Medicare Advantage (MA) is the growing public/private form of Medicare that now over half of Medicare beneficiaries are enrolled in. The quality of MA programs is rated using Star Ratings, with 1 being the lowest score and 5 the highest. MA plan payment is tied to Star Rating performance, so plans have a strong incentive to aim for high Star…

C-TAC recently submitted a comment letter to CMS on the Advance Notice of Methodological Changes for CY 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies. Here are C-TAC’s comments on pertinent measures in the proposed Advance Notice: Changes to Existing Star Ratings Measures for the 2025 Measurement Year and Beyond Cross-cutting: Gender-Affirming Quality…

Nothing gets done in Washington, right? Well…in a year when Congress had the fewest bills passed, ever, and polarization seemed at its highest, it was a breakthrough year for C-TAC’s policy advocacy. The public policy wins in this recap of 2023 will have an immediate impact for patients, caregivers, and their care teams in 2024. We couldn’t have done it…

The White House announced (fact sheet) the selection of sickle cell disease (SCD) as the initial focus of the Cell and Gene Therapy (CGT) Access Model, aimed at enhancing health outcomes, increasing access to therapies, and reducing healthcare costs for vulnerable populations. With over 100,000 Americans affected by SCD, the model, led by the Centers for Medicare and Medicaid Services…

Medicare Advantage is the growing public-private form of Medicare and a recent rule proposed changes to the important supplemental benefits for those with chronic illnesses. C-TAC reviewed those changes and submitted comments on them to CMS on the proposed 2025 Medicare Advantage changes. We also commented on the proposal to add an annual health equity analysis for utilization management policies,…

In a groundbreaking announcement, Medicare will now pay for a number of services C-TAC has long championed, which promise to benefit people living with serious illness.  The final CY2024 “Physician Fee Schedule” includes provisions that, under specified circumstances, will pay for services such as: Community Health Integration (CHI) Service Referrals– There are now new billing codes for community health integration…

C-TAC’s Senior Regulatory Advisor, Marian Grant, co-authored a recently published review of federal advance care planning (ACP) policy entitled “Federal Advance Care Planning Policy Primer – Key Aspects, Barriers, and Opportunities.” This content was also presented at the 2023 AAHPM and HPNA Annual Assembly in Montreal.

C-TAC recently responded to a CMMI request for information on episode-based payment models. C-TAC highlighted some of our work including the Serious Illness Multi-Payer Learning Collaborative, an engaged group of leading health plans, integrated delivery systems, and accountable care organizations who are paving the way to deliver better care for those living with serious illness and their families.

C-TAC recently submitted comments on CMS’s proposed rule for hospice for FY 2024 that advocated for reforming the Medicare Hospice Benefit to allow for transitional concurrent care and more equitable access to this important benefit. Key comments were: Misleading use of the term “palliative care”. C-TAC noted our appreciation that CMS’s definition of palliative care includes mention of its being appropriate “throughout the continuum of illness.”

In 2022, C-TAC expanded our relationships on the Hill, deepened our engagement with state leaders, and continued our dialogue with the Administration through our regulatory and administrative advocacy. Heading into 2023 our focus remains on creating a continuum of care for patients and their families from diagnosis through to the end of life, working with innovative care models such as: Home-Based Primary Care, Palliative Care, PACE, and Hospice.

In a nod to another way that health care is changing due to the Covid-19 pandemic, C-TAC continues to support legislation that will enable Medicare beneficiaries to use telehealth services after the pandemic emergency has ended.

On March 28, 2022, the Biden-Harris Administration’s Budget of the U.S. Government Fiscal Year 2023 was released and sent to Congress for consideration.