Medicare Watch

Proposed Rule Increases Access to Preventive Care under Medicare

Starting January 2011, cost will no longer be a barrier to many preventive services for Medicare consumers. On June 25, the Centers for Medicare & Medicaid Services (CMS) released a new proposed rule, implementing health reform, which will eliminate out-of-pocket costs for certain preventive services. Those that are graded A or B by the U.S. Preventive Services Taskforce, such as mammograms and colorectal cancer screenings, will be free to people with Medicare. The proposed rule also establishes free annual wellness visits under Medicare, as included in health reform, so that physicians can assess current and future care needs of their Medicare patients. Currently, only a one-time “Welcome to Medicare Examination” is fully covered.

The proposed rule invests in primary care through incentive payments to primary care practitioners, and improves the accuracy of payments to physicians to better prevent fraud.

CMS is accepting comments from the public until August 24, 2010. A final rule is expected sometime in November 2010.

Read the CMS fact sheet on the new rule and the proposed rule.

Groups Suggest Consumer-Centered Improvements to Medicare Private Health and Drug Plans’ Enrollment Processes

Medicare Rights Center and other organizations that advocate on behalf of people with Medicare, such as the Center for Medicare Advocacy and the National Senior Citizens Law Center, submitted comments today to the Centers for Medicare & Medicaid Services (CMS) on the Medicare Managed Care and Prescription Drug Enrollment guidance. The comments address the need for greater availability of materials and notices in languages other than English for non-English speakers, among other issues. The groups also ask CMS to limit private Medicare plans’ ability to recoup retroactive premiums from low-income individuals if the plan did not provide proper and timely notice about premiums owed.

Read comments on the Managed Care Enrollment Guidance.

Read comments on the Prescription Drug Coverage Enrollment Guidance.

Medicare Reminder

Medicare consumers who have Extra Help, the federal program that helps pay for prescription drugs, receive a premium subsidy for Part D prescription drug coverage. This is why people with Extra Help pay no monthly premium if they are enrolled in a drug plan with a premium that is less than or approximately equal to the subsidy.

Last week, the Centers for Medicare & Medicaid Services (CMS) mailed a notice to the 1.6 million people with Extra Help who chose a drug plan with a premium above the subsidy amount. The notice informs these consumers that there are premium-free plans available. People with Extra Help are allowed to switch plans once per month at any time of the year.

Read the sample notice from CMS.

Read more about the Extra Help program at www.medicareinteractive.org.

Spotlight

The U.S. House of Representatives last Thursday voted to reverse a 21 percent cut to Medicare physician payments that took effect on June 1. The bill, which has now been signed into law by President Obama, delays the scheduled cuts until November 30, 2010.

Read an article from The Hill on the House vote.