News & Analysis as of

CMMI

McDermott+

CMMI’s Accountable Care Strategy: A Perspective

McDermott+ on

McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. Click here to subscribe to future blog posts. October 10, 2024 – For several years, the Center for Medicare & Medicaid...more

Miles & Stockbridge P.C.

Are You Part of the TEAM? CMS Prepares for New, Mandatory Payment Model

The CMS Innovation Center (CMMI) continues to prepare for its next episode-based alternative payment model, the Transforming Episode Accountability Model, or TEAM for short. This five-year model will offer both incentive...more

Manatt, Phelps & Phillips, LLP

CMMI Transforming Maternal Health (TMaH) Model Applications Due Soon

On June 26, the Centers for Medicare & Medicaid Services (CMS) released the Notice of Funding Opportunity (NOFO) for the Transforming Maternal Health (TMaH) Model. TMaH is ten-year delivery and payment model designed to test...more

Holland & Knight LLP

CMS Releases Fiscal Year 2025 Inpatient Prospective Payment System Final Rule

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The Centers for Medicare & Medicaid Services (CMS) issued the final rule for fiscal year (FY) 2025 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) on Aug. 1, 2024....more

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

McDermott+

A Buffet of Hospital Alternative Payment Models: Will Too Many Entrees Be Overwhelming?

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Over the last several months, the Center for Medicare and Medicaid Innovation (CMMI), within the Centers for Medicare & Medicaid Services (CMS), has introduced several alternative payment models (APMs) geared toward...more

Akin Gump Strauss Hauer & Feld LLP

2024 Guide to the IRA and Other Drug Pricing Initiatives: Impact on Life Sciences Investments

The Inflation Reduction Act of 2022 (IRA) was signed into law by President Biden on August 16, 2022, and includes key sections addressing climate and clean energy, corporate taxes and health care. The health care provisions...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

McDermott+

CMMI Proposes New Mandatory Episode-Based Payment Model

McDermott+ on

Last week, the Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year 2025 Inpatient Prospective Payment System (IPPS) proposed regulation. This 1,900+ page annual reg updates Medicare payments and policies...more

Manatt, Phelps & Phillips, LLP

Specialty Value Based Care: A 2024 Checklist for Survival and Success

2023 was a difficult year for specialty value based care start-ups. Revenue fell below expectations, engagement lagged and many start-ups struggled. Health system work in this arena was modest despite a critical mass of...more

Manatt, Phelps & Phillips, LLP

New CMMI Innovation Models Support Digitally Enabled Care

With the recent announcements of two new innovation models, the Centers for Medicare & Medicaid Services (CMS) is recognizing the role of digitally enabled care in improving access and outcomes. ...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

CMMI's Transforming Maternal Health Model: Considerations for State Medicaid Agencies

On December 15, 2023, the CMS Innovation Center (CMMI) announced a new voluntary model for state Medicaid agencies called Transforming Maternal Health (TMaH). TMaH was developed in response to the profound maternal morbidity...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

McDermott+ on

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

Foley Hoag LLP

CMMI Releases More Details on New Cell and Gene Therapy Access Model

Foley Hoag LLP on

Model Overview - CMS as Negotiator - Under the model, CMS will negotiate OBAs with participating manufacturers, which will tie pricing for SCD treatments to whether the therapy improves health outcomes for people with...more

Epstein Becker & Green

CMS Announces New Primary and Behavioral Health Care Integration Demonstration Model

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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

Foley & Lardner LLP

Episode 10: Building the Decarbonized Future with Chris Rezendes of Context Labs

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In our tenth episode, Chris Rezendes, Chief Business Officer from Context Labs, joins Chris McKenna to discuss how digitalization can help companies achieve their climate goals. How is the use of data changing for energy...more

Epstein Becker & Green

The Guiding an Improved Dementia Experience (“GUIDE”) Model

Epstein Becker & Green on

On July 1, 2024 the Center for Medicare and Medicaid Innovation (“CMMI”) will be inaugurating a new value-based payment model designed specifically to address the devastating impacts that a diagnosis of dementia or...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

[Webinar] Investing in a Strong Primary Care Health System: An Overview of CMMI’s Making Care Primary Model - November 16th, 1:00...

High-quality primary care is foundational to providing “whole person care” that emphasizes prevention, as well as team-based and relationship-based care. To help improve primary care, the Center for Medicare and Medicaid...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

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