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I. HAP HAPpenings
- UPCOMING OPPORTUNITY: 2008-2009 Collaborative State Projects
- HAP Tool: Dual Eligibles
- New HAP Resource Center: SHIP Funding
- SAVE THE DATE: Health Action 2008, January 24-26
II. Highlights from CMS
III. Items of Interest
- Shrinking Drug Formularies
- MedPAC Recommends an Increase in SHIP Funding
- Patient Advocates Support Legislation Increasing Off-label Drug Coverage
- New Kaiser Resources on Part D Available
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 Celebrating SHIP Successes!
Ohio’s SHIP Mates Program Partners OSHIIP Volunteers with Hospitals
The Ohio Senior Health Insurance Information Program (OSHIIP) created the SHIP Mates volunteer project to connect with Medicare beneficiaries when they are in great need, often while hospitalized.
Learn more about how the SHIP Mates model might work for your program by visiting HAP's Celebrating SHIP Successes page.
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I. HAP HAPpenings
UPCOMING PARTNERSHIP OPPORTUNITY: 2008-2009 Collaborative State Projects
In January 2008, HAP will be seeking applications from State SHIP Directors to participate in the 2008-2009 Collaborative State Projects (CSP). HAP works with up to four states each year from April 1 to March 31.
CSPs are customized capacity building initiatives intended to strengthen and expand upon existing practices. Previous projects have centered on volunteer program development, Medicare education and counseling, and the implementation of web-based management tools.
Be on the lookout for the 2008-09 Request for Proposal.
HAP Tool: Dual Eligibles
HAP recently released an overview on Medicare and Medicaid: Dual Eligible Beneficiaries, including:
- Which Medicare Beneficiaries Are Eligible to Enroll in Medicaid?
- What Benefits Do Dual Eligible Beneficiaries Receive?
- What Is Meant by "Full Dual Eligible" and "Partial Dual Eligible"?
HAP's new chart, Cost-Sharing for Dual Eligible Beneficiaries, details the types of Medicare costs that Medicaid pays for full and partial dual eligible beneficiaries.
New HAP Resource Center: SHIP Funding
Recent activity in both houses of Congress shows that there is a growing recognition of the need to increase SHIP funding. Since SHIPs are in the best position to educate Congress about the importance of increased and sustainable funding in order to continue helping Medicare beneficiaries, HAP has created a SHIP Funding Resource Center to assist SHIPs in educating members of Congress about the vital role that SHIPs play.
For more information on HAP's efforts to increase SHIP funding, contact Ellen Leitzer at eleitzer@hapnetwork.org.
SAVE THE DATE: Health Action 2008, January 24-26
Grassroots advocates, health care providers, and policy-makers from around the country will gather in Washington, DC for the annual Families USA conference, Health Action 2008. Workshops and sessions cover a variety of topics, including Medicare, Medicaid, and minority health issues. The conference is a great place to learn and share strategies with individuals concerned about health care access, and to recharge for the year ahead.
For more information, please visit Health Action 2008.
II. Highlights from CMS
REMINDER: 1-800-Medicare Will Be Closed December 25
Confirm Enrollments Online
SHIPs can now check the status of online enrollments completed using the plan finder by using a new online tool from CMS. Detailed instructions and the password are also available online.
Enrollment status for both 2007 and 2008 online enrollments can be confirmed with the 14-digit confirmation number provided upon completion of the online application. Available information includes: the drug plan's contract number, the date of the online enrollment, and if the plan has begun processing the enrollment.
CMS Describes Social Security Reductions for MA Part B Premiums
CMS recently reported that 30,000 beneficiaries have errors in their Part B premium reductions while enrolled in Medicare Advantage plans. These beneficiaries will receive a letter from CMS at the beginning of December explaining why their Social Security payments will be lower starting in December.
It is unclear from the letter if CMS will try to recoup past payments from beneficiaries. Some of these beneficiaries have not had sufficient reductions taken from their Social Security since 2006. The majority of beneficiaries who have these errors are in Puerto Rico, Florida, Texas, and California.
2008 LIS Resource Limits
The 2008 low-income subsidy (LIS) resource limits are $7,790 ($12,440 if married) for full LIS and $11,990 ($23,970 if married) for partial LIS. CMS will release the 2008 federal povery levels in early 2008, which will establish income thresholds for LIS in 2008.
HAP's chart provides information on eligibility levels for income and resources as well as Part D costs for low-income beneficiaries with LIS. This chart includes information both on those deemed eligible for LIS and those who must apply for the subsidy.
PFFS Oversight
The Bush Administration has encouraged the Senate to make no changes to Part D or Medicare Advantage (MA) plans. Administration officials have stated that they will oppose provisions in a Senate Medicare package giving states more power to punish private MA plans for questionable marketing practices. Check out HAP's PFFS Resource Center for more information on MA marketing guidelines.
CMS has its own monitoring strategy for MA private fee-for-service (PFFS) plan marketing activity. CMS will increase secret shopping of marketing events, sharing of agent and broker data with state insurance departments, and enrollment verifications of PFFS plan enrollees. Plans in violation of marketing rules may be subject to activity suspensions, monetary penalties, or termination from the Medicare program.
CMS Lists Poorest Performing Nursing Homes Along with Nursing Home Selection Tools
On November 30, 2007, CMS published a list of the nation's poor-performing nursing homes.
CMS advises people exploring nursing homes to understand their rights using the Nursing Home Brochure and utilize the Nursing Home Compare tool to ensure that the home they select provides quality care.
Quick Reference Describes Sources of Assistance
CMS released a one-page chart describing what questions should be directed by CMS Regional Offices and CMS Central Office, SHIP Resource Center and NPR contractor, CMS online tools, and 1-800-MEDICARE.
III. Items of Interest
Shrinking Drug Formularies
Avalere Health has issued a report reflecting a significant reduction in Part D formularies. The impact on Medicare beneficiaries includes:
- Increased exceptions requests for non-formulary drug coverage,
- Increased inability to find a drug plan covering all their medications, and
- A pronounced need to revisit drug plan choices on an annual basis.
MedPAC Recommends an Increase in SHIP Funding
Ongoing discussions about increasing participation in Medicare Savings Programs and the low-income subsidy at Medicare Payment Advisory Commission (MedPAC) meetings have resulted in three draft policy recommendations. The first draft recommendation requests that the Secretary "increase SHIP funding and the SHIPs should use the additional money to support work to increase participation in programs targeted to low-income Medicare beneficiaries."
The transcripts and the presentations given to the MedPAC commissioners are available online.
Patient Advocates Support Legislation Increasing Off-label Drug Coverage
Medicare Access for Patients Rx (MAPRx) is a coalition urging Congress to broaden Part D off-label drug coverage in alignment with the Part B program. The Part B definition of "medically accepted" is more expansive than that in the Part D program.
New Kaiser Resources on Part D Available
Two new data spotlights examine key changes and variations in drug plans available in 2008. These analyses focus on premiums and the coverage gap.
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