Announcement/Press release

CMS recently released a proposed National Coverage Determination (NCD) decision that would, for the first time, expand coverage for power seat elevation equipment on certain power wheelchairs to Medicare individuals. The proposed NCD is open for public comment for 30 days and will end on March 17, 2023. If finalized, power seat elevation equipment would be covered by Medicare for individuals with a Group 3 power wheelchair, which are designed to meet the needs of people with Medicare with severe disabilities, to improve their health as they transfer from the wheelchair to other surfaces.

On Monday, February 13, 2023 The Centers for Medicare & Medicaid Services released a press release on the Biden-Harris administration’s efforts to implement section 6101(a) of the Affordable Care Act. The proposed rule would require additional ownership and management information about nursing homes across the United States be disclosed. The Administrations attempts to implement the rule is part of a continued effort by the administration to improve quality of care at nursing homes.

Yesterday the Centers for Medicare & Medicaid Services (CMS) announced next steps describing how the agency will implement the new Medicare Prescription Drug Inflation Rebate Program, including a timeline of key dates. As part of the Inflation Reduction Act (IRA) of 2022 (P.L. 117-169), the Medicare Prescription Drug Inflation Rebate Program requires drug companies to pay a rebate to Medicare if they raise prices for certain drugs faster than the rate of inflation. Based on a 12 month period starting October 1, 2022, drug companies will be required to pay rebates to Medicare for raising prices that outpace inflation on certain Part D drugs.

This past Wednesday, February 1st, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2024 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies.

On Monday, January 31st, CMS issued a final rule for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. The MA RADV program is used to identify improper risk adjustment payments made to Medicare Advantage Organizations (MAOs) for claims made to Medicare without supporting evidence from a beneficiary’s medical record. Payments to MAOs are adjusted based on the health status of a MAO’s enrollees using medical diagnoses reported by the insurer. The new policy will apply to plan contracts since 2018.

KFF released a brief “What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access” (January 31, 2023) that the describes the major health-related COVID-19 emergency declarations made by the federal government since January 2020, and the flexibilities resulting from the declarations. The areas covered in the brief include coverage, costs, and payment for COVID-19 testing, treatments, and vaccines; Medicaid coverage and federal match rates; and telehealth, among other provisions. According to KFF, the list does not include all federal policy and regulatory provisions made in response to COVID-19 emergency declarations.

The KFF recently published two analyses on demographics and program enrollment and spending of Medicare and Medicaid dually eligible beneficiaries or dual eligibles. The article, “A Profile of Medicare-Medicaid Enrollees”, analyzes the demographic, socioeconomic, and health characteristics of dual eligibles using data from the 2020 Medicare Current Beneficiary Survey. The second article, “Enrollment and Spending Patterns Among Medicare-Medicaid Enrollees (Dual Eligibles)”, examines national and state-level data on enrollment and spending for Medicare-Medicaid enrollees. The authors used data from the 2019 and 2020 Medicare Beneficiary Summary Files and the 2019 Transformed Medicaid Statistical Information System for this analysis.

The National Conference of State Legislatures recently released an article exploring different steps that states are taking to address the rapidly aging population and how to keep that population in their homes longer. The article looks at approaches from across the country exploring food security, financial support, transportation, housing, the direct care workforce, social isolation prevention, and more.

The Federal Communications Commission released guidance earlier this week permitting states and managed care plans to make calls, or robocalls, and send text messages under certain circumstances without violating federal law. The FCC’s ruling comes in response to a letter from the Secretary of the U.S. Department of Health and Human Services requesting an exception to the federal Telephone Consumer Protection Law as states reach out to enrollees to raise awareness of forthcoming Medicaid eligibility redeterminations. The federal guidance clarifies how states working with local government agencies and managed care companies may, under certain circumstances, make robo calls or send autodialed text messages

There are several changes that may affect SNAP household’s benefit amounts over the coming months. The temporary boost to SNAP benefits put in place during the COVID-19 pandemic, known as emergency allotments, will end nationwide after the February 2023 issuance. In addition, households that receive SNAP and Social Security benefits will see a decrease in their SNAP benefits because of the significant cost of living increase to Social Security benefits that took effect on Jan. 1, 2023.