In its annual report to Congress, the Board of Trustees for Medicare said the program’s hospital insurance trust fund (Part A) could lack funds to pay full benefits by 2026—three years earlier than projected in last year’s report. Despite this finding, the Medicare program itself remains strong and sustainable. The trustees report identifies several factors that impact the balance of program funds.

The Kaiser Family Foundation released a new report looking at the history of the concept of Medicare drug price negotiation, including the dramatically different role that the federal government has in securing good prices for Medicare beneficiaries, compared to its active involvement in establishing drug prices for other government health programs, including Medicaid and the Department of Veterans Affairs (VA). The report outlines various bills that have been introduced in Congress since the enactment of the Part D benefit, and discusses how enthusiasm for making this change tracks closely with the rate of increase in Part D drug costs.

The recently-passed Bipartisan Budget Act of 2018 (BBA of 2018) makes a number of changes to Medicare, including permanently authorizing Dual Special Needs plans (D-SNPs), which are Medicare Advantage (MA) plans for people who are dually eligible for Medicare and Medicaid.

To help inform implementation of these changes, earlier this month the Centers for Medicare & Medicaid Services (CMS) issued a request for stakeholder input on (1) The design of an integrated Medicare-Medicaid appeals approach for D-SNPs; and (2) The establishment of minimum state contract requirements for D-SNPs.

This week, the Centers for Medicare & Medicaid Services (CMS) released the final Medicare Advantage and Part D 2019 Rate Announcement and Call Letter. This is the finalized annual update to Medicare Advantage and Part D programs, which includes payment updates and policy changes for payment in calendar year (CY) 2019.

The Commonwealth Fund recently released a report analyzing different proposals by states to impose a work requirement for Medicaid benefits and how those proposals would impact older adults and people with disabilities. To date, 12 states have proposed conducting demonstrations that add work requirements to Medicaid, and the Centers for Medicare & Medicaid Services (CMS) has so far approved proposals from Kentucky, Indiana, and Arkansas. Among other policy changes, these demonstrations would tie Medicaid benefits to a minimum work requirement.

This week, the Medicare Rights Center submitted comments in response to the Advance Notice of Methodological Changes for Calendar Year 2019 for the Medicare Advantage CMS-HCC Risk Adjustment Model and Call Letter (Call Letter). The Call Letter outlines CMS’s payment and policy strategies for upcoming plan years. As in years past, Medicare Rights provided comprehensive comments and feedback, highlighting the concerns and issues beneficiaries tell us about on the helpline every day.

Late last week, Congress passed and the President signed a sweeping spending bill that will fund the government through March 23 and raise the spending caps imposed by the Budget Control Act of 2011 for two years, paving the way for a longer-term spending agreement. The legislation – the Bipartisan Budget Act of 2018 (BBA of 2018) – also contains a number of health care provisions important to people with Medicare and their families, including changes to Medicare Part D prescription drug coverage that will close the donut hole in 2019.

Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories. These essential documents, which beneficiaries depend on to make informed plan selection and provider choices, have long been a source of frustration and confusion for Medicare beneficiaries and advocates.

This week, Medicare Rights Center submitted comments in response to the Centers for Medicare & Medicaid Services (CMS) proposed rule for Medicare Parts C & D. The proposed rule contemplates many broad changes to the Medicare Advantage and prescription drug coverage programs, largely focusing on providing more flexibility and options for plan sponsors. CMS’s stated aim is to allow plans to use the proposed flexibility to better serve beneficiaries—by creating disease- or condition-specific sets of benefits, offering more plans, and altering cost sharing arrangements.

This week, the White House’s Office of Management and Budget (OMB) approved a Centers for Medicare and Medicaid Services (CMS) request to increase the frequency of review for Medicare Advantage (MA) plan networks.