Summarizes the mission of the Centers for Medicare & Medicaid (CMS) and highlights changes to Medicaid program allowances related to designated state health programs (DSHPs) and designated state investment programs (DSIPs). Includes examples of program costs that will no longer be allowed.
Highlights the priorities for the Centers for Medicare & Medicaid (CMS) and new Administrator Dr. Mehmet Oz. Provides information on how the priorities will align with the President's Make America Healthy Again initiative.
Apr 1, 2025 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on an information collection Medicare Transaction Facilitator (MTF) for 2026 and 2027 under Sections 11001 and 11002 of the Inflation Reduction Act (IRA). The MTF will collect information from manufacturers of drugs covered under Medicare Part D selected will be used for negotiation under the Inflation Reduction Act for the initial price applicability years 2026 and 2027 and the dispensing entities that dispense the selected drugs to MFP-eligible individuals. Comments are due by May 1, 2025.
Request for input regarding barriers to participation in population-based total cost of care (PB-TCOC) models from the Physician-Focused Payment Model Technical Advisory Committee (PTAC). Topics of interest include business decisions impacting participation for different organization types, streamlining models, and incentivizing participation for both primary and specialty care. Asks for feedback regarding types of organizations best positioned to serve rural and other communities. Comments can be emailed to PTAC@HHS.gov by April 18, 2025.
Source: Physician-Focused Payment Model Technical Advisory Committee, Office of the Assistant Secretary for Planning and Evaluation
Mar 21, 2025 - The Centers for Medicare & Medicaid Services (CMS) is seeking comments on the following information collections: 1) Application for Enrollment in Medicare Part B (Medical Insurance); 2) Application for Medicare Part A and Part B Special Enrollment Period (Exceptional Circumstances); 3) Request for Enrollment in Supplementary Medical Insurance (SMI); 4) CMS Plan Benefit Package (PBP) and Formulary CY 2026; and 5) Dual Eligible Special Needs Plan Contract with the State Medicaid Agency. Comments are due by April 21, 2025.
Mar 19, 2025 - Notice of proposed rule related to implementation of Patient Protection and Affordable Care Act and Health Insurance Marketplace. Among other things, this rule proposes revisions to standards relating to past-due premium payments; the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance; income eligibility verifications for premium tax credits and cost-sharing reductions; annual eligibility redetermination; the annual open enrollment period; special enrollment periods; and more. Comments are due by April 11, 2025.
Offers an overview of a proposed Centers for Medicare & Medicaid Services rule implementing changes to the Health Insurance Marketplaces. Changes include premium payment guidelines, enrollment, eligibility guidelines, services offered, and compliance regulation.
