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  • Does CMS support payment reform and value-based care initiatives?

    Comment: A commenter supported CMS's effort to establish the infrastructure needed to support payment reform and value-based care initiatives via the Provider Access API, stating that these initiatives are critical to reducing the costs of health care delivery while maximizing quality for Medicare enrollees.

  • What is a skilled nursing facility advance beneficiary notice (SNF ABN)?

    Issued to beneficiaries receiving home health care benefits for notification of plan of care changes. Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN, Form CMS-10055)

  • Should CMS require payers to notify providers when a request is received?

    Comment: A commenter recommended that CMS require payers to notify providers once they have received a request and the specific date a provider should expect to receive information in response.

  • Can a Medicaid beneficiary switch between FFS and managed care?

    A Medicaid or CHIP beneficiary may switch between FFS and managed care delivery systems within the same state's Medicaid or CHIP program. Despite these shifts, an eligible beneficiary remains a beneficiary of the state program. States may also change the Medicaid or CHIP managed care plans or entities with which they contract.

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