The Centers for Medicare & Medicaid Innovation (CMMI) announced (model website) that it is planning to test a new voluntary, value-based care model to increase access to high-quality integrated care for Medicaid and Medicare beneficiaries with substance use disorder and moderate to severe mental health conditions. The Innovation in Behavioral Health (IBH) Model builds off knowledge gained from previous models, including the Integrated… (Marceno, January 19, 2024) #Care Coordination, #Community Health Centers, #Delivery Reform, #Dual Eligibles, #Health Equity, #Health Information Technology, #Mental and Behavioral Health, #Social Determinants of Health, #Value-Based Insurance Design

The Biden-Harris Administration launched a new program called Health care Rewards to Achieve Improved Outcomes (HEROES) through the Advanced Research Projects Agency for Health (ARPA-H). This initiative is part of President Biden’s Unity Agenda and aims to address preventable health challenges, particularly in underserved communities. The HEROES program focuses on increasing investment in community-level preventative care resources. What it is. The program seeks… (Colocho, January 19, 2024) #Care Coordination, #Health Equity, #Health Information Technology, #Prevention, #Social Determinants of Health, #Women’s Health

The Department of Agriculture (USDA) Food and Nutrition Service (FNS) announced a request for applications (RFA) for cooperative agreements to support the use of Indigenous foods in child nutrition programs. FNS will award up to $2 million in total funding to up to four organizations to provide regionally focused training and technical assistance to school nutrition professionals on the procurement, preparation, and crediting… (McClurg, January 19, 2024) #Health Equity, #Nutrition

The Government Accountability Office (GAO) released a report on product labels for prenatal supplements. GAO says that it was asked to assess the accuracy of over-the-counter prenatal supplement labels for amounts of certain nutrients, and to determine if the supplements contain harmful substances. Key takeaways are included below: Background: GAO notes that prenatal supplements can help individuals who may not obtain the appropriate nutrients… (McClurg, January 19, 2024) #Nutrition

The Centers for Medicare and Medicaid Services (CMS) released a final rule to advance interoperability and improve prior authorization (press release; fact sheet). The regulations apply to Medicare Advantage (MA) organizations, Medicaid managed care plans, State Medicaid Agencies, Children’s Health Insurance Program (CHIP) agencies and managed care entities; issuers of Qualified Health Plans (QHPs) on the Federally-Facilitated Exchanges (FFEs), and eligible hospitals and… (McClurg, Colocho, Slifer, Llamas, January 17, 2024) #Health Information Technology

The Department of Justice (DOJ) issued a Notice of Proposed Rulemaking (NPRM) under Title II of the Americans with Disabilities Act (ADA) to update regulations regarding the accessibility of medical diagnostic equipment (MDE) (press release, fact sheet). What is it. DOJ has received complaints from individuals with disabilities citing instances where health care providers failed to provide basic, vital health care, such as obtaining… (Colocho, January 16, 2024) #Health Equity, #Hospitals, #Medical Devices, #Public Health

The Medicare Payment Advisory Commission (MedPAC) convened a session to provide a status report on ambulatory surgical centers (ASCs) supply, volume of services provided to beneficiaries, and Medicare spending. Principal Policy Analyst Daniel Zabinski presented the current landscape of ASCs, highlighting the prevalence of procedures like cataract, gastroenterology, and pain management services. The presentation noted the increasing share of complex services provided by ASCs, such… (Colocho, January 16, 2024) #Ambulatory Surgical Centers, #Costs, #Hospitals, #Quality, #Transparency

The Medicare Payment Advisory Commission (MedPAC) convened two sessions on Medicare Advantage (MA), including a status report on the program and policy recommendations for standardized benefits. In examining the MA program and the Commission’s recent analyses, staff highlighted the role of coding intensity and favorable selection in contributing to excess payments to MA plans that total $88 billion in 2024…. (Slifer, January 12, 2024) #Costs, #Medicare Advantage, #Program Integrity, #Quality, #Transparency

The House Committee on Education and Workforce (Ed & Workforce) Subcommittee on Health, Employment, Labor, and Pensions (HELP) convened a hearing that sets the stage for the Committee to further tackle high health care costs in the commercial sector. Democrats and Republicans agree that increasing price transparency will help reduce commercial cosets, but that is where bipartisanship ends. The different… (Llamas, January 11, 2024) #Costs, #Hospitals, #Physicians

On January 11, the Medicare Payment Advisory Commission (MedPAC) held a public meeting at which it considered a series of payment update recommendations to Medicare payment systems in 2025 for inclusion in its March 2024 Report to Congress. These sessions continued conversations from the Commission’s December meeting (Impact summary) and included a vote on the final recommendations. Most of the Commission expressed… (McClurg, Marceno, January 11, 2024) #Home Health, #Hospice, #Hospitals, #Inpatient Rehabilitation Facilities, #Long-Term Care, #Physicians, #Program Integrity, #Skilled Nursing Facilities