical Bills
June 14: To help consumers understand their rights and protections under the No Surprises Act, CMS created a new set of web pages on CMS.gov. In addition to providing information about protection against unexpected medical bills, the pages include an interactive tool to help consumers identify actions they can take to resolve their billing situation, as well as a redesigned complaint form so they can more easily report a violation if they believe the rules aren’t being followed. The new consumer content can be found at https://www.cms.gov/medical-bill-rights.
Correction: The June 2 CMS Roundup included a link to the wrong fact sheet regarding CMS’ announcement of a temporary gap in the Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) Competitive Bidding Program (CBP) starting on January 1, 2024. The link to the correct fact sheet can be found here. We apologize for the error.
Other Recent Releases:
June 8: CMS Announces Multi-State Initiative to Strengthen Primary Care
June 12: HHS Takes Additional Actions to Keep People Covered as States Resume Medicaid & CHIP Renewals
June 14: CMS Office of the Actuary Releases 2022-2031 National Health Expenditure Projections
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CMS, an agency within the U.S. Department of Health and Human Services, serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes. The agency protects public health by administering the Medicare program and working in partnership with state governments to administer Medicaid, CHIP, and the Health Insurance Marketplace.
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