CMS Medicare-Medicaid Coordination Office (MMCO) May Announcements

Updates The Centers for Medicare & Medicaid Services (CMS), Medicare-Medicaid Coordination Office (MMCO) is pleased to share: CMS FY2022 IPPS/LTCH PPS proposed rule (CMS-1752-P); Medicaid Provider Enrollment and Medicare Cost-sharing for Dually Eligible Beneficiaries Webinar: Diabetes Care Assessment, Planning, and Management during COVID-19 Webinar: Supporting the Preventive Health Care Needs of Dually Eligible Women with Disability Announcing CMS FY2022 IPPS/LTCH PPS proposed rule (CMS-1752-P) Medicaid Provider Enrollment and Medicare Cost-sharing for Dually Eligible Beneficiaries On April 27, 2021, CMS issued the FY2022 IPPS/LTCH PPS proposed rule (CMS-1752-P), including a proposal that aims to improve state processing of Medicare cost sharing claims for services provided to dually eligible individuals. The proposal would require state Medicaid agencies to allow enrollment of Medicare-enrolled providers and suppliers for purposes of processing claims for Medicare cost sharing on services for dually eligible individuals. If finalized, this proposal would improve compliance with current statute and reduce burden for providers related to crossover claims submission and the claiming of Medicare bad debt. Additionally, we are requesting information from stakeholders on instances where states determine their cost-sharing liability for a Medicare service by applying the Medicaid payment and coverage rules for the service as if the service (rather than the cost-sharing) were being paid by Medicaid. The NPRM is available at https://www.federalregister.gov/public-inspection/2021-08888/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the. For the provision specific to dually eligible individuals, please see Section X (“Medicaid Enrollment of Medicare Providers and Suppliers for Purposes of Processing Claims for Cost-Sharing for Services Furnished to Dually Eligible Beneficiaries”) and proposed changes to regulatory text in 42 CFR 455.10. The comment period closes on June 28, 2021. Webinar: Diabetes Care Assessment, Planning, and Management during COVID-19 Date/Time: Wednesday, May 5, 2021 – 12:00-1:30 pm ET Register here. The physical distancing protocols associated with the COVID-19 pandemic have made it difficult for health plans and providers to connect with individuals dually eligible for Medicare and Medicaid in order to identify needs, develop care plans, and provide ongoing care coordination. Consistent care coordination is particularly important for people with diabetes — 23 percent of dually eligible beneficiaries aged 21-64, and 25 percent of dually eligible beneficiaries 65 and over [1] —  as uncontrolled diabetes can lead to poor health outcomes, including cardiovascular disease, nerve damage, or damage to the kidneys, eyes, and feet [2]. Additionally, emerging research indicates that those with diabetes are at increased risk for severe illness or death from COVID-19 [3]. These statistics only heighten the need for health plans and providers to strengthen strategies for successful diabetes assessment, planning, and management. This webinar will feature speakers with expertise in diabetes care management who have adjusted approaches to diabetes care assessment, planning, and management since the onset of the pandemic. Speakers will address the use of telehealth in providing both clinical management and self-management education and support. They will also share concrete strategies for connecting people with diabetes to resources, including secure housing, food, medications, and diabetes management supplies. Finally, a person with diabetes will share their first-hand experience in managing their diabetes during the pandemic. By the end of this webinar, participants should be able to: Describe the disproportionate impact of COVID-19 on dually eligible individuals with diabetes, particularly those from communities of color Identify approaches to providing both clinical management and self-management education and support while adhering to physical distancing protocols Recognize barriers to telehealth for some members and identify ways to successfully overcome them Name strategies for effectively connecting members to resources and supports, including food, medications, and supplies, during COVID-19 Featured Speakers: Vivian Cheng, PharmD, BCPS, Primary Care Clinical Pharmacy Specialist; Talya Salant, MD, Interim Medical Director: Bowdoin Street Health Center Nicole Kohler, MS, CDCES, Clinical Design Specialist - Diabetes; Katie Sheridan, MSW, LSW, Supervisor, Medicare Case Management; Gateway Health Vivian Nnacho Ayuk, PharmD, CDCES, Chief Executive Officer; Sorogi Fontella Young, Consumer Continuing Education Credits will be available for this webinar through the National Association of Social Workers at no cost to participants. Webinar: Supporting the Preventive Health Care Needs of Dually Eligible Women with Disability Date/Time: Wednesday, May 12, 2021 – 1:00-2:30 pm ET Register here. In observance of National Women’s Health Week, we invite you to join our webinar to learn about strategies providers and health plans can employ to meet the health and safety needs of dually eligible women with disability. Individuals dually eligible for Medicare and Medicaid with disability are more likely to report that they were unable to get necessary medical care, tests, or treatments compared to those without disability [4]. Women with disability experience a myriad of barriers in accessing preventive health care services, which may adversely impact their overall health and exacerbate health disparities [5]. Barriers to care include physical and structural obstacles, such as inaccessible facilities and limited transportation options to access services; communication challenges; provider bias, including lack of awareness among providers; and financial and systemic barriers [6]. As a result, women with disability have lower preventive care screening rates as compared to women without disability, which can delay detection and adequate treatment of health concerns [7]. This webinar will explore the challenges and barriers that women with disability face in accessing screenings and health services, and highlight promising practices providers and health plans can employ to achieve better integrated, person-centered care. The webinar will also address increased challenges to accessing preventive health care during the time of the COVID-19 public health emergency. By the end of this interactive webinar, participants will be able to: Recognize the challenges and barriers to accessing health care that women with disability face, including attitudinal biases, physical access barriers, communication challenges, stigma, and unmet social needs Identify how providers, care teams, and non-clinical staff can employ integrated and person-centered approaches to support women with disability in receiving care that meets their needs and preferences Describe how health plans and providers can support women with disability by improving communication and physical accessibility Featured Speakers: Monika Mitra, PhD, Director, Lurie Institute for Disability Policy, Brandeis University John Harris, MD, MSc, Assistant Professor, Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Women’s Hospital, University of Pittsburgh Medical Center (UPMC) Sarah Triano, Director, Policy and Innovation, Complex Care, Centene Corporation Amy Shannon, Consumer Continuing Education Credits will be available for this webinar through the National Association of Social Workers at no cost to participants. [1] Medicare Payment Advisory Commission and Medicaid and CHIP Payment and Access Commission (2018). Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid. Retrieved from https://www.macpac.gov/wp-content/uploads/2020/07/Data-Book-Beneficiaries-Dually-Eligible-for-Medicare-and-Medicaid-January-2018.pdf. [2] Centers for Disease Control and Prevention (2019). Prevent Complications. Retrieved from https://www.cdc.gov/diabetes/managing/problems.html.  [3] Centers for Disease Control and Prevention (2020). COVID-19 (Coronavirus Disease): People with Certain Medical Conditions. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. [4] Centers for Medicare & Medicaid Services. (2019). How Does Disability Affect Access to Health Care for Dual Eligible Beneficiaries? Retrieved from https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Data-Highlight_How-Does-Disability-Affect-Access-to-Health-Care-for-Dual-Eligible-Beneficiaries.pdf [5] Association of State and Territorial Health Officials. (2013). Access to Preventive Healthcare Services for Women with Disabilities. Retrieved from https://www.astho.org/Access-to-Preventive-Healthcare-Services-for-Women-with-Disabilities-Fact-Sheet/ [6] Association of State and Territorial Health Officials. (2013). [7] Association of State and Territorial Health Officials. (2013).