13 recent CMS actions

CMS recently released new data on hospital changes of ownership, a health equity plan and said it would end a legal battle with Texas over Medicaid. Becker's has reported on the following 13 CMS moves since April 8.

Finance

1. No hospitals received price transparency notices in April, CMS says
CMS issued no additional warning notices to hospitals noncompliant with its price transparency regulations in April, CMS told Becker's. About 345 notices have been sent to hospitals since the rule went into effect Jan. 1, 2021.

2. 19% of South Carolina hospitals sold in 6 years, new data shows
CMS on April 20 released public data on mergers, acquisitions, consolidations and ownership changes of hospitals and nursing homes enrolled in Medicare, the first time this data has been reported.

3. CMS proposes 1,495 changes to ICD-10 diagnosis codes
CMS proposed 1,495 changes to the ICD-10-CM diagnostic code set in its proposed Inpatient Prospective Payment System rule released April 18. 

4. CMS pitches inpatient payment rule for 2023: 10 things to know
CMS released its annual Inpatient Prospective Payment System proposed rule April 18, which proposes a reimbursement boost for acute care hospitals. 

5. CMS revises surprise-billing arbitration process
Arbiters will need to consider more than insurer's median in-network rates for billed items when deciding surprise-billing disputes, CMS said in updated guidance this week.

6. CMS to end reimbursement to Montana State Hospital over patient safety concerns
CMS will no longer reimburse the Montana State Hospital after failing to meet Medicare's basic health and safety standards, the agency said in an April 8 letter. 

Clinical

7. CMS releases health equity plan, encourages leaders to participate
CMS has released a multipronged health equity strategy to be used throughout the agency and is encouraging healthcare leaders to get involved in creating sustainable, equitable strategies, CMS reported April 20. 

8. CMS gives California rehabilitation hospital 30 days to avoid shutdown
CMS cut funding to San Francisco-based Laguna Honda Hospital after a recent inspection found a new list of violations, The San Francisco Chronicle reported April 14.

9.  'Birthing-friendly' hospital designation to launch in 2023, CMS says
CMS will roll out a new "birthing-friendly" designation for hospitals in fall 2023 as part of a larger effort to improve maternal health outcomes, the agency said April 13. 

Payer

10. CMS issues final 2023 Medicare Advantage, Part D prescription drug rules
CMS issued its final 2023 Medicare Advantage and Part D rule April 29 that aims to expand access to care and improve health equity through lower out-of-pocket prescription drug costs and improved consumer protections.

11. New CMS rule aims to make ACA coverage more accessible, affordable
CMS released the Notice of Benefit and Payment Parameters for 2023 Final Rule on April 28, with changes aiming to make ACA coverage more accessible and affordable. The rule helps simplify the consumer shopping experience by establishing standardized plan options for issuers offering qualified health plans.

12. CMS ends efforts to rescind Texas Medicaid waiver
CMS sent a letter to Texas' Medicaid and Children's Health Insurance Program director April 22 to say that it would no longer work to rescind an extension of a Texas Medicaid waiver. The move to revoke the waiver was first announced in April 2021 and would have halted billions of dollars in Medicaid funding to the state. Texas sued CMS over the revocation in May 2021. In August 2021, a federal judge issued a preliminary injunction against CMS over the decision, arguing that the agency did not provide the state with enough prior notice before issuing the decision.

13. CMS proposes changes to eliminate Medicare coverage delays
CMS proposed a rule change April 22 it said would eliminate delays in Medicare coverage and extend coverage of immunosuppressive drugs for certain beneficiaries.

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