Centers for Medicare & Medicaid Services

Soon for Short-Term Acute Care Hospitals A new release of PEPPER for Short Term Acute Care hospitals will be available to Authorized Officials (AO) and Access Managers (AM) in mid-December. Confirm your I&A System access permission today. If you are a provider, consult with your AO and AM to access your PEPPER report when available. 🔐 Access Details Initially, only Authorized Officials (AOs) and Access Managers (AMs) with active Identity & Access Management (I&A) System accounts will be able to download the report from the PEPPER Portal here: https://lnkd.in/gRe59G3W ✅ Next Steps: AOs and AMs: Confirm your I&A access today. Providers: Coordinate with your AO or AM to access your report once it is live. Turn insights into action – drive compliance smarter and outcomes higher. #PEPPER #MedicareCompliance #HealthcareData #ShortTermAcuteCare

ACCESS Creates New Opportunities for Technology-Supported Care A new HHS Issues Brief, “Opportunities for Technology-Enabled Care: Economic and Payment Issues,” amplifies why the CMS Innovation Center’s ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model is so critical in bringing digital technology to people with Medicare. Read the report: go.cms.gov/48jfmcj. ACCESS tests an outcome-aligned payment approach designed to give clinicians and people with Original Medicare innovative new care options to prevent and manage chronic disease. The voluntary model focuses on common conditions, such as high blood pressure, diabetes, chronic musculosketal pain, depression, affecting millions of Americans. Visit the ACCESS Model webpage: go.cms.gov/ACCESS.

The ACCESS Model Expands Access to Digital Health in Original Medicare What’s new: The ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model will give people with Original Medicare new ways to improve their health and manage common chronic conditions with modern technology-supported care. Why it matters: Today, people with Original Medicare have limited access to modern, technology-supported care for managing their chronic conditions. What to expect: CMS will begin accepting applications for the 10-year voluntary model on January 12, 2026. ACCESS will begin July 1, 2026. Learn more: go.cms.gov/ACCESS

CMS is hiring a Supervisory IT Specialist

Drawing on her own experience with a mental health concern, one Innovation Center expert is working to develop and implement the Innovation in Behavioral Health (IBH) Model that will help people with Medicare and Medicaid get the services they need. Through IBH, CMS is seeking additional states to take part in a whole-person, integrated care approach to mental health, substance use disorder, and physical health services. Learn more and apply by June 3, 2026: https://go.cms.gov/4oVjHrX

Calling all pharmacists! CMS is launching the Medicare Transaction Facilitator Data Module (MTF DM) for the Medicare Drug Price Negotiation Program. Enrollment in the MTF DM is FREE and a critical step to ensure pharmacies are prepared for the effectuation of the new negotiated maximum fair prices on certain drugs under Medicare Part D beginning on January 1, 2026. Enroll today, visit https://go.cms.gov/3XDJAAu to get started.

⏰ Got a minute? CMS Administrator Dr. Oz explains value-based care and the connection to healthy aging: https://go.cms.gov/46vGYu3 Learn how value-based care providers can work with you to support your health goals as you age: go.cms.gov/VBC. Value-based care is focused on quality of care, provider performance, and the patient experience – what you value most: https://go.cms.gov/46vtb6I

Navigating the U.S. health care system shouldn’t be a maze of paperwork and inefficiencies. That’s why the CMS Innovation Center is implementing a new transformative strategy rooted in 15 years of research and evidence to protect patients, providers, and taxpayers. The approach will prioritize high-value care over unnecessary procedures, implement downside risk in payment models, and create transparent benchmarks. Read the Innovation Center’s blog, “Three Ways CMMI Is Applying Evidence To Protect Patients, Providers And Taxpayers” in Health Affairs to learn about the Innovation Center’s new strategy to drive efficiency and reduce unnecessary spending, while ensuring care remains safe, effective, and patient centered: https://bit.ly/4oKAgH3

What’s new: Through the Innovation in Behavioral Health (IBH) Model, CMS is seeking additional states to take part in a whole-person, integrated care approach to mental health, substance use disorder, and physical health services for people with Medicaid and Medicare, to comprehensively address root causes of health issues sooner before they become severe. Why it matters: Through early screening for behavioral health conditions and connecting people with preventive services, IBH can help people avoid costly emergency room visits and hospitalizations while supporting a more efficient, prevention-focused health system. What to expect: Up to five additional states will be selected for this second cohort of the state-led model, joining Michigan, New York, and South Carolina; award notices are expected to be issued in December 2025. The big picture: The IBH Model offers a “no wrong door” approach to delivering care and promoting prevention – meaning that behavioral health settings can serve as a point of entry to identify an individual’s range of needs, secure further care, and facilitate close collaboration with primary and specialty care providers to keep people healthier longer. Interested applicants should submit their applications by June 3, 2026. Learn more and apply: go.cms.gov/IBH. More details will be shared during a forthcoming webinar on December 11, 2025. Register today: https://go.cms.gov/4nYKxOO.

CMS announces the new GENEROUS Model in which CMS will negotiate with drug manufacturers to lower prescription drug costs for Medicaid. What’s new: The GENEROUS Model is designed to reduce drug costs in the Medicaid program, which supports our most vulnerable populations. Why it matters: By engaging directly with drug manufacturers, CMS can negotiate lower prices to what other comparable countries pay, reducing burden to Medicaid programs and allowing for States to do more for the American people What to expect: CMS is issuing a Request for Applications to solicit drug manufacturers to participate in negotiations, and will issue a Letter of Intent for state Medicaid programs; GENEROUS will launch in 2026 with state Medicaid agencies on a rolling basis. Learn more: go.cms.gov/generous