CMS

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2023 NTP Virtual Workshop Recordings

The Centers for Medicare & Medicaid Services (CMS) has made the recordings of the 2023 National Training Program (NTP) Virtual Workshop available on their website for those who were unable to attend the live sessions. Session topics include: Social Security Medicare Enrollment, Eligibility, Part A, and Part B Medicare Supplement Insurance (Medigap) Drug Coverage When Using Medicare Medicare Advantage Medicare for People with Disabilities Medicare for People with End-Stage Renal Disease (ESRD) Medicare Current Topics Coordination of Benefits Medicare Scenarios (Casework Session) Medicare & Tax-Favored Health Programs Medicare Plan Finder

Short URL: http://www.advancingstates.org/node/74936

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Assurance of Transportation: A Medicaid Transportation Coverage Guide

On September 28, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director Letter which introduces the Medicaid Transportation Coverage Guide. The guidance highlights existing policies and also includes new policies to address scenarios for extended wait times and long-distance trips, 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 encourages states to use the document as a guide when developing and updating policies and procedures that facilitate robust transportation programs, noting that Medicaid transportation is a critical service that has a direct impact on health outcomes.

Short URL: http://www.advancingstates.org/node/74931

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Civil Money Penalty Reinvestment Program (CMPRP) Revisions Memo

On September 25, the Centers for Medicare & Medicaid Services (CMS) issued a Civil Money Penalty Reinvestment Program (CMPRP) Revisions Memo: Ref: QSO-23-23-NHS. A civil money penalty (CMP) is a monetary penalty that CMS may impose against nursing homes for noncompliance with federal requirements. A portion of CMPs is collected from nursing homes and returned to the state in which CMPs are imposed. State CMP funds may be reinvested to support activities that support quality of care and life for nursing home residents. In order to ensure a consistent and equitable manner for CMP fund distribution, CMS has issued the CMPRP Revisions Memo to revise the structure of CMPRP in the following manner...

Short URL: http://www.advancingstates.org/node/74930

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2023 NTP Virtual Workshop Recordings

The Centers for Medicare & Medicaid Services (CMS) has made the recordings of the 2023 National Training Program (NTP) Virtual Workshop available on their website for those who were unable to attend the live sessions. Session topics include: Social Security Medicare Enrollment, Eligibility, Part A, and Part B Medicare Supplement Insurance (Medigap) Drug Coverage When Using Medicare Medicare Advantage Medicare for People with Disabilities Medicare for People with End-Stage Renal Disease (ESRD) Medicare Current Topics Coordination of Benefits Medicare Scenarios (Casework Session) Medicare & Tax-Favored Health Programs Medicare Plan Finder

Short URL: http://www.advancingstates.org/node/74913

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Medicare Drug Price Negotiation Program Patient-Focused Listening Sessions

The Centers for Medicare & Medicaid Services (CMS) are hosting an upcoming series of patient-focused Listening Sessions this fall as part of the Medicare Drug Price Negotiation Program. These virtual public Listening Sessions will provide opportunities for patients, beneficiaries, caregivers, consumer and patient organizations, and other interested parties to share input relevant to drugs selected for the first round of negotiations. CMS will host 10 Listening Sessions this fall, one for each of the 10 selected drugs: (Click attached links to find times for all 10 listening sessions).

Short URL: http://www.advancingstates.org/node/74895

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Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting (CMS 3442-P)

On September 1, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to establish staffing requirements, including national minimum nurse staffing standards, for nursing facilities. Nursing facilities participating in Medicare and Medicaid would be required to: provide residents with a minimum of 0.55 hours of care from a registered nurse (RN) per resident per day (hours per resident day or HPRD) and 2.45 hours of care from a nurse aide (NA) per resident per day; have a registered nurse onsite 24 hours per day, seven days per week to provide direct resident care; and complete facility assessments on staffing needs. CMS proposes that implementation of the final requirements will occur in three phases over a three-year...

Short URL: http://www.advancingstates.org/node/74861

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CMS Selects the First Drugs for Medicare Drug Price Negotiation

The Centers for Medicare & Medicaid Services (CMS) recently announced the first 10 drugs covered under the Medicare Part D prescription drug benefit selected for negotiation. As a result of the Inflation Reduction Act (P.L. 117-169), Medicare, for the first time, has the ability to directly negotiate prices of certain high expenditure, single source drugs without generic or biosimilar competition, based on total gross covered prescription drug costs under Medicare Part D and other criteria as required by the law. The negotiations with participating drug companies will occur in 2023 and 2024, and any negotiated prices will become effective beginning in 2026. The negotiation process will consider the selected drug’s clinical benefit...

Short URL: http://www.advancingstates.org/node/74860

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CMS Announces Request for Applications for the “Making Care Primary” Model

The Centers for Medicare & Medicaid Services (CMS) has released a Request for Applications (RFA) detailing model payment, care delivery, quality, and other policies for the Making Care Primary (MCP) Model. CMS announced the new voluntary primary care model in June to improve care and strengthen coordination between primary care clinicians, specialists, social service providers, and behavioral health clinicians as well as address individuals’ health-related social needs. Stating July 1, 2024, CMS will test the 10.5 year model in eight states— Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington—and will work with these states’ Medicaid agencies to align their programs with the new model...

Short URL: http://www.advancingstates.org/node/74859

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Anniversary of the Inflation Reduction Act: Update on CMS Implementation

The CMS fact sheet notes the one-year anniversary of the Inflation Reduction Act (IRA) of 2022 and describes provisions in the law affecting Medicare and Marketplace plans, including a summary of milestones CMS has met. A list of public education tools to help people with Medicare and those who assist them in understanding the changes under the IRA are included.

Short URL: http://www.advancingstates.org/node/74809

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CMS Issues Several Fiscal Year 2024 Final Rule Payment Policies

CMS recently issued several final rules on payment rates and policies fiscal year for (FY) 2024. 1. FY 2024 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1785-F and CMS-1788-F Fact Sheet 2. Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System Final Rule - CMS-1779-F 3. Fiscal Year 2024 Hospice Payment Rate Update Final Rule (CMS-1787-F) 4. Fiscal Year 2024 Medicare Inpatient Psychiatric Facility Prospective Payment System and Quality Reporting Final Rule 5. Fiscal Year 2024 Inpatient Rehabilitation Facility Prospective Payment System Final Rule (CMS-1781-F)

Short URL: http://www.advancingstates.org/node/74806

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