Payment and Rate Setting Policy

CMS Invites Comments on Draft Manual for State Payment of Medicare Premiums

REMINDER: Comments due February 29, 2020.

On December 13, the Centers for Medicare & Medicaid Services (CMS) released a draft Manual for State Payment of Medicare Premiums (formerly called the “State Buy-in Manual”) to states and other stakeholders for review and comment. The draft manual updates information and instructions to states on federal policy, operations, and systems concerning the payment of Medicare Parts A and B premiums (or buy-in) for individuals dually eligible for Medicare and Medicaid.

Overview of State Considerations for Medicaid Managed Long-Term Services and Supports (MLTSS) Rate Setting

Study Hall Call
March-16

This webinar features an overview of MLTSS rate setting basics, shares initial findings from a project on Medicaid MLTSS rate setting, and also includes a facilitated discussion with an expert actuary and state representatives from Tennessee and Texas.

Value-Based Payment in Nursing Facilities: Options and Lessons for States and Managed Care Plans

This brief describes value-based payment approaches currently used in select states and managed care plans, including the quality and performance measures they use, benchmarks or targets for those measures, and incentives that reward facilities. It also describes approaches to designing, administering, and evaluating state programs.

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