Fact Sheets

On June 30th, the Centers for Medicare and Medicaid Services (CMS) released revised guidance detailing the requirements and parameters of the new Medicare Drug Price Negotiation Program for the first round of negotiations, which will occur in 2023 and 2024. The agency received over 7,500 comments on the initial guidance which was released in March 2023. According to CMS, the agency is releasing the revised guidance with changes from the initial guidance to improve transparency and foster an effective negotiation process....

Justice in Aging has published a fact sheet providing guidance for advocates working with older adults who are dually eligible for Medicare and Medicaid. It emphasizes two important features of the Medicare Part D Low-Income Subsidy (LIS): Medicaid termination does not immediately end LIS enrollment, and LIS eligibility is often more generous than Medicaid and Medicare Savings Program (MSP) eligibility rules. The fact sheet offers practice tips to help advocates ensure that older adults understand their LIS enrollment during the Medicaid unwinding period and their options for continuing their LIS coverage...

CMS issued a proposed procedural notice on June 22nd that describes a new Medicare coverage pathway to achieve more timely and predictable access to new medical technologies for people with Medicare. The new Transitional Coverage for Emerging Technologies (TCET) pathway for Breakthrough Devices uses current national coverage determination and coverage with evidence development processes to expedite Medicare coverage of certain Breakthrough Devices. The TCET pathway is intended to balance multiple considerations when making coverage determinations: (1) facilitating early, predictable, and safe beneficiary access to new technologies; (2) reducing manufacturers’ and innovators’ uncertainty about coverage...

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.