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September
8, 2022 | Volume 13, Issue 33
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Top Story
Biden
Administration Proposals Would Expand Access to Vital Health Care
Services
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This
week, Medicare Rights submitted
comments in response to a proposed
rule that would extend Medicare coverage of dental and
behavioral health services. If finalized, these policies would broaden
the current availability of “medically
necessary” dental coverage and expand the number of
Medicare mental health and substance use disorder providers.
Currently,
CMS interprets Medicare law as not allowing the program to pay for
comprehensive dental care, leaving millions of older adults and people
with disabilities without this vital coverage. While some Medicare
Advantage plans cover dental, this coverage tends to be extremely
limited. All Medicare beneficiaries can face high out-of-pocket costs
when they need serious oral health care.
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CMS
Proposes Rule to Streamline Medicaid and CHIP Processes
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The
Centers for Medicare & Medicaid Services (CMS) recently announced
a proposed
rule to streamline Medicaid and CHIP application,
eligibility determination, enrollment, and renewal processes, as well
as improve program integrity. Several of the changes would ease access
to care and coverage for people who are dually enrolled in Medicare and
Medicaid.
In a
fact
sheet accompanying the proposal, CMS explains that
current policies can contribute to or fail to address enrollment and
coverage barriers. As an example, the agency notes the Medicare
Savings Program (MSP) enrollment process is overly
complex, which likely contributes to widespread
under-enrollment.
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Upcoming
Webinar
Fall Open
Enrollment and Medicare Reminders
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Fall
Open Enrollment takes place from October 15 to December 7 and is the
time of year when people with Medicare can make unrestricted changes to
their coverage options. Knowing how to navigate coverage options will
help you or your clients make the most informed decisions during Fall
Open Enrollment.
- Date: Thursday, September 15
- Time: 3:00 – 4:00 PM Eastern
Time
- Fee: $40 per person for the
live webinar and recording, or
$30 per person for the recording
only
Experts
from the Medicare Rights Center will answer your questions about the
following topics:
- Changes beneficiaries
can make during Fall Open Enrollment
- Strategies for making
coverage decisions
- Medicare marketing
rules
- Important Medicare
reminders
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Medicare
Reminder
Medicare
Coverage of Telehealth Services
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A
telehealth service is a full visit with a provider using
telephone or video technology that allows for both audio and video
communication. Original Medicare covers certain telehealth
benefits, such as professional consultations, office visits, including psychiatry
services, and a limited number of other services.
Original Medicare only
covers telehealth in limited situations:
- You live in a rural
area and travel from your home to a local medical facility to get
telehealth services.
- You require telehealth
services to treat behavioral health conditions, including
substance use disorder. You have the option of accessing
telehealth services from your home or from a medical facility.
- You require telehealth
services to diagnose, evaluate, or treat symptoms of acute stroke.
You have the option of accessing telehealth services from your
home or from a medical facility.
Medicare
Advantage Plans must cover all of the telehealth benefits included
in Original Medicare, but they may also cover additional telehealth
benefits. Additional telehealth benefits offered by Medicare Advantage
Plans may be available if you live outside of a rural area and may be
covered in your home. If you have a Medicare Advantage Plan, you should
contact your plan to learn about its costs and coverage rules for
additional telehealth benefits.
Note:
In response to the COVID-19
public health emergency, Medicare has expanded coverage
for and access to telehealth benefits.
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