How the Hold Harmless Provision Protects Your Benefits

November 30, 2020 • By Darlynda Bogle, Assistant Deputy Commissioner

Social Security works together with the Centers for Medicare & Medicaid Services to make sure you won’t have a reduction in your Social Security benefits as a result of Medicare Part B premium increases.

A special rule called the “hold harmless provision” protects your Social Security benefit payment from decreasing due to an increase in the Medicare Part B premium. The Part B base premium for 2021 is $148.50, which is $3.90 higher than the 2020 base premium.

Most people with Medicare will pay the new premium amount because the increase in their benefit amount will cover the increase. However, a small number of people will see little or no increase in their Part B premium — and their Social Security benefit checks will remain the same — because the amount of their cost-of-living adjustment isn’t large enough to cover the increase.

To qualify for the hold harmless provision, you must:

• Receive Social Security benefits or be entitled to Social Security benefits for November and December of the current year.
• Have your Medicare Part B premiums for December and January deducted from your monthly benefits.

There are exceptions:

The hold harmless provision does NOT apply to you if:

• You enroll in Part B for the first time in 2021.
• You pay an income-related monthly adjustment amount premium.
• You are dually eligible for Medicaid and have your premium paid by a state Medicaid agency.

You can learn more by visiting Medicare.

https://blog.ssa.gov/how-the-hold-harmless-provision-protects-your-benefits/?utm_medium=email&utm_source=govdelivery

GM Wants a Bank

Eakinomics: GM Wants a Bank The news emerged late last week that General Motors was seeking a bank charter. As per The Wall Street Journal: “General Motors Financial Company Inc. has been talking to federal and state banking regulators for months about forming an industrial loan company and could file applications to do so as early as December, the people said. It would be supervised by the Federal Deposit Insurance Corp. and the Utah Department of Financial Institutions, which grants the majority of these charters.” Is this a good idea? At one level, this is fairly innocuous. As explained by AAF’s Thomas Wade, industrial loan companies (ILCs) “emerged in the early 1900s as a source of funding for industrial workers and other wage earners with moderate incomes, to whom traditional commercial banks were at the time not willing to offer uncollateralized loans.” Of note, ILCs did not take deposits and offered a very limited range of products. Nevertheless, they dominated the consumer credit business until commercial banks expanded consumer lending in the 1940s and beyond. From this perspective, GM getting an ILC does not appear problematic. Today’s ILC, however, is not your 1920s ILC. Over time, states expanded their charters of ILCs to permit an ever-growing range of consumer products. In addition, in 1982 an unintended consequence of deposit insurance legislation was to make ILCs eligible for federal deposit insurance, albeit by entering the regulatory oversight of the Federal Deposit Insurance Corporation (FDIC). As a result, ILCs grew dramatically and posed real competition to commercial banks, but without any obligation for oversight by the Federal Reserve. Thus, they had an advantage on the regulatory playing field, and posed the potential for different kinds of risks as a result. This was among the reasons the FDIC denied Walmart a charter in 2006, and further imposed a moratorium on ILC charters. The moratorium was ended earlier this year: “On March 17, the Federal Deposit Insurance Corporation unanimously approved a proposed rule that would 'codify existing practices' used by the FDIC in managing the industrial loan companies​ that it supervises. This proposed rule was closely followed on March 18 by news that the FDIC had approved ILC charters for fintech company Square and student loan servicer Nelnet.” In some sense, GM is just following the crowd. But there is also the nagging thing called history. GM has already had an ILC, the General Motors Acceptance Corporation (GMAC), which failed to survive the 2008 financial crisis and had to be bailed out by the taxpayer. The re-organized entity was sold off in 2010 and became Ally Financial. In principle, the modernized FDIC supervision of ILCs should make this move non-problematic. It was supposed to be non-problematic the last time around as well, however. The jury remains out.

On the Record 12 01 2020

"We found that [this program] increased prescribing of evidence-based cancer drugs without changing overall spending. This is a big deal, given how important evidence-based cancer drug prescribing is to achieving the best possible outcomes in cancer care."

— Justin Bekelman, M.D., director of the Penn Center for Cancer Care Innovation at the Abramson Cancer Center, spoke with AIS's RADAR on Specialty Pharmacy about his recent study of Anthem's Cancer Care Quality Program treatment pathways.

 

Subscribers may read the RADAR on Specialty Pharmacy article in which this quote appeared online. Learn more about subscribing to AIS Health's publications.

Cigna Corp. last week said...

 ...it is significantly expanding its 2021 Affordable Care Act exchange presence in North Carolina, offering coverage in 68 counties in 2021, up from just five in 2020. Cigna currently enrolls just 0.4% of North Carolina's exchange membership, with 2,000 lives. The state's largest exchange insurers are Blue Cross and Blue Shield of North Carolina (425,000 members), Bright Health (23,000 members) and Centene Corp. (15,084 members).

From AIS's Directory of Health Plans

Insurers Concern Over Rising COVID-19 Testing Costs

by Peter Johnson

With the COVID-19 pandemic getting worse than ever, health insurers are facing an uncertain level of exposure to testing costs. That's because payers and plan sponsors are on the hook for the entire cost of coronavirus tests and they could be required to pay for even more testing depending on the strategy that the Biden administration plans to pursue.

The Families First Coronavirus Response Act and the Coronavirus Aid, Relief and Economic Security (CARES) Act require plan sponsors to pay all in- and out-of-network claims for diagnostic and antibody testing services. The CARES Act says those claims must be paid at a listed "cash price," which essentially allows labs to name a price for test processing.

And costs for out-of-network testing seem to be increasing, according to a survey of claims data prepared by America's Health Insurance Plans (AHIP). The survey, which was conducted in October, found that the average price for out-of-network COVID-19 tests has increased by 10% since July, and that about 23% of all claims for COVID-19 tests processed by commercial insurers are out-of-network.

Joe Paduda, founder of health care consultancy Health Strategy Associates, tells AIS Health via email that "plans have little to no control over out-of-network entities," and adds that "plans should be actively and assertively educating members about the issue" to keep testing costs down.

Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, agrees that the issue of overcharging for COVID-19 testing is observable, and blames policymakers for allowing it to happen.

"This should be capped. [Typical] lab tests are paid pretty much on par with Medicare [rates], or actually slightly less than Medicare, often, by commercial plans," says Adler. He adds that policymakers in the CARES Act "could have pretty easily chopped off the worst abuses" by pegging COVID-19 testing prices to Medicare rates for normal lab testing.

Adler is uncertain about how high out-of-network testing charges will impact premiums going forward, partly because plans haven’t had to deal with this problem before.

He cautions that testing will not be the same in 2021 and points out that the Biden administration is much more committed to expanding access to testing than the Trump administration. He adds that the imminent vaccine rollout is another factor that makes projecting testing spend difficult.

From Health Plan Weekly

TDI posts new reports, including SB 1264 report

View as webpage New TDI reports posted The Texas Department of Insurance has posted the following reports: Balance billing protections: Senate Bill 1264 biennial report Annual Report for FY 2020 Agency Legislative Appropriations Request (LAR) for 2022-2023

 

Stay Connected

VA Blue Button reaches 10-year anniversary

Feature on My HealtheVet lets Veterans access electronic health records

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 Posted onTuesday, December 1, 2020 9:50 am Posted in Health, Inside Veterans Health by VAntage Point Contributor

The VA Blue Button feature on My HealtheVet makes it easy for Veterans to access and download copies of their VA electronic health records.

VA recently marked the 10-year anniversary of the VA Blue Button.

Using VA Blue Button, Veterans can create customizable Blue Button reports that contain the information and records that they choose. Blue Button reports combine all the selected information into a single electronic file that Veterans can access and download in a simple text file or PDF.

Blue Button reports can include VA lab results and images, VA prescriptions, and past and upcoming VA appointment information. Reports can also contain health information that Veterans enter into My HealtheVet, such as emergency contact information.

It can also contain personal medical history, as well as labs, tests and prescriptions from non-VA providers.

Since 2010, over 2.5 million My HealtheVet users have downloaded over 41 million files through VA Blue Button.

Blue Button info can include DoD military service information

Eligible Veterans can even choose to include Department of Defense military service information, such as military occupational specialty codes, and pay, deployment and retirement details.

Once a Veteran has created a report, they can read, print, or save it on their computer or share it with their outside providers, caregivers or family members.

Since 2010, over 2.5 million My HealtheVet users have downloaded over 41 million files through VA Blue Button.

For Veterans and their families, being able to easily access VA medical records through My HealtheVet’s VA Blue Button feature has been a huge help in managing their VA care.

“My HealtheVet has been awesome”

Woodrow “Woody” Young is an Army Veteran. He said accessing his VA records online through VA Blue Button has helped him take charge of his care.

His wife and caregiver, Julie Parson, added, “For Woody’s care, My HealtheVet has been awesome.”

To learn more about VA Blue Button, visit the My HealtheVet website.

To access all the information through VA Blue Button, you need a My HealtheVet Premium account. Premium accounts are free, and you can upgrade in only a few steps. Learn more on the My HealtheVet Premium webpage.

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Gwendolyn McMillian is a communications specialist with the Office of Connected Care.

https://www.blogs.va.gov/VAntage/81645/va-blue-button-reaches-10-year-anniversary/