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Jeffrey Davis Director of Regulatory and External Affairs at ACEP

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  • On June 28, the Biden-Harris Administration released a Maternal Health Blueprint (Blueprint and Fact Sheet).
  • On June 27, the Departments of Health and Human Services, Labor, and Treasury wrote a letter to group health plans and health issuers reminding them of their obligations under the Affordable Care Act (ACA) to provide coverage for contraceptive services at no cost.
  • On June 15, ACEP responded to the Fiscal Year (FY) 2023 Inpatient Prospective Payment System (IPPS) proposed rule—the major rule impacting Medicare payments for inpatient hospital services.
  • On June 27, CMS announced a new alternative payment model called the “Enhancing Oncology Model (EOM)” that is aimed at improving cancer care for Medicare patients. EOM is a voluntary model that will run from July 2023 through June 2028 and participants will include oncology practices that treat people with Medicare undergoing chemotherapy for breast cancer, chronic leukemia, lung cancer, lymphoma, multiple myeloma, prostate cancer, and small intestine/colorectal cancer.
  • On June 17, CMS published a blog entitled “Pathways for Specialty Care Coordination and Integration in Population-based Models” that includes insights on increasing access to coordinated and integrated specialty care. The blog describes four major findings: 1) Providing data on specialist performance and enhancing data sharing across practices would facilitate integration with primary care; 2) Episode-based payment models can be designed to align incentives between specialists and ACO initiatives; 3) Many ACOs and primary care practices recognize value in specialty care assuming primary responsibility for special populations and beneficiaries with specific conditions; and 4) Beneficiaries with complex conditions may benefit from specialists integrated into primary care delivery pathways.

 

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