Medicare Watch

Your Weekly Medicare Consumer Advocacy Update

Medicare Rights Comments on Chronic Care Working Group Proposals

January 28, 2016

Medicare Rights Submits Comments in Response to Senate Finance Committee Chronic Care Working Group Proposals

This week, the Medicare Rights Center submitted comments to the bipartisan Senate Finance Committee Chronic Care Working Group. The working group, co-chaired by Senator Johnny Isakson (R-GA) and Senator Mark Warner (D-VA), intends to draft legislation to address the chronic care needs of older adults and people with disabilities through Medicare innovations and expansions. To further this process, the working group released a Policy Options document outlining over 20 proposals under consideration.

Examples of the proposals include: allowing people with End Stage Renal Disease (ESRD) to enroll in Medicare Advantage (MA) plans, permitting MA plans to tailor coverage for people with chronic conditions and to expand on supplemental benefits, waiving Part B cost sharing for newly available chronic care management services, creating systems to support beneficiaries in voluntarily aligning with Accountable Care Organizations (ACOs), and more.

Medicare Rights’ comments strongly supported the aims and several of the proposals outlined in the Policy Options document. Medicare Rights also urged the Senate Finance Committee to incorporate lessons learned from ongoing demonstrations and to adequately test and evaluate any new or revised care models. In addition, the comments provided input directly from Medicare Rights national helpline about common challenges people with Medicare face related to plan selection and appeals processes.

Read the full Policy Options Document.

Read Medicare Right’s Comments.

CMS Releases Evaluations of Medicare-Medicaid Alignment Demonstrations

The Centers for Medicare & Medicaid Services recently released two reports evaluating state-based demonstration programs to test managed care models for people dually eligible for Medicare and Medicaid. The demonstrations were created to deliver person-centered care that includes a full range of medical, behavioral health, and long-term services and supports for this population.

The first report released by CMS  examines early implementation activities, including the status of “… integrated delivery systems, enrollment, care coordination models, beneficiary safeguards, and stakeholder engagement.” The second report highlights key measurements used to evaluate the impact of the demonstrations on beneficiary experience as well as the quality, utilization, and cost of health care over time.

Medicare Rights leads and coordinates the Coalition to Protect the Rights of New York’s Dually Eligible (CPRNYDE). The coalition works closely with New York officials to improve the quality of care for people in New York who have Medicare and Medicaid by actively tracking these demonstrations and advocating on behalf of this population.

Read the reports:

Report on Early Implementation of Demonstrations under the Financial Alignment Initiative

Measurement, Monitoring, and Evaluation of the Financial Alignment Initiative for Medicare-Medicaid Enrollees

Volume 7, Issue 4

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Medicare Reminder

People with Medicare should not be confused by the approaching January 31 deadline to buy coverage through the Marketplace.

For people already enrolled in Medicare, no action needs to be taken before the open enrollment period for Marketplace coverage ends.

People with Marketplace coverage need to be aware of when they will become eligible for Medicare so they can cancel their Marketplace coverage and enroll in Medicare. Failure to enroll in Medicare could result in higher health care costs, gaps in health coverage, disrupted access to needed care, and tax penalties.

To help people nearing Medicare eligibility understand how and when to transition from Marketplace coverage to Medicare, the Medicare Rights Center has information on its website, Medicare Interactive.

Visit Medicare Interactive to find out more about Medicare and the Marketplace, and enrolling in Medicare when you have other types of insurance.

 

Spotlight

The National Council on Aging (NCOA) recently released a fact sheet developed by the Medicare Rights Center explaining what people who are enrolled in expansion Medicaid need to know when they become eligible for Medicare. The fact sheet provides answers to important questions about transitioning to Medicare so that individuals in this population can avoid unnecessary gaps in coverage or increases in their health care costs.

Visit NCOA to read the fact sheet.

 

Stay up-to-date on Medicare policy and advocacy developments, and learn about changes in Medicare benefits and rules with this weekly newsletter.

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Health Care Professionals:

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Get answers to your Medicare questions from Medicare Interactive at www.medicareinteractive.org.

© 2016 by Medicare Rights Center. All rights reserved.

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