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CMS

Verma: Price Transparency Rule Critical First Step for CMS

January 14, 2019 - Healthcare organizations may only need to post chargemaster lists online for now, but that doesn’t mean they can’t create their own initiatives to improve price transparency, said CMS Administrator Seema Verma in a press call last week. The call came following significant press coverage of a new CMS policy that requires hospitals to publicly post their chargemaster prices...


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Patient-Centered Care Coordination Key for MA Telehealth Plans

by Sara Heath

Although telehealth shows promise for driving more convenient patient care access, supporting that technology with effective care coordination and continuity will be essential to a quality patient experience, according to a recent comments...

Price Transparency Rules Take Effect, Slated to Empower Patients

by Sara Heath

As of January 1, 2019, hospitals across the country are responsible for full price transparency, a move that will allow patients to make informed decisions about care access. The mandates come as a part of the 2019 inpatient prospective...

Part D Drug Price Proposal Could Limit Patient Access to Care

by Sara Heath

Utilization management strategies such as formulary tiers and copayments serve as significant barriers to Medicare Part D drugs for many patients managing serious illness, according to a new report conducted by Avalere Health on behalf of...

CMS Drug Price Proposal Aims to Cut Out-of-Pocket Patient Spending

by Sara Heath

CMS has proposed a new drug price model for Medicare Parts C and D that will ideally reduce out-of-pocket patient spending. The policies, which if approved would go into effect in 2020, would impact Medicare Advantage and Medicare Parts C...

CMS Program to Support Patient Safety in Nursing Home Care

by Sara Heath

CMS is ramping up its efforts to improve patient safety and care quality in nursing home settings. Through the Civil Money Penalty Reinvestment Program (CMPRP), the agency aims to give nursing home employees and caregivers the tools...

CMS: Work Continues to Address Rural Patient Care Access Issues

by Sara Heath

The Centers for Medicare & Medicaid Services (CMS) is working to address patient care access and other issues faced by individuals residing in rural areas, according to a recent blog post from agency administrator Seema Verma. The...

AHA: OPPS Site-Neutral Payments to Hinder Patient Access to Care

by Sara Heath

The American Hospital Association did not mince words when commenting on the site-neutral payment provisions included in the Hospital Outpatient Prospective Payment System (OPPS). Implementing site-neutral payment is set to harm hospitals...

CMS Updates Aim to Improve Patient-Centered Care, Care Access

by Sara Heath

The Centers for Medicare & Medicaid Services has issued a slew of final rules aimed at reducing administrative simplification and improving patient-centered care. Late last week, CMS finalized its 2019 Physician Fee Schedule (PFS),...

Medicare Advantage Propose to Expand Patient Access to Telehealth

by Sara Heath

CMS has announced plans to modernize Medicare Advantage and Part D plans. Updates will expand patient access to care by adding telehealth as a covered benefit. The agency says it will update the way it reimburses providers to make it...

CMS Model to Push Care Access for Maternal Opioid Use Disorder

by Sara Heath

CMS is launching a new Medicaid care model that will improve care coordination, behavioral health integration, and access to care for expectant and new mothers with opioid use disorder (OUD). The Maternal Opioid Misuse (MOM) model aims to...

CMS Releases Quality Star Ratings for Medicare Plan Patient Access

by Sara Heath

CMS has released the quality star ratings for Medicare Advantage and Medicare Part D prescription drug plans, according to a public statement. This move comes ahead of the open enrollment session and as a part of the agency’s efforts...

CMS Revises Medicare Program Manual to Boost Patient Access to Care

by Sara Heath

CMS has made revisions to Medicare’s Program Integrity Manual in an effort to improve patient access to care services and healthcare devices. The revisions will make it easier for Medicare Administrative Contractors (MACs) to...

CMS Updates eMedicare Website to Improve Beneficiary Experience

by Sara Heath

CMS has revamped the eMedicare website, adding new tools to enhance the Medicare beneficiary experience when searching for a health plan. These updates include tools aimed at making it easier for beneficiaries to understand plan details,...

CMS Announces Patient Navigator Funding, Enrollment Changes

by Sara Heath

CMS has announced the recipients of $10 million grant funding for patient navigator programs, considerably slashing the resources states will have to connect patients with comprehensive health insurance. The patient navigator program was...

Experts State 2019 Physician Fee Schedule Harms Patient Care Access

by Sara Heath

More healthcare industry leaders are expressing concerns over provisions included in the 2019 proposed Physician Fee Schedule, specifically stating that statutes to reduce reimbursement for evaluation and management (E/M) services could...

CMS Rule May Reduce Reporting Burden, But Harm Patient Care Access

by Sara Heath

Proposed changes for the 2019 Physician Fee Schedule would effectively put “patients over paperwork,” helping to deliver on a promise from CMS to improve patient-centered care and patient care access, said the American Medical...

CMS Overhauls ACO Programs, Pushes for Beneficiary Engagement

by Sara Heath

The Centers for Medicare & Medicaid Services (CMS) has proposed a major overhaul of its accountable care organization (ACOs) Medicare Shared Savings Program (MSSP) model, aiming to tamp down on spending, drive healthcare transparency,...

CMS Allows Medicare Advantage Plans to Adopt Step Therapy

by Sara Heath

CMS has given new authority to Medicare Advantage plans that allows those plans to negotiate lower drug prices. These new policies will specifically allow Medicare Advantage Plans to practice step therapy, which CMS says will create cost...

MyHealthEData, Patients Over Paperwork Key in CMS Final Rules

by Sara Heath

CMS has issued final rules related to the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System. Finalized changes will support patient-centered care by reinforcing the MyHealthEData...

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