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Submitted URL: https://innovation.cms.gov/
Effective URL: https://www.cms.gov/priorities/innovation/overview
Submission: On April 10 via api from US — Scanned from DE
Effective URL: https://www.cms.gov/priorities/innovation/overview
Submission: On April 10 via api from US — Scanned from DE
Form analysis
2 forms found in the DOMGET /search/cms
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POST https://public.govdelivery.com/accounts/USCMS/subscribers/qualify
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Text Content
Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Centers for Medicare & Medicaid Services CMS NEWSROOM Header * About CMS * Newsroom * Data & Research SEARCH CMS.GOV Search Search Popular terms * Physician Fee Schedule * Local Coverage Determination * Medically Unlikely Edits * Telehealth * Covid-19 CMS.GOV MAIN MENU * Medicare Back to main menu MEDICARE * Enrollment & renewal Back to menu ENROLLMENT & RENEWAL * Annual Medicare Participation Announcement * Providers & suppliers * Medicare-Medicaid information * Medicare Managed Care Eligibility and Enrollment * Part D plans * Health plans * Health Care Prepayment Plans (HCPPs) * Cost plans * Special needs plans * Coverage Back to menu COVERAGE * Coverage Determination Process * Medicare Coverage Database * Approved facilities, trials, & registries * Telehealth * Medicare Summary Notice * Prescription drug coverage contracting * Coverage with evidence development * Investigational device exemption studies * Prescription drug coverage * Drug coverage claims data * Dental coverage * Preventive Services * Medicare Coverage Center * End Stage Renal Disease (ESRD) Center * Ambulances Services Center * Regulations & guidance Back to menu REGULATIONS & GUIDANCE * Manuals * Transmittals * CMS Records Schedule * Medicare Fee-for-Service payment regulations * National Provider Identifier Standard (NPI) * Advisory committees * Legislation * Promoting Interoperability Programs * CMS rulemaking * CMS Hearing Officer * Office of the Attorney Advisor (OAA) * Provider Reimbursement Review Board (PRRB) * Medicare Geographic Classification Review Board (MGCRB) * Physician Self-Referral * Quarterly provider updates * E-Prescribing * Coding & billing Back to menu CODING & BILLING * Place of service codes * ICD-10 codes * Healthcare Common Procedure Coding System (HCPCS) * Outpatient Code Editor (OCE) * National Correct Coding Initiative (NCCI) edits * NCCI for Medicaid * Electronic billing * Medicare Administrative Contractors (MACs) * Provider Customer Service Program * Skilled Nursing Facility (SNF) consolidated billing * Roster billing * Therapy services * Medicare claims & public health emergencies * Guide for Medical Technology Companies and Other Interested Parties * Payment Back to menu PAYMENT * Medicare Part B Drug Average Sales Price * All Fee-For-Service-Providers * Fee schedules * Prospective Payment Systems * Opioid Treatment Programs (OTP) * Covid-19 Vaccine Toolkit * Bankruptcy * Sustainable Growth Rates & Conversion Factors * Medicare Advantage Rates & Statistics * Health plan payment * Medicare-Medicaid coordination Back to menu MEDICARE-MEDICAID COORDINATION * Medicare-Medicaid Coordination Office * Qualified Medicare beneficiary program * Financial alignment initiative * Initiative to reduce avoidable hospitalizations * Program of All-Inclusive Care for the Elderly (PACE) * Resources for Medicare-Medicaid plans * Resources for state Medicaid agencies * Center for Program Integrity * Healthcare Fraud Prevention Partnership * Clinical Templates * Appeals & grievances Back to menu APPEALS & GRIEVANCES * Original Medicare appeals * Managed Care appeals & grievances * Prescription drug appeals & grievances * Ombudsman Center * Appeals Decision Search (Part C & Part D) * Quality Back to menu QUALITY * Value-based programs * Person & Family Engagement * Quality improvement organizations * Nursing home quality improvement * Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP) * Home Health Quality Reporting Program * ESRD Quality Incentive Program * CMS National Quality Strategy * Hospice Quality Reporting Program * Long-Term Care Hospital (LTCH) Quality Reporting Program (QRP) * Appropriate Use Criteria Program * Quality measures * Clinical Laboratory Improvement Amendments (CLIA) * Medicare Advantage quality improvement program * Physician compare initiative * Quality initiatives * Part C and D Performance Data * Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) * Health & safety standards Back to menu HEALTH & SAFETY STANDARDS * Quality, safety & oversight - General information * Accreditation programs * Civil monetary penalties * Medicare termination notices * Quality, safety & oversight - Emergency preparedness * State survey agencies * Certification & compliance * Enforcement * Quality, safety & oversight - Guidance for laws & regulations * Promising practices project * Quality, safety & oversight - Education division (QSED) * Conditions for coverage & participation * Employers & plan sponsors Back to menu EMPLOYERS & PLAN SPONSORS * Creditable coverage * Innovation Center Back to menu INNOVATION CENTER * Overview * Audits & Compliance Back to menu AUDITS & COMPLIANCE * Part A cost report audit * Part C/Part D compliance & audits * Forms & notices Back to menu FORMS & NOTICES * CMS forms * CMS forms list * Beneficiary Notices Initiative (BNI) * Health & drug plans Back to menu HEALTH & DRUG PLANS * Plan payment * Plan payment data * Medical loss ratio * Coverage Gap Discount Program * Managed care marketing * Medicare Advantage application * Medigap (Medicare supplement health insurance) * Medical Savings Account (MSA) * Private Fee-for-Service Plans * Network adequacy * Coordination of benefits & recovery Back to menu COORDINATION OF BENEFITS & RECOVERY * Overview * Mandatory Insurer Reporting for Group Health Plans (GHP) * Mandatory insurer reporting (NGHP) * Workers' comp Medicare set aside arrangements * Attorney services * Beneficiary services * COBA Trading Partners * Employer services * Insurer services * Prescription drug assistance programs * Provider services * Settlements Back to menu SETTLEMENTS * Jimmo Settlement * Ryan Settlement Close this menu * Medicaid/CHIP Back to main menu MEDICAID/CHIP * What is Medicaid? Back to menu WHAT IS MEDICAID? * Visit Medicaid.gov * View Medicaid maps * Visit CHIP.gov * Medicare-Medicaid Coordination Back to menu MEDICARE-MEDICAID COORDINATION * Integrated care resources * Initiative to reduce avoidable hospitalizations * Financial alignment initiative * Medicaid Integrity Institute * Regulations & guidance Back to menu REGULATIONS & GUIDANCE * Manuals * Transmittals * CMS Records Schedule * Medicare Fee-for-Service payment regulations * National Provider Identifier Standard (NPI) * Advisory committees * Legislation * Promoting Interoperability Programs * CMS rulemaking * CMS Hearing Officer * Office of the Attorney Advisor (OAA) * Provider Reimbursement Review Board (PRRB) * Medicare Geographic Classification Review Board (MGCRB) * Physician Self-Referral * Quarterly provider updates * E-Prescribing * Innovation Center Back to menu INNOVATION CENTER * Overview Close this menu * Marketplace & Private Insurance Back to main menu MARKETPLACE & PRIVATE INSURANCE * About the Marketplace Back to menu ABOUT THE MARKETPLACE * Marketplace oversight * Affordable Care Act * Overview of the exchanges * Exchange coverage maps * Medicare and the Marketplace * Private Health Insurance Back to menu PRIVATE HEALTH INSURANCE * Patient’s Bill of Rights * Medical loss ratio * Annual limits * Review of insurance rates * Market rating * Self-funded, non-federal governmental plans * Grandfathered plans * Health Reimbursement Arrangements * Coverage for young adults * Student health plans * Mental health parity and addiction equity * Prevention * Consumer protections & enforcement * Pre-existing condition insurance plan * Qualifying Health Coverage (QHC) * Regulations & guidance Back to menu REGULATIONS & GUIDANCE * CCIIO Regulations & Guidance * Manuals * Transmittals * CMS Records Schedule * Medicare Fee-for-Service payment regulations * National Provider Identifier Standard (NPI) * Advisory committees * Legislation * Promoting Interoperability Programs * CMS rulemaking * CMS Hearing Officer * Office of the Attorney Advisor (OAA) * Provider Reimbursement Review Board (PRRB) * Medicare Geographic Classification Review Board (MGCRB) * Physician Self-Referral * Quarterly provider updates * E-Prescribing * In-person assisters Back to menu IN-PERSON ASSISTERS * Information for Partners * Assister outreach & education * Applications, forms, & notices * Assister programs & procedures * Assister technical resources * Assister training & webinars * Agents & Brokers Back to menu AGENTS & BROKERS * Resources for Agent & Brokers * Registration & training * Open enrollment * Direct enrollment partners * General resources * Video Learning Center * Agent & Broker FAQ * Marketplace help desk & call centers * Registration Completion List * Marketplace Registration Tracker * AB Suspension & Termination List * Find local help * Issuer and direct enrollment partner directory * Help on demand * SHOP Resources * Health Plans & Issuers Back to menu HEALTH PLANS & ISSUERS * Qualified health plan certification * Summary of benefits & coverage * Insurance programs * Premium stabilization programs * Health insurance market reforms * Minimum essential coverage * Employers & sponsors Back to menu EMPLOYERS & SPONSORS * Coverage * Regulation & guidance * Small business tax credit & premium assistance * Appeals * Small Business Health Options Program (SHOP) * Early retiree reinsurance program * Employer initiatives * States Back to menu STATES * Planning & establishing a Marketplace * Territory cooperative agreements * Early innovator program * State flexibility to stabilize the Market * Section 1332 (State Innovation) Waiver * Exchange establishment grants * Pre-existing condition insurance plan * Resources Back to menu RESOURCES * About Us * Data resources * Fact sheets & FAQs * Forms, reports, & other resources * Funding opportunities * Letters * Regulations & Guidance * Training resources Close this menu * Priorities Back to main menu PRIORITIES * Innovation Center Back to menu INNOVATION CENTER * Overview * About * Key Concepts * Value-Based Care Spotlight * Innovation Models * Where Innovation is Happening * Events * Data & Reports * Health Equity Back to menu HEALTH EQUITY * Coverage to Care * Minority health * Cobertura de atención * Grants & awards * Recent Legislation Back to menu RECENT LEGISLATION * Inflation Reduction Act and Medicare * No Surprises Act * Key Initiatives Back to menu KEY INITIATIVES * Opioids * Flu * Medicare Open Enrollment * Medicare OE partner resources * Marketplace Open Enrollment * E-health * Open Payments * Burden reduction * Returning to regular operations after COVID-19 * Healthplan price transparency * Hospital price transparency * Lookup tools * Measure development * Give feedback * Your Patient Rights Back to menu YOUR PATIENT RIGHTS * Emergency room rights * Medical bill rights Close this menu * Training & Education Back to main menu TRAINING & EDUCATION * CMS National Training Program Back to menu CMS NATIONAL TRAINING PROGRAM * National Training Program resources * Class modules * Partner outreach resources Back to menu PARTNER OUTREACH RESOURCES * Partner with CMS * National Medicare Education Program (NMEP) * Low-Income Subsidy (LIS) outreach * Become a champion for coverage * Flu Vaccine Partner Toolkit * Faith-Based Partners * Rural Health Partners * American Indian/Alaska Native * Partnering with CMS Center * Medicare Learning Network (MLN) Back to menu MEDICARE LEARNING NETWORK (MLN) * Resources & training * Newsletter * Compliance * Partnerships * CMS Open Door Forums Back to menu CMS OPEN DOOR FORUMS * About Open Door Forums * Ambulance * End-Stage Renal Disease (ESRD) & Clinical Laboratories * Home Health, Hospice & Durable Medical Equipment (DME) * Hospital * Long-Term Services & Supports * Physicians, Nurses and Allied Health Professionals * Rural Health * Skilled Nursing Facilities (SNFs)/Long-Term Care * Special Open Door forums * Look up topics Back to menu LOOK UP TOPICS * Medicare * Medicaid * CHIP * American Indian/Alaska Native Center * Quality of care * Special populations * Fraud & abuse * States * Privacy * Health conditions & campaigns * New Medicare Card * HIPAA Administrative Simplification * Learn More Back to menu LEARN MORE * Attend events * Find resources * Get training * Find tools to help you help others * Get digital media * Find your provider type Back to menu FIND YOUR PROVIDER TYPE * Physicians & other health professionals * Facilities * Health & drug plans * Employers & unions Close this menu BREADCRUMB * * Priorities * Innovation Center * Overview OVERVIEW OUR INNOVATION MODELS The CMS Innovation Center has a growing portfolio testing various payment and service delivery models that aim to achieve better care for patients, smarter spending and healthier communities. Want to join a model? Learn more about CMS Innovation Center models WHERE INNOVATION IS HAPPENING See where our Innovation Model Partners are located. Find out where innovation is happening STRATEGIC DIRECTION Background on the CMS Innovation Center's Strategic Refresh – Putting All Patients at the Center of Care The CMS Innovation Center's strategic direction DATA & REPORTS The CMS Innovation Center contributes reports and datasets to the community of health care innovators, data researchers, and policy analysts. Access and download CMS Innovation Center data and reports EVENTS The CMS Innovation Center offers webinars and forums about its programs. These provide opportunities to learn about current programs, upcoming events, and initiatives, as well as to ask questions and offer feedback. Find information on upcoming and past events CONNECT WITH US Learn how to engage with CMS Innovation Center Models; stay updated on Center activities, events and news; and find open positions with the CMS Innovation Center. Learn how to engage with the CMS Innovation Center RECENT MILESTONES & UPDATES * April 8, 2024 Maryland Total Cost of Care Model Announced: Progress reports for the first 4 years of the model posted Learn moreabout Maryland Total Cost of Care Model Announced Progress reports for the first 4 years of the model posted * March 19, 2024 ACO Primary Care Flex Model Announced: Voluntary model focused on improving funding and other resources to support primary care delivery in the Medicare Shared Savings Program Learn more * March 7, 2024 Cell and Gene Therapy (CGT) Access Model Announced: Manufacturer Request for Applications (RFA) released Learn more More ABOUT THE CMS INNOVATION CENTER Learn more INTRODUCTION TO KEY CONCEPTS Learn more APMS AND THE QUALITY PAYMENT PROGRAM Learn more FOLLOW US! * Email us * Follow us on Twitter Page Last Modified: 04/08/2024 10:20 AM Help with File Formats and Plug-Ins GET EMAIL UPDATES Sign up to get the latest information about your choice of CMS topics. You can decide how often to receive updates. Email Sign up - opens in a new window Sign up CMS & HHS Websites CMS & HHS Websites * Medicare.gov * Medicaid.gov * InsureKidsNow.gov * HealthCare.gov * HHS.gov * HHS.gov/Open About CMS About CMS * About Us * Careers * Newsroom * Blog * Podcast Tools Tools * Acronyms * Archive * Contacts * Glossary Helpful Links Helpful Links * Privacy Policy * Plain Language * Privacy Settings Privacy Settings * Nondiscrimination & Accessibility * Developer Information * Vulnerability Disclosure Policy USA Government Sites USA Government Sites * Freedom of Information Act * No Fear Act * Inspector General * USA.gov CONNECT WITH CMS * Linkedin link * Youtube link * Facebook link * Twitter link * RSS Feed link A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 Feedback