The Centers for Medicare and Medicaid Services (CMS) released the Contract Year (CY) 2025 Policy and Technical Changes to the Medicare Advantage (MA) program and Medicare Prescription Drug Benefit Program (Part D) proposed rule (press release, fact sheet). What it is. The proposed rule includes proposals intended to enhance beneficiary protections, advance health equity, and improve access to behavioral health… (Slifer, November 6, 2023) #Biosimilars, #Health Equity, #Medicare Advantage, #Medicare Part D, #Mental and Behavioral Health

The Medicaid Payment and Access Commission (MACPAC) held a session to discuss federal requirements related to Medicaid Home- and Community-Based Services (HCBS) across different Section 1915 authorities that states use to run these programs. MACPAC staff provided an overview of Medicaid HCBS, including waiver and state plan options, and discussed state considerations when choosing Section 1915 authorities. The session also… (Colocho, November 6, 2023) #Care Coordination, #Health Equity, #Home Health

The Medicare Payment Advisory Commission (MedPAC) convened a session to discuss its workplan concerning hospice and end-of-life care. MedPAC staff provided an overview of new and ongoing projects the Commission is undertaking over the next eighteen months, including assessing hospice’s impact on net Medicare spending, studying the hospice aggregate cap and its effect on beneficiary outcomes, examining nonhospice spending for… (Colocho, November 3, 2023) #End-Stage Renal Disease, #Hospice

The Medicare Payment Advisory Commission (MedPAC) convened a session to discuss the new Rural Emergency Hospital (REH) program established by the Consolidated Appropriations Act, 2021 (based on a MedPAC recommendation). The legislation requires MedPAC to review payment to REHs annually starting in 2024. In preparation, MedPAC Senior Analyst Brian O’Donnell and Principal Policy Analyst Jeff Stensland presented important context for… (Testa, November 3, 2023) #Critical Access Hospitals, #Hospitals, #Program Integrity, #Rural Health

The Medicare Payment Advisory Commission (MedPAC) convened a session on software as a medical service (SaaS) and prescription digital therapeutics (PDTs). The staff provided an overview of current coverage and payment for SaaS and software as a medical device (SaMD) under the different Medicare payment streams and posed whether policy changes are needed in this space. The Commissioners were divided on whether… (Slifer, November 3, 2023) #Health Information Technology, #Medical Devices

The Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) final rule (press release; fact sheet; MSSP fact sheet; QPP fact sheet), which addresses an array of policies under Medicare Part B and the Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program (QPP).   What it is. CMS’ major… (Testa, November 2, 2023) #Care Coordination, #Clinical Labs, #Health Equity, #Medicare Access and Chip Reauthorization Act of 2015 (MACRA), #Mental and Behavioral Health, #Opioids, #Physicians, #Primary Care, #Quality, #Social Determinants of Health, #Telehealth, #Therapy

The Federal Communications Commission (FCC) issued a notice of inquiry (NOI) soliciting input on ways to enhance its “Mapping Broadband Health in America” platform to leverage digital health tools for maternal care improvement. The platform facilitates data-driven decision-making at the intersection of broadband and health, with a focus on maternal health. The platform allows for customized maps and analysis of… (Colocho, November 2, 2023) #Health Equity, #Health Information Technology, #Public Health, #Rural Health, #Women’s Health

The Centers for Medicare & Medicaid Services (CMS) issued the cycle year (CY) 2024 home health prospective payment and rate update final rule (fact sheet). What it is. The final rule updates Medicare payment policies and rates applying to home health agencies (HHAs) beginning January 1, 2024. Why it is important for you. CMS finalized a -2.890 percent permanent adjustment… (Colocho, November 2, 2023) #Costs, #COVID-19, #Durable Medical Equipment, #Health Equity, #Home Health

The Agency for Healthcare Research and Quality’s (AHRQ’s) Effective Health Care (EHC) Program is requesting public comments on challenges and barriers for people with disabilities to receive clinical preventative services. The review seeks to: (1) compile and summarize the key obstacles and facilitators for individuals with disabilities accessing clinical preventive services, and (2) collect the existing literature on the efficacy… (Marceno, October 31, 2023) #Health Equity, #Prevention, #Primary Care

The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a report on the Centers for Disease Control and Prevention (CDC) initial COVID-19 test kit failure. After researchers in China posted the genome sequence for COVID-19, CDC began the creation of a test kit on January 10th, 2020. The Food and Drug Administration (FDA) issued… (McClurg, October 31, 2023) #COVID-19