CMS recently proposed five alternative payment models for chronic kidney disease (CKD) treatments.
One model is mandatory and the others are optional. All of the models are in response to the...
Yesterday, CMS announced a proposed rule that would cut down the regulatory burden for long-term care (LTC) facilities and released a finalized rule which updated the requirements for nursing home...
CMS recently released new state relief and empowerment waiver resources for states to use as they stabilize their insurance markets through reinsurance and other methods.
“While states have...
On July 11, CMS proposed a rule that would start the transition to value-based payment in the home healthcare field and make a home infusion benefit available to Medicare...
CMS is proposing to relax rules requiring states to submit and update Medicaid access monitoring review plans, which would largely leave states in charge of ensuring adequate Medicaid beneficiary...
CMS recently approved Louisiana’s subscription model for hepatitis C therapies in Medicaid, which would allow the state to negotiate supplemental rebate agreements from prescription drug...
CMS recently released a summary report of the Affordable Care Act (ACA) risk adjustment program for the 2018 benefit year, asserting in the report that the data proves the program acted as intended...
CMS recently approved two section 1115 demonstration waivers that will allow Minnesota and Nebraska to improve and expand upon their Medicaid institutions for mental diseases (IMDs) over the course of...
CMS continues to wage war on the opioid epidemic with a new grant opportunity for plans to reduce opioid use disorders (OUD).
“CMS is pulling every lever to combat the opioid epidemic, and...
A new rule from CMS calls for electronic prior authorization (ePA) updates, aiming to improve prescribers’ decision-making processes, ease administrative burden, and decrease the wait time for...
The Centers for Medicare & Medicaid Services (CMS) released renewed guidance on Medicaid eligibility determinations and spending integrity the organization announced.
According to CMS, Medicaid...
In the Medicare Payment Advisory Commission’s (MedPAC) annual June report to Congress, the commission designed the Medicare Advantage value incentive program (MA-VIP), a new set of quality...
CMS recently approved Washington state’s value-based purchasing proposal to lower drug prices for Medicaid.
The approval will allow the state to implement a “subscription” model for...
More Medicare Advantage beneficiaries know about the Medicare Star Ratings than ever before, but the door is still wide open for CMS and health plans to educate consumers about making a plan purchasing...
CMS and state Medicaid agencies are not always transparent about the consequences of 1115 demonstration waivers, specifically about how various demonstrations might impact beneficiaries, according to a...
New guidance from CMS addresses the issue of prescription drug price spreading and reiterates Medicaid and CHIP managed care program obligations to account for the practice when calculating certain...
CMS is streamlining the Medicaid review process and making it more transparent, efficient, and less burdensome in an effort to speed up approval times for state programs.
“At CMS, we are making...
CMS is issuing a request for information (RFI) asking states for ideas to develop State Relief and Empowerment Waivers to reduce costs in the individual insurance market.
In a recent blog post, CMS...
CMS and HHS have announced the CMS Primary Cares Initiative, a new set of value-based care payment models that will strengthen primary care and deliver better value for patients.
The CMS Primary Cares...
One of the largest healthcare fraud schemes investigated by the FBI and HHS and prosecuted by the Department of Justice resulted in $1.2 billion in losses and charges against 24 executives of...
