Recording and Slides of the Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule Education Session

We are sending this announcement on behalf of our colleagues in the Office of Burden Reduction and Health Informatics. Questions should be submitted to [email protected].

We’re pleased to provide you with the recording (password: 4%2M!3c?) and slides of the February 9, 2023, virtual education session hosted by the CMS Office of Burden Reduction and Health Informatics on the Advancing Interoperability and Improving Prior Authorization Processes proposed rule. Thanks to those of you who were able to attend the event and to everyone with an interest in the proposed rule.

As a reminder, we welcome your feedback on the proposed policies introduced in the CMS Advancing Interoperability and Improving Prior Authorization Processes proposed rule (CMS-0057-P). Comments must be received within the 90-day comment period, which closes on March 13, 2023. When commenting, please refer to file code: CMS-0057-P.

You may use one of the following methods to officially submit comments:

• Electronically through regulations.gov;
• Regular mail; or
• Express or overnight mail.

Please see the proposed rule for mailing addresses. Note, we do not accept comments via fax nor via the Health Informatics and Interoperability Group inbox.

New CMS Resources 

CMS Releases Updated Resources to Prepare for the May 11 End of the COVID-19 Public Health Emergency and National Emergency

The Biden Administration announced its intent to end the COVID-19 national emergency and public health emergency declarations on May 11, 2023. To ensure a smooth transition and help protect the health and well-being of the American people, CMS has taken immediate action to update fact sheets and other supporting resources to prepare for changes that will occur beginning on May 11.

CMS Acts to Help Individuals and Families Maintain Medicaid Coverage or Successfully Transition to the Health Insurance Marketplaces

In preparation for helping states/territories redetermine tens of millions of enrollees’ eligibility for Medicaid and CHIP following the March 31, 2023 end to the Medicaid continuous enrollment condition, CMS issued a state health official letter outlining new requirements for states in the Consolidated Appropriations Act, 2023 (CAA, 2023). This process  will be the single largest health coverage transition since the first open enrollment period of the Affordable Care Act. CMS is using every tool to ensure all eligible individuals can maintain their Medicaid or CHIP coverage, or transition to other affordable coverage, such as the Health Insurance Marketplaces. As part of these efforts, CMS developed a toolkit with important information for people with Medicaid or CHIP about steps they need to take to renew their coverage through those programs.

Many individuals and families who are no longer eligible for Medicaid or CHIP will be able to transition to other coverage options, including health insurance plans available from the Health Insurance Marketplaces. To help these consumers successfully transition, CMS has outlined Special Enrollment Period flexibilities for qualified individuals and their families who lose Medicaid or CHIP coverage following the unwinding of the Medicaid continuous enrollment condition.

CMS Announces New Resources for States to Strengthen Home and Community-Based Direct Service Workforce

CMS shared tools and best practices related to the home- and community-based services (HCBS) direct service workforce (DSW) as part of its commitment to strengthening the health care workforce. Direct service workers provide essential supports to older adults and people with intellectual and developmental disabilities, physical disabilities, and behavioral health needs. As part of the ongoing effort to support this workforce, CMS released an online training course and a series of resources that offer strategies and information on self-direction of home and community-based services, strengthening the DSW in rural areas, and emerging strategies for states. The online training also provides guidance and helpful information on finding, hiring, and retraining direct service workers.

McBee On-Demand Webinar - Additional Documentation Requests: Avoid Panic and Mitigate Denials

Now that Additional Documentation Requests (ADRs) are in full effect after being paused during the public health emergency (PHE), it is important to ensure your agency can respond to ADR requests efficiently while decreasing your risk of denial or payment delays.

In this on-demand webinar, McBee experts Arrica Canty and Dee Geray will discuss the best approach to proactively plan and have processes in place that make the ADR process seamless to expedite payment or avoid repayment. Additionally, attendees will learn recent denial reasons, share best practices to prepare for ADRs, and how to tackle/manage denials.

View Webinar

Biden Gives Nod to Home Care in State of the Union Address

McKnight’s Home Care | By Liza Berger

Providers and aging services advocates praised President Biden for expressing support for home care and family caregivers in his State of the Union address on Tuesday night.
 
“The president was right to support the workforce needed to care for older adults who choose to remain in their homes as they age, and to highlight the need to provide relief for millions of family caregivers,” Terry Fulmer, PhD, RN, president of the The John A. Hartford Foundation, said in a statement Wednesday.
 
In his address delivered before Congress, Biden mentioned the need to grow home- and community-based services and give relief to family caregivers.
 
“Let’s get seniors who want to stay in their homes the care they need to do so,” Biden said. “Give more breathing room to millions of family caregivers looking after their loved ones. Pass my plan so we get seniors and people with disabilities the services they need.” 
 
With the end of the public health emergency approaching, the government must ensure that older adults, their families and professional caregivers receive the support they need, Katie Smith Sloan, president and CEO of LeadingAge, commented in a statement directly after the speech.
 
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