News & Analysis as of

CMMI Medicare

McDermott+

CMMI Finalizes TEAM: Comparison of Proposed and Final Policies

McDermott+ on

The fiscal year 2025 Inpatient Prospective Payment System (IPPS) final regulation has been released! Embedded in this massive, 2,987-page final reg is a new episode-based payment model, called the Transforming Episode...more

Manatt, Phelps & Phillips, LLP

What States Should Know Before Applying to CMMI’s Innovation in Behavioral Health NOFO

Summary On June 17, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) released a notice of funding opportunity (NOFO) for Innovation in Behavioral Health...more

Manatt, Phelps & Phillips, LLP

CMMI’s Innovations in Behavioral Health: Promoting Physical and Mental Well-being

Summary- On January 18, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) announced Innovations in Behavioral Health (IBH), a new eight-year model focused...more

Holland & Knight LLP

Key Value-Based Care Developments to Watch in 2024

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The goal of value-based care (VBC) is to promote better care for individual patients and improved health outcomes for communities at reduced costs. This is an important and admirable purpose as many VBC stakeholders attempt...more

Miles & Stockbridge P.C.

Highlights from the Inaugural Hot Topics in Health Care Law

The Miles & Stockbridge Health Care Practice Group hosted its inaugural Hot Topics in Health Care Law seminar last month for clients from Maryland and beyond. Miles & Stockbridge health care lawyers kicked off the seminar...more

Manatt, Phelps & Phillips, LLP

Palliative Care Reimbursement, Innovation and Reform

Palliative Care Defined The term “palliative care” is often used by doctors and other health care professionals during a serious illness or toward the end of life. Federal regulations define palliative care as...more

McDermott+

Policy Update: CMS Approves New York 1115 Medicaid Redesign Waiver

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On January 9, 2024, the Centers for Medicare and Medicaid Services (CMS) approved the New York State (NY) 1115 Medicaid waiver “Medicaid Redesign Team” (MRT). The MRT is a long-standing waiver in NY that has continuously...more

Epstein Becker & Green

CMS Announces New Primary and Behavioral Health Care Integration Demonstration Model

Epstein Becker & Green on

On January 18th, the Centers for Medicare & Medicaid Services (CMS) announced a new demonstration model called the Innovation in Behavioral Health (IBH) Model, which is designed to improve outcomes for adults with mental...more

Manatt, Phelps & Phillips, LLP

CMMI Issues Report on Status of Pending Drug Models

The Center for Medicare and Medicaid Innovation (CMMI) has provided new updates on CMS’ planned initiatives to address prescription drug costs in a blog post from Director Liz Fowler. One test, the Accelerating Clinical...more

Manatt, Phelps & Phillips, LLP

Understanding the New CMMI GUIDE Model

The CMS Center for Medicare and Medicaid Innovation (CMMI) is launching a new Alternative Payment Model (APM) focused on Dementia Care: The GUIDE model. It will launch in July 2024 and run for eight years. More details will...more

Holland & Knight LLP

Holland & Knight Health Dose: October 3, 2023

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more

Holland & Knight LLP

Holland & Knight Health Dose: September 12, 2023

Holland & Knight LLP on

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

Sheppard Mullin Richter & Hampton LLP

CMS Announces Changes to ACO REACH Model

On August 14, 2023, the Centers for Medicare & Medicaid Services (CMS) released guidance on changes to the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model starting in performance...more

McDermott Will & Emery

CMS Announces New Voluntary Multi-Payer Primary Care Model in Eight States

McDermott Will & Emery on

The new MCP Model is a 10.5-year multi-payer model with three participation tracks that build upon previous primary care models. Colorado, Massachusetts, Minnesota, New Mexico, New Jersey, North Carolina, Washington and...more

Foley Hoag LLP - Medicaid and the Law

CMMI Introduces New Multi-State Initiative Focused on Enhancing Primary Care Delivery

CMMI was established to test innovative payment and service delivery models expected to reduce expenditures and preserve or enhance care quality under Medicare, Medicaid, and the Children’s Health Insurance Program. Over the...more

McDermott Will & Emery

Top Takeaways | How to Succeed in CMMI Payment Models

In this session, McDermott Will & Emery partner Matthew Perreault moderated a panel that discussed the current state of value-based care in original Medicare and lessons learned from the panelists’ experiences with various...more

Foley Hoag LLP - Medicaid and the Law

CMMI Describes Progress on Addressing Health Equity

In October of 2021, the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) unveiled its 2030 vision to achieve “equitable outcomes through high quality, affordable, and...more

Manatt, Phelps & Phillips, LLP

The Pennsylvania Rural Health Model: Lessons Learned and What’s Next for Rural Payment Policies

Since 2010, a reported 140 rural hospitals have closed their doors, including a record 19 hospitals in 2020 alone as a result of the financial pressures of COVID-19 compounded by many other long-standing challenges facing...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - April 2023 #2

As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access...more

Akin Gump Strauss Hauer & Feld LLP

Drug Pricing Déjà Vu: The Biden-Harris Administration’s Fiscal Year 2024 Budget Doubles Down on Inflation Reduction Act Reforms;...

Are Accelerated Approval Drugs a New Target for Cost Reductions? As outlined in our prior analysis, the Inflation Reduction Act (IRA) included sweeping drug pricing reforms for the Medicare program and the Biden-Harris...more

Foley Hoag LLP

HHS Issues Report Outlining Three New Drug Models for Testing by CMMI

Foley Hoag LLP on

On February 14, 2023, and in response to Executive Order 14087 (“Lowering Prescription Drug Costs for Americans”), the Secretary of Health and Human Services (HHS) issued a report announcing the selection of three models that...more

Ankura

Writing a health equity plan? Don't start with your Community Needs Assessment

Ankura on

Many health system leaders are developing health equity plans to participate in new value-based care payment models. The new ACO REACH payment model from the Center for Medicare and Medicaid Innovation (CMMI) has increased...more

Foley & Lardner LLP

Enhancing Oncology Model - Successor to Oncology Care Model: What’s New

Foley & Lardner LLP on

The Center for Medicare and Medicaid Innovation (CMMI) is launching a long awaited new oncology model, the Enhancing Oncology Model (EOM). EOM is a successor to the Oncology Care Model (OCM), which ended June 30, 2020 after a...more

Holland & Knight LLP

2022 Congressional Outlook and Top 10 Federal Health Policy Issues to Watch

Holland & Knight LLP on

As Congress reconvenes, it faces a packed agenda in a legislative year that will be shortened by the upcoming midterm elections and remains buffeted by the persistent coronavirus pandemic. The list of healthcare priorities is...more

Manatt, Phelps & Phillips, LLP

CMS Innovation Center’s Strategic Plan to Drive Health System Change in the Next Decade

Last month, the Center for Medicare and Medicaid Innovation (the Innovation Center, or CMMI) released its long-anticipated white paper, “Innovation Strategy Center Refresh,” outlining the Innovation Center’s strategic outlook...more

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