CMS Round Up
CMS Roundup (Sep. 22, 2023)
Today, the Centers for Medicare & Medicaid Services (CMS) provides an at-a-glance summary of news from around the agency.
Mobile Crisis Intervention Services for People with Medicaid Approved for DC and Indiana
Under the American Rescue Plan, states have a new option for supporting community-based mobile crisis intervention services for individuals with Medicaid. Recently, CMS approved mobile crisis state plan amendments for the District of Columbia (September 8) and Indiana (September 19). Mobile crisis intervention services provide rapid, critical services to people experiencing mental health or substance use crises by connecting them to a behavioral health specialist 24 hours per day, 365 days a year. This option will help states integrate these services into their Medicaid programs, a critical component in establishing a sustainable, public health-focused support network.
CMS Publishes Study on the Prevalence of Oral Health Problems Among Nursing Home Residents
September 12: In a paper titled Oral Health Among Medicare Beneficiaries in Nursing Homes, published in JAMA Network OPEN, CMS analyzed oral health problems among Medicare beneficiaries in nursing homes, finding considerable prevalence and disparities across various demographic and clinical factors, and highlighting the need for targeted interventions that address oral health among vulnerable nursing home residents. Improved access to oral health services and coverage is a key strategic initiative CMS is working on to help people achieve the best health outcomes possible.
CMS Posts FAQs Educating Mental Health Counselors and Marriage and Family Therapists on Proposed Rule Definition of Mental Health Counselors and Marriage and Family Therapists and Existing Enrollment Process
September 13: CMS posted some Frequently Asked Questions (FAQs) to educate mental health counselors and marriage and family therapists on the CY 2024 Physician Fee Schedule (PFS) proposed rule related to the existing enrollment process. The FAQs outline proposed qualifications and enrollment steps mental health counselors and marriage and family therapists would need to take to get enrolled in Medicare so they can bill Medicare for services. Specifics around the definition of mental health counselors and marriage and family therapists and required credentials are being proposed in the CY 2024 PFS, which can be viewed here.
Indiana Medicaid Approved to Reimburse School-Based Services
September 13: CMS approved a state plan amendment (SPA) for Indiana Medicaid, allowing the program to reimburse medically necessary school-based nursing services, psychologist testing services (if done by a licensed individual), and school-based transportation for qualified Medicaid enrolled children. These SPAs are based on CMS guidance that gives states the option to provide physical and behavioral health care services to any school student who is enrolled in Medicaid — and to get federal Medicaid reimbursement for those services.
Wyoming Approved to Extend Postpartum Coverage for a Full Year to People with Medicaid
September 14, 2023: CMS approved a postpartum coverage extension state plan amendment (SPA) for Wyoming to extend postpartum coverage for a full year for individuals enrolled in Medicaid. The opportunity to extend postpartum coverage was made possible under the American Rescue Plan and made permanent in the Consolidated Appropriations Act, 2023. Wyoming’s approval marks 37 states, D.C., and the U.S. Virgin Islands that have extended postpartum Medicaid coverage to a full year. This approval supports the CMS Maternity Care Action Plan and Biden-Harris Maternal Health Blueprint.
CMS Releases Federal Funding Methodology for 2024 Basic Health Program Payment Rates
September 15: CMS released an Informational Bulletin on the 2024 federal funding methodology for the Basic Health Program under the Affordable Care Act (ACA), which provides basic health care coverage to low-income residents who qualify. Participating states have the option to provide more affordable coverage than what is offered in the ACA Marketplace to people with incomes between 133% and 200% of the federal poverty level and who do not qualify for Medicaid, Childrens Health Insurance Program (CHIP), or other minimum coverage. The funding methodology is an annual release that supports states in their efforts to provide access to health care coverage.
CMS and Health Resources and Services Administration (HRSA) Announce Collaborative Organ Transplantation Affinity Group for Improving the Organ Transplantation System
September 15: CMS and HRSA announced through a blog an action plan of their collaborative Organ Transplantation Affinity Group (OTAG) to improve organ donation, procurement, transplantation, and clinical outcomes. The blog introduced five goals for organ transplantation system improvement to strengthen accountability, equity, and transparency. The blog also includes a patient journey map illustrating the transplantation journey, challenges, and actions to take along the way. Improving the organ transplantation system is a priority for the Biden-Harris Administration.
CMS Announces Recipients of the 2023 Minority Research Grant Program
September 19: CMS Office of Minority Health (OMH) announced awardees for the 2023 Minority Research Grant Program and posted it on CMS.gov. Three recipients will be awarded grants to expand CMS' commitment to advancing health equity among the populations served. Each grantee will receive $333,000 to support their projects, examining critical public health disparities and increasing health equity research capacities at minority-serving institutions. The 2023 grantees include Morgan State University (Racial Disparities in Maternal Child Health and the Role of Doulas in Reducing Disparities), University of New Mexico Health Sciences Center (Community Peer Education Project: Prisoner Health is Public Health), and California State University San Marcos Corporation (Community Schools Bridges2Health Research).
CMS Updates Nursing Home Staffing Measures Used for Nursing Home Compare
September 20: CMS updated the methodology used for the Nursing Home Care Compare’s Staffing and Quality Measures to align with changes to underlying resident assessment data. Staffing in nursing homes has a substantial impact on the quality of care and outcomes residents experience, and refining the staffing and quality measures posted on Nursing Home Care Compare continues the Biden-Harris Administration’s commitment to transparency.
CMS Issues Guidance Reinforcing that Nurse Midwives can Efficiently and Effectively Provide Care Without the Oversight of Providers
September 21: CMS issued guidance reinforcing that hospitals can allow nurse midwives to admit and provide care to non-Medicare beneficiaries without the oversight of a Doctor of Medicine or Osteopathy. The guidance allows for efficient access to both primary and maternity care and supports CMS’ Maternity Care Action Plan—part of the Biden-Harris Maternal Health Blueprint for addressing the Maternal Health Crisis.
CMS Innovation Center Explains “How an Idea Becomes a Model”
September 21: The CMS Innovation Center published a webpage that explains how models are formulated, vetted, and selected to become models. The page also provides an overview of model development and evaluation and includes a list of resources to learn more about the work being done by the Innovation Center.
Other Recent Releases:
September 21: Coverage for Half a Million Children and Families Will be Reinstated Thanks to HHS’ Swift Action
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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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