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  • CMS Approves Nebraska Medicaid Demonstration to Provide Pathway to Enhanced Benefits for Eligible Adults

    Centers for Medicare and Medicaid Services approves Nebraska Medicaid Demonstration to Provide Pathway to Enhanced Benefits for Eligible Adults | site |



    (October 20, 2020) - - The Centers for Medicare and Medicaid Services published today, October 20, 2020, the following information:

    Today, the Centers for Medicare & Medicaid Services (CMS) announced its approval of Nebraska’s new Medicaid Section 1115 demonstration called “Heritage Health Adult.” This demonstration is designed to create a pathway for certain Nebraska adults with newly gained Medicaid coverage to access additional benefits if they participate in certain activities to promote health and independence. This demonstration is effective October 20, 2020, through March 31, 2026, with implementation beginning April 1, 2021.


    “Governor Ricketts and his team deserve credit for responding to President Trump’s invitation to design innovative state-led solutions that promote
    ...
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  • Trump Administration Drives Telehealth Services in Medicaid and Medicare

    Trump Administration Drives Telehealth Services in Medicaid and Medicare

    Trump Administration Drives Telehealth Services in Medicaid and Medicare | site |


    (October 14, 2020) - - The Centers for Medicare and Medicaid Services published today, October 14, 2020, the following information: Today, the Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE). CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand access to telehealth. The actions reinforce President Trump’s Executive Order on Improving Rural Health and Telehealth Access to improve the health of all Americans by increasing access to better care. “Responding to President Trump’s Executive Order, CMS is taking action to increase telehealth adoption across the country,” said CMS Administrator Seema Verma. “Medicaid patients should not be ...
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  • U.S. Centers for Medicare and Medicaid Services Updates COVID-19 Testing Methodology for Nursing Homes

    U.S. Centers for Medicare and Medicaid Services Updates COVID-19 Testing Methodology for Nursing Homes | site |



    (September 29, 2020) - - The United States Centers for Medicare & Medicaid Services published today, September 29, 2020, the following information: Today, the Centers for Medicare & Medicaid Services (CMS) announced an update to the methodology the agency employs to determine the rate of coronavirus disease 2019 (COVID-19) positivity in counties across the country. Counties with 20 or fewer tests over 14 days will now move to “green” in the color-coded system of assessing COVID-19 community prevalence. Counties with both fewer than 500 tests and fewer than 2,000 tests per 100,000 residents, and greater than 10 percent positivity over 14 days – which would have been “red” under the previous methodology – will move to “yellow.” This information is critical to nursing homes, which are required to test their staff for COVID-19 at a freque
    ...
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  • CMS Announces Innovative Payment Model to Improve Care, Lower Costs for Cancer Patients

    Centers for Medicare and Medicaid Services Announces Innovative Payment Model to Improve Care, Lower Costs for Cancer Patients | site |



    (September 18, 2020) - - The Centers for Medicare and Medicaid Services published today (September 18, 2020) the following information:

    Today, the Centers for Medicare & Medicaid Services (CMS) finalized a new Innovation Center model expected to improve the quality of care for cancer patients receiving radiotherapy and reduce Medicare expenditures through bundled payments that allow providers to focus on delivering high-quality treatments. The new Radiation Oncology (RO) Model allows this focus on value-based care by creating simpler, more predictable payments that incentivize cost-efficient and clinically effective treatments to improve quality and outcomes. The RO Model, part of a final rule on specialty care models issued by CMS, will begin on January 1, 2021 and is estimated to save Medicare $230 million over...
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  • Centers for Medicare and Medicaid Services posts Guidance for Implementing New Testing Requirements in Nursing Homes and Labs

    Centers for Medicare and Medicaid Services posts Guidance for Implementing New Testing Requirements in Nursing Homes and Labs | site |




    (August 26, 2020) - - The Centers for Medicare & Medicaid Services published today (August 26, 2020) the following information:

    Today, the Centers for Medicare & Medicaid Services (CMS) released guidance for nursing homes and clinical laboratories to assist in enhancing their abilities to prevent the spread of the coronavirus disease 2019 (COVID-19) to nursing home residents and their front line staff.

    Nursing homes are particularly vulnerable to the prevalence and spread of COVID-19. CMS continues to take proactive steps to enhance infection control policies, including practices that limit potential transmission, and prevent outbreaks within these facilities to protect residents. Today’s guidance requires all nursing homes to test all residents and staff for COVID-19. A new survey
    ...
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  • Centers for Medicare and Medicaid Services Announces Actions to Address Spread of Coronavirus

    Centers for Medicare and Medicaid Services Announces Actions to Address Spread of Coronavirus| site |





    CMS calls on all health care providers to activate infection control practices and issues guidance to inspectors as they inspect facilities affected by Coronavirus





    (March 4, 2020) - - Today, the Centers for Medicare and Medicaid Services published the following information: Today, the Centers for Medicare & Medicaid Services (CMS) is announcing several actions aimed at limiting the spread of the Novel Coronavirus 2019 (COVID-19). Specifically, CMS is issuing a call to action to health care providers across the country to ensure they are implementing their infection control procedures, which they are required to maintain at all times. Additionally, CMS is announcing that, effective immediately and, until further notice, State Survey Agencies and Accrediting Organizations will focus their facility inspections...
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  • Centers for Medicare and Medicaid Services Office of the Actuary Releases 2018 National Health Expenditures

    Centers for Medicare and Medicaid Services Office of the Actuary Releases 2018 National Health Expenditures | site |



    (December 5, 2019) - - Today, the U.S. Office of Medicare and Medicaid Services published the following information: Total national healthcare spending in 2018 grew 4.6 percent, which was slower than the 5.4 percent overall economic growth as measured by Gross Domestic Product (GDP), according to a study conducted by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS) and published today ahead of print by Health Affairs. As a result, the share of the economy devoted to health spending decreased from 17.9 percent in 2017 to 17.7 percent in 2018. Growth in overall healthcare spending has averaged 4.5 percent for 2016-2018, slower than the 5.5 percent average growth for 2014-2015, that was affected by expanded Medicaid and private insurance coverage and increased spending for prescription drugs, particularly for drugs
    ...
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  • Centers for Medicare and Medicaid Services discuss Delay of Inclusion of Territories in Medicaid Drug Rebate Program; Covered Outpatient Drug Interim Final Rule, CMS 2345-IFC3

    Centers for Medicare and Medicaid Services discuss Delay of Inclusion of Territories in Medicaid Drug Rebate Program; Covered Outpatient Drug Interim Final Rule (CMS 2345-IFC3) | site |



    (November 21, 2019) - - Today (November 21, 2019), the Centers for Medicare & Medicaid Services published the following information:

    Delay of Inclusion of Territories in Medicaid Drug Rebate Program; Covered Outpatient Drug Interim Final Rule (CMS 2345-IFC3) On February 1, 2016, the Centers for Medicare & Medicaid Services (CMS) published the “Medicaid Program; Covered Outpatient Drug” Final Rule with Comment Period (CMS-2345-FC) in the Federal Register (81 FR 5170). As part of that final rule with comment period, we amended the regulatory definitions of “States” and “United States” to include the U.S. Territories (American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands) beginning A
    ...
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  • Remarks by Administrator Seema Verma at the Alliance for Connected Care Telehealth Policy Forum for Health Systems

    Remarks by Medicare and Medicaid Administrator Seema Verma at the Alliance for Connected Care Telehealth Policy Forum for Health Systems



    (November 15, 2018) - - Today, the Centers for Medicare and Medicaid Services (CMS) published the following "Remarks by Administrator Seema Verma at the Alliance for Connected Care Telehealth Policy Forum for Health Systems":


    Remarks by Administrator Seema Verma at the Alliance for Connected Care Telehealth Policy Forum for Health Systems
    (As prepared for delivery – November 15, 2018)

    Thank you Krista for that kind introduction, and thank you all for joining us today. It’s a privilege to be here with the Alliance for Connected Care. I’m glad I got to meet with your organization early in my tenure – and I’m particularly happy to continue our conversation on how we can make the promise of connected, coordinated...
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  • Centers for Medicare and Medicaid Services Proposes Changes to Streamline and Strengthen Medicaid and CHIP Managed Care Regulations

    Centers for Medicare and Medicaid Services Proposes Changes to Streamline and Strengthen Medicaid and CHIP Managed Care Regulations


    Proposed Rule Continues Commitment to Promote Flexibility, Strengthen Accountability, and Maintain and Enhance Program Integrity in Medicaid and CHIP

    (November 8, 2018) - - Today, the Centers for Medicare & Medicaid Services (CMS) is proposing significant regulatory revisions to streamline the 2016 managed care regulatory framework. The changes reflect a broader strategy to relieve regulatory burdens; support state flexibility and local leadership; and promote transparency, flexibility, and innovation in care delivery. While the 2016 managed care final rule was a substantial and comprehensive rewrite of the Medicaid and Children’s Health Insurance Program (CHIP) regulatory structure, it included provisions that many states and stakeholders identified as...
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  • Centers for Medicare and Medicaid Services Model Addresses Opioid Misuse among Expectant and New Mothers

    Centers for Medicare and Medicaid Services Model Addresses Opioid Misuse among Expectant and New Mothers



    Goals are to improve quality of care, increase access to treatment based on state-specific needs, and reduce expenditures


    (October 23, 2018) - - Today the Centers for Medicare & Medicaid Services (CMS) announced the Maternal Opioid Misuse (MOM) model, an important step in advancing the agency’s multi-pronged strategy to combat the nation’s opioid crisis. The model addresses the need to better align and coordinate care of pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD) through state-driven transformation of the delivery system surrounding this vulnerable population. By supporting the coordination of clinical care and the integration of other services critical for health, wellbeing, and recovery, the MOM model has the potential to improve
    ...
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  • Centers for Medicare and Medicaid Services Administrator Seema Verma Statement on Burden Reduction Accomplishments

    Centers for Medicare and Medicaid Services Administrator Seema Verma Statement on Burden Reduction Accomplishments



    (October 17, 2018) - - The Centers for Medicare and Medicaid Services Administrator Seema Verma's Statement on Burden Reduction Accomplishments: “I would like to thank President Trump for his leadership and commitment to reducing burdensome federal regulations and Secretary Azar’s action to moving our healthcare system towards providing value for patients. CMS will continue our efforts to eliminate unnecessary regulations that take providers away from patients and stifle innovation. Every hour saved from reducing needless administrative burden is an hour more that our healthcare system can spend improving Americans’ health outcomes, and every duplicative requirement we eliminate saves patients and taxpayers money. Upon taking office, President Trump made reducing burdensom...
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  • U. S. Centers for Medicare and Medicaid Services Announces Participants in New Value-Based Bundled Payment Model

    U. S. Centers for Medicare and Medicaid Services Announces Participants in New Value-Based Bundled Payment Model




    Participation is robust in Administration’s Bundled Payments for Care Improvement-Advanced model, which is designed to improve quality and reduce costs for inpatient & outpatient care



    (October 9, 2018) - - Today, the Centers for Medicare & Medicaid Services (CMS) announced that 1,299 entities have signed agreements with the agency to participate in the Administration’s Bundled Payments for Care Improvement – Advanced (BPCI Advanced) Model. The participating entities will receive bundled payments for certain episodes of care as an alternative to fee-for-service payments that reward only the volume of care delivered. The Model participants include 832 Acute Care Hospitals and 715 Physician Group Practices – a total of 1,547 Medicare providers a
    ...
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  • Centers for Medicare and Medicaid Services Announces New Streamlined User Experience for Medicare Beneficiaries

    Centers for Medicare and Medicaid Services Announces New Streamlined User Experience for Medicare Beneficiaries




    (October 1, 2018) - - Today, the Centers for Medicare & Medicaid Services (CMS) announced a multi-year initiative that will empower patients and update Medicare resources to meet beneficiaries’ expectation of a more personalized customer experience. The eMedicare initiative will modernize the way beneficiaries get information about Medicare and create new ways to help them make the best decisions for themselves and their families. The eMedicare initiative’s goal is to provide a seamless online health care experience to meet the growing expectations for this generation of Medicare beneficiaries. CMS has a cohesive, multi-year strategy of consumer data integration and web product development to modernize Medicare.gov and improve access to p...
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  • CMS Continues Efforts to help with Hurricane Florence Emergency Response

    in News

    CMS Continues Efforts to help with Hurricane Florence Emergency Response

    Centers for Medicare and Medicaid Services Continues Efforts to help with Hurricane Florence Emergency Response



    Agency waivers take effect in Virginia



    (September 14, 2018) - - The Centers for Medicare & Medicaid Services (CMS) today announced efforts underway to support Virginia in response to Hurricane Florence. This week, Health and Human Services Secretary Alex Azar declared a public health emergency in Virginia. With the public health emergency in effect, CMS has taken several actions to provide immediate relief to all those affected by the hurricane along the east coast. The actions include temporarily waiving or modifying certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements; creating special enrollment opportunities for individuals to access healthcare immediately; and taking steps to ensure dialysis patients obtain critical
    ...
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  • Staff Reporter 1
    CMS Approves Nebraska Medicaid Demonstration to Provide Pathway to Enhanced Benefits for Eligible Adults
    by Staff Reporter 1
    Centers for Medicare and Medicaid Services approves Nebraska Medicaid Demonstration to Provide Pathway to Enhanced Benefits for Eligible Adults | site |



    (October 20, 2020) - - The Centers for Medicare and Medicaid Services published today, October 20, 2020, the following information:

    Today, the Centers for Medicare & Medicaid Services (CMS) announced its approval of Nebraska’s new Medicaid Section 1115 demonstration called “Heritage Health Adult.” This demonstration is designed to create a pathway for certain Nebraska adults with newly gained Medicaid coverage to access additional benefits if they participate in certain activities to promote health and independence. This demonstration is effective October 20, 2020, through March 31, 2026, with implementation beginning April 1, 2021.


    “Governor Ricketts and his team deserve credit for responding to President Trump’s invitation to design innovative state-led solutions that promote
    ...
    10-22-2020, 11:20 PM
  • Staff Reporter 1
    Trump Administration Drives Telehealth Services in Medicaid and Medicare
    by Staff Reporter 1
    Trump Administration Drives Telehealth Services in Medicaid and Medicare | site |


    (October 14, 2020) - - The Centers for Medicare and Medicaid Services published today, October 14, 2020, the following information: Today, the Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE). CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand access to telehealth. The actions reinforce President Trump’s Executive Order on Improving Rural Health and Telehealth Access to improve the health of all Americans by increasing access to better care. “Responding to President Trump’s Executive Order, CMS is taking action to increase telehealth adoption across the country,” said CMS Administrator Seema Verma. “Medicaid patients should not be ...
    10-17-2020, 02:06 AM
  • Staff Reporter 1
    U.S. Centers for Medicare and Medicaid Services Updates COVID-19 Testing Methodology for Nursing Homes
    by Staff Reporter 1
    U.S. Centers for Medicare and Medicaid Services Updates COVID-19 Testing Methodology for Nursing Homes | site |



    (September 29, 2020) - - The United States Centers for Medicare & Medicaid Services published today, September 29, 2020, the following information: Today, the Centers for Medicare & Medicaid Services (CMS) announced an update to the methodology the agency employs to determine the rate of coronavirus disease 2019 (COVID-19) positivity in counties across the country. Counties with 20 or fewer tests over 14 days will now move to “green” in the color-coded system of assessing COVID-19 community prevalence. Counties with both fewer than 500 tests and fewer than 2,000 tests per 100,000 residents, and greater than 10 percent positivity over 14 days – which would have been “red” under the previous methodology – will move to “yellow.” This information is critical to nursing homes, which are required to test their staff for COVID-19 at a freque
    ...
    10-04-2020, 04:17 AM
  • Staff Reporter 1
    CMS Announces Innovative Payment Model to Improve Care, Lower Costs for Cancer Patients
    by Staff Reporter 1
    Centers for Medicare and Medicaid Services Announces Innovative Payment Model to Improve Care, Lower Costs for Cancer Patients | site |



    (September 18, 2020) - - The Centers for Medicare and Medicaid Services published today (September 18, 2020) the following information:

    Today, the Centers for Medicare & Medicaid Services (CMS) finalized a new Innovation Center model expected to improve the quality of care for cancer patients receiving radiotherapy and reduce Medicare expenditures through bundled payments that allow providers to focus on delivering high-quality treatments. The new Radiation Oncology (RO) Model allows this focus on value-based care by creating simpler, more predictable payments that incentivize cost-efficient and clinically effective treatments to improve quality and outcomes. The RO Model, part of a final rule on specialty care models issued by CMS, will begin on January 1, 2021 and is estimated to save Medicare $230 million over...
    09-21-2020, 11:16 PM
  • Staff Reporter 1
    Centers for Medicare and Medicaid Services posts Guidance for Implementing New Testing Requirements in Nursing Homes and Labs
    by Staff Reporter 1
    Centers for Medicare and Medicaid Services posts Guidance for Implementing New Testing Requirements in Nursing Homes and Labs | site |




    (August 26, 2020) - - The Centers for Medicare & Medicaid Services published today (August 26, 2020) the following information:

    Today, the Centers for Medicare & Medicaid Services (CMS) released guidance for nursing homes and clinical laboratories to assist in enhancing their abilities to prevent the spread of the coronavirus disease 2019 (COVID-19) to nursing home residents and their front line staff.

    Nursing homes are particularly vulnerable to the prevalence and spread of COVID-19. CMS continues to take proactive steps to enhance infection control policies, including practices that limit potential transmission, and prevent outbreaks within these facilities to protect residents. Today’s guidance requires all nursing homes to test all residents and staff for COVID-19. A new survey
    ...
    08-31-2020, 01:21 PM

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