WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services (CMS) has unveiled a series of updates designed to enhance patient rights, streamline coverage transitions, and address health disparities through impactful initiatives. These developments underscore CMS’s commitment to improving healthcare access and quality for Americans relying on Medicare and Medicaid services.
On August 13, CMS released an updated poster detailing patient rights under the Emergency Medical Treatment and Labor Act (EMTALA). This initiative aims to ensure that Medicare-participating hospitals prominently display information about patient rights in emergency departments and other critical areas. The poster also guides patients on how to file complaints should they feel their rights have been violated. This effort emphasizes the importance of transparency and patient empowerment in healthcare settings.
In parallel, CMS has been preparing for a significant transition in coverage for Pre-exposure Prophylaxis (PrEP) antiretroviral drugs, intended to prevent HIV. The information posted encourages pharmacies and other stakeholders to prepare for the shift from Medicare Part D to Part B, anticipated to commence once CMS finalizes the National Coverage Determination in late September 2024. This strategic move aims to ensure continued access to preventive HIV treatments under more comprehensive coverage terms.
On August 15, CMS announced a Notice of Funding Opportunity (NOFO) for the Cell and Gene Therapy (CGT) Access Model. This voluntary initiative seeks to enhance access to transformative treatments for Medicaid beneficiaries with rare and severe diseases. Eligibility extends to states and territories participating in the Medicaid Drug Rebate Program. This model represents a significant step toward equitable access to cutting-edge therapies for vulnerable populations.
Responding to public feedback, CMS has decided against finalizing the proposed Local Coverage Determination (LCD) for MolDx Molecular Testing related to organ transplantation rejection. Announced on August 16, this decision allows Medicare beneficiaries meeting existing criteria to continue accessing these critical blood tests. CMS plans to issue a revised proposed LCD in the forthcoming months, reflecting its adaptive approach to policy-making based on stakeholder input.
Additionally, CMS issued guidance on August 19 to promote Medicaid continuity for individuals receiving home- and community-based services (HCBS). This bulletin highlights available flexibilities to ensure ongoing access to essential Medicaid services, reflecting CMS’s dedication to supporting vulnerable individuals in maintaining their coverage and care.
On August 20, CMS updated its Health Equity Disparities Impact Statement. This tool aims to assist healthcare stakeholders in identifying and addressing health disparities, with a focus on underserved communities, including racial and ethnic minorities, individuals with disabilities, and those with limited English proficiency. This update aligns with CMS’s broader efforts to promote equity and inclusivity within the healthcare system.
Finally, CMS shared insights into its data sharing strategy through a blog published in Health Affairs Forefront on August 21. This strategy outlines the Innovation Center’s approach to identifying data sharing needs across various models, underscoring the importance of data in driving healthcare innovation and improvement.
Through these initiatives, CMS aims to enhance patient rights, expand access to healthcare, and reduce disparities, reflecting a holistic approach to advancing the health and well-being of all Americans. As these developments unfold, CMS seeks to ensure that Medicare and Medicaid services are accessible, equitable, and effective for the diverse populations they serve.
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