Category: HRSA

Request for Information: Medicare $2 Drug List Model – Respond by December 9

October 17, 2024

Request for Information: Medicare $2 Drug List Model – Respond by December 9

In response to an Executive Order to lower prescription drug costs, the Centers for Medicare & Medicaid Services (CMS) developed a model to test whether a simpler approach to offering low-cost, clinically important generic drugs can improve medication adherence, lead to better health outcomes, and improve satisfaction with the Part D prescription drug benefit for people with Medicare and for prescribers.

This RFI aims to obtain input from a broad range of interested parties to support continued development of the model. CMS’ primary areas of interest include:

  • Drug List Development Process;
  • Maximizing Plan Participation;
  • CMS Outreach Efforts;
  • Part D Sponsor Outreach and Education Efforts for Beneficiaries;
  • Assessment of Model Impact;
  • Drug List Modifications.

CMS is interested in hearing from all stakeholders, including, but not limited to:

  • Medicare beneficiaries
  • Advocates
  • Medicare Part D plan sponsors
  • Pharmacy benefit managers
  • Prescribers
  • Pharmacists
  • Pharmacies
  • Policy experts
  • Researchers
  • Drug manufacturers
  • Wholesalers
  • Distributors
  • All other interested parties

Click Here to Read More

Click Here to Read Executive Order

Process for Submitting Response:

  • Deadline to respond: December 9, 2024, 11:59 p.m. PST
  • Comments can be submitted here

Policy Update: Final Rule on Medicare Beneficiaries’ Appeal Rights for Certain Changes in Patient Status

October 17, 2024

Policy Update: Final Rule on Medicare Beneficiaries’ Appeal Rights for Certain Changes in Patient Status

In response to a court order, the Centers for Medicare & Medicaid Services (CMS) has finalized appeals processes for certain Medicare beneficiaries who are initially admitted as hospital inpatients but are subsequently reclassified as outpatients receiving observation services during their hospital stay, along with other eligibility criteria.

This final rule establishes processes for

  • Standardized appeals,
  • Expedited appeals,
  • and retrospective appeals for beneficiaries.

It also extends the timeframe for providers to submit a claim following a favorable decision and to submit records as requested by a contractor.

While CMS estimates a relatively low number of appeals that meet these criteria, they acknowledge that there will be administrative costs for hospitals to accommodate the new appeals process.

This final rule is effective October 11, 2024.

Click Here to Read Full Details

HRSA Announces Major Investment to Integrate Mental Health and Substance Use Disorder Services into Primary Care

October 17, 2024

HRSA Announces Major Investment to Integrate Mental Health and Substance Use Disorder Services into Primary Care

On September 19, the Health Resources and Services Administration (HRSA) announced $240 million in awards to launch and expand mental health and substance use disorder services in more than 400 HRSA-funded community health centers that provide care for more than 10 million people across the country.

HRSA-funded health centers are a primary source of care for people who are uninsured, underinsured, or enrolled in Medicaid, making them well-positioned to respond to the urgent need for high-quality behavioral health services that are stigma-free, culturally competent, and readily accessible.

The grants will help expand access to needed care to help tackle the nation’s behavioral health and opioid crises.

Click Here to Read More

HRSA Announces Overhaul of OPTN Board of Directors

October 17, 2024

HRSA Announces Overhaul of OPTN Board of Directors

In September, the Health Resources and Services Administration (HRSA) announced the overhaul of the Organ Procurement and Transplantation Network (OPTN) – the governing board that develops national organ allocation policy.

The OPTN Board is now separately incorporated and independent from the Board of long-time OPTN contractor, the United Network for Organ Sharing. HRSA has awarded an OPTN Board Support contract to American Institutes for Research to support the newly incorporated OPTN Board of Directors.

These critical actions to better serve patients by breaking up the monopoly that ran the nation’s organ allocation system are part of the OPTN modernization plan announced by HRSA in March 2023. Prior to these steps, the national body responsible for developing organ allocation policy for the country, the OPTN and the corporate entity contracted to implement the policy UNOS, shared the exact same Board or Directors.

The new board support contractor will be accountable to HRSA and will organize a special election for a new OPTN Board of Directors with a focus on eliminating conflicts of interest and ensuring that data, evidence, and the voices of clinical leaders, scientific experts, patients, and donor families are driving action and accountability. Moving forward, no member of the OPTN Board can sit on an OPTN vendor’s board of directors.

Click Here to Read More

HRSA Takes Historic Steps to Modernize the Nation’s Organ Transplant System

October 17, 2024

HRSA Takes Historic Steps to Modernize the Nation’s Organ Transplant System

On September 19, the Health Resources and Services Administration (HRSA) announced the first-ever multi-vendor contract awards to modernize the nation’s organ transplant system.

For the first time in 40 years, multiple contractors will contribute their expertise and experience to improve the national organ donation and transplant system for the more than 100,000 people on the organ transplant waitlist.

The transition from a single vendor to multiple vendors to support operations of the Organ Procurement and Transplantation Network (OPTN) is a critical step in advancing innovation in the transplant system to better serve patients and their families.

HRSA is announcing multiple OPTN modernization awards to support critical actions including:

  • Improving patient safety
    • Arbor Research Collaborative for Health will provide support on patient safety and the policy compliance systems and processes overseen by the OPTN Board of Directors and the Membership and Professional Standards Committee to improve oversight of the multiple entities in the OPTN.
  • Supporting OPTN IT Modernization
    • General Dynamic Information Technology (CDIT) will focus on the opportunities to improve the OPTN organ matching IT system and inform HRSA’s Next Generation IT procurement and development work.
  • Increasing Transparency and Public Engagement in OPTN Policy Development
    • Maximus Federal will advance opportunities to improve public visibility and engagement in the OPTN policy making process, including improving transparency around OPTN policy making committees’ deliberations and actions.
  • Strengthening Patient-Centered Communications
    • Deloitte will focus on improvements in communications from the OPTN, within the OPTN and, importantly, with patients and families.
  • Improving OPTN Financial Management
    • Guidehouse Digital will address improvements for OPTN’s budget development and management systems and processes.

Click Here to Read More

Pricing Transparency Tools Available

October 17, 2024

Pricing Transparency Tools Available

The Centers for Medicare and Medicaid Services (CMS) has developed and maintains tools to support hospitals in meeting some of the machine-readable file (MRF) requirements for Hospital Price Transparency.

  • Online Validator
    • Tests machine readable files against the required CMS template layouts and data specifications (45 CFR 180.50(c)(2)).
    • The online validator runs in a user’s web browser, and it is recommended for nontechnical users.
  • Command Line (CLI) Validator
    • Tests machine readable files against the required CMS template layouts and data specifications (45 CFR 180.50(c)(2)).
    • The CLI is a downloaded tool that runs locally in the user’s terminal, and it is recommended for technically proficient users validating multiple files simultaneously or integrating the validator into a software pipeline.
  • MRF Naming Wizard
    • Assists users in generating the MRF file name in accordance with the naming convention requirements (45 CFR 180.50(d)(5)).
  • TXT File Generator
    • Assists users in generating a TXT file with the required attributes of information to improve accessibility to MRFs (45 CFR 180.50(d)(6)(i)).

CMS Webinar: New Hospital Price Transparency Requirements, October 21

October 17, 2024

CMS Webinar: New Hospital Price Transparency Requirements, October 21

Hosted by the Centers for Medicare & Medicaid Services (CMS), this webinar will review the new hospital Price Transparency data elements that all U.S. hospitals and Critical Access Hospitals are required to include in their comprehensive machine-readable file (MRF) starting January 1, 2025.

According to regulations, hospitals must show their standard charges for all items and services they provide in an MRF that conforms to a CMS template layout and data specifications.

Cost: Free

When: Monday, October 21, 12:00 p.m.

Click Here to Register

Webinar: Hospital Price Transparency: What Hospitals Need to Know – Part 2, October 15

October 10, 2024

Webinar: Hospital Price Transparency: What Hospitals Need to Know – Part 2, October 15

Beginning January 1, 2021, hospitals operating in the United States are required to provide clear, accessible pricing information online about the items and services they provide.

This webinar will discuss the latest hospital price transparency policies effective January 1, 2024.

The Centers for Medicare and Medicaid Services (CMS) subject matter experts will review the latest policy requirements and enforcement actions for hospital price transparency effective July 1, 2024 through January 30, 2025

Click Here to Access Slide and Audio from Part 1 of this series

Cost: Free

When: Tuesday, October 15, 11:00 a.m.

Click Here to Register

Upcoming HRSA Webinar: Navigating Screening Mammography: Guidelines, Importance, and Reaching Underserved Populations, October 22

October 10, 2024

Upcoming HRSA Webinar: Navigating Screening Mammography: Guidelines, Importance, and Reaching Underserved Populations, October 22

In recognition of Breast Cancer Awareness Month, the Health Resources and Services Administration’s (HRSA’s), Bureau of Primary Health Care is hosting a webinar discussing the guidelines and methods to reach underserved populations better.

The presenter is Dr. Stamatia Destounis a breast radiologist and managing partner at Elizabeth Wende Breast Care in Rochester, NY.

Cost: Free

When: Tuesday, October 22, 2:00 p.m. – 4:00 p.m. ET

Click Here to Register

Save the Date for the Next Office of Women’s Health (OWH) Webinar, November 7

October 10, 2024

Save the Date for the Next Office of Women’s Health (OWH) Webinar, November 7

The Health Resources and Services Administration’s (HRSA’s) Office of Women’s Health (OWH) invites you to a webinar “Addressing the Intersection of Intimate Partner Violence (IPV) and Substance Use in Maternal Health Care.”

This webinar will feature speakers from

  • HRSA’s Maternal and Child Health Bureau,
  • Office of the Assistant Secretary for Health (OASH),
  • Office on Women’s Health

Attendees will learn about the National Strategy to Improve Maternal Mental Health Care as well as HRSA and OASH’s initiatives that are integrating prevention and care for IPV, substance use, and maternal health.

Cost: Free

When: Thursday, November 7, 1:00 p.m.

Click Here to Register