Here are seven CMS moves made since April physicians should know:
- New York became the 35th state to be approved for comprehensive coverage after pregnancy through Medicaid and the Children's Health Insurance Program.
- CMS launched a pilot value-based primary care model across eight states through the Center for Medicare and Medicaid Innovation that aims to create more coordinated care for rural and underserved communities.
- HHS, through CMS, proposed steps to further drive down drug costs under Medicaid by increasing transparency into how much drugs cost to manufacture and distribute; increasing transparency into how much managed care plans pay pharmacy benefit managers; and ensuring that drugs are properly classified so states receive the correct rebates. .
- CMS introduced stricter price transparency enforcement, giving hospitals 90 days after a corrective action plan is requested by CMS to be in full compliance.
- CMS published detailed information on the ownership of more than 6,000 hospices and 11,000 home health agencies that are approved to participate in Medicare on its website in an effort to protect patients and promote competition.
- CMS proposed a rule that would recognize homelessness as a potential indicator in acute inpatient hospital settings, resulting in higher payment for certain hospital stays.
CMS issued a final rule revising the Medicare Advantage, Medicare Part D, Medicare Cost Plan and Programs of All-Inclusive Care for the Elderly regulations. The rule addresses programmatic areas such as star ratings, marketing and communications, health equity, provider directories and coverage criteria.