"Additionally, the CY 2025 hospital Outpatient Prospective Payment System final rule expands access to behavioral health services, increases access to certain high-cost drugs for those facing cancer in tribal communities, and addresses barriers to Medicare coverage for those formerly inc...
METHODOLOGY: Researchers assessed the Million Hearts CVD Risk Reduction Model in a pragmatic, cluster-randomized trial among 342 healthcare organizations — half in the intervention group and half in the standard care control group. Among 218,684 medium- or high-risk Medicare beneficiaries (median ag...
CMS states that in light of the equity and beneficiary access concerns that prompted the agency's CY 2024 comment solicitation and the input received in response to that solicitation, the agency proposes, starting Jan. 1, 2025, to separately pay IHS and tribal hospitals for high-cost drugs ...
(NOTE: “Frequently abused drugs” include opioids and benzodiazepines.) As proposed, the Final Rules integrate the new drug management program with CMS’s existing Overutilization Monitoring System (OMS). Under the expanded OMS, sponsors may limit (i.e., “lock-in”) an at-risk ...
CMS declined to finalize its proposal to develop a process to collect data from manufacturers and wholesalers regarding what the agency describes as “high-cost drugs” that are reimbursed under the MDRP, stating that it is “continuing to review the input provid...
Community Health Integration services address unmet SDOH needs that affect a patient's diagnosis and treatment. Principal Illness Navigation services assist Medicare beneficiaries diagnosed with high-risk conditions like cancer and substance use disorder by matching them with appropriate clinical re...
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely regarded as one risk factor, which influences chronic kidney disease (CKD) progressio... Nderitu,Paul,Doos,... - 《Family Practice》 被引量: 45发表: 2013年 Obtaining the CMS Ridge effect with Multiparton Interactions We show that the...
pharmacists will have the ability to override this restriction. CMS is also enhancing its overutilization monitoring system (OMS) so that it identifies high-risk beneficiaries who use drugs that can be dangerous in combination with opioids such as gabapentin and pregabalin — the monitoring system al...
Those changes include the first-ever requirement that the US Department of Health & Human Services negotiate prices for some high-cost drugs and linking price increases for certain drugs to increases in the Consumer Price Index. The effect will be to reduce cost sharing for Medicare beneficiaries...
CMS proposes several changes to the hierarchical condition category (HCC) risk adjustment model. The impact of the proposals on MA risk scores is projected to be minus 3.12 percent, representing $11 billion in estimated net savings to the Medicare Trust Fund in 2024. ...