cms hedis measures 2023

To ensure that HEDIS stays current, the National Committee for Quality Assurance (NCQA) has established a process to evolve the measurement set each year through its Committee on Performance Measurement. Data Point: Discharge Planning Codes Identify Where the Patient is Being Referred, Post-Acute Care Transfer to Home Health Reduced Readmissions, Post-Acute Transfer to a Home with Home Health Services, OIG Report: Medicare to Overpay More Than $267 Million, Fast Facts About the Post-Acute Transfer Policy, Post-Acute Care Transfer Policy: The Overpayment for Discharges, Empowering Your Clinical Team to Increase Patient and Family Engagement, COVER STORY: Home-Based Primary Care: Its Time to Think Beyond the Clinic Walls, Telehealth: 2021 New Billing Codes for Physician Home Visits and Care Planning, Home-Based Primary Care Models are Disrupting the Traditional Primary Care Market, The Vulnerabilities of COVID-19 Expand Insurers Capabilities In the Home, Stronger Strategic Partnerships: Data Exchange is a Driving Factor, Marketing Hospice Service to ALF: Preferred-Provider Agreements. The deadline to submit applications is August 15 at 3 p.m. CMS, an agency within the U.S. Department of Health and Human Services, serves the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes. Childhood and adult weight/body mass index assessment. Neither Party shall assign or otherwise delegate this Agreement or any rights, duties and/or obligations hereunder without the prior written consent of the other Party. 1 0 obj Payers wanted to improve their performance on this measure. The TAC will aid Medicaid agencies, local education agencies (LEAs), and school-based entities. Healthcare Effectiveness Data and Information Set (HEDIS) . residence exclusions are specified in HEDIS measures where the services being captured may not be of benefit for this population or may not be in line with patients' goals of care. 0000019122 00000 n If any portion of this Agreement is determined by a court of competent jurisdiction or any appropriate legislature or governmental agency to be wholly or partially unenforceable, for any reason, such term shall be deemed to be modified to the minimum extent necessary to comply with such law, ruling or regulation, and the remainder of this Agreement shall not be affected thereby. Louisiana and Ohio require MCOs to reimburse providers for SDOH screening and submitting applicable diagnosis codes (Z codes) on claims. The HEDIS measures listed here are part of the Medicare Star Rating Program governed by CMS. Steward . CMS publicly reports the results of its patient experience surveys, and some surveys affect payments to CMS providers. Copyright 2023 National Committee for Quality Assurance. This approach is consistent with the. BECAUSE SOME STATES OR JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR DAMAGES, THE ABOVE LIMITATIONS MAY NOT APPLY TO LICENSEE. Unauthorized internal distribution of HEDIS Volume 2 and materials therein - beyond the number of Licensed Users by your organization - is prohibited. Healthcare Effectiveness Data and Information Set (HEDIS) Measure for 2023Lead Screening in Children (LSC)Guidelines Update. May/June 2023 IssueFREE CONTENT Learn the five key areas that home-based care organizations could assist in discharge planning. An official website of the United States government One of those measures is Social Need Screening and Intervention (SNS-E). Kevin Buchan, Jr., Ph.D., AVP of Analytics at ApolloMed, said, "We are very excited about this measurement year's certification from NCQA. 0000018867 00000 n A Licensed User must be using HEDIS Volume 2 under the License and solely on behalf of the Licensee. NCQA hereby grants to Licensee a non-exclusive, non-transferable license and right to display the below Marks solely in connection with the Licensed Measure Specifications as expressly permitted under this Agreement. The adjusted measure specification may be used only for internal quality improvement purposes. With the widespread use of telehealth during the COVID-19 pandemic, measuring the quality of care provided through this modality has become increasingly important. The agency protects public health by administering the Medicare program and working in partnership with state governments to administer Medicaid, CHIP, and the Health Insurance Marketplace. 0000017251 00000 n Z codes can be used in any health setting (e.g., doctors office, hospital, skilled nursing facility (SNF) and by any provider (e.g., physician, nurse practitioner). For more insight into which patient populations are using Z codes the most, read Patient Discharge: Is Your Organization Asking Hospitals, SNFs, and Physicians for Z Codes?. Collecting race and ethnicity is key to improving health disparities and will aid in the identification of care gaps and inequitable care. Before sharing sensitive information, make sure youre on a federal government site. 0 "Licensee" means only the individual or legal entity whose authorized acceptance appears below as evidence of agreement to the Agreement terms below. CMS contracts with NCQA to collect Healthcare Effectiveness Data and Information Set (HEDIS) measures from Medicare Special Need Plans (SNPs). If you are not receiving our newsletters, then the first thing to do is to check your spam folder. <<05F302D9A0F06D4CB6F9B03DD38AA851>]/Prev 231433/XRefStm 1948>> June 23: The U.S. Virgin Islands (USVI) received approval to extend postpartum coverage for a full year after pregnancy for individuals enrolled in Medicaid. Noncompliance may also disqualify Licensee from receiving future goods and services from NCQA. 0000028623 00000 n This button displays the currently selected search type. Marylands waiver extension provides a continued implementation of its state-based reinsurance program, called the Maryland State Reinsurance Program (SRP), for plan years 2024 through 2028. Need help building a strategy? Listed below are the HEDIS measures to which these exclusions have been added. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 0000095223 00000 n Health Plan HEDIS Report Ohio Medicaid quality measures assess managed care plan performance in key program areas (i.e., access, clinical quality, consumer satisfaction). HEDIS MY 2023 Volume 2: Technical Specifications for Health Plans View Table of Contents for this Publication. Usability: Report measures for HEDIS MY 2023 and other quality reporting programspossible because measures use Health Level Seven International (, Appropriate Testing for Pharyngitis (CWP), Appropriate Treatment for Upper Respiratory Infection (URI), Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB), Depression Remission or Response for Adolescents and Adults (DRR-E), Depression Screening and Follow-Up for Adolescents and Adults (DSF-E), Follow-Up After Emergency Department Visit for Mental Illness (FUM), Follow-Up Care for Children Prescribed ADHD Medication (ADD-E), Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-E), Non-Recommended PSA-Based Screening in Older Men (PSA), Postpartum Depression Screening and Follow-Up (PDS-E), Prenatal Depression Screening and Follow-Up (PND-E), Social Need Screening and Intervention (SNS-E), Unhealthy Alcohol Use Screening and Follow-Up (ASF-E), Use of Opioids from Multiple Providers (UOP), Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E). Licensee may use NCQA's registered trademark "HEDIS" only when describing the Licensed Measure Specifications as permitted under this Agreement, and to refer to the HEDIS measure specifications for the relevant year. ) Also, Licensee must prominently display the following notice near each adjusted Licensed Measure Specification using the Rules, or display as a footnote on each page in which an adjustment Licensed Measure Specification exists: The NCQA HEDIS measure specification has been adjusted pursuant to NCQA's Rules for Allowable Adjustments of HEDIS. Measure Submission Type: Measure data may be submitted by individual MIPS eligible clinicians, groups, or third party intermediaries. Quality Indicator Physician Guide for Medicare HEDIS, HOS, CAHPS and Patient Safety measures . <>/Metadata 1343 0 R/ViewerPreferences 1344 0 R>> in their efforts to deliver expanded Medicaid services to students. The Importance of the Measure is derived from the HEDIS MY 2023 Volume 1: Narrative Reprinted with permission from NCQA (MY) 2023 Provider Tips for Optimizing HEDIS Results HEDIS Measurement Year (MY) 2023 Provider Tips for Optimizing HEDIS Results. HEDIS Adult Pocket Guide: 2023 Measurement Year For a complete list of codes, please visit the NCQA website at www.ncqa.org, or see the HEDIS value sets. 0000010207 00000 n PCR 3x and weights reflect CMS guidance from theAdvance Notice 02/01/23 MY2022/BY2025 Feb. 1, 2022: Until CMS provides further guidance, MRP is a stand-alone measure Osteoporosis ManagementStatin Therapy forCardiovascular DiseaseFollow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions THE LIMITATIONS OF DAMAGES AND LIABILITIES SET FORTH IN THIS AGREEMENT ARE FUNDAMENTAL ELEMENTS OF THE BASIS OF THE BARGAIN BETWEEN NCQA AND LICENSEE. they represent a codified way to document unmet needs. Remingtons Home Care Leadership Think Tank brings together the nations home-based care leadership and healthcare ecosystem partners who have a vested interest in the advancement of home-based care and who seek to improve care delivery through mutually beneficial referral partnerships. Get CMS news at cms.gov/newsroom, sign up for CMS news via email, and follow CMS on Twitter @CMSgov, CMS News and Media Group HEDIS Measures relate to many significant public health issues, such as cancer, heart disease, smoking, asthma, and diabetes. One of the most notable changes. June 28: As part of the Biden-Harris Administrations ongoing initiative to increase the transparency of corporate ownership in the nations nursing homes, CMS posted additional nursing home ownership and operator affiliation data on Nursing Home Compare. Also, you can decide how often you want to get updates. Statin Therapy for Patients Selected researchers will gain access to CMS-restricted data to conduct health services research on racial and ethnic minority groups; people with disabilities; members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community; individuals with limited English proficiency; individuals residing in rural areas; and individuals adversely affected by persistent poverty or inequality. HEDIS Volume 2 contains proprietary and copyrighted information and notice to that effect must appear on all authorized copies of HEDIS Volume 2 (including the Licensed Measure Specifications) made by Licensee under this Agreement. The License is not transferable from Licensee to any other person, entity, organization or association. 0000009139 00000 n The HEDIS VSD is made available for customers that purchase a license for HEDIS Volume 2 from NCQA. CMS also released the Nursing Home Affiliated Entity Performance Measures dataset on data.cms.gov, which aggregates safety, staffing, and quality performance metrics across affiliated entities. . Recent RFPs have included requirements that MCOs incorporate SDOH into their quality assessment and performance improvement (QAPI) programs and that MCOs provide SDOH training for staff. remington@remingtonreport.com, Copyright 2012 document.write(new Date().getFullYear());|The Remington Report|All Rights Reserved|Privacy Policy|Terms & Conditions|Powered by LeadWorks. One of those measures is Social Need Screening and Intervention (SNS-E). Anyone contemplating a use beyond a personal, non-commercial use, including but not limited to a commercial use, internal or external reproduction, distribution or publication of any part of a product or use of a product to identify records or calculate HEDIS measure results, must contact the NCQA licensing team by submitting a request through https://my.ncqa.org to discuss the need for a license.Licensee agrees and understands that any score or numeric result calculated from access and use of HEDIS Volume 2 does not constitute a preliminary or final score and does not predict achievement of accreditation, certification or recognition, as applicable. Measures apply only to Special Needs Plans 3. This approach is consistent with the National Coverage Determination (NCD) CMS issued on April 7, 2022. You will receive a link to create a new password via email. 0000022253 00000 n You can decide how often to receive updates. Specifications for the Medicare Health Outcomes Survey, Case Management (CM) and Long-Term Services and Supports (LTSS), Managed Behavioral Healthcare Organizations (MBHO), Utilization Management/Credentialing/Provider Network (UM/CR/PN), Credentials Verification Organizations (CVO), Patient-Centered Specialty Practice (PCSP), Quality Compass 2023 (MY 2022) Commercial, Quality Compass 2023 (MY 2022) Exchange Data File, Quality Compass 2023 (MY 2022) Member Experience Data Set, California Align Measure Perform (AMP) & Value Based Pay for Performance (VBP4P). An important component of this effort is to provide Medicare consumers and their caregivers with meaningful information about quality alongside information about benefits and costs to assist them in being informed and active health care consumers. Across the 67 group practices . Accreditation helps accountability and ongoing quality improvement efforts of aging and disability networks. 2023 HEDIS Measures HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). 0000007718 00000 n Bringing together home-based care leadership and healthcare ecosystem partners. A 2019 cross-sectional survey in the New England Journal of Medicine, examined the screening of social needs by physician practices and hospitals. Instead of only paying for the number of services provided, CMS also pays for providing high quality services. x+=6[#x>D3 sz>g#\1G58 }"~}D HEDIS MY 2023 Measures . Licensee shall indemnify and hold harmless NCQA and its directors, officers and employees from and against any and all liability, loss, cost, expense (including reasonable attorney fees), damage, or claim ("Losses"), including any Losses asserted by third parties, in proportion to, and to the extent the Losses arise from / or relate to the Licensee's breach of this Agreement. Hospitals will be required to report what portion of their population is screened for various SDOH and how many screen positive in each category. Catherine Howden, DirectorMedia Inquiries Form Details are available in the, . HEDIS helps us measure the performance of many health issues, including: Antidepressant medication management. Prohibited Use AcknowledgementAn organization's Licensed Users may use HEDIS Volume 2 solely for a personal non-commercial purpose without obtaining NCQA approval. 0000001948 00000 n For example, in Arizona, MCOs are required to utilize a Statewide Closed-Loop Referral System (CLRS) to refer enrollees to community-based organizations (CBOs) addressing SDOH. 2023-05-27T09:20:09-04:00By Lisa Remington|2023 Issue 3 May-Jun, Current Issue, FutureFocus, Remington Report|. The screening looks at food, housing, and transportation needs. CMS Innovation Center Announces Participants in the Enhancing Oncology Model. For 2024, CMS proposes increasing ESRD PPS total payments to ESRD facilities by approximately 1.6 percent compared to 2023. endobj CMS Announces Funding Opportunity for Minority Health Researchers. No individual or entity may use HEDIS Volume 2 to evaluate another organization against NCQA standards, except as part of Licensee's internal preparation for an NCQA survey or review.2. Please enter your username or email address. CMS provided guidance to states on implementing new mandatory vaccine coverage for adults to reduce hospitalizations, deaths, and morbidity. The overall rating is the weighted average of a plan's HEDIS and CAHPS measure ratings, plus bonus points for plans with a current Accreditation status as of June 30, 2023. 0000028014 00000 n Federal government websites often end in .gov or .mil. Ohio Medicaid quality measures assess managed care plan performance in key program areas (i.e., access, clinical quality, consumer satisfaction). 0000021603 00000 n The HEDIS measurement set is sponsored, supported and maintained by NCQA. All other uses, including a commercial use (including but not limited to vendors or consultants using or embedding the measures and specifications and/or HEDIS VSD into any product or service to calculate measure results or provide any measure-related service to customers for any purpose) and/or any internal or external reproduction, distribution or publication (including but not limited to federal and state entities using or incorporating the measures into their programs) must be approved by NCQA and are subject to a license at the discretion of NCQA. HEDIS Measure Hemoglobin A1c Control for Patients With Diabetes (HBD) Line of business: Commercial Medicaid Medicare Data Collection Method: Administrative (Claims) Hybrid (HEDIS Chart Chase . The previous measure only applied to women aged 50-74, but the new measure will include women aged 40-49 as well. 0000024103 00000 n In a move to improve patient safety, the Centers for Medicare and Medicaid Services (CMS) recently released CMS 1785-P, the Inpatient Prospective Payment System 2024 proposed rule. The License is limited subject to the following terms and conditions. This rule also proposes updates to the Acute Kidney Injury dialysis payment rate for renal dialysis services furnished by ESRD facilities; a payment change for pediatric ESRD patients; payment changes to support access to certain new renal dialysis drugs and biological products; reporting requirements for dialysis duration, and for discarded amounts of certain renal dialysis drugs and biological products; and updated requirements for the ESRD Quality Incentive Program. Understanding the 2023 HEDIS and CMS Star Rating measures and what they mean to your practice will help you better comply with the new requirements, boost your ratings, and improve your #payerreimbursements (revenue). Measure evaluates percentage of members 18-75 years of age with diabetes (type 1 and type 2) whose HbA1c was at the following levels: HbA1c control (<8.0%) HbA1c . CMS will respond to public comments in a subsequent final notice. What is HEDIS? CMS measures Centers for Medicare & Medicaid Services (CMS) Part D medication adherence measures are used to help increase the number of Medicare members taking their cholesterol (statin), diabetes and/or hypertension (RAS antagonist) medications as prescribed. Workforce: How Will Medicare Fee-For-Service Trends Change the Way You Think About Future Staffing Needs? The initial perception in the industry suggested that providers could not charge payers for the time, manpower, and mailing costs associated with producing records for a HEDIS Review. 0000024188 00000 n Z codes are a tool for identifying a range of issues related but not limited to education and literacy, employment, housing, ability to obtain adequate amounts of food or safe drinking water, and occupational exposure to toxic agents, dust, or radiation. The full HEDIS digital measure specifications are only available by purchasing a HEDIS digital measure product. Marylands waiver extension provides a continued implementation of its state-based reinsurance program, called the Maryland State Reinsurance Program (SRP), for plan years 2024 through 2028. Trends & Foresight: State of the Industry. Fact sheet 2023 Medicare Advantage and Part D Star Ratings Oct 06, 2022 Medicare Part C Medicare Part D Share Note: The information included in this Fact Sheet is based on the 2023 Star Ratings published on the Medicare Plan Finder on October 6, 2022. Licensee Representation and Warranty: Licensee represents and warrants to NCQA that this Agreement shall be binding on Licensee, and, unless Licensee is an individual, Licensee represents and warrants that this Agreement was executed by an authorized signatory of Licensee with the authority to enter into binding agreements on behalf of Licensee. 0000005428 00000 n 1. The Worst States? Lost your password? June 23: The U.S. Virgin Islands (USVI) received approval to extend postpartum coverage for a full year after pregnancy for individuals enrolled in Medicaid. We explain the quality measures across providers and stakeholders. The obligations of both Parties shall not terminate upon any assignment or delegation attempted without such prior written consent. h 047 1.2 "Marks" means the NCQA trademarks and/or service marks related to the Licensed Measure Specifications described in Section 5. To ACCEPT this Agreement, click the accompanying checkbox/button to accept the terms of this product, which will create a legal contract that will bind Licensee and NCQA. for Stars is 50-75 years old . CMS . Research shows that social determinants can be more important than health care or lifestyle choices in influencing health. CMS created a. , including an FAQ, social media toolkit, and more, to help ensure people can benefit from these important provisions. Payers understand the tremendous staff burden on providers and are willing to reimburse them for their efforts. View Table of Contents for this Publication. As promised in the May 23 release of the School-Based Services (SBS) Comprehensive Guide to Medicaid Services and Administrative Claiming , CMS launched the SBS Technical Assistance Center (TAC). Such statements are based on the current expectations and certain assumptions of the Company's management, and some or all of such expectations and assumptions may not materialize or may vary significantly from actual results. Additional details can be found on this, CMS Innovation Center announced the organizations participating in the Enhancing Oncology Model (EOM). Retired Measures Breast Cancer Screening (BCS) *. Anyone contemplating a commercial use, or external reproduction, distribution or publication of any part of Volume 2, should not purchase HEDIS Volume 2 via the NCQA Store, and must contact the NCQA licensing teamto discuss the need for a license. NCQA and Licensee may be individually referred to as a "Party", or collective, the "Parties". Note: NCQA has updated the naming convention of HEDIS publications to refer to the measurement year (MY) for HEDIS measures.Read more about the HEDIS schedule change here.. A required resource for anyone involved in collecting, calculating or submitting HEDIS data, Volume 2 features . with current federal and state laws and industry guidelines issued . CMS Proposes New Pathway for Transitional Coverage for Emerging Technologies. Copyright 2023 National Committee for Quality Assurance. About Apollo Medical Holdings, Inc.ApolloMed is a leading physician-centric, technology-powered, risk-bearing healthcare management company. 0000000016 00000 n June 26: CMS issued a proposed rule that updates payment Medicare rates under the end-stage renal disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to people with Medicare beginning on January 1, 2024. The updates to HEDIS requirements and measures for 2023 focus on #telehealth, cancer screening, pediatric oral care and diabetic care. This Agreement is deemed to be made under and shall be interpreted in accordance with the laws of the District of Columbia, without regard to its conflict of law principles. The proposed rule will be published in the Federal Register on June 30, with comments due by August 25, 2023. However, this is not the case. A CMS-facilitated data submission platform that clinicians can use for this purpose will be ready in the event the FDA grants traditional approval to one of these drugs. 2 0 obj 0000147170 00000 n New HEDIS MY 2023 Measures Changes to Existing HEDIS Measures Cross-Cutting Concepts Race/Ethnicity Stratification. Selected researchers will gain access to CMS-restricted data to conduct health services research on racial and ethnic minority groups; people with disabilities; members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community; individuals with limited English proficiency; individuals residing in rural areas; and individuals adversely affected by persistent poverty or inequality. CMS is seeking public comment until 5 p.m. on August 28, 2023, via the, . Sole ownership rights to the Licensed Measure Specifications and any modifications, alterations or adjustments thereof reside with NCQA. Details can be found on this, ; additional information on the model, including a link to the participants list, can be found. All notices to be given under this Agreement to Licensee shall be submitted by NCQA via e-mail at the account Licensee provided to NCQA. %PDF-1.4 % Providers should take a proactive approach and follow these three tips. Breast cancer screening. Rather than relying on third-party video messaging services, its significantly safer to use a purpose-built telehealth solution. The following sections shall survive termination of this Agreement: Sections 2, 6, 7, 8, 9, 10, 11, 12 and 18. Specifically, Medicare will cover Alzheimers drugs that receive traditional Food and Drug Administration (FDA) approval when a physician and clinician team participates in an effort to collect real-world information that will help to study the usefulness of these drugs for people with Medicare. Sign up to get the latest information about your choice of CMS topics. These changes will help healthcare organizations better understand and improve the care they provide to their patients, ultimately advancing the overall health of their communities. May/June 2023 IssueFREE CONTENT In the May/June issue of The Remington Report, we provide a special industry report for home-based care providers to identify the gaps in care delivery. HEDIS MY 2021 Patient-Level Detail data files. CMS Announces New Details of Plan to Cover New Alzheimers Drugs. 934 0 obj <>stream Overall, the changes to 2023 HEDIS and CMS Star Rating measures reflect the ongoing evolution of healthcare delivery and the importance of measuring the quality of care provided through telehealth and other new modalities. on June 30, with comments due by August 25, 2023. Details and additional information can be found in this fact sheet and blog posted on CMS.gov. T. he Inflation Reduction Act (IRA) mandates Medicaid and CHIP coverage of Food and Drug Administration approved adult vaccines recommended by the Advisory Committee on Immunization Practices and their administration, without cost-sharing beginning October 1, 2023. applies to nearly all full-benefit people covered under traditional Medicaid and CHIP beneficiaries aged 19 and older. n4C. HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance. HEDIS Digital Quality Measures (dQMs) are digitalized versions of existing HEDIS measuresthe kind of measures that plans have used and reported to NCQA since the early 1990s. 0000078757 00000 n The CMS letter to states can be viewed here. Oral health is vital to patients overall well-being, especially children. All organizations that submit HEDIS summary contract-level data are also required to submit audited HEDIS Patient-Level Detail (PLD) data files to CMS's HEDIS PLD contractor. No amendment, other modification or waiver of any term of this Agreement will be valid unless in writing signed by both parties. The individual accepting this Agreement on behalf of Licensee represents that by electronically signing this Agreement, the individual hereby binds the Licensee to the terms of this Agreement, and that such individual is an employee of Licensee and duly authorized to enter into and bind Licensee to the terms of this Agreement. Across the 67 group practices, there are over 600 sites of care representing approximately 37 states and over 3,000 unique practitioners. .gov NCQA is proposing to introduce race and ethnicity stratifications to five HEDIS measures for MY 2022 with an expansion to a minimum of 15 measures by MY 2024 to help identify and reduce disparities in care. ( 0000005561 00000 n 0000028964 00000 n Elderly individuals are prone to experiencing severe hypoglycemia, which can result in potentially life-threatening incidents like falls, fractures, and even cognitive decline. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. The Centers for Medicare & Medicaid Services (CMS) reported that Z codes have been captured for just 1.6% of Medicare beneficiaries. June 28: CMS approved Maryland's 1332 Waiver extension request to continue implementing its state-based reinsurance program for another five years. For the best experience on our site, be sure to turn on Javascript in your browser. Members: On March 31, 2023, the pilot program between Gold Coast Health Plan (GCHP) and AmericasHealth Plan (AHP) ended. CMS's new SDOH quality measures was published in the 2023 Medicare Hospital Inpatient Prospective Payment System rule, released Aug. 1. . CMS Consumer Assessment of Healthcare Providers & Systems (CAHPS). CMS created a series of resources, including an FAQ, social media toolkit, and more, to help ensure people can benefit from these important provisions. In working with payer record reviews, several practical strategies have emerged to minimize payer-provider abrasion and reduce operational costs.

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