CMS Round Up Aug 16, 2024

CMS Roundup (August. 23, 2024)

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Today, the Centers for Medicare & Medicaid Services (CMS) provides an at-a-glance summary of news from around the agency.

CMS Releases Updated Poster for Hospital Posting of the Emergency Medical Treatment and Labor Act (EMTALA) Rights for all Patients

August 13: CMS released a new poster for hospitals to display for patients to know their Emergency Medical Treatment & Labor Act (EMTALA) rights, as well as a Quality, Safety & Oversight (QSO) memo for State Survey Agency Directors announcing the release of the poster. CMS regulations require Medicare-participating hospitals to post signage outlining patients’ rights under EMTALA in the emergency department and areas where patients will be examined or treated, or wait to be examined or treated, for emergency medical conditions (EMCs). The poster, which can be viewed in the “Downloads” section at the bottom of the linked page, includes information about patient rights through EMTALA and how to file a complaint if patients believe their rights have been violated. Hospitals are encouraged to use this updated model signage in emergency room departments and other hospital settings to meet the required posting obligations.

CMS Posts Content on Medicare.gov in Preparation of Coverage Transition from Part D to Part B of Antiretroviral Drugs to Prevent HIV

August 13: CMS posted information encouraging pharmacies and other affected parties to prepare now for the expected transition of coverage, from Medicare Part D to Medicare Part B, for Pre-exposure Prophylaxis (PrEP) antiretroviral drugs to prevent HIV. The final National Coverage Determination (NCD) is expected to be released in late September 2024, and coverage under Part B will begin once CMS releases the final NCD. Information about this coverage transition can be found at: PrEP for HIV & Related Preventive Services.

CMS Announces State Notice of Funding Opportunity (NOFO) for participants in the Cell and Gene Therapy (CGT) Access Model

August 15: CMS announced the state Notice of Funding Opportunity (NOFO) for participants in the Cell and Gene Therapy (CGT) Access Model. The CGT Access Model is a voluntary model that aims to improve the lives of people with Medicaid living with rare and severe diseases by increasing access to potentially transformative treatments. All states and U.S. territories that participate in the Medicaid Drug Rebate Program (MDRP) are eligible to apply to participate in the model. 

CMS Shares Medicare Administrative Contractor (MAC) Update Regarding Proposed Local Coverage Determination (LCD) for MolDx Molecular Testing for Solid Organ Allograft Rejection 

August 16: In response to public comments and upon further review of evidence, Medicare Administrative Contractors (MACs) are not finalizing the most recently proposed Local Coverage Determination (LCD) for MolDx Molecular Testing for Solid Organ Allograft Rejection, which is a blood test that monitors for organ transplantation rejection, and instead anticipate issuing a new proposed LCD in the coming months. CMS informed partners of this update. 

Patients with transplanted hearts, lungs, or kidneys who meet Medicare’s existing local coverage criteria can continue to access these blood tests under the current LCD. 

CMS Releases Guidance on Federal Medicaid Renewal Requirements to Promote Continuity of Coverage for Individuals Receiving Home- and Community-Based Services 

August 19: CMS released an informational bulletin to highlight federal renewal requirements and available flexibilities to promote continuity of coverage for individuals eligible for home- and community-based services (HCBS) through Medicaid. This bulletin continues CMS' work helping eligible people renew their Medicaid coverage so that they can continue receiving the critical services they need. 

CMS Updates Health Equity Disparities Impact Statement

August 20: CMS updated the Health Equity Disparities Impact Statement, which is posted online and was sent to partners via listserv. This tool can be used by all health care stakeholders to identify and address health disparities while improving the health of all people, including people with disabilities, sexual and gender minorities, racial and ethnic minorities, individuals with limited English proficiency, and those who live in underserved areas. 

CMS Publishes a Blog in Health Affairs Forefront Outlining the Innovation Center’s Data Sharing Strategy

August 21: CMS published in Health Affairs Forefront a blog outlining the Innovation Center's data sharing strategy. Given the role and importance of data to the work of CMS and model participants, CMS developed a data sharing strategy with a primary goal of identifying data sharing needs across CMS Innovation Center models. The blog covers the output of this work, including key takeaways, recommendations, and next steps. 

Other Recent Releases: 

August 15: CMS Announces New, Lower Prices under the Medicare Drug Price Negotiation Program

August 16: CMS Commemorates the 2nd Anniversary of the Biden-Harris Lower Cost Prescription Drug Law 

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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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