Today, the Centers for Medicare & Medicaid Services (CMS) provides an at-a-glance summary of news from around the agency.
CMS Extends MassHealth Demonstration Promoting Affordable Coverage, Continuous Eligibility to Additional Populations, and Health-Related Social Needs Services
April 19: CMS approved an amendment to the MassHealth Medicaid and Children's Health Insurance Plan (CHIP) Section 1115 Demonstration. This amendment expands current features within the MassHealth demonstration, including Marketplace subsidies and cost-sharing assistance to promote affordable coverage and care, as well as continuous eligibility to additional populations to support stable coverage. The amendment also expands health-related social needs services and infrastructure to help individuals stay connected to coverage and access to care. This amendment further expands Medicaid coverage and access by removing the waiver of retroactive eligibility from the demonstration effective no later than January 1, 2026. As a result, all people with Medicaid will have up to three months of retroactive coverage available upon confirmation of eligibility by the Commonwealth. Previously in the 2022 demonstration extension, CMS approved the removal of the waiver of retroactive eligibility for pregnant persons and children up to age 19 only, effective July 1, 2023.
Local Coverage Determination Proposed for Skin Substitute Grafts, Public Comments Open
April 25: CMS issued a statement on a proposed Local Coverage Determination (LCD) released by Medicare Administrative Contractors for coverage of Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers. The intent of the proposed LCD is to ensure that people with Medicare have access to skin substitute products that are supported by science, do not cause harm, and have demonstrated success for diabetic foot and venous leg ulcer closure in the shortest duration of time. Public comments are being accepted here until June 8, 2024.
CMS Initiates National Coverage Analysis for Implantable Heart Failure Management Device, Public Comments Open
April 30: CMS is initiating a national coverage analysis on Implantable Pulmonary Artery Pressure Sensors for Heart Failure Management. Information on the national coverage analysis and the public comments section can be found here.
CMS Publishes Health Care Guide to Assist Individuals Re-Entering Communities After Incarceration
April 30: CMS released and posted a publication Returning to the Community: Health Care After Incarceration to assist individuals re-entering the community to better understand their health care needs, including physical and behavioral health. Developed in partnership with the Department of Justice, the guide contains information to help individuals connect to health care services pre- and post-release, and to learn about insurance coverage types and how to apply, and tips to get started using health coverage to receive needed services to support a successful reentry and healthy life.
Other Recent Releases:
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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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