CMS Round Up Nov 02, 2023

CMS Roundup (Nov. 3, 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 Announces Final Medicare Payment Rules for Several Provider Types & Services 

October 27: CMS finalized the 2024 payment rate and policy updates for the End-Stage Renal Disease Prospective Payment System for renal dialysis services furnished to people with Medicare. Details are available in this fact sheet

November 1: CMS released the Calendar Year 2024 Home Health Prospective Payment System Rate Update final rule that updates Medicare payment policies and rates for home health agencies. In addition, the final rule establishes a Medicare benefit for lymphedema compression treatment items and finalizes several hospice-related enrollment provisions that will help protect people receiving hospice services by more closely scrutinizing hospice owners and ensuring that they do not pose program integrity risks. Details are available in this fact sheet.

November 2: CMS released the Outpatient Prospective Payment System Remedy for the 340B-Aquired Drug Payment Policy Final Rule, which details the remedy for 340B-acquired drug payments for 2018 to 2022. Information is available in this fact sheet.

 CMS Highlights Strategy to Promote Health Equity for Underserved Populations 

October 20: In an article published by JAMA Health Forum titled "Rewarding Excellent Care for Underserved Populations: A CMS Strategy to Promote Equity Across Quality and Value Programs," CMS highlights how the agency is building on its National Quality Strategy to create a more aligned set of measures across programs to drive care transformation more effectively to address the profound levels of disparities that exist in the U.S. health care system. 

Tribal Protections in Medicaid and CHIP Managed Care Oversight Toolkit

October 30: As part of its commitment to advancing high-quality, person-centered care in Medicaid and the Children’s Health Insurance Program (CHIP), CMS released the Tribal Protections in Medicaid and CHIP Managed Care Oversight toolkit. The toolkit provides resources for states, managed care plans, and Indian Health Care Providers (IHCP) to maximize the benefits of Medicaid and CHIP managed care for American Indian and Alaska Native enrollees and the IHCPs consistent with the statutory and regulatory Indian managed care protections. This is part of CMS efforts to advance health equity, expand coverage, and improve health outcomes for individuals who rely on Medicaid and CHIP.

Blog Outlines CMS’ Role Related to HHS Proposed Rule to Address Information Blocking

October 30: HHS released a proposed rule that would establish disincentives for health care providers that have committed information blocking when providers limit the access, exchange, or use of electronic health information. The Office of the National Coordinator for Health Information Technology published a blog, co-authored by CMS Principal Deputy Administrator & Chief Operating Officer Jonathan Blum, outlining CMS’ role in discouraging information blocking through its programs.

Health Insurance Marketplace Open Enrollment Period Kicks-off 

November 1: Enrollment for 2024 Health Insurance on the Marketplace is open and will continue through January 15, 2024. Consumers are encouraged to visit HealthCare.gov to enroll if they are uninsured, lost their Medicaid or Children's Health Insurance Program (CHIP) coverage, or are looking to find health coverage at a lower cost or a plan that better meets their needs. Tools, tips, and resources on finding the best coverage options available to individuals and families in the federal Marketplace can be found here. Customers who enroll by December 15, 2023, will have coverage that begins January 1, 2024. The Biden-Harris Administration believes health coverage is a human right – and thanks to the Inflation Reduction Act and the American Rescue Plan, health coverage will continue to be affordable. Additional information on the 2024 Health Insurance Marketplace can be found on this fact sheet.

Other Recent Releases: 

October 25: Biden-Harris Administration Launches Window-Shopping Ahead 11th ACA Marketplace Open Enrollment

October 27: Biden-Harris Administration Advances Efforts to Improve the Surprise Billing Payment Dispute Process

October 30: HHS Proposes Rule to Establish Disincentives for  Health Care Providers that have Committed Information-Blocking

November 2: CMS Finalizes Physician Payment Rule that Advances Health Equity

November 2:  CMS Makes Hospital Prices More Transparent and Expands Access to Behavioral Health Care

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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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