CMS Round Up
CMS Roundup (June. 14, 2024)
Today, the Centers for Medicare & Medicaid Services (CMS) provides an at-a-glance summary of news from around the agency.
CMS Announces Recipients of the 2024 CMS Health Equity Award
May 30: CMS announced the recipients of the 2024 CMS Health Equity Award. The CMS Health Equity Award is given to organizations working towards advancing health equity by showing others how to reduce disparities in health care access, quality, and outcomes. The CMS Health Equity Awardees were recognized at the CMS Health Equity Conference on May 30, 2024.
CMS Seeks Comment on Data & Information to be Collected from Drug Manufacturers Under the Medicare Prescription Drug Inflation Rebate Program
June 3: CMS invites public comment on the data and information to be collected from drug manufacturers, through a revised Information Collection Request (ICR) for Rebate Reduction Requests, under the Medicare Prescription Drug Inflation Rebate Program, Sections 11101 and 11102 of the Inflation Reduction Act (IRA).
The IRA requires drug companies that raise the prices of certain drugs covered under Medicare Part B and Part D faster than the rate of inflation to pay Medicare a rebate. Drug companies seeking to reduce the rebate amount for a Part B or Part D rebatable biosimilar or Part D rebatable generic drug due to a severe supply chain disruption, or for a Part D rebatable generic drug due to a likely shortage will be required to submit a rebate reduction request with supporting documentation.
The revised ICR can be found in the Federal Register. Comments are due by July 3, 2024. Revised guidance on the Medicare Prescription Drug inflation Rebate Program can be found here.
CMS Details Innovation Center Progress in Advancing Health Equity Strategies
June 4: CMS published a blog in Health Affairs detailing the CMS Innovation Center’s progress on its health equity initiative. The Innovation Center tests value-based approaches to health care payment and service delivery that have the potential to lower program expenditures while preserving or enhancing quality of care for people with Medicare and Medicaid. The models, or pilot programs, are incorporating innovative payment incentives and supports for providers caring for underserved populations, and new requirements for sociodemographic data collection and reporting, screening and referral for health-related social needs (HRSNs), and development of health equity plans. By making health equity a key component of the models, CMS aims to reach a more diverse group of providers and beneficiaries, connecting people with services they need to stay healthy, and helping to strengthen the health care workforce.
The blog lays out new work in 2024 in these areas: ensuring a pathway for safety net providers, such as federally qualified health centers and rural health clinics, to participate in models to improve care for more people; up front infrastructure payments to eligible model participants, including lower levels of financial risk; data collection that supports whole-person care; and payment innovations to close disparities.
CMS Posts FAQs Clarifying State Requirements for Medicaid Coverage of Peer Support Services for Adults with Mental Illness and/or Substance Use Disorder
June 5: CMS released FAQs clarifying existing policy regarding Medicaid coverage of peer support services, as established in an August 15, 2007, State Medicaid Director letter ("Peer Support Services for Adults with Mental Illness and/or Substance Use Disorder"). Specifically, the FAQs clarify the supervision requirement included in the 2007 letter. CMS encourages states to expand availability and use of peer support services to serve adults, youth, and families who experience mental illness and/or substance use disorder, including by allowing coverage in emergency room and inpatient settings. Furthermore, CMS encourages states to ensure that payment rates for peer support services are sufficient to support a living wage for these critical members of the care team.
CMS Updates Information on New Hospital Price Transparency Requirements Commencing July 1, 2024
June 5: CMS posted updated FAQs on the Hospital Price Transparency website with additional information to help hospitals understand and meet new compliance requirements taking effect on July 1, 2024. The FAQs also provide additional information for hospitals, consumers, and other stakeholders.
CMS Issues Notice of Funding Opportunity for States to Expand Access to Women’s Reproductive & Maternal Health
June 7: CMS announced a new notice of funding opportunity, the Expanding Access to Women’s Health Grant. The grant will provide a funding source for a 24-month period to states to support planning and implementation activities to enhance and expand access to reproductive and maternal health information, coverage, and services. Through the grant, states may develop specific activities and programs to address disparities in reproductive and maternal health outcomes resulting from women having difficulty accessing reproductive health care information, coverage, or services. A letter of intent is due on July 8, 2024, and deadline to submit applications is August 7, 2024, at 11:59 p.m. EST. This action aligns with CMS’ Maternal Care Action Plan — part of the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis.
Other Recent Releases:
June 12: CMS Releases 2023-2032 National Health Expenditure Projections
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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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