As directed by President Trump’s Executive Order on Improving Price and Quality Transparency in American Healthcare, today the Department of Health and Human Services is announcing that the Centers for Medicare & Medicaid Services (CMS) is issuing two rules that take historic steps to increase price transparency to empower patients and increase competition among all hospitals, group health plans and health insurance issuers in the individual and group markets.
Coverage Leadership Legislation Quality
For the first time, the Centers for Medicare & Medicaid Services (CMS) will require the display of the five-star Quality Rating System (or star ratings) available nationwide for health plans offered on the Health Insurance Exchanges beginning with the 2020 Open Enrollment Period.
This report provides effectuated enrollment, premium, and advance payments of the premium tax credit (APTC) data, for the Federally-facilitated and State-based Exchanges (“the Exchanges”) for February 2019 and for the 2018 plan year.
Data highlights enrollment remained largely unchanged since 2017 while affordability continues to be problematic for those without tax subsidies.
Decision ensures consistency in access to the innovative new cancer therapy, and CMS is working closely with sister agencies to monitor outcomes for patients receiving the therapy
New Medicaid Drug Utilization Review standards build on existing state activities to encourage appropriate use of opioids and other medications.
Historic changes to the Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System mean better quality and access