Each year the Centers for Medicare and Medicaid Services (CMS) reviews payment practices and policy changes under fee-for-service, or traditional, Medicare. The CY2024 PFS included important coding and payment changes for services to address health-related social needs (HRSNs) through separate payments for Community Health Integration (CHI), SDOH Risk Assessment, and Principal Illness Navigation (PIN) services.
In July 2024, CMS released its annual draft proposed updates for next year’s rules (CY2025 Medicare Physician Fee Schedule), which includes a request for information (RFI) regarding barriers to implementation for services to address HRSNs.
The draft rule also includes proposed updates to:
- Caregiver Training Services;
- ACO quality measures re: screening for HRSNs; and
- the Advanced Primary Care Model (APCM)
All of these proposed changes could affect services to address HRSNs.
SIGN-ON REQUEST:
Please consider joining the Partnership to Align Social Care Co-Chairs and other organizational stakeholders on TWO sign-on letters offering comments. You may sign on to one or both letters:
- Sign-on letter responding to the RFI re: barriers to implementing services to address HRSNs
- Sign-on letter responding changes needed and proposed updates for telehealth, caregiver training services, ACO quality measures, and the Advanced Primary Care Model
We also encourage you to download template language covering all of these issues and incorporate as applicable into your organization’s response . As a reminder, comments are due by 5:00 p.m. ET on September 9, 2024, and can be submitted online.
RESOURCES:
- SIGN-ON Letters (combined) responding to CMS CY2025 PFS Proposed Rule (pdf)
- Template language provided by the Partnership (Word version available for download)
- CMS CY2025 PFS Proposed Rule: https://www.regulations.gov/document/CMS-2024-0256-0045
- Additional information and resources from the Partnership about this proposed rule: https://www.partnership2asc.org/implementation-resources/ and Resources List