CMS Round Up
CMS Roundup (Aug. 11, 2023)
Today, the Centers for Medicare & Medicaid Services (CMS) provides an at-a-glance summary of news from around the agency.
CMS Finalizes Fiscal Year 2024 Medicare Payment Policies
July 28: CMS issued the Fiscal Year 2024 final rule for Medicare hospice payments, which includes a statutory aggregated cap limiting the overall payments per patient made to a hospice annually to $33,494.01. The rule also takes on several important steps as part of CMS’ broader efforts to address hospice fraud, waste, and abuse. Details are in this fact sheet.
July 31: CMS issued the Fiscal Year 2024 final rule that updates Medicare payment policies and rates for skilled nursing facilities. The rule also includes the adoption of a measure in the SNF Value-Based Purchasing program intended to address staff turnover, as outlined in the President’s Executive Order 14070, Increasing Access to High-Quality Care and Supporting Caregivers. The rule also finalizes a constructive waiver process to ease administrative burdens for CMS related to processing Civil Monetary Penalty appeals. Details are in the fact sheet.
CMS Outlines the Agency’s Vision for Accelerating the Growth of Accountable Care Organizations (ACOs)
July 31: CMS published a blog outlining the agency’s vision for Accountable Care Organizations (ACOs) and the agency’s strategy to accelerate the reach of ACOs and support improved care experiences, access, and quality for consumers, especially those in underserved areas. The article describes how CMS plans to achieve its bold goal of having 100% of people with traditional Medicare in accountable care relationships with providers, who are responsible for the quality and total costs of their care, by 2030.
CMS Posts Proposed Rate Changes for Plan Year 2024 Coverage in the Individual and Small Group Markets
August 1: CMS posted proposed rate changes for all plan year 2024 single risk pool coverage (including both qualified health plans (QHPs) and non-QHPs) in the individual and small group (or merged) markets, in all states, on RateReview.Healthcare.gov for consumers to review and comment. Issuers are required to annually submit proposed rate changes, which are posted to provide an early look at issuers’ initial rate estimates. This year, insurers reported common drivers of rate increases include medical cost and utilization trends, provider reimbursement changes, emerging claims experience being different than expected, market morbidity changes due to Medicaid redeterminations, and plan benefit design changes. Rate changes are often revised before being finalized for the upcoming plan year.
CMS Celebrates No Cost-Sharing Vaccines for People with Medicare During National Immunization Awareness Month
August 1: CMS encouraged partners to remind people with Medicare prescription drug coverage about free recommended vaccines during August, which is National Immunization Awareness Month.
CMS Authorizes an Extension Date of COVID-19 Public Health Emergency Flexibilities in State Medicaid Home and Community-Based Services Waivers
August 2: CMS issued guidance to states on actions they can take to extend flexibilities, such as the use of telehealth that were authorized as part of the COVID-19 public health emergency for Home and Community-Based Services (HCBS) beyond the November 11, 2023, expiration date. Since January 2023, CMS has consistently provided states with information to prepare for the May 11 end of the COVID-19 national emergency and public health emergency declarations, including key dates certain flexibilities are set to expire.
CMS Releases to States a New Postpartum Care Toolkit — Increasing Access, Quality, and Equity in Postpartum Care in Medicaid and CHIP
August 10: CMS released a Medicaid and Chip Postpartum Care Toolkit states can use to increase access, quality, and equity in postpartum care in their communities. The toolkit provides practical information to help state Medicaid and CHIP agencies maximize the use of existing authorities, and it includes a strategy checklist with suggestions for partnering with Medicaid and CHIP managed care plans (MCPs) to implement Quality Improvement (QI) strategies. The tool kit is a key resource aimed at improving maternal health outcomes in the United States and supports the CMS Maternity Care Action Plan and Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis.
Other Recent Releases:
July 28: CMS Responds to Data Breach at Contractor
July 31: CMS Announces 2024 Projected Decrease in Medicare Average Part D Premium
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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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