In This Issue:
- Federal Regulatory Initiatives
- Congressional Initiatives
- Upcoming Congressional Hearings
- Excerpt from Federal Regulatory Initiatives:
CMS Releases Draft Rules on Medicaid Managed Care: The Centers for Medicare and Medicaid Services (CMS) proposed a set of regulations for Medicaid and Children’s Health Insurance Program (CHIP) managed care plans. These regulations include requirements that states adopt network adequacy standards that are similar to Medicare Advantage plans’ and that at least 85 percent of the revenue for Medicaid managed care plans cover medical expenses. Under CMS’ new regulations for Medicaid managed care plans, states could place these plans in delivery system reforms, such as health information exchanges. In addition, they could give providers who are ineligible for meaningful use payments incentive payments to deploy information technology.
HHS Launches New Payment Model to Combat Heart Disease: The Department of Health and Human Servcices (HHS) Secretary Sylvia Burwell unveiled a new payment model for health care providers to reduce cardiovascular disease. The model will assign each patient a personalized risk score, which it will factor into its calculations for payments to insurance providers. This model’s personalization departs from the current model, which assesses providers on metrics standardized for all patients. The initiative’s goal is to prevent one million heart attacks and strokes by 2017.
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