This week, HCAOA joined 70 other consumer groups, provider associations, health systems, community-based nonprofits, and other health leaders urging CMS to ensure continued support for Medicare Advantage beneficiaries.
Better Medicare Alliance (BMA) has released a new, searchable 2022 Medicare Advantage enrollment map, featuring MA enrollment data by state, Congressional district, and county. The map is populated with April 2022 state and county enrollment data from CMS. The map shows that MA is now the dominant form of Medicare in more than 120 Congressional districts nationwide.
In Performance Year 7 of the Independence at Home (IAH) Demonstration (2020), CMS found that the expenditures for IAH practices’ applicable beneficiaries were approximately 18%, or equating to $42.3 million below their spending targets, an average reduction of $6,585 per beneficiary. All 10 IAH participants (nine practices and one consortium) reduced the per-beneficiary-per-month (PBPM) expenditures relative to the practice’s PBPM spending target. A total of 6,436 beneficiaries were enrolled in the demonstration at 10 participating practices.
The nation’s leading research and advocacy organization supporting Medicare Advantage, Better Medicare Alliance (BMA), released a statement on the annual Medicare Trustees Report from the U.S. Department of the Treasury, Departments of Health and Human Services and Labor, CMS, and the Social Security Administration.
The report shows an improved fiscal outlook compared to last year and predicts that funds will last two years longer than expected. BMA President and CEO Mary Beth Donahue said in the statement she hopes the news will encourage policymakers to continue making advancements in MA to protect the nation’s seniors and individuals with disabilities.
ATI Advisory and LTQA Releases Policy Recommendations to Advance New Supplemental Benefits in Medicare Advantage
The Long-Term Quality Alliance and ATI Advisory released a policy report last week highlighting three top recommendations for Congress to advance non-medical benefits in Medicare Advantage (MA).
The report notes that the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act made strides in advancing holistic care to improve the quality of life for Americans with complex medical needs. In addition, the Special Supplemental Benefits for the Chronically Ill (SSBCI) gave MA the flexibility to address the diverse needs of these individuals, but according to the report, they believe three policy recommendations would advance these supplemental benefits to improve upon the framework already in place.
A recent update from the CDC recommends that certain immunocompromised individuals and people over 50 years who received an initial booster dose at least four months ago are eligible for another booster to increase their protection against COVID-19. People with Medicare can get a second Pfizer-BioNTech or Moderna COVID-19 vaccine at no cost with no applicable copayment, coinsurance or deductible. CMS is covering the cost for qualified individuals in an effort to ensure maximum access to COVID-19 vaccinations. Medicaid beneficiaries can also get COVID-19 vaccines, including first boosters, at no cost.
The CDC also recommends that adults who received a primary vaccine and booster dose of Johnson & Johnson’s Janssen COVID-19 vaccine at least four months ago can receive a second booster dose of a Pfizer-BioNTech or Moderna COVID-19 vaccine.
More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available at https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html and through the CMS COVID-19 Provider Toolkit.
Visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.
The Biden-Harris Administration announced that Americans with Medicare Part B, including Medicare Advantage, can access up to eight free over the counter COVID-19 tests each month.
Members: this is an opportunity to assist your clients who are on Medicare to access at-home kits to reduce the spread of COVID-19.
Medicare is not requiring participating eligible pharmacies and health care providers go through any new Medicare enrollment processes.
National pharmacy chains participating in this initiative include Albertsons Companies, Inc., Costco Pharmacy, CVS, Food Lion, Giant Food, The Giant Company, Hannaford Pharmacies, H-E-B Pharmacy, Hy-Vee Pharmacy, Kroger Family of Pharmacies, Rite Aid Corp., Shop & Stop, Walgreens, and Walmart.
Additional eligible pharmacies and health care providers may also participate, so people with Medicare should check with their pharmacy or health care provider to find out whether they are participating.
This initiative adds to existing options for people with Medicare to access COVID-19 testing, including:
More information can be found on this fact sheet.
People with Medicare can get additional information by contacting 1-800-MEDICARE or visiting https://www.medicare.gov/medicare-coronavirus.
Medicare also maintains several resources to help ensure beneficiaries receive the correct benefits while also avoiding the potential for fraud or scams here.
The Hospital Inpatient Modernization Act (S3792/HR7053) was introduced earlier this month to extend the CMS waiver that was initiated during the pandemic to provide acute care to patients in their homes.
Last week, HCAOA released “State of Home Care: Industry at a Crossroads” during a special livestream event featuring members and caregivers. This new report spotlights data and industry challenges, calls on home care industry leaders and policymakers to unite around six policy priorities that address the rapidly growing demand for care and to help Americans age in their own homes with comfort, safety and independence.
Late last week, the 6th U.S. Circuit Court of Appeals lifted the stay on the OSHA rule requiring covered employers to ensure workers have received the COVID vaccine or undergo weekly COVID-19 testing. Employers with at least 100 employees will need to determine the COVID-19 vaccination status of their employees and develop a written vaccine-or-testing policy under the OSHA rule.
To give employers time to comply, OSHA will not enforce any requirements under its Emergency Temporary Standard (ETS) until Jan. 10. Additionally, the agency "will not issue citations for noncompliance with the standard's testing requirements before Feb. 9, so long as an employer is exercising reasonable, good-faith efforts to come into compliance with the standard," according to an OSHA update.
The U.S. Supreme Court could decide to block this directive again.
Also last week, the 5th U.S. Circuit Court of Appeals reversed a nationwide injunction put into place on Nov. 30, ruling that the injunction halting enforcement of the CMS vaccine mandate nationwide should apply only to the 14 states involved in that lawsuit. Eleven other states had previously challenged the CMS Rule in separate actions.
The end result is that the CMS vaccine mandate remains in place in the 14 states who were parties to the original litigation: Louisiana, Montana, Arizona, Alabama, Georgia, Idaho, Indiana, Mississippi, Oklahoma, South Carolina, Utah, West Virginia, Kentucky, and Ohio. The CMS vaccine mandate is also enjoined for the time being in the 10 states litigating in the District of Missouri: Alaska, Arkansas, Iowa, Kansas, Missouri, Nebraska, New Hampshire, North Dakota, South Dakota, and Wyoming.
HCAOA will provide up-to-the-minute updates as they become available. Click here for an updated memo from Polsinelli with the latest information about the mandates.
Overall, the number of Medicare Advantage plans offering at least one of five recently expanded supplemental benefits – including home care – jumped 43% (575 to 824) from 2021 to 2022, while the number of plans offering more than one benefit increased 15% (175 to 202). A new brief released last week by Better Medicare Alliance (BMA) and prepared by the actuarial consulting firm Milliman highlights the continued expansion of supplemental benefits in Medicare Advantage for Contract Year 2022.
At the same time OSHA released its ETS on vaccine mandates last week, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule requiring vaccines for all health care workers participating in Medicare and Medicaid programs. The rule comes just weeks after CMS’ new rule requiring vaccinations for nursing home employees, and extends similar requirements to a wide array of healthcare industry employees.
The deadline to comply is January 4, 2022 – the same as the compliance requirement for the OSHA ETS.
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