December 6, 2024

CMS Finalizes New Model to Improve Access to Kidney Transplants

On November 26, 2024, the Centers for Medicare & Medicaid Services (CMS) finalized a rule establishing a new, six-year mandatory model aimed at increasing access to kidney transplants.

Starting in July 2025, selected transplant hospitals will receive financial incentives to perform more kidney transplants.

The final rule also includes standard provisions for all mandatory CMS innovation center models starting after January 1, 2025.

Click Here to Read CMS New Model

Click Here to Read Final Rule

December 6, 2024

CMS Proposed Changes to Medicare Part C and D

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would revise the Medicare Advantage (MA) Program and Medicare Prescription Drug Benefit Program (Part D).

Proposals include:

• Permitting Medicare and Medicaid coverage of anti-obesity medications,
• Further clarifications to the rules on what MA plans must cover,
• Limits on enrollee cost-sharing for behavioral health,
• Expanded topics that agents/brokers must cover when assisting beneficiaries,
• Parameters around the use of debit cards for supplemental MA benefits,
• Codifying requirements for the Medicare Prescription Payment Plan, and
• Integrating member identification cards for individuals dually eligible for Medicare and Medicaid.

As of January 2023, about 45 percent of rural Medicare beneficiaries were enrolled in an MA plan.

Click Here to Learn More

Click Here to Read Proposed Rule

Click Here to Go to Medicare Prescription Payment Plan

December 6, 2024

CMS Seeks Feedback on Quality Measures for Medicare Hospitals, including REHs, Comment by December 30

The Centers for Medicare & Medicaid Services (CMS) would like public feedback on 41 measures under consideration for quality reporting and value-based programs before the measures are formally proposed through the rulemaking process.

Categories of quality measures for hospitals receiving payment through Medicare, including CMS-designated Rural Emergency Hospitals (REHs) are:

• Post-acute care/long-term care measures
• Clinician Measures
• Hospital Measures

For example, CMS would like early feedback on including the measure Median Time to Pain Medication for Patients with a Diagnosis of Sickly Cell Disease with Vaso-Occlusive Episode in the Rural Emergency Hospital Quality Reporting Program, and the measure Proportion of Patients who Died from Cancer Admitted to Hospice for less than 3 Days in the Hospital Quality Reporting Program.

CMS will hold three listening sessions, one for each of these categories, December 17-19. Register to make live comments or ask questions during these sessions:

Click on the topic, below to learn more and register for the listening session:

• Tuesday, December 17, 1:00 p.m. – 4 p.m. ET: Clinician Listening Session
• Wednesday, December 18, 1:00 p.m. – 4:00 p.m. ET: Hospital Listening Session
• Thursday, December 19, 1:00 p.m. – 2:00 p.m.: Post-Acute Care/Long-term Care (PAC/LTC) Listening Sessions

Click Here for Instructions on Submitting a Comment