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Rural Health
News by Topic: Health insurance

May 17, 2024 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) describing a new mandatory Medicare payment model, the Increasing Organ Transplant Access Model (IOTA Model). The IOTA Model would test whether performance-based incentive payments paid to or owed by participating kidney transplant hospitals increase access to kidney transplants for patients with end-stage renal disease (ESRD) while preserving or enhancing the quality of care and reducing Medicare expenditures. This proposed rule also describes standard provisions for CMS Innovation Center (CMMI) models relating to beneficiary protections, cooperation in model evaluation and monitoring, audits and records retention, rights in data and intellectual property, monitoring and compliance, and more. These standard provisions would apply to any CMMI model whose first performance period begins on or after January 1, 2025, and in whole or in part to any CMMI model whose first performance period began before January 1, 2025. Comments are due by July 16, 2024.
Source: Federal Register
May 17, 2024 - An analysis by the Georgetown University Center for Children and Families showed that Alaska, Arkansas, Colorado, Idaho, Montana, New Hampshire, South Dakota, and Utah had fewer children enrolled in Medicaid at the end 2023 than before the pandemic. States with the largest drops in coverage have large rural areas, where clinician shortages, long drives to care, and poorer health outcomes are common.
Source: Stateline
May 16, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the extension of an information collection titled "Prior Authorization Process and Requirements for Certain Hospital Outpatient Department (OPD) Services." CMS requires prior authorization for certain covered OPD services as a condition of Medicare payment to help to reduce unnecessary utilization and payments for these services. Comments are due by June 17, 2024.
Source: Federal Register
May 14, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on revisions to an information collection titled "Fast Track Appeals Notices: NOMNC/DENC." Skilled nursing facilities (SNFs), home health agencies (HHAs), comprehensive outpatient rehabilitation facilities (CORFs), and hospices must provide notice to all beneficiaries/enrollees whose Medicare-covered services are ending no later than two days in advance of the proposed termination of service via the Notice of Medicare Non-Coverage (NOMNC). Comments are due by July 15, 2024.
May 10, 2024 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) implementing improvements to increase transparency and accountability, standardize data and monitoring, and create opportunities for States to promote active beneficiary engagement in their Medicaid programs, with the goal of improving access to care. These regulations are effective July 9, 2024.
Source: Federal Register
May 10, 2024 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) advancing CMS' efforts to improve access to care, quality and health outcomes, and better address health equity issues for Medicaid and Children's Health Insurance Program (CHIP) managed care enrollees. This rule specifically addresses standards for timely access to care and States' monitoring and enforcement efforts, reduces burden for some State directed payments and certain quality reporting requirements, adds new standards that will apply when States use in lieu of services and settings (ILOSs) to promote effective utilization and specify the scope and nature of ILOS, specifies medical loss ratio (MLR) requirements, and establishes a quality rating system for Medicaid and CHIP managed care plans. These regulations are effective July 9, 2024.
Source: Federal Register
May 10, 2024 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) establishing minimum staffing standards for long-term care facilities. This rule also requires states to report the percentage of Medicaid payments for certain Medicaid-covered institutional services that are spent on compensation for direct care workers and support staff. These regulations are effective on June 21, 2024, except for § 483.71, § 483.35(b)(1) and (c)(1), § 483.35(b)(1)(i) and (ii), and §§ 438.72(a) and 442.43 as indicated.
Source: Federal Register
May 10, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing its approval of The Compliance Team for continued recognition as a national accrediting organization for Rural Health Clinics that wish to participate in the Medicare or Medicaid programs. This recognition is applicable July 17, 2024, to July 17, 2028.
Source: Federal Register
May 8, 2024 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) making several clarifications and updating the definitions used to determine whether a consumer is "lawfully present" in order to be eligible to enroll in a Qualified Health Plan (QHP) through an Exchange; a Basic Health Program (BHP), in states that elect to operate a BHP; and for some state Medicaid and Children's Health Insurance Programs (CHIPs). This rule includes Deferred Action for Childhood Arrivals (DACA) recipients and certain other noncitizens in the definitions of "lawfully present" for purposes of eligibility for these insurance affordability programs. These regulations are effective November 1, 2024.
Source: Federal Register
May 8, 2024 - The U.S. Department of Health and Human Services (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) is seeking public comments on potential viral hepatitis quality measures for implementation at the state and territory level. Specifically, HHS requests comments on the clinical significance, usability, feasibility, and likely uptake of hepatitis C screening and hepatitis C treatment initiation quality measures, as well as recommendations on other feasible viral hepatitis measures. Comments are due by June 7, 2024.
Source: Federal Register