Fact Sheets

On June 22nd, The Centers for Medicare and Medicaid Services (CMS) released details describing how Medicare beneficiaries can obtain Medicare-covered drugs that may slow the progression of Alzheimer’s disease. Medicare will cover drugs with traditional FDA approval when a physician and clinical team participates in the collection of evidence about how these drugs work, also known as a registry. To get Medicare coverage people will need to 1) be enrolled in Medicare, 2) be diagnosed with mild cognitive impairment or mild Alzheimer’s disease dementia, and 3) have a physician participating in a registry with an appropriate clinical team and follow-up care...

On June 26th, CMS issued a proposed rule that proposes to update payment rates and policies and includes requests for information under the end-stage renal disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2024. For calendar year 2024, CMS is proposing to increase the ESRD PPS base rate to $269.99, increasing total payments to ESRD facilities by approximately 1.6 percent totaling $6.4 billion. The CY 2024 ESRD PPS proposed rule also includes several proposals and requests for information related to ESRD PPS payment policies. This rule also proposes an update to the Acute Kidney Injury dialysis payment rate for renal dialysis services furnished by ESRD...

The Aging and Disability Business Institute, in collaboration with the Partnership to Align Social Care and the Camden Coalition, has released a new resource guide that emphasizes the importance of addressing health-related social needs (HRSN) and details the benefits of partnering with community-based organizations (CBOs) and community care networks for health plans. This comprehensive guide outlines how CBOs serve as powerful innovation partners, foster trust with members, offer a significant return on investment, provide greater efficiency in coverage through community care networks, and contribute to securing public contracts. This resource serves as a practical tool for health plans looking to establish meaningful collaborations with..

The Administration for Community Living (ACL) and Centers for Medicare & Medicaid Services (CMS) announced actions to improve enrollment in the Extra Help with Medicare Prescription Drug Plan Costs program, also known as the Low-Income Subsidy. The Extra Help program provides eligible older adults and individuals with disabilities with help paying for their Medicare Part D prescription drug premiums and cost-sharing. Up to three million older adults and individuals with disabilities are eligible for the Extra Help program but are not enrolled. Actions to increase uptake of the program include targeted efforts to reach those eligible for the program, including individuals living in rural and underserved communities...

AARP has released a fact sheet that explores the topic of medication management for older adults, highlighting the challenges they face and the available programs and interventions. This resource emphasizes the importance of effective medication management in preventing adverse events and improving health outcomes for older adults. The fact sheet explores formal medication management programs, such as Medication Therapy Management (MTM) in Medicare and Medicaid, while emphasizing the essential skills required for older adults to effectively manage their medication.

CMS created consumer fact sheets that provide information on Medicare, Medicaid, and private insurance coverage of COVID-19 tests following the end of the PHE on May 11, 2023. The fact sheets are available in both English and Spanish. Centers for Medicare & Medicaid Services (CMS)

Justice in Aging has published a fact sheet aimed at aging and disability advocates, providing an overview of the US Department of Housing and Urban Development's (HUD) proposed rule on the Fair Housing Act's (FHA's) Affirmatively Furthering Fair Housing (AFFH) mandate. The fact sheet summarizes the proposed rule's key features, which include setting out obligations for HUD grantees to identify and address fair housing issues in their communities. Advocates can provide input on the proposed rule until April 24, 2023.

HHS recently announced the ‘HHS Bridge Access Program For COVID-19 Vaccines and Treatments Program’ creating a $1.1 billion public-private partnership to help maintain uninsured individuals’ access to COVID-19 care at their local pharmacies, through existing public health infrastructure, and at their local health centers. Centers for Disease Control and Prevention (CDC) will purchase and distribute COVID-19 vaccines to 64 state and local health department immunization awardees, and the awardees will distribute vaccines to local health departments and health centers supported by the federal Health Resources and Services Administration (HRSA). Second, create is creating a novel, funded partnership with pharmacy chains.

On Friday, April 28th, CMS released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of January 2023, over 65.5 million people are enrolled in Medicare; more than 33.9 million are enrolled in fee-for-service Medicare and nearly 31.6 have a Medicare Advantage plan. Over 93 million enrollees have Medicaid and CHIP; more than 85.9 million individuals have Medicaid and nearly 7.1 million have coverage through CHIP. Over 12 million individuals are dually eligible for Medicare and Medicaid and are counted in the enrollment figures for both programs.

CMS issued the fiscal year (FY) 2024 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system Reporting (IQR) program and are meaningful electronic health record (EHR) users is projected to be 2.8% for FY 2024. Hospitals may be subject to payment adjustments under the IPPS. The proposed increase in operating and capital IPPS payment rates will generally increase hospital payments in FY 2024 by $3.3 billion.