These are eight recent policy changes made by CMS that have been reported by Becker's since March :
Provider
1. CMS proposed its annual Inpatient Prospective Payment System rule April 10, which proposes a 2.8 percent reimbursement boost for acute care hospitals and a 2.5 percent decrease for long-term care hospitals in fiscal year 2024. Comments on the rule will be accepted through June 9.
2. CMS proposed its annual Skilled Nursing Facility Prospective Payment System rule April 4, which proposes a 3.7 percent, or $1.2 billion, pay bump for skilled nursing facilities in fiscal year 2024. Comments on the rule will be accepted through June 6.
3. CMS proposed its annual Inpatient Rehabilitation Facility Prospective Payment System rule April 3, which would increase payments to inpatient rehab facilities by 3.7 percent in fiscal year 2024. Comments on the rule will be accepted through June 2.
4. HHS Secretary Xavier Becerra was questioned by senators March 22 on the agency's remote work policies after a photo reportedly showed an empty parking lot at CMS' headquarters at 10:40 a.m. on a Monday.
5. CMS issued initial guidance March 15 on key elements of the Medicare Drug Price Negotiation Program for 2026, the first year the negotiated prices will apply. Negotiations will focus on key questions, including the selected drug's clinical benefit, if it fulfills an unmet medical need and how it affects Medicare beneficiaries. Comments on the initial guidance are due by April 14.
Payer
6. CMS issued a final rule April 5 that aims to streamline Medicare Advantage and Part D prior authorizations and clamp down on misleading marketing practices. Prior authorization policies may only be used to confirm the presence of diagnoses or other medical criteria and/or ensure that an item or service is medically necessary. The agency is also banning ads that do not mention a specific MA plan name and is introducing a health equity measurement for star ratings in 2027.
7. CMS issued Medicare Advantage risk adjustment changes March 31 that payers and some provider groups opposed, but the agency will phase in the model over three years. MA plans will see an average payment increase of 3.32 percent between 2023 and 2024, up from 1.03 percent in the advance notice.
8. CMS instructed all independent dispute resolution entities March 17 to resume issuing No Surprises Act payment determinations involving out-of-network services and items. The agency had paused all payment determinations in early February following a federal court decision in Texas that ruled its arbitration process "continues to place a thumb on the scale" in favor of insurers.