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Healthcare Centers for Medicare & Medicaid Services (CMS) 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

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

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

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

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

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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

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

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

McDermott+

A Government Shutdown Is Likely on the Horizon: Will the Regulatory Process Also Hit Pause?

McDermott+ on

Passing the 12 annual appropriations bills that fund the federal government for the next fiscal year (which starts on October 1), or enacting a stopgap continuing resolution in the interim, seems to come down to the wire...more

McDermott+

McDermottPlus Check-Up: September 8, 2023

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CONGRESS - House Republicans Release Healthcare Package. On September 6, House Republicans unveiled the Lower Costs, More Transparency Act, a draft package of healthcare transparency provisions, pharmacy benefit manager...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

VBC Symposium 2023 | Washington Update

During this session, Mara McDermott, Vice President, McDermott+Consulting, moderated a panel that discussed the current political and policymaking environment on Capitol Hill and what to watch for in 2023....more

Foley & Lardner LLP

Payor/Provider Convergence and What It Means for You

Foley & Lardner LLP on

Welcome to the Payor/Provider Convergence Series of the Health Care Law Today blog. This series is dedicated to exploring the intersection between payors and providers in the health care space; in particular, the evolving...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

Manatt, Phelps & Phillips, LLP

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

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

Ankura

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

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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

Rivkin Radler LLP

ACO REACH Tweaks Help Smaller Group Practices, Promote Health Equity

Rivkin Radler LLP on

A March 21 article in Part B News, ACO REACH tweaks help smaller group practices, promote health equity,” discussed the Accountable Care Organization (ACO) Realizing Equity, Access and Community Health (REACH) model, which...more

Sheppard Mullin Richter & Hampton LLP

Global and Professional Options Direct Contracting Model RFA and LOI Now Active

On April 21, 2019, the Center for Medicare and Medicaid Innovation (“CMMI”) announced the CMS Primary Cares Initiative – a voluntary, risk-based initiative to transform the Medicare program’s reimbursement of primary care...more

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