Today, the Centers for Medicare & Medicaid Services (CMS) provides an at-a-glance summary of news from around the agency.
CMS Updates Medicare Part B Quarterly Average Sales Pricing Files
March 26: Under the Medicare Prescription Drug Inflation Rebate Program, some people with Medicare may see lower out-of-pocket costs for certain Part B drugs and biologicals with prices that have increased faster than the rate of inflation. For these drugs and biologicals, the beneficiary coinsurance is 20% of the inflation-adjusted payment amount, which is less than what the beneficiary would pay in coinsurance otherwise. CMS updated the Medicare Part B Quarterly Average Sales Price (ASP) pricing files on the Medicare Part B Average Sales Price webpage and posted a fact sheet with the 41 Part B rebatable drugs that have an adjusted coinsurance rate for the quarter April 1 – June 30, 2024.
CMS Announces Minority Research Grant Program Notice of Funding Opportunity
April 1: CMS announced a Notice of Funding Opportunity for the 2024 Minority Research Grant Program (MRGP). The MRGP supports researchers at minority-serving institutions who are investigating or addressing health care disparities affecting all minority populations, including racial and ethnic minority groups, people with disabilities, members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community, individuals with limited English proficiency, individuals residing in rural areas, and individuals adversely affected by persistent poverty or inequality. CMS will award up to five grants totaling up to $1,275,000. Application deadline is June 3, 2024. Additional information on the MRGP can be found here.
CMS Publishes Blog Highlighting Progress in Specialty Care Strategy
April 2: CMS published a blog highlighting progress on the CMS Innovation Center’s Specialty Care Strategy. Addressing the entirety of a person’s care journey requires incentives to reach and connect primary care and specialty providers at each step of the way. This includes delivering data for more transparency in specialist performance, refocusing specialty care on the person’s experience and outcomes, and by facilitating specialty care partnerships with primary care-based Accountable Care Organizations as part of a move to more value-based care. CMS is committed to supporting both primary and specialty care practices in delivering coordinated and state-of-the-art care so that people feel empowered to make decisions about their treatment and overall approach to managing their health.
CMS Publishes Blog Highlighting Impact of a New Quality Pathway on Patient Experience
April 3: CMS published a blog examining how the integration of a new Quality Pathway will positively impact overall patient experience in CMS Innovation Center models. The Quality Pathway aims to align quality goals within CMS alternative payment models, elevate outcomes and experience measures, and ensure that evaluations are better designed to assess the impact of models on patient-centered goals. These determinations will help the CMS Innovation Center make critical decisions about which models to expand in the pursuit of improving the quality of care for people with Medicare and Medicaid.
CMS Approves Medicaid State Plan Amendment for Mobile Crisis Services in Vermont
April 4: CMS approved a state plan amendment (SPA) for mobile crisis services in Vermont. Authorized under President Biden’s American Rescue Plan, states have a new option for supporting community-based mobile crisis intervention services for individuals with Medicaid. Mobile crisis intervention services are essential tools to meet people in crisis where they are and rapidly provide critical services to people experiencing mental health or substance use crises by connecting them to a behavioral health specialist 24 hours per day, 365 days a year. This new option helps states integrate these services into their Medicaid programs, a critical component in establishing a sustainable public health-focused support network. This is the 17th mobile crisis SPA approved.
Other Recent Releases:
March 28: CMS Issues FY 25 Skilled Nursing Facility Prospective Payment System Proposed Rule (CMS 1802-P)
March 28: CMS Issues Fiscal Year 2025 Hospice Payment Rate Update Proposed Rule (CMS-1810-P)
March 28: HHS Takes Additional Actions to Help People Stay Covered During Medicaid and CHIP Renewals
April 1: CMS Finalizes Payment Updates for 2025 Medicare Advantage and Medicare Part D Programs
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CMS, an agency within the U.S. Department of Health and Human Services, serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes. The agency protects public health by administering the Medicare program and working in partnership with state governments to administer Medicaid, CHIP, and the Health Insurance Marketplace.
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