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On October 28th, the
Centers for Medicare & Medicaid Services (CMS) released the Medicare
Program: Implementing Certain Provisions of the Consolidated
Appropriations Act, 2021 and other Revisions to Medicare Enrollment and
Eligibility final rule. This rule includes several provisions
related to dually eligible individuals and will impact states, including
changes to (a) extend the Medicare Savings Programs (MSPs) to cover
premiums and cost sharing for individuals enrolling in the new Medicare
immunosuppressive drug benefit, (b) beginning January 1, 2024, limit
retroactive Medicare Part B premium liability for states to 36 months,
and (c) retire the old stand-alone buy-in agreements and specify
that the provisions of a state buy-in agreement shall be set forth in the
state’s Medicaid state plan.
This rule also creates a new
Medicare special enrollment period (SEP) for individuals losing Medicaid
eligibility and who did not enroll in Medicare on time. The most salient
content begins under the section headers “SEP to Coordinate with
Termination of Medicaid Coverage,” “Modernizing State Payment of Medicare
Premiums,” and “Ensuring Coverage under the Medicare Savings Programs.”
CMS encourages stakeholders to review the rule, and will be providing an
overview to states next week. You can find the rule here: https://www.federalregister.gov/public-inspection/2022-23407/medicare-program-implementing-certain-provisions-of-the-consolidated-appropriations-act-2021-and
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