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CMS Approves Washington State Plan Amendment Proposal to Allow Supplemental Rebates involving a “Subscription” Model for Prescription Drug Payment in Medicaid
Today, the Centers for Medicare & Medicaid Services (CMS) approved the fourth Medicaid state plan amendment proposal to negotiate supplemental rebate agreements involving value-based purchasing arrangements with drug manufacturers that allows states to link payment for prescription drugs to the value delivered.
Press releaseCMS Issues New Guidance Addressing Spread Pricing in Medicaid, Ensures Pharmacy Benefit Managers are not Up-Charging Taxpayers
Agency issues guidance for Medicaid Managed Care and CHIP health plans that clarifies how current regulations require “spread pricing” to be accounted in the calculation of Medical Loss Ratios (MLRs)
Press releaseCMS Finalizes Rule to Protect Medicaid Provider Payments
The Centers for Medicare & Medicaid Services (CMS) today released the Medicaid Provider Reassignment Regulation final rule removing a state’s ability to divert portions of Medicaid provider payments to third parties outside of the scope of what the statute allows.
Press releaseCMS Announces New Opportunities to Test Innovative Integrated Care Models for Dually Eligible Individuals
Today, the Centers for Medicare & Medicaid Services (CMS) sent a letter to State Medicaid Directors inviting states to partner with CMS to test innovative approaches to better serve those who are dually eligible for Medicare and Medicaid.
Press releaseCMS Issues New Guidance on State Implementation of Home and Community Based Services Regulation
Updates guided by extensive stakeholder process, focus on promoting beneficiary choice while maintaining commitment to community living
Press releaseCMS Strengthens Monitoring and Evaluation Expectations for Medicaid 1115 Demonstrations
Today, the Centers for Medicare & Medicaid Services (CMS) released new state tools and guidance that provide standard monitoring metrics and recommended research methods geared specifically for section 1115 demonstrations that test innovative approaches to Medicaid eligibility and coverage policies.
Press releaseOpioid Prescribing Mapping Tool Improved with Medicaid and Rural Data
New features offer local communities greater transparency into opioid prescribing rates.
Press releaseCMS Approves Arizona’s Medicaid Community Engagement Demonstration Amendment
Today, the Centers for Medicare & Medicaid Services (CMS) approved Arizona’s request for an amendment to add a community engagement requirement to its section 1115 Medicaid demonstration project, entitled “Arizona Health Care Cost Containment System (AHCCCS).”
Press releaseCMS achieved improper payment rate reductions in Medicare Fee-For-Service (FFS), Medicare Part C, Medicare Part D, Medicaid, and Children’s Health Insurance Program
CMS has implemented several initiatives to address improper payments, resulting in this being the first year in improper payment reporting history that the Medicare Fee-For-Service (FFS), Medicare Part C, Medicare Part D, Medicaid and Children’s Health Insurance Program achieved reductions in all five programs’ improper payment rates.
Fact sheetCMS Announces New Medicaid Demonstration Opportunity to Expand Mental Health Treatment Services
Today, the Centers for Medicare & Medicaid Services (CMS) sent a letter to State Medicaid Directors that outlines both existing and new opportunities for states to design innovative service delivery systems for adults with serious mental illness (SMI) and children with serious emotional disturbance (SED).
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