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Centers for Medicare & Medicaid ServicesCMS Roundup

Today, the Centers for Medicare & Medicaid Services (CMS) provides an at-a-glance summary of news from around the agency.

*CMS Releases Fiscal Year 2024 Improper Payment Data for All Programs*

November 15: In keeping with its commitment to responsible stewardship of public funds and to promote the sustainability of its programs, CMS released the Fiscal Year 2024 Improper Payment Data for Medicare (Fee for Service, Part C and Part D), Medicaid, Children’s Health Insurance Program, and the Advance Payment of Premium Tax Credits for the Federally Facilitated Health Insurance Exchange. While the reporting of improper payments is designed to protect the integrity of CMS programs, not all improper payments are the result of fraud or abuse — they can be overpayments, underpayments or payments where insufficient information was provided to determine whether a payment was proper. Information can be found in this fact sheet [ https://www.cms.gov/newsroom/fact-sheets/fiscal-year-2024-improper-payments-fact-sheet ] and in the 2024 HHS Agency Financial Report. [ https://www.hhs.gov/sites/default/files/fy-2024-hhs-agency-financial-report.pdf ]

*CMS Infographic Highlights Internet Access & Use by People with Medicare*

November 15: In observance of National Rural Health Day, CMS released an infographic [ https://www.cms.gov/files/document/internet-access-and-use-among-medicare-beneficiaries-living-community-metropolitan-residence-status.pdf ]   highlighting information on internet access and use among people with Medicare by metropolitan residence status. CMS also released updated data [ https://www.cms.gov/research-statistics-data-and-systems/research/mcbs/data-tables/2023-mcbs-early-puf-internet-access-and-use-among-medicare-beneficiaries ] on internet access and use   among people with Medicare, with data for 2023, and an annual data update on socio-demographic and health characteristics [ https://www.cms.gov/research-statistics-data-and-systems/research/mcbs/data-tables/mcbs-socio-demographic-and-health-characteristics-medicare-beneficiaries-living-community ] of people with Medicare by metropolitan residence status, with data for 2022.

*CMS Updates Nursing Home Surveyor Guidance to Strengthen Nursing Home Quality of Care *

November 18: CMS released revised guidance [ https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states/revised-long-term-care-ltc-surveyor-guidance-significant-revisions-enhance-quality-and-oversight-ltc ] for nursing home surveyors. The revised guidance includes updates to several areas, including procedures related to admissions, transfers and discharge of residents, discouraging the unnecessary use of psychotropic drugs and chemical restraints, compliance related to the use of the Payroll-Based Journal for reporting of nurse staffing, definitions of levels of pain and pain management, and other topics. These revisions are meant to ensure that guidance remains aligned with current standards of practice and reflects the evolving needs of residents.

*CMS Updates States on Medicaid Coverage of Substance Use Disorder Treatment Provisions*

November 19: CMS issued a state Medicaid director letter [ https://www.medicaid.gov/federal-policy-guidance/downloads/smd24004.pdf ] addressing the extension of Medicaid coverage of services to treat substance use disorders, the permanence of the mandatory Medicaid benefit for medication-assisted treatment for opioid use disorder, and the provision of medical assistance for certain individuals who are patients in eligible inpatient facilities (known as “IMDs”), in which Medicaid benefits generally are not otherwise covered.

*CMS Posts Awards for Medicare-Funded Residency Slots for Hospitals in Medically Underserved Areas *

November 21: CMS posted graduate medical education (GME) residency slot awards [ https://www.cms.gov/files/zip/section-126-cap-increase-round-3.zip ] as authorized by the Consolidated Appropriations Act (CAA), 2021. This is the third round of the 1,000 new Medicare-funded medical residency positions, phased in at no more than 200 slots per year beginning in Fiscal Year 2023, provided under Section 126 of the CAA. The law requires that the third round of 200 residency slots be announced no later than January 31, 2025, and become effective July 1, 2025. There were 206 hospitals that applied in Round 3 for the 200 available slots. Using the health professional shortage areas (HPSA) prioritization and other criteria, 109 hospitals will be awarded slots. Additional information about the program can be found here [ https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/direct-graduate-medical-education-dgme ].

*CMS Hosts Virtual Conference on Optimizing Health Care Delivery to Improve Patient Lives*

November 21: CMS posted the agenda [ https://cmsburdenreductionconference.com/agenda/ ] for the 2024 Conference on Optimizing Health Care Delivery to Improve Patient Lives, taking place on December 12, 2024. This virtual conference will explore innovative ideas, lessons learned, and best practices that strengthen patient health care delivery and access to high quality care, by reducing administrative burdens that impact patients and the health care workforce. Registration is still open, and information on the conference can be found here [ https://cmsburdenreductionconference.com/ ].

*CMS Issues 2024 Measures Under Consideration List for Adoption Through Medicare Rulemaking *

November 25, 2024: As required by statute, CMS posted the 2024 Measures Under Consideration (MUC) List [ https://mmshub.cms.gov/measure-lifecycle/measure-implementation/pre-rulemaking/lists-and-reports ]. One hundred percent of the 41 measures on the list use digital data sources, advancing the CMS National Quality Strategy [ https://www.cms.gov/medicare/quality/meaningful-measures-initiative/cms-quality-strategy ] goal of prioritizing the development of interoperable and digital quality measures. Additionally, 37% of the measures address person-centered care, with the goal of enhancing the health, well-being, and overall care experience of those we serve. CMS makes these measures publicly available to seek input. Information on the process, including deadlines, can be found here [ https://mmshub.cms.gov/measure-lifecycle/measure-implementation/pre-rulemaking/overview ].

*Other Recent Releases: *

November 22: Over 496,000 New Consumers Selected Affordable Health Coverage in ACA Marketplace [ https://www.cms.gov/newsroom/press-releases/over-496000-new-consumers-selected-affordable-health-coverage-aca-marketplace ]__

November 26: Biden-Harris Administration Announces Medicare Advantage and Medicare Part D Prescription Drug Proposals that Aim to Improve Care and Access for Enrollees [ https://www.cms.gov/newsroom/press-releases/biden-harris-administration-announces-medicare-advantage-and-medicare-part-d-prescription-drug ]

November 26: Biden-Harris Administration Finalizes New Model to Improve Access to Kidney Transplants [ https://www.cms.gov/newsroom/press-releases/biden-harris-administration-finalizes-new-model-improve-access-kidney-transplants ] __

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CMS, an agency within the U.S. Department of Health and Human Services, serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes. The agency protects public health by administering the Medicare program and working in partnership with state governments to administer Medicaid, CHIP, and the Health Insurance Marketplace.

 

Get CMS news at cms.gov/newsroom [ https://www.cms.gov/newsroom ], sign up for CMS news via email [ https://www.cms.gov/About-CMS/Agency-Information/Aboutwebsite/EmailUpdates ], and follow CMS on X (Formerly Twitter) @CMSgov [ https://twitter.com/cmsgov ]







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