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Archive Author: Stephanie Lomas

Senior Health Policy Manager

For 2024, CMS Finalizes Changes Resulting in a 3% Increase in Plan Payments and Implements Inflation Reduction Act Provisions on Part D Benefit 

The Centers for Medicare & Medicaid Services (CMS) has released its Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies that would update program policies for Medicare Advantage and Medicare Part D beginning in 2024. Notably, CMS changes center on implementing provisions of the Inflation [...] Read More

For 2024, CMS Proposes Changes Resulting in a 1% Increase in Plan Payments and Implements Inflation Reduction Act Provisions on Part D Benefit

The Centers for Medicare & Medicaid Services (CMS) has released its Advance Notice of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies that would update program policies for Medicare Advantage and Medicare Part D beginning in 2024, if finalized. Notably, CMS proposals [...] Read More

New rule regarding discarded drugs

Effective January 1, the companies which manufacture certain drugs in single dose containers and the providers who administer them are subject to new regulations specific to discarded drugs. The regulations stem from the Centers for Medicare & Medicaid Services’ (CMS’s) implementation of the 2021 Infrastructure, Investment, and Jobs Act (IIJA) requiring manufacturers of single-dose or [...] Read More

For FY 2023, CMS Increases Inpatient Psychiatric Facility Payments by 2.5% and Receives Feedback for Future Payment Adjustments and Health Equity

On July 27, 2022, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2023 final rule for Inpatient Psychiatric Facilities (IPFs), which includes final policies for payment and quality reporting in these facilities. CMS also released a fact sheet on the final rule. In this year’s rule, CMS is finalizing several [...] Read More

CMS Finalizes CY 2023 Policy Changes for Medicare Advantage and Part D Plans; Including Patient Cost-Sharing, Patient Protections, and Provider Accessibility

On April 29, 2022, the Centers for Medicare & Medicaid Services (CMS) released its final rule and a fact sheet, containing policies for Medicare Advantage (MA) and Medicare Part D plans in CY (contract year) 2023. The rule includes the following changes: Redefining ‘negotiated price’ for Part D drugs so prices at point of sale [...] Read More

CMS Proposes Changes Increasing Inpatient Psychiatric Facility Payments and Seeks Comments on Future Payment Adjustments and Health Equity

On March 31, 2022, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2023 proposed rule for inpatient psychiatric facilities (IPFs), which includes proposed policies for payment and quality reporting in these facilities. CMS also released a fact sheet on the proposed rule. This year’s proposals are primarily payment related including [...] Read More

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