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As requested by interested parties in comments on the initial Medicare Part D Drug Inflation Rebate Guidance, the repository could allow covered entities to submit these data directly to CMS (or a contractor), rather than through claims that dispensers submit to Part D plan sponsors
Background We have been engaged in a multi-year examination of coordinated and collaborative care services in professional settings, and as a result established codes and separate payment in the PFS to independently recognize and pay for these important services
Proposed CY 2025 Productivity-Adjusted Market Basket Update for FQHCs For CY 2025 (that is, January 1, 2025, through December 31, 2025), we propose to use an estimate of the proposed 2022-based FQHC market basket to update payments to FQHCs based on the best available data
If an ACO is not eligible to receive a prior savings adjustment or a HEBA, and the regional adjustment, expressed as a single value, is negative or zero, then the ACO would not receive an adjustment to its benchmark
This raises further questions about the utility of reopening payment determinations versus maintaining administrative finality of initial determinations
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