New Rules and Resources from CMS

The Centers for Medicare and Medicaid Services (CMS) issued a string of announcements that could be relevant to our members, either because the announcements affect how they deliver supports to people with disabilities or because they share data which could inform members’ planning and advocacy. We summarize these announcements below.

• Final rule on Medicaid prescription drug payments issued: “CMS finalized regulatory changes to modernize Medicaid prescription drug purchasing and propel payment innovation by providing states, private payers and manufacturers more flexibility to enter into value-based purchasing (VBP) arrangements for prescription drugs.” Learn more through a CMS fact sheet and the full rule.
• ICF state survey letter: CMS released a document comprised of a series of FAQs to help facilities with COVID-19 prevention, treatment and mitigation, including strategies to assist with people who refuse to test, are confirmed COVID-19 positive or have COVID-19 symptoms but are unable or unwilling to isolate, cohort or wear personal protective equipment (PPE).
• Updated COVID-19 vaccination toolkit: “CMS released a new update to the Coverage and Reimbursement of COVID-19 Vaccines, Vaccine Administration and Cost Sharing under Medicaid, the Children’s Health Insurance Program, and Basic Health Program Toolkit that was originally released on October 28 and first updated on November 23. This update includes additional information regarding vaccine administration reimbursement and outlines a streamlined review process available to states looking to expeditiously adjust vaccine administration reimbursement rates in their state plan.”
• New data on early screening: This CMS page provides information on children’s receipt of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services in all 50 states and DC. This data is reported by states to CMS; scroll down on the page to the section titled Annual EPSDT Reporting Using the Form CMS-416 to access the newest data.