CMS Round Up
CMS Roundup (Oct. 6, 2023)
Today, the Centers for Medicare & Medicaid Services (CMS) provides an at-a-glance summary of news from around the agency.
CMS Revises Civil Money Penalty Reinvestment Program to Advance Quality Care for Nursing Home Residents
September 25: CMS issued updated guidance for the Civil Money Penalty Reinvestment Program (CMPRP) for projects to support the quality of care and life for nursing home residents in long-term care facilities certified by Medicare and Medicaid. Under the program, a portion of civil money penalty (CMP) funds for noncompliance is provided to the State to reinvest in activities that will benefit residents to protect and improve their safety and quality of care. The CMPRP revised policies clarify the allowable uses of CMP funds, with maximum funding limits per nursing home and a clear list of the non-allowable uses of CMP funds.
CMS Approves Virginia Medicaid Plan to Reimburse School-Based Services
September 25: CMS approved an expanded school-based services state plan amendment (SPA) for Virginia Medicaid, allowing the program to cover medically necessary school-based nursing services, psychologist testing services (if done by a licensed individual), and school-based transportation for qualified Medicaid and Childrens Health Insurance Program (CHIP) enrolled children. SPAs like Virginia’s are based on CMS guidance that gives states the option to provide physical and behavioral health care services to eligible students through Medicaid. The approval is a win for the health and safety of Virginia children and their families who rely on Medicaid.
CMS Announces 2023 Health Equity Data Access Program Grantees
September 25: CMS’ Office of Minority Health (OMH) announced the grantees selected for the 2023 Health Equity Data Access Program (HEDAP). CMS supports up to three “seats” that are granted unrestricted access to CMS data for minority health research stored in the CMS Virtual Research Data Center (VRDC), with each grant worth up to $90,000. The HEDAP assists researchers from public and state-controlled or private higher education institutions to access the data for minority health research that can be used to identify trends and potential solutions for improving health equity, a top CMS priority.
CMS Releases Comprehensive Medicaid Transportation Coverage Guide for States
September 28: CMS released a Medicaid Transportation Coverage Guide, a compilation of Medicaid transportation policy providing a one-stop transportation resource for states on federal requirements and state flexibilities. The guide highlights existing policies and includes new policies to address scenarios for extended wait times, long-distance trips to health care facilities, and scenarios where non-Medicaid-eligible parents, family members, or other caregivers may require transportation to participate in a Medicaid-eligible child’s care. CMS is committed to equity and ensuring that individuals who rely on Medicaid, including those living in rural areas, can access the care they need to stay healthy.
CMS Launches Sickle Cell Disease Action Plan to Expand, Improve Coverage, Care & Outcomes
September 28: As part of CMS’ efforts to expand access and coverage for individuals with sickle cell disease (SCD), CMS released its action plan in conjunction with Sickle Cell Disease Month. Sickle Cell Disease – an inherited blood disorder, affects approximately 100,000 individuals in the United States, the majority of whom are Black/African American, and/or Hispanic. The plan addresses the challenges specific to CMS programs and is designed to improve health outcomes and reduce health disparities for individuals with SCD. Additional information is included in this blog authored by CMS Administrator, Chiquita Brooks-LaSure and CMS Office of Minority Health Acting Director, Dr. Aditi Mallick.
CMS Approves Mobile Crisis Intervention Services for People with Medicaid in Massachusetts
September 29: CMS approved a mobile crisis state plan amendment for Massachusetts. Authorized under President Biden’s American Rescue Plan (ARP), mobile crisis intervention services provide rapid, critical services to people experiencing mental health or substance use crises by connecting them to a behavioral health specialist 24 hours per day, 365 days a year. This option will help states integrate these services into their Medicaid programs, a critical component in establishing a sustainable, public health-focused support network. A link to the approval can be found here.
CMS Seeks Public Comment on Implementation of Mental Health Parity and Addiction Equity Requirements
September 29: CMS is working to help ensure that insurance coverage for mental health conditions, including substance use disorders, is no more restrictive than coverage for any other medical condition. The agency recently posted information and questions for public comment on potential improvements that could be made to Mental Health Parity and Addiction Equity (MHPAEA) requirements in Medicaid and the Children's Health Insurance Program (CHIP) to address mental health coverage roadblocks. This request for comment will gather information to address concerns regarding compliance with MHPAEA requirements in Medicaid and CHIP. Comments must be submitted to the following email address by November 3rd, 2023, to receive full consideration: MedicaidandCHIP-Parity@cms.hhs.gov.
CMS Posts Reports on Medicare-Medicaid Financial Alignment Initiative for Three States
October 5: CMS is working with states to identify innovative ways to improve care and reduce costs for individuals who are dually eligible for Medicare and Medicaid. CMS posted three reports on the Medicare-Medicaid Financial Alignment Initiative (FAI), which is a CMS partnership with states that test payment models designed for Medicare-Medicaid enrollees to improve quality, reduce expenditures, and integrate primary, acute, behavioral health, and long-term services to create a more connected system of care. CMS is releasing the third evaluation report for Ohio, the preliminary third evaluation report for the New York Intellectual and Developmental Disabilities (IDD) demonstration, and an Actuarial Report for the Washington demonstration.
Other Recent Releases:
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.