Policy alerts, briefs, letters & papers

KFF’s brief, “Key Facts About Medicare Part D Enrollment and Costs in 2023”, analyzes enrollment and costs for the Medicare Part D benefit in 2023 and trends. Medicare Part D provides outpatient prescription drug coverage through a standalone Medicare Part D plan (PDP) to supplement Original or Traditional Medicare, or through a Medicare Advantage Prescription Drug plan (MA-PD) or other Medicare Health Plan with drug coverage. The analysis notes that in 2023 over half of those with Medicare Part D coverage are enrolled in a Medicare Advantage plan with a Part D benefit. Enrollment in the MA-PD plans continues to outpace enrollment in PDPs. MA-PD enrollment grew by 47% between 2019 and 2023 while PDP enrollment fell by 12%.

The Centers for Medicare & Medicaid Services (CMS) recently introduced the Transitional Coverage for Emerging Technologies (TCET) pathway, a voluntary expedited Medicare coverage process for certain FDA-designated Breakthrough Devices. This new pathway aims to support innovation while ensuring faster and more consistent access to emerging medical technologies for Medicare beneficiaries. The TCET pathway offers manufacturers increased pre-market engagement with CMS and a high level of flexibility to address evidence gaps for coverage. This initiative seeks to develop reliable evidence for informed healthcare decision-making and to ensure high-quality care for Medicare beneficiaries.

On July 25, the Centers for Medicare & Medicaid Services (CMS) released the Medicaid and CHIP Mental Health (MH) and Substance Use Disorder (SUD) Action Plan Overview and Guide, outlining the agency's strategies for enhancing treatment and support for enrollees with these conditions. Key areas of focus include enhancing coverage and integration to expand access to prevention and treatment services, promoting engagement in care through increased availability of home and community-based services, and extending coverage to non-traditional services and settings. Additionally, the plan aims to improve the quality of care for individuals with MH conditions and SUDs.

This new issue brief, co-authored by Justice in Aging and the National Women’s Law Center, analyzes employment, income, and health data of older women of color and calls attention to targeted policy solutions to support them. There is a specific focus on how the COVID-19 pandemic disproportionately impacted the experience of older women of color and the data that reflects that. This brief emphasizes the need for immediate policy solutions that preserve the economic dignity and health support systems of older women of color.

On July 12, the Kaiser Family Foundation (KFF) released an issue brief describing high-cost drugs which accounted for a disproportionate share of Medicare spending. As required under the Inflation Reduction Act, the federal government will announce 10 Medicare Part D prescription drugs by September 1, 2023, selected for price negotiations in 2026. To provide an understanding of the potential impact of negotiating prices, KFF’s analysis found that Medicare Part D spending was concentrated among a small number of prescription drugs, and ten top-selling Medicare-covered prescription drugs in 2021 accounted for 22 percent or nearly one-fourth of gross Part D spending....

On July 13th, HHS released a letter directed to COVID-19 manufacturers regarding the transition of vaccines to more traditional pathways and the upcoming 2023-2024 COVID-19 vaccination campaign. The letter states that HHS expects vaccines will remain available following the transition in current locations, such as pharmacies and clinics, and priced at reasonable rates. HHS expects vaccine manufacturers that plan to offer the updated COVID-19 vaccines prepare a sufficient supply of doses for the upcoming vaccination campaign...

Read the latest publication from the Partnership to Align Social Care, USAging’s Aging and Disability Business Institute, and the Camden Coalition to learn more about the benefits of partnerships between CBOs and health plans. This new resource highlights the top five reasons why health plans should partner with CBOs and provides case examples from real-life partnerships.

The Centers for Medicare & Medicaid Services (CMS) recently announced the launch of the School-Based Services (SBS) Technical Assistance Center (TAC). The goal of the TAC is to assist State Medicaid agencies and local education agencies (LEAs) in expanding their capacity for providing Medicaid SBS. The TAC works with these agencies to expand school-based health services to ensure that children have the health services and support necessary to build resilience and thrive. Recent CMS and CDC reports show that poor mental health and suicidal thoughts have increased since the COVID-19 pandemic, while primary and preventative health services have decreased. The TAC’s new guide gives comprehensive suggestions on how to improve...

Representatives Debbie Dingell (D-MI) and Jen Kiggans (R-VA), together with Senators Michael Bennet (D-CO) and Shelley Moore Capito (R-W. Va.), have announced the relaunch of the bipartisan, bicameral Assisting Caregivers Today (ACT) Caucus. The caucus aims to address the challenges faced by family caregivers and advocate for supportive policies. With nearly 20 million adults requiring assistance and 53 million caregivers in the United States, the ACT Caucus seeks to raise awareness and find solutions to provide much-needed support for caregivers and their loved ones.

On June 7, Justice in Aging published an issue brief titled “An Equity Framework for Evaluating and Improving Medicaid Home and Community Based Services.” In recent decades, long-term care has shifted from institutional settings to home and community-integrated settings. While access to HCBS has been steadily increasing over time, systemic inequalities due to racism, sexism, ageism, classism, etc. have led to large disparities in HCBS for diverse communities. This issue brief evaluates several ways in which the current setup of HCBS can cause inequities to arise. This includes program design, provider availability, awareness of HCBS, implicit bias in services, and provision of HCBS...