Revised Rhode Island Medicare-Medicaid Reporting Requirements Update 2025
Relevant to: State Medicare-Medicaid Plan Handbooks
Each week, we scan the latest CMS memos to find the most important ones that apply for PACE programs. Below is a summary of what you need to know.
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Click here to read the complete memo from CMS.
Introduction
The Centers for Medicare & Medicaid Services (CMS) issued a memorandum on June 10, 2025, regarding the revised Medicare-Medicaid Capitated Financial Alignment Model Reporting Requirements specific to Rhode Island. The updated guidelines include technical specifications for state-specific measures, impacting how the Rhode Island Medicare-Medicaid Plan collects and reports data. This memo details changes from prior versions and provides instructions on which versions to use based on reporting deadlines.
Key Dates and Deadlines
- Original Release: February 29, 2024
- Amendment Date: February 28, 2025
- Effective Date for Updates: June 2, 2025
- Memo Release Date: June 10, 2025
PACE Compliance
This memo is relevant to PACE programs because it outlines specific reporting requirements that align with the Medicare-Medicaid Capitated Financial Alignment Model in Rhode Island. Participation in this program necessitates compliance with the updated technical specifications and measures contained herein to ensure cohesion in data reporting and quality measurement.
These requirements include:
- New refined criteria for specific measures that must align with the updated discharge status code, such as including “12 Home under care of organized home health service organization.” Plans are required to account for these changes in their reporting metrics.
- The incorporation of updates from the measure steward, CMS/Minimum Data Set (MDS), must be strictly adhered to so that all collected data remains compliant and comprehensive under the state-specific measures.
It is crucial for all PACE-related submissions to be accurate and meet the detailed specifications to avoid any issues with compliance or data integrity. Compliant submissions help ensure continuity and accuracy across program evaluations and outcomes.
Required Actions
1. Review the revised Medicare-Medicaid Capitated Financial Alignment Model Reporting Requirements: Rhode Island-Specific Reporting Requirements to familiarize yourself with the updated technical specifications.
2. Utilize the updated 2024 and 2025 versions for measures due before and on or after June 2, 2025, respectively.
3. Direct any questions or concerns to the Medicare-Medicaid Coordination Office at mmcocapsreporting@cms.hhs.gov.
FAQs
- “What are the revised reporting requirements for the Rhode Island Medicare-Medicaid Plan?”
- “How have the Rhode Island-specific measures changed in the 2024 and 2025 versions?”
- “What is the significance of Measure RI4.5 in the updated requirements?”
- “Where can I find additional information or ask questions about the updated requirements?”
