Recommendations Would Increase Participation In Medicare Programs For Low-Income Beneficiaries

Armen Hareyan's picture


The Medicare Payment Advisory Commission on Thursday approved a set of recommendationsfor Medicare programs that provide financial assistance to lower-incomebeneficiaries and for Medicare special needs plans, CQ HealthBeat reports.

During the first day of a two-day meeting, commissioners approved arecommendation to have Congress stipulate that the HHSsecretary make Medicare prescription drug benefit claims available"regularly and in a timely manner" to certain federal agencies"for purposes of program evaluation, public health and safety." MedPACalso approved recommendations that would:

  • Urge Congress to mandate that the Social Security Administration screen applicants for Medicare Part D's low-income subsidy to determine if beneficiaries also are eligible for the Medicare Savings Programs and then to enroll those that qualify;

  • Urge the HHS secretary to increase funding to State Health Insurance Assistance Programs to enable the programs to better identify and enroll qualified individuals; and

  • Urge Congress to raise MSP income and asset eligibility to match the eligibility for Medicare Part D's low-income subsidy program, which is higher than MSP levels. If eligibility for both programs were the same, SSA offices would be able to screen and enroll beneficiaries at the same time, according to commissioners.

MedPACcommissioners approved several recommendations for SNPs, which serve dualeligibles, beneficiaries who are institutionalized and patients with severechronic diseases or conditions. One SNP recommendation would urge Congress toextend the authority to limit program enrollment, set to expire in December2008, for an additional three years under conditions set out in otherrecommendations approved on Thursday.


One of the recommendations said that the HHS secretary should establishadditional performance measures for SNPs and evaluate the plans on thesemeasures every three years. In addition, MedPAC recommended that the HHSsecretary provide beneficiaries and others with information that compares SNPs'benefits and quality measures with those of Medicare Advantage plans andtraditional Medicare. MedPAC also recommended that SNPs that serve dualeligibles work more closely with states to improve coordination with Medicaid.MedPAC also said Congress should mandate that SNPs enroll at least 95% of theirtarget population (Carey, CQ HealthBeat, 12/6).

Draft Payment Recommendations

In related news, MedPAC onThursday released a draft recommendation to Congress that fiscal year 2009Medicare payments for inpatient and outpatient care be increased at a rateequal to the change of the "market basket" index, which Medicare usesto measure the costs of delivering treatment, CQ HealthBeat reports. Anadditional MedPAC recommendation would freeze Medicare payments to skillednursing facilities at current levels because profit levels have been in thedouble digits for the past six years, according to MedPAC staff Carol Carter.

MedPAC Chair Glenn Hackbarth said that the draft recommendation is a beginningpoint of discussion and might undergo revisions. The commission in Jan. 2008will vote on the final language of the recommendations, which will then becomepart of a report to Congress submitted in March (Reichard, CQ HealthBeat,12/6).

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