CMS

On September 30, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of June 2024, over 67.5 million people are enrolled in Medicare; more than 33.4 million are enrolled in fee-for-service Medicare, and nearly 34.1 million are enrolled in Medicare Advantage or other health plans. Over 79.9 million enrollees have Medicaid and CHIP. Nearly 72.9 million individuals have Medicaid, and more than seven million have coverage through CHIP. Over eight million individuals are dually eligible for Medicare and full-benefit Medicaid and are counted in the enrollment figures for both programs.

The Centers for Medicare & Medicaid Services released an informational bulletin that provides information on the timing and expectations for all states to achieve compliance with all federal renewal requirements. All states are required to complete a compliance assessment, demonstrate compliance with federal Medicaid and CHIP renewal requirements described at 42 C.F.R. §§ 435.916 and 457.343 and submit a plan outlining steps and milestones for addressing identified areas of non-compliance to CMS by December 31, 2024. CMS also released a compliance template, which states should use to submit the compliance plan and a slide deck to serve as an additional resource on renewal compliance guidance.

On August 30, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of May 2024, over 67.4 million people are enrolled in Medicare; more than 33.4 million are enrolled in fee-for-service Medicare, and nearly 34 million are enrolled in Medicare Advantage or other health plans. Over 80.8 million enrollees have Medicaid and CHIP. Nearly 73.8 million individuals have Medicaid, and over seven million have coverage through CHIP. About eight million individuals are dually eligible for Medicare and full-benefit Medicaid and are counted in the enrollment figures for both programs.

On July 31, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of April 2024, over 67.2 million people are enrolled in Medicare; more than 33.3 million are enrolled in fee-for-service Medicare, and over 33.9 million are enrolled in Medicare Advantage or other health plans. Over 81.6 million enrollees have Medicaid and CHIP. More than 74.6 million individuals have Medicaid, and over seven million have coverage through CHIP. Nearly 12 million individuals are dually eligible for Medicare and Medicaid and are counted in the enrollment figures for both programs.

The 2025 CMS Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG), Schematron, and Sample Files for Eligible Clinician (EC) Programs outlines requirements for EC to report electronic clinical quality measures (eCQMs) for the 2025 calendar year. Some of the changes included are added support for the Making Care Primary (MCP) model, updates to require the CMS Electronic Health Record (EHR) Certification ID for the Merit-Based Incentive Payment System (MIPS), and an updated QRDA Category III Report.

On July 12, 2024, CMS released a companion guide to the Ensuring Access to Medicaid Services (Access) Final Rule. This new resource provides guidance on the fee-for-service financial provisions of the Access Rule that relate to documentation of access to care and service payment rates. The guide is intended to help states understand when requirements apply to them and how to meet the requirements.

The Centers for Medicare & Medicaid Services (CMS) launched Guiding an Improved Dementia Experience (GUIDE) Model, with almost 400 participating organizations building Dementia Care Programs (DCPs) that serve Medicare beneficiaries nationwide. Through the GUIDE Model, CMS will test an alternative payment for participants who deliver support services to people with dementia, including comprehensive, person-centered assessments and care plans, care coordination, and 24/7 access to a support line. People with dementia and their caregivers will have access to a care navigator who will assist in gaining access to services and supports through community-based organizations.

On June 28, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of March 2024, over 67.1 million people are enrolled in Medicare; more than 33.3 million are enrolled in fee-for-service Medicare, and over 33.8 million are enrolled in Medicare Advantage or other health plans. Over 82.7 million enrollees have Medicaid and CHIP. More than 75.6 million individuals have Medicaid, and over 7.1 million have coverage through CHIP. Over 12 million individuals are dually eligible for Medicare and Medicaid and are counted in the enrollment figures for both programs.

On June 14, CMS released an informational bulletin, Accessing Enhanced Federal Medicaid Matching Rates for State Information Technology Expenditures to Improve Access to Mental Health and Substance Use Disorder Treatment and Care Coordination. This informational bulletin, developed in collaboration with the Department of Health and Human Services Office of the National Coordinator for Health Information Technology, provides examples of state Medicaid information technology expenditures to improve access to and coordination of treatment and support services for Medicaid beneficiaries with mental health conditions and/or substance use disorders that may qualify for enhanced federal matching rates.

On June 12th, the Centers for Medicare & Medicaid Services (CMS) released an Addendum to the 2024-2025 Medicaid Managed Care Rate Development Guide. The guide also includes the provisions of the final rule that will take effect on July 9th, 2024. The 2024-2025 Medicaid Managed Care Rate Development Guide is a resource for states to use when setting capitation rates with managed care plans for care beneficiaries to receive through Medicaid managed care programs. The guide provides details around information that must be included in the states’ actuarial rate certifications for CMS to review and approve for rating periods between July 1, 2024, and June 30, 2025.