This week, the Centers for Medicare and Medicaid Services released a much-anticipated proposed rule implementing important changes implemented by the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, key provisions of which were included in the Consolidated Appropriations Act, 2021 (CAA), which was signed into law on December 27, 2020. […]
Today, the Department of Health and Human Services Office of Inspector General (OIG) released a report showing that Medicare Advantage (MA) plan use of prior authorization sometimes delayed or denied beneficiary coverage or provider payment for Medicare-covered services. Such delays or denials can cause negative health outcomes, increase costs and […]
Medicare provides vital health coverage, but the program’s high premiums, deductibles, and other cost-sharing requirements can put care out of reach, particularly for people with limited incomes. Some who need help paying for coverage and prescription drugs may qualify for Medicare’s low-income assistance programs. This includes the Medicare Savings Programs […]
This week, the Centers for Medicare & Medicaid Services (CMS) outlined an action plan to drive health equity. CMS’s vision focuses on changing both the agency itself and encouraging health leaders to make their own commitments to advance health equity. CMS defines health equity as “the attainment of the highest […]
Last week, New York Governor Kathy Hochul and the State Legislature passed a budget that will improve health coverage and care for older adults and people with disabilities in the state. The New York fiscal year 2022-2023 budget expands eligibility for Medicaid and the Medicare Savings Program (MSP), two urgently […]
A recently released report from the Urban Institute shows that a firm limit on out-of-pocket (OOP) Part D costs, like the $2,000 cap included in the Build Back Better budget reconciliation bill, would have created significant savings for Medicare beneficiaries had it been in place in 2019. Using claims data, […]
Last week, the Biden-Harris Administration submitted its annual budget request to Congress. While presidential budget requests are not binding on Congress and do not directly lead to any program or funding changes, they are important policy documents that articulate an administration’s goals and values. This year’s budget includes significant highlights […]
On Monday, the Centers for Medicare and Medicaid Services (CMS) announced that for the duration of the COVID-19 public health emergency period, Medicare will cover up to eight over-the-counter (OTC) COVID-19 tests per enrollee, per month, at no cost. People with Part B, whether in Original Medicare or a Medicare […]
