Archive
I. Conference Call Information
Next Medicare Conference Call on June 21
II. In the News
CMS Issues Medicaid Citizenship Documentation Guidelines
SHIP Funding Raised at Ways and Means Committee Hearing on Medicare Part D
Secretary Leavitt Issues Fourth Part D Progress Report
Kaiser Family Foundation Updates Plan Tracker
III. Helpful Information
Medicare Ombudsman Seeks Topics for Next Open Door Forum Call
New Long-Term Volunteer Recruitment Opportunity for SHIPs
CMS Takes Steps to Identify Newly Dually Eligible Persons
CMS Announces Demo to Transition Enrollment of LIS Beneficiaries
IV. HAP Resources
“HAPpy” Hour at the Annual SHIP Director’s Conference
I. Conference Call Information
Next Medicare Conference Call on June 21
HAP’s next Medicare Conference Call, “Talking to Part D Plans: A HIPAA Privacy Refresher,” will take place next Wednesday, June 21, at 3:00 p.m., EDT. As they counsel and assist Medicare beneficiaries, SHIPs and their partners must often give and receive specific information about the people they are helping. We will look at how the HIPAA privacy rule applies to Part D. We will examine issues such as plan enrollment, switches, cost sharing, and resolving problems related to filling prescriptions in light of the HIPAA privacy rule. We will describe a number of HIPAA’s tools for disclosing and receiving protected health information, and discuss how advocates can use them to enable productive problem-solving with Part D plans. We will soon be posting the background materials for the call on HAP’s website.
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II. In the News
CMS Issues Medicaid Citizenship Documentation Guidelines
Late last Friday, June 9, the Centers for Medicare & Medicaid Services (CMS) released a five-page Medicaid Fact Sheet and a fourteen-page letter to State Medicaid Directors (SMD) with guidance for documenting citizenship as part of the Medicaid eligibility determination process. The guidelines implement a statutory requirement of the Deficit Reduction Act (DRA) for persons to document their U.S. citizenship when applying or re-applying for Medicaid benefits. The new documentation rules take effect on July 1, 2006. For more information on the rules and their implications for SHIPs, please see HAP’s website.
SHIP Funding Raised at Ways and Means Committee Hearing on Medicare Part D
On June 14, the U.S. House of Representatives Committee on Ways and Means held a hearing on Implementation of the Medicare Drug Benefit. Dr. Mark McClellan and Secretary Michael Leavitt testified, along with representatives of various organizations including America’s Health Insurance Plans (AHIP), National Association of Insurance Commissioners (NAIC), and Families USA. Topics of interest to the Committee members included: Part D enrollment numbers, the elimination of the late enrollment penalty, Part D drug prices, and SHIP funding. Representative Thompson (CA) recognized the tremendous work of SHIPs and the need to increase funding for the network. Several of the witnesses also delivered this message during their testimony. We will continue to keep you posted on this very important issue. If you have any questions, please contact Lee Thompson at lthompson@healthassistancepartnership.org.
Secretary Leavitt Issues Fourth Part D Progress Report
Health & Human Services (HHS) Secretary Mike Leavitt yesterday, June 14, released his department’s latest progress report on the Medicare Part D program. The Secretary reported that over 38 million Medicare beneficiaries, nearly 90 percent of the people with Medicare, now have prescription drug coverage. That figure includes 10.4 million who are enrolled in stand-alone prescription drug plans (PDP) and 6 million in Medicare Advantage with prescription drug (MA-PD) plans. According to the report, 1.2 million people are new enrollees in these Medicare Advantage plans.
Kaiser Family Foundation Updates Plan Tracker
On June 7, the Kaiser Family Foundation (KFF) announced an updated version of its Plan Tracker which contains updated local, regional, and national data on Medicare Advantage (MA) and stand-alone Prescription Drug Plans (PDPs). This resource enables users to compare current information as well as trends in MA plans nationally, or by state or county. The Plan Tracker also enables users to look up quick facts about the 1,429 stand-alone prescription drug plans offering Medicare benefits in 2006. The quick facts include the number of participating plans, range of monthly premiums, share of plans with no deductible, and share of plans with a coverage gap.
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III. Helpful Information
Medicare Ombudsman Seeks Topics for Next Open Door Forum Call
The Office of the Medicare Ombudsman (OMO) earlier this week announced on its ListServ that it is seeking topics for its next Open Door Forum conference call in July. OMO wrote, “we want you to tell us what topics are currently impacting beneficiaries that we should discuss via the [conference call].” The OMO will consider recommendations that it receives by Noon EDT tomorrow, Friday, June 16.
New Long-Term Volunteer Recruitment Opportunity for SHIPs
The Corporation for National and Community Service (CNCS), which creates volunteer opportunities through Senior Corps, AmeriCorps, and Learn and Serve America, recently launched a new campaign to increase volunteerism among the baby boomer population (individuals born between 1946 and 1964). The Boomer Campaign, found at www.getinvolved.gov, is designed to encourage volunteerism among baby boomers by connecting them to a variety of community service opportunities that match their skills, interests, and availability.
If your state or local SHIP has worked with Senior Corps volunteers and/or AmeriCorps members, or if you are interested in recruiting long-term volunteers to perform a multitude of activities through this new Corporation for National and Community Service initiative, HAP would like to talk with you. Please contact Mike Klug at mklug@healthassistancepartnership.org.
CMS Announces SEP for Low-Income Beneficiaries and Katrina Victims
CMS released a Fact Sheet on June 14 to announce a Special Enrollment Period (SEP) for certain Medicare beneficiaries who enroll in Part D plans. The SEP is available to beneficiaries who enroll in the low-income subsidy (LIS) program, and to those who were affected by Hurricane Katrina. Eligible persons can enroll in a Part D plan without paying a premium penalty through December 31, 2006.
CMS Takes Steps to Identify Newly Dually Eligible Persons
On June 8, CMS released an information package to partners to inform them of steps the agency is taking to identify new dually eligible beneficiaries and also to ensure these beneficiaries receive prompt access to drugs. The information package contains a number of items, including a letter dated May 25, 2006 from the Center for Medicaid and State Operations Disabled and Elderly Health Programs Group (DEHPG) to State Medicaid Directors about planned initiatives to facilitate the process of providing prompt drug coverage to newly dually eligible individuals. These include requiring the drug plans to implement a system to identify and enroll Medicare beneficiaries who are about to become Medicaid eligible, who are turning 65 and/or reaching the end of the Medicare disability waiting period. The package also includes the "Welcome to Medicare" booklet that CMS provides to new Medicare beneficiaries. This publication gives an overview of the program and a summary of decisions that beneficiaries must make initially as their Medicare coverage is about to start. Finally, CMS added the fact sheet for pharmacists about the Wellpoint 4-step process to the information package. This is a step-by-step guide outlining the point-of-service facilitated enrollment process.
CMS Announces Demo to Transition Enrollment of LIS Beneficiaries
CMS announced in a memorandum to all Part D plan sponsors that it will adopt a transitional approach to its calculation of the regional low-income subsidy (LIS) benchmark premium amounts for 2007. Rather than use actual plan enrollment figures as a weighting factor in calculating the benchmark premium, CMS said that it will adopt a transitional approach, using equalized bid amounts, to “help ensure that low-income beneficiaries have access to a variety of affordable plans.” In effect, the move is designed to increase the number of LIS benchmark plans.
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IV. HAP Resources
“HAPpy” Hour at the Annual SHIP Director’s Conference
HAP is hosting a reception at the Annual SHIP Director’s Conference on Monday, June 26, 2006 from 5:30 to 7:30 pm in the Windows Room. We invite you to stop by to chat with HAP staff and other SHIP personnel from around the country. Light appetizers will be provided and a cash bar will be available. If you have any questions, please contact us at infohap@healthassistancepartnership.org
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