CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments

Federal Register

Dec 9, 2024

Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) addressing: 1) changes to the Physician Fee Schedule and Medicare Part B payment policies; 2) policies for the Medicare Prescription Drug Inflation Rebate program under the Inflation Reduction Act of 2022; 3) updates to the Medicare Diabetes Prevention Program expanded model; 4) payment for dental services inextricably linked to specific covered medical services; 5) updates to drugs and biological products paid under Part B including immunosuppressive drugs and clotting factors; 6) Medicare Shared Savings Program requirements; 7) updates to the Quality Payment Program; 8) Medicare coverage of opioid use disorder services furnished by opioid treatment programs; 9) updates to policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); 10) electronic prescribing for controlled substances for a covered Part D drug under a prescription drug plan or an MA-PD plan; 11) updates to the Ambulance Fee Schedule regulations; 12) updates to Clinical Laboratory Fee Schedule regulations; 13) updates to the diabetes payment structure and COVID-19 public health emergency (PHE) flexibilities; 14) expansion of colorectal cancer screening and Hepatitis B vaccine coverage and payment; 15) establishing payment for drugs covered as additional preventive services; and 16) Medicare Parts A and B Overpayment Provisions of the Affordable Care Act and Medicare Parts C and D Overpayment Provisions of the Affordable Care Act. These regulations are effective January 1, 2025.

Diabetes · Emergency medical services · Federally Qualified Health Centers · Healthcare quality · Illicit drug use · Legislation and regulations · Medicare · Oral health · Pharmacy and prescription drugs · Prescription drug misuse · Reimbursement and payment models · Rural Health Clinics