CMS Round Up

CMS Roundup (Jan. 26, 2023)

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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 Approves State Plan Amendments Extending Postpartum Coverage in Texas

January 17: CMS marked another important maternal health milestone by approving Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage extensions in Texas through the American Rescue Plan (ARP). Nationally, people across 43 states and the District of Columbia now have access to Medicaid and CHIP coverage for a full 12 months following pregnancy — up from just 60 days before the ARP. Postpartum coverage extensions form one of the cornerstones of CMS’ Maternity Care Action Plan—part of the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis. Here are the approved state plan amendments for Medicaid and CHIP

CMS Adds More Utilization Data to Doctor and Clinician Profiles on Care Compare Tool

January 18: CMS announced that it has added utilization data, specifically procedure volume, for the first time on the compare tool’s profile pages for doctors and clinicians. The procedures initially added to profile pages were performed by doctors and clinicians for Traditional Medicare and Medicare Advantage patients in the last 12 months, after allowing a three-month claim processing period (for example, claims for dates of service occurring between June 1, 2022, through June 30, 2023, that were processed by September 30, 2023).   

This is the latest example of CMS’ transparency efforts to ensure the compare tool on provides patients and caregivers with information about services they may value as they search for clinicians.

The U.S. Department of Health and Human Services and the Departments of Labor and the Treasury Issue FAQs on Coverage of Contraceptives Under the Affordable Care Act

January 22: U.S. Departments of Health and Human Services, Labor, and the Treasury issued new FAQs to help group health plans and health insurance issuers comply with the requirements under the Affordable Care Act to cover contraception without cost-sharing. A related press release can be found here.

CMS Posts “Data to Drive Decision Making Cross-Cutting Initiative” 

January 25: CMS is committed to taking a data-driven approach by increasing the availability and flow of data to help improve health outcomes. The agency detailed its approach in a new “Data to Drive Decision Making Cross-Cutting Initiative” Fact Sheet, which outlines CMS' data principles and operating norms. This work supports the Biden-Harris Administration's commitment to making more informed policy decisions based on data and driving innovation and person-centered care through the seamless exchange of data.

Other Recent Releases: 

January 17: CMS Finalizes Rule to Expand Access to Health Information and Improve the Prior Authorization Process

January 18: CMS Announces New Model to Advance Integration in Behavioral Health

January 18: FDA and CMS Statement: Americans Deserve Accurate and Reliable Diagnostic Tests, Wherever They Are Made 

January 22: CMS Announces New Actions to Help Hospitals Meet Obligations under EMTALA

January 24: Historic 21.3 Million People Choose ACA Marketplace Coverage

January 24:  CMS Announces $50 Million in Grants to Deliver Critical School-Based Health Services to Children

January 25: Biden-Harris Administration Launches Effort to Increase Medicare Advantage Transparency


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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