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CMS Releases Final Rule for 2025 Qualified Health Plans, Aimed at

WEBOn April 2, 2024, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) issued the final Notice of …

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URL: https://www.appliedpolicy.com/cms-releases-final-rule-for-2025-qualified-health-plans-aimed-at-strengthening-network-adequacy-patient-access-and-protections-and-improving-plan-selection-and-enrollment/

CMS Releases Final Rule for 2023 Qualified Health

WEBOn April 28, 2022, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) issued the final 2023 Notice of Benefit …

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CMS Releases Final Rule for 2024 Qualified Health

WEBOn April 17, 2023, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) issued the final Notice of Benefit and …

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CMS Finalizes Changes to Prior Authorization, Expanding Access to

WEBOn January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Advancing Interoperability and Improving Prior Authorization Processes for Medicare …

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Prior Authorizations and Health Equity

WEBFor health insurance plans, prior authorizations can be an effective means of controlling healthcare spending and assuring that medications and treatments are properly …

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CMS finalizes payment increase for ESRD facilities in CY 2024, new …

WEBOn October 27, the Centers for Medicare & Medicaid Services (CMS) issued the End-Stage Renal Disease (ESRD) Prospective Payment System final rule for …

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Programs Focused on the Social Determinants of Health: …

WEBAccording to the CDC, these social determinants are “economic and social conditions that influence the health of people and communities” and are shaped by the …

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The development and accuracy of National Health Expenditures

WEBWhen the Centers for Medicare & Medicaid Services (CMS) released the 2021-2030 National Health Expenditure (NHE) report, prepared by the CMS Office of …

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Reconciling health equity and value-based purchasing

WEB12.31.2022. Two decades ago, value-based purchasing (VBP) and health equity were emerging concepts in healthcare, largely unknown outside of policy conversations or …

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ACA 101: What Difference Does a Benchmark Plan Make

WEBLast Friday evening, the Department of Health and Human Services (HHS) released the proposed requirements for qualified health plans (QHPs) in 2019. QHPs …

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CMS Proposes CY 2025 Policy Changes for Medicare Advantage …

WEBOn November 6, 2023, the Centers for Medicare & Medicaid Services (CMS) released its Medicare Program: Contract Year 2025 Policy and Technical Changes to the Medicare …

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CMS Increases Payments for Inpatient Rehabilitation Facilities and

WEBOn March 31, 2022, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2023 proposed Inpatient Rehabilitation Facilities (IRFs) payment …

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An Overview of CMS Continuous Enrollment Condition

WEBIn March 2020, the Families First Coronavirus Response Act established the “continuous enrollment condition,” which provided states with extra federal Medicaid …

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The Growing Food as Medicine Movement

WEBThe Growing Food as Medicine Movement. 04.13.2023. As an appreciation for the impact of social determinants of health moves from academia to practical …

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VALID v. VITAL: Which bill will win in the fight to reform IVD testing

WEBVITAL: Which bill will win in the fight to reform IVD testing? 03.15.2022. With the deadline for the reauthorization of the Medical Device User Fee Amendments (MDUFA) looming …

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CMS Holds Office Hours on the End of the Public Health Emergency

WEB05.06.2023. On April 25, the Centers for Medicare & Medicaid Services (CMS) hosted an office hours session to help providers, facilities, and Medicare beneficiaries prepare for …

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Private equity in healthcare

WEBPrivate equity in healthcare. 04.05.2022. The role of private equity in healthcare has received a great deal of attention in recent years, with some lauding its …

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The Debate over Step Therapy

WEBStep therapy is the process under which a health insurance plan requires a patient to try one or more alternative—typically lower cost— drugs or treatment options before they …

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CMS Increases Payments for Inpatient Rehabilitation Facilities in FY

WEBOn April 3, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2024 Inpatient Rehabilitation Facility (IRF) Prospective Payment System …

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