On April 4, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that revises the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program (Medicare Part D), Medicare Cost Plan Program, Programs of All-Inclusive Care for the Elderly (PACE), and Health Information Technology Standards and Implementation Specifications. The final rule includes provisions addressing integrated care, including replacing Medicare’s current quarterly special enrollment period (SEP) with a one-time-per-month SEP for dually eligible individuals and those enrolled in the Part D low-income subsidy program to elect a standalone PDP; creating a new monthly Medicare integrated care SEP to facilitate aligned enrollment for full-benefit dually eligible individuals; limiting the number of dual eligible special needs plans; and, redefining broker and agent compensation, among others. The regulations take effect Monday, June 3, 2024.
For more information, see CMS' fact sheet and the final rule.