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📢 URGENT: Protect Medicaid for Millions of People with Medicare

Julie Carter

Senior Federal Policy Associate

Administrative Proposal to Lower Medicare Drug Prices Shows Promise but Risks Remain

In November, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced new proposals that could potentially lower prices for some of the drugs covered by Medicare Part B but could threaten access to medications for people with Medicare. CMS invited comment on their proposals and, last month, Medicare Rights responded.

Health care affordability is a top issue on our national helpline each year, and the high cost of prescription drug coverage is one major component of this. Most of the medications people with Medicare take are covered under Part D. Part B only accounts for a small percentage of Medicare-covered drugs, but they are some of the most expensive. It is clear that Part B medications can drive significant out-of-pocket costs for people with Medicare with life-altering conditions like cancer, end-stage renal disease, or rheumatoid arthritis.

Leveling the Medigap Playing Field

At the Medicare Rights Center, we encourage states to provide equal protections for people with Medicare, regardless of age. Last week, we joined the American Kidney Fund to explain the importance of Medigap access for people under 65 to the National Conference of State Legislatures.

Most people with Medicare have two major options when choosing how to receive their Medicare coverage: Original Medicare or Medicare Advantage. While this decision is complicated, those who choose Original Medicare may have another decision to make as well—whether to add Medigap coverage.

Medicare Advantage Directories Remain Full of Errors Due to CMS Inaction

It is important that Medicare Advantage organizations (MAOs) supply complete, accurate, and easily accessed provider directories to ensure those who enroll in Medicare Advantage (MA) plans know which providers are in a given plan’s network. Unfortunately, as we have highlighted before, MAO provider directories are not complete and accurate. Instead, for the third year running, the Centers for Medicare & Medicaid Services (CMS), the agency that runs the Medicare program, has revealed directory audit results showing widespread errors and inaccuracies.

Help Us Help Congress Protect and Strengthen Medicare

As we recently discussed, there are two big ways Congress can help protect and strengthen Medicare in the current lame duck session—by passing the BENES Act and protecting important Part D reforms. But we need your help! Follow the steps below to ask your lawmakers to prioritize people with Medicare.

Call your Members of Congress by dialing the Capitol Switchboard at 202-224-3121. Ask to be connected with your Representative and Senators.

Advocacy Success: Improvements to Proposed Physician Payment Rules

Earlier this year, the Centers for Medicare & Medicaid Advocacy (CMS)—the federal agency that oversees the Medicare program—proposed changing the way Medicare pays physicians, in part by creating a flat fee per office visit. As Medicare Rights and other commenters noted, doing so could have devastating consequences for people with Medicare.

Guidance for Advocates to Help People Move from Expansion Medicaid to Medicare

Last week, the Medicare Rights Center and the National Council on Aging (NCOA) released a new resource on the expansion Medicaid-to-Medicare transition process. Our Expansion Medicaid Transitions Guide is designed, in part, to help advocates learn about their state’s transition process and better assist clients when they need to switch from expansion Medicaid to Medicare. The guide includes terminology, an overview of select state processes, and some troubleshooting steps advocates can consider when encountering problems.

Trump Administration Drug-Pricing Proposal Includes Big Changes to Medicare Part B

Last week, the Department of Health & Human Services (HHS), the department of the federal government that oversees the Medicare program, previewed some changes it will be proposing for Medicare Part B prescription drug coverage. The administration claims these changes will lower the cost of Part B medications.

Most prescription drugs are covered under Medicare Part D, but a select number of drugs–usually ones that are administered by providers–are covered under Part B. These drugs tend to be very expensive and are generally used to treat serious conditions such as cancer, End-Stage Renal Disease, autoimmune disorders, or in the event of an organ transplant.

Pre-Existing Conditions: Here’s What You Need to Know

Pre-existing conditions have been prominent in the news lately and much of the discussion includes some misunderstandings about what it actually means to protect coverage of pre-existing conditions and why it matters. While Medicare and Medicaid cover pre-existing conditions and that coverage is not under threat, there are changes in laws and regulations, and even a pending court case, that do put coverage at-risk for millions of people in the United States who are covered by employer or individual insurance. Polling consistently finds that Americans want protections for pre-existing conditions, with 75% of the public saying it’s “very important” such protections remain law. But there is a lot of confusion about what this means.

In this Halloween Season, Zombie Threats to Health Care Put Us at Risk

Certain threats to health care seem to arise from the dead regularly, and this Halloween season features an assortment of such zombie threats to Medicare, Medicaid, and the Affordable Care Act (ACA). As 2018 winds down, we must remain vigilant about attempts to cut or eliminate these vital programs that help older adults, people with disabilities, and their families and caregivers.

New Medicare Advantage and Part D Plan Landscape Reveals Challenges Ahead

In late September, the Centers for Medicare & Medicaid Services (CMS)—the federal agency that oversees the Medicare program—released an overview of the upcoming year in Medicare Advantage (MA) and the Part D prescription drug program. Among the notable inclusions, CMS expects more people to join MA plans than ever before, shows a sharp increase in the number of plans available, and reveals the number of plans that will offer expanded supplemental benefits.