CMS Medicare-Medicaid Coordination Office (MMCO) June Announcements

Updates The Centers for Medicare & Medicaid Services (CMS), Medicare-Medicaid Coordination Office (MMCO) is pleased to announce the following update: Training Opportunity: Navigating COVID-19: Supporting Individuals with Dementia and their Caregivers Contract Year 2021 Medicare Advantage and Part D First Final Rule Released Opportunities to Support Enrollment in the Medicare Savings Programs and Extra Help Hospital Inpatient Prospective Payment Systems (IPPS) Proposed Rule Released for Public Comment Training Opportunity: Navigating COVID-19: Supporting Individuals with Dementia and their Caregivers Date/Time: Tuesday, June 23rd, 12:00 - 1:30 pm EDT The current COVID-19 public health emergency presents new and unique challenges for individuals diagnosed with Alzheimer’s disease and related dementia (ADRD) as well as the family and friends providing care for them. Providers and health plans can play a key role in supporting individuals with ADRD and their caregivers as they navigate these challenges. This webinar will provide information on how COVID-19 affects and presents in people with ADRD, strategies for family and friend caregivers for supporting those with ADRD living at home during COVID-19, and opportunities for health care systems to prepare to meet the needs of people with ADRD diagnosed with COVID-19. Register Here Featured Speakers: Freddi Segal-Gidan, PA, PhD; Director, USC-Rancho California Alzheimer’s Disease Center (CADC), Assistant Professor Clinical Neurology and Family Medicine, Keck School of Medicine of USC Joseph Herrera, MSW; Director, Outreach and Education, USC-Rancho CADC Jennifer Schlesinger, MPH, CHES; Director, Professional Training and Healthcare Services, Alzheimer’s Los Angeles Tom von Sternberg, MD; Senior Medical Director of Geriatrics, Home Care, and Hospice and Case Management, HealthPartners Intended Audience: This webinar is intended for a wide range of stakeholders, including frontline workers; caregivers; staff at health plans, including Medicare-Medicaid Plans (MMPs), Dual Eligible Special Needs Plans (D-SNPs), and managed LTSS plans; and other health care and community-based organizations who are interested in strategies for supporting individuals with ADRD and their caregivers during the COVID-19 public health emergency.  Contract Year 2021 Medicare Advantage and Part D First Final Rule Released On May 22, 2020, CMS issued the Contract Year (CY) 2021 Medicare Advantage and Part D Final Rule (CMS-4190-F1) that finalizes a subset of the proposals from the February 18, 2020 proposed rule (85 FR 9002), including new contract limitations related to “D-SNP look-alikes.” CMS plans to address the remaining proposals in a subsequent second final rule. Opportunities to Support Enrollment in the Medicare Savings Programs and Extra Help The Medicare Savings Programs and Extra Help are important programs designed to help low-income individuals afford Medicare coverage. Many people who are eligible for these programs are not yet enrolled. Each May, the Social Security Administration (SSA) sends letters to two million low-income Medicare beneficiaries, informing them about the Medicare Savings Programs and how they can help with Medicare costs. These include the Qualified Medicare Beneficiary (QMB), Specified Low-income Medicare Beneficiary (SLMB), and Qualifying Individual (QI) programs. The letters provide information on what Medicare Savings Programs cover, a brief description of the income and asset criteria, and how to apply. SSA also sends a data file to each state – sent this year on May 8th – identifying the Medicare beneficiaries to whom the outreach letters are being mailed. States can use these data files to conduct targeted outreach to individuals who may qualify, and support customer service representatives at Medicaid hotlines who may receive calls. More information on this outreach effort and the model letters (see specifically SSA-L447 and SSA-L448) is found on the SSA website; the data file name is OLBG.BTI.S**.MEDOUT1.Ryymmdd. See also the data file specifications. Hospital Inpatient Prospective Payment Systems (IPPS) Proposed Rule for Released Public Comment On May 11, 2020, CMS released the FY 2021 Hospital Inpatient Prospective Payment Systems (IPPS) proposed rule for public comment (CMS-1735-P). In this rule, CMS is proposing to retroactively codify in regulation longstanding Medicare bad debt sub-regulatory guidance. One bad debt provision specifically relates to providers serving dually eligible individuals. Consistent with previous guidance, CMS proposes that, in order to claim Medicare bad debt for unpaid cost sharing amounts for Qualified Medicare Beneficiaries (QMBs) and certain other dually eligible individuals, the provider must bill the state and submit the Medicaid remittance advice (RA) to Medicare to evidence the state’s Medicare cost sharing liability. In the rule, CMS notes that it is difficult for providers to comply with this “must bill” policy to claim bad debt when a state does not process the claim for cost sharing and issue a RA. The proposed rule states that we are considering alternatives for providers to comply and still evidence a state’s cost sharing liability (or absence thereof) that could be finalized in the final rule. The rule welcomes suggestions from stakeholders regarding the best alternative documentation to the Medicaid RA that a provider could obtain and submit to Medicare. The IPPS proposed rule is available here, and comments are due 5:00 pm on July 10th. For the provisions specific to dually eligible individuals, please see Section IX.B.2.c. “Reasonable Collection Effort, Dual Eligible Beneficiaries and the Medicaid Remittance Advice.”