CMS Statement on Proposed Local Coverage Determination (LCD) for Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers.

CMS is aware that on April 25, 2024,  the Medicare Administrative Contractors (MACs) released a proposed Local Coverage Determination (LCD) For skin substitutes in treating chronic diabetic foot and venous leg ulcers. Comments are due by June 8, 2024, with MACs hosting public sessions in May. Ensuring access to appropriate items and services for Medicare recipients is a priority for CMS, closely monitoring engagement opportunities.

Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule (CMS 3442-F)

On April 22, 2024, CMS affirms its commitment to nursing home residents’ safety with the new Minimum Staffing Standards rule. Comprehensive nurse staffing requirements aim to improve care quality, including 3.48 hours per resident day with staggered implementation and exemptions for qualifying facilities. CMS prioritizes safety while addressing workforce challenges, with ongoing monitoring for future updates. States will report Medicaid spending on direct care worker compensation for increased transparency.

Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality Final Rule (CMS-2439-F)

With over 70% of Medicaid and CHIP beneficiaries enrolled in managed care, recent executive orders aim to strengthen access to high-quality, affordable healthcare. The final rule enhances standards for timely care access, quality, and program integrity while also addressing health-related social needs and establishing a quality rating system for managed care plans. This underscores the administration’s commitment to improving coverage and care accessibility. This final rule, along with the Ensuring Access to Medicaid Services (CMS-2442-F) final rule, underscores the Biden-Harris administration’s commitment to strengthening access to coverage and care.

Ensuring Access to Medicaid Services Final Rule (CMS-2442-F)

Ensuring access to covered services is a priority for Medicaid and CMS. Executive Orders 14009 and 14070 aim to strengthen Medicaid and the ACA, making high-quality healthcare accessible to all. The Ensuring Access to Medicaid Services (Access rule) final rule advances access and quality of care for beneficiaries across delivery systems, including home- and community-based services. It increases transparency and promotes beneficiary engagement to improve overall access to care, underscoring the administration’s commitment to strengthening coverage and care accessibility. This final rule, along with the Medicaid and Children’s Health Insurance Program Managed Care Access, Finance, and Quality Final Rule (CMS-2439-F), underscores the Biden-Harris Administration’s commitment to strengthening access to coverage and care.

HHS data reveals 10M+ Medicare recipients got free vaccines under the President's Inflation Reduction Act.

The Inflation Reduction Act, a cornerstone of President Biden’s healthcare agenda, is making strides in reducing healthcare costs and improving access to prescription drugs for millions of Americans. By allowing Medicare to negotiate directly with drug companies, this law is driving down prices and saving families money on essential medications. In 2023, 10 million people received a free vaccine. In 2023, the number of Medicare enrollees receiving the shingles vaccine increased by over 42%, totaling approximately 3.9 million compared to 2.7 million in 2021. Additionally, the Tdap vaccine saw a remarkable 112% increase in uptake, with nearly 1.5 million enrollees in 2023 compared to about 700,000 in 2021. Furthermore, the introduction of RSV vaccines for adults 60 and older in June 2023 resulted in 6.5 million Medicare Part D enrollees accessing the vaccine free of charge that same year.

HHS data reveals 10M+ Medicare recipients got free vaccines under the President's Inflation Reduction Act.

The Inflation Reduction Act, a cornerstone of President Biden’s healthcare agenda, is making strides in reducing healthcare costs and improving access to prescription drugs for millions of Americans. By allowing Medicare to negotiate directly with drug companies, this law is driving down prices and saving families money on essential medications. In 2023, 10 million people received a free vaccine. In 2023, the number of Medicare enrollees receiving the shingles vaccine increased by over 42%, totaling approximately 3.9 million compared to 2.7 million in 2021. Additionally, the Tdap vaccine saw a remarkable 112% increase in uptake, with nearly 1.5 million enrollees in 2023 compared to about 700,000 in 2021. Furthermore, the introduction of RSV vaccines for adults 60 and older in June 2023 resulted in 6.5 million Medicare Part D enrollees accessing the vaccine free of charge that same year.

CMS Statement on Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program (MDRP) Proposed Rule (CMS-2434-P)

Today, the Centers for Medicare & Medicaid Services (CMS) is providing an update on CMS’ work related to the Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program proposed rule (CMS-2434-P).  CMS received numerous inquiries and comments on the Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program (MDRP) proposed rule. The proposed rule includes policies to implement new statutory authorities included in the Medicaid Services Investment and Accountability Act of 2019 (MSIAA) to address situations in which manufacturers incorrectly report or misclassify their drugs in the MDRP.