CMS may periodically re-evaluate the fifteen chronic conditions as it gathers evidence on the effectiveness of care coordination through the SNP product, and as health care research demonstrates advancements in chronic condition management. The list of SNP-specific chronic conditions is not intended for purposes other than clarifying eligibility for the C-SNP CCP benefit package. Extensive paralysis (i.e., hemiplegia, quadriplegia, paraplegia, monoplegia).Chronic and disabling mental health conditions limited to:.Sickle-cell disease (excluding sickle-cell trait).Severe hematologic disorders limited to:.End-stage renal disease (ESRD) requiring dialysis.Cancer, excluding pre-cancer conditions or in-situ status.Chronic alcohol and other drug dependence.After discussing public comments on a proposed list of SNP-specific chronic conditions, the panelists recommended, and CMS subsequently approved, the following 15 SNP-specific chronic conditions: 15 SNP-Specific Chronic Conditions: Panelists included six clinical experts on chronic condition management from three federal agencies-the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), and CMS. Section 1859(b)(6)(B)(iii) of the Act and 42 CFR 422.2 define special needs individuals with severe or disabling chronic conditions as special needs individuals “who have one or more co-morbid and medically complex chronic conditions that are substantially disabling or life threatening have a high risk of hospitalization or other significant adverse health outcomes and require specialized delivery systems across domains of care.” CMS solicited public comments on chronic conditions meeting the clarified definition and convened the SNP Chronic Condition Panel in the fall of 2008. Approximately two-thirds of Medicare enrollees have multiple chronic conditions requiring coordination of care among primary providers, medical and mental health specialists, inpatient and outpatient facilities, and extensive ancillary services related to diagnostic testing and therapeutic management. A link to the RFI can be found at the bottom of this webpage in the Downloads section.Ĭ-SNPs are SNPs that restrict enrollment to special needs individuals with specific severe or disabling chronic conditions, defined in 42 CFR 422.2. Responses to the RFI will be accepted from Augthrough 11:59 p.m. Comments will be used to inform the panel’s review and update of the current list of qualifying chronic conditions. ***New*** Request for Information (RFI) for Chronic Condition Special Needs Plans (C-SNPs)ĬMS has released a Request for Information (RFI) seeking input from the public on the review and updating of the list of special needs plan (SNP) specific chronic conditions by a panel of clinical advisors to be held during the fall of 2019.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |