Over the last decade, seniors have been choosing Medicare Advantage (MA) plans for their healthcare insurance at an increasing rate. More than half of those eligible are now enrolled in MA plans, and participation is expected to grow to sixty percent by the end of this decade. A cursory look at the increasing popularity of [...] Read More
Applied Policy attended the Medical Device Manufacturers Association (MDMA) Annual Meeting in Washington, D.C., held from April 17-19. The event featured discussions with members of Congress and representatives from the FDA and the Center for Devices and Radiological Health (CDRH). Dora Hughes, M.D., M.P.H., CMS’s Acting Chief Medical Officer and Acting Director of the Center [...] Read More
In proposing a mandatory, episode-based payment model for certain hospitals, the Centers for Medicare & Medicaid Services (CMS) has provided a window into how value-based care might be addressed under a possible second Biden Administration. At issue is the Transforming Episode Accountability Model (TEAM), which was included within the fiscal year (FY) 2025 Hospital Inpatient [...] Read More
Applied Policy joined more than 4,000 attendees at the Academy of Managed Care Pharmacy (AMCP) Annual Meeting from April 15-18 in New Orleans, Louisiana, to connect with fellow industry stakeholders (and to try beignets from the famous Café Du Monde). A key event for managed care pharmacy professionals, AMCP’s Annual Meeting brings together pharmacists, payers, [...] Read More
On April 22, the Centers for Medicare & Medicaid Services (CMS) released two final rules: Ensuring Access to Medicaid Services and Medicaid and Children's Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality. These rules aim to improve care access, promote transparency and accountability, streamline data collection and monitoring, and increase opportunities to promote [...] Read More
On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting final rule and fact sheet. As part of the Biden Administration’s Nursing Home Reform initiative, this rule establishes national minimum nurse staffing standards to ensure safe and high-quality [...] Read More
On April 11 and 12, 2024, the Medicare Payment Advisory Commission (MedPAC) held a virtual public meeting, which included the following sessions: Considering approaches for updating the Medicare physician fee schedule; Telehealth in Medicare: Status report; Alternative approaches to lowering Medicare payments for select conditions in inpatient rehabilitation facilities; Assessing consistency between plan-submitted data sources [...] Read More
On April 10, 2024 the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2025 Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Long-Term Care Hospital (LTCH) Prospective Payment System proposed rule. See the press release here. CMS released a fact sheet accompanying the rule. The rule proposes [...] Read More
On April 4, 2024, the Centers for Medicare & Medicaid Services (CMS) released its Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Program for Contract Year 2024--Remaining Provisions and Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, [...] Read More
On April 2, 2024, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) issued the final Notice of Benefit and Payment Parameters for 2025 (CMS-9895-F) with a press release and fact sheet. This rule makes the following changes: Changes certain EHB prescription drug benefit requirements, Strengthens [...] Read More