The survey that informs Medicare Advantage Star Ratings requires modernization to accurately gauge member experience and effectively promote value-based care, according to new research conducted...
Six months after the public health emergency ends, states will need to have completed certain Medicaid eligibility and enrollment processes, CMS has indicated. They must prepare in advance in order to...
The Biden administration has chosen Liz Richter, the Deputy Center Director of CMS, to be acting CMS Administrator while the new president chooses an official appointee for the role.
As the...
Today, the Centers for Medicare & Medicaid Services (CMS) passed a final rule that promotes data sharing, patient access to health information, coordinated care, and interoperability to streamline...
CMS has released its final rule for Contract Year 2022 Medicare Advantage and Part D which requires Part D plans to offer a real-time benefits comparison tool.
The agency estimated that the...
CMS has released its final snapshot for Affordable Care Act enrollment on the federal platform for the 2021 open enrollment period.
This year’s open enrollment was unique in part due to the...
CMS has issued a final rule entitled Medicare Coverage of Innovative Technology (MCIT) that aims to accelerate Medicare coverage of technological innovations.
“Government processes have slowed...
In its first decade, the Center for Medicare and Medicaid Innovation (CMMI) introduced and honed models to support value-based care, exploring multiple avenues for lowering costs and refining risk...
The Affordable Care Act marketplace presents many opportunities for developing new strategies and technological solutions, particularly for states that are transitioning to state-based marketplaces,...
CMS has approved a waiver for TennCare, Tennessee’s Medicaid program, which seeks to control Medicaid spending by implementing a block grant.
“The negotiated agreement includes the major...
CMS has released a new roadmap outlining how states can improve social determinants of health and reinforce their value-based care approach using Medicaid flexibilities.
“The new guidance...
CMS has finalized a rule which promotes private payers and states negotiating value-based purchasing contracts for Medicaid drugs, along with other changes.
The final rule was built upon the Medicaid...
States are increasingly relying on provider taxes and local government funds for their share of federal Medicaid payments according to a new Government Accountability Office (GAO) report. Officials are...
CMS has released preliminary data on the 2021 federal open enrollment season, which saw 8.2 million people select health plans on the Affordable Care Act federal exchange.
“Annual enrollment...
Humana has announced a new value-based primary care services model for Medicare Advantage members using the CMS Primary Care First model.
“The creation of this model comes at a critical time....
CMS has introduced a new Medicare value-based contracting model that encourages greater care coordination and requires participants to take full risk for Medicare fee-for-service beneficiaries based on...
CMS has issued a final rule to regulate the Affordable Care Act risk adjustment data validation program.
The risk adjustment data validation program, run by HHS, certifies the integrity of data that...
CMS has proposed diminishing federal exchange fees in order to lower Affordable Care Act premiums on the federal exchange platform. This proposal comes as part of the 2022 payment...
Over the last couple of years, Medicare Advantage supplemental benefits have seen a great deal of reinterpretation that has led to their expansion and evolution, a Milliman brief commissioned by Better...
As the Supreme Court deliberates the fate of the Affordable Care Act after hearing the oral arguments, payers and the public alike are processing the court case and its implications for the healthcare...
