Medicare and Medicaid Programs; Approval of the Community Health Accreditation Program for Continued CMS-Approval of its Home Health Agency Accreditation Program.The article offers information on a notice issued by the U.S. Centers for Disease Control and Prevention to inform about an application ...
and patients must keep their traditional Medicare. There is no prior authorization requirement in traditional Medicare. Until the day comes that we get rid of Medicare Advantage Organizations for good, it must be mandatory for Medicare Advantage Organizations to stop false advertisements, as they ...
In the meantime, CMS intends to rely on a 2013 notice that indicates prioritization would be based on the “magnitude of potential impact on the Medicare program and its beneficiaries and staffing resources.”Outline of the TCET ProcessLetter of Intent. Manufacturers would have the opportunity t...
Tennessee is set to become the first state to implement a Medicaid block-grant program after the Centers for Medicare and Medicaid Servicesapprovedthe state's waiver last week. Using a modified block grant, called an "aggregate cap," the TennCare III program creates a fixed spending target base...
anticipates emerging clinical advances, including these CAR T[-cell] therapies, UHC has several concerns that while promising clinically, CAR T[-cell] therapies could create significant financial risks for CMS, both Original Medicare FFS and Medicare Advantage plans,” Castillo wrote in his let...
The Centers for Medicare & Medicaid Services (CMS) published aFinal Ruleon April 4, 2024, that makes a number of changes to regulations governing the Programs of All-Inclusive Care for the Elderly (PACE). Among other things, the Final Rule gives CMS additional grounds on which to deny PACE...
CMS created the first HCPCS Level II code for a virtual reality program, characterizing it as durable medical equipment and creating a pathway for Medicare and commercial payer coverage.
States are required to get CMS approval for any changes they want to make to their Medicaid programs, no matter how simple. Beth Jones Sanborn, Managing Editor The Centers for Medicare and Medicaid Services announced changes to the Medicaid Review Process that the agency said will ...
In a statement released by the American Society of Hematology (ASH) President Mohandas Narla, DSc, from the New York Blood Center Enterprises, said, “We recently celebrated the approval of the first gene therapies for SCD, a significant step forward for the SCD community. However...
PhRMA believes that the real-time benefits tool CMS has proposed as part of Medicare Part D would be able to “facilitate more meaningful conversations” and “shared clinical decision making,” but that there would need to be additional details worked out for such tools ...