Archive
Weekly Email: Week of July 3
I. Conference Call Information
Next Medicare Conference Call on July 19
II. In the News
Federal Case Challenges Medicaid Citizenship Documentation Rules
CMS Efforts to Improve Customer Service by Medicare Drug Plans
III. Helpful Information
KFF Releases DRA Citizenship Documentation Fact Sheet
NHELP’s Resources on DRA Citizenship Documentation Rules
CMS Issues 2007 Draft Coordination of Benefits (COB) Guidance
CMS Issues State Medicare Part D Enrollment Profiles by Congressional Districts
CMS Invites Comments on 2007 Part D Plan Reporting Requirements
IV. HAP Resources
HAP to Partner with the Kansas and Maine SHIP Programs on Collaborative Project
Independence Day
I. Conference Call Information
Next Medicare Conference Call on July 19
HAP’s next Medicare Conference Call, “New Medicaid Citizenship Documentation Rules,” will take place on Wednesday, July 19, at 3:00 p.m., EDT. The Deficit Reduction Act of 2005 requires state Medicaid programs to implement new rules to document the citizenship of those who apply or re-apply for Medicaid benefits, starting on July 1, 2006. Many advocates and others are concerned that the rules will cause some Medicaid recipients to lose their benefits because they cannot produce the required documents, such as birth certificates. For a large number of older duals, official documentation of their births does not exist. Gene Coffey, an attorney with the National Senior Citizen Law Center, will join us as a guest speaker. We will discuss the rules, state efforts to implement them, and their implications for SHIP programs and their low-income clients. If you have specific questions about the rules that you would like Mr. Coffey or HAP staff to address during the call, please contact Mike Klug at mklug@healthassistancepartnership.org.
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II. In the News
Federal Case Challenges Medicaid Citizenship Documentation Rules
On Wednesday, June 28, the National Health Law Program (NHELP) and the Sargent Shriver National Center on Poverty Law, based in Washington, DC and Chicago, respectively, filed a class action lawsuit in federal District Court in Chicago to challenge the constitutionality of the Deficit Reduction Act’s (DRA) Medicaid citizenship documentation provisions. According to NHELP’s press release, the attorneys for the plaintiffs believe that, “the new law will cause enormous harm to people who can’t produce the special documents, even though there is no doubt that they are American citizens.” NHELP asserts that seniors in nursing homes, people with mental or physical disabilities, disaster victims, and those who were not born in hospitals are at the greatest risk of losing Medicaid coverage because many are unable to produce passports, birth certificates or other documents that the law requires. Attorneys also contend that the DRA will create new administrative and cost burdens for states. Formerly, the states sought documentary proof only of people whose citizenship was in doubt. Now, they will have to seek documentation for more than 50 million current Medicaid recipients. For more details, see the text of the complaint in the case, Bell v. Leavitt.
CMS Efforts to Improve Customer Service by Medicare Drug Plans
On June 29, the Centers for Medicare & Medicaid Services (CMS) released information on its efforts to ensure that Medicare drug plans are providing the highest level of care available. According to CMS, "Medicare has taken more than 1,000 compliance actions to improve prescription drug plans service to beneficiaries." Such actions include monitoring the performance of plans' call centers, sending warning letters to plans for issues such as posting errors on the Medicare Personal Plan Finder, and sending requests to plans for specific steps as to how they will improve their call center performance. Beginning in mid-July, CMS plans to issue plan-level information on complaints about beneficiary service. CMS will release additional performance data before the start of the next Annual Open Enrollment Period on November 15. CMS also issued a one page chart showing the results of a its survey on the average length of time drug plans took to answer the phones at their Beneficiary and Pharmacy Call Centers.
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III. Helpful Information
KFF Releases DRA Citizenship Documentation Fact Sheet
The Kaiser Family Foundation (KFF) recently released a fact sheet describing the new rules for citizenship documentation in Medicaid under the Deficit Reduction Act (DRA) and CMS guidance released on June 9. Prior to the DRA’s passage, state Medicaid programs determined citizenship by allowing applicants, under penalty of perjury, to give written attestation to their citizenship. The fact sheet describes how the DRA now requires states to seek acceptable documents of citizenship, and the government’s four-tier “hierarchy of reliability.” The fact sheet goes on to list eight “implications” of the new rules. Significantly, KFF raises concerns that the DRA’s new rules will result in Medicare coverage being delayed or denied for many, in part because obtaining required documents may be difficult and costly for low-income citizens.
NHELP’s Resources on DRA Citizenship Documentation Rules
The National Health Law Program (NHELP) has created a page on its website with a number of resources to educate advocates about the DRA’s impact on Medicaid recipients. NHELP’s DRA Folder contains links to a six page Q&A on the DRA’s Medicaid Citizenship Documentation Requirements, a 24 page analysis of the DRA and its implications for advocacy, and other charts and reference materials.
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CMS Postings
CMS Issues 2007 Draft Coordination of Benefits (COB) Guidance
On June 22, 2006, CMS released a draft of the 2007 Coordination of Benefits (COB) Guidance for review and comment. According to CMS, changes made to this guidance include clarification of existing policy, descriptions of updated systems and processes related to COB, and explanations of new and proposed policy and requirements. Changes from the 2006 guidelines are identified in this red-line version of the draft, with alterations specified in the right-hand column of the document. Please note that the deadline for submitting comments on this draft is July 14, 2006. Send comments to drugbenefitimpll@cms.hhs.gov. CMS requests that the subject line for all comments submitted include COB Guidelines.
CMS Issues State Medicare Part D Enrollment Profiles by Congressional Districts
CMS recently released two state-level summary charts that reflect Part D enrollment, as of June 11, 2006, by Congressional district. These charts can help SHIPs in identifying the areas in their states that might be targeted specifically for enrollment outreach and assistance. One chart shows the number of beneficiaries with prescription drug coverage and the breakdown of coverage from Medicare or former employers. The other chart shows the Part D enrollment percentage increase from Jan 21 until June 11, 2006.
It is important to note that these data do not include individuals with other creditable coverage. The statewide average percentage of those with other creditable coverage is footnoted on each individual state table. Additional Part D enrollment data, including state and county break-downs, is available on CMS' website.
CMS Invites Comments on 2007 Part D Plan Reporting Requirements
On June 21, CMS released a revised version of its “Medicare Part D Reporting Requirements: Contract Year 2007” document, and announced a 60 day public comment period. According to CMS, this latest version of the reporting requirements reflects changes made in response to comments received during the first 30 day comment period earlier in the spring. The Reporting Requirements detail CMS’s expectations of the Part D plans with respect to reporting data on topics that include enrollment and disenrollment, grievances, transition, exceptions, and appeals. Comments and recommendations are due to CMS’s Office of Strategic Operations and Regulatory Affairs no later than 5:00 p.m., EDT, on Tuesday, August 15.
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V. HAP Resources
HAP to Partner with the Kansas and Maine SHIP Programs on Collaborative Project
HAP would like to thank the states that expressed interest in working with us over the next year on an intensive and collaborative project. All applicants submitted very compelling survey responses, making our selection of the two states extremely difficult. Ultimately, HAP chose the Kansas and Maine SHIP programs. We anticipate that working with smaller states during the first year of our Atlantic Philanthropies grant will allow us to test new approaches and tools that will in due course benefit the entire SHIP network and the Medicare beneficiaries that SHIPs serve. Congratulations to Kansas and Maine!
Independence Day
The HAP staff wish you a safe and happy Independence Day celebration. Our office will be closed on the Fourth of July. It will re-open on Wednesday, July 5.
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