I. HAP HAPpenings

• HAP Tool: Part D Training Manual
• HAP Tool: Part D Marketing Dos and Don'ts
• HAP Tool Available: 2008 PDP Chart for Your State 
• HAP Welcomes Radha Choudary

II. Highlights from CMS

• Medicare Advantage Plans Not Renewing Contracts
• Medicare & You 2008
• Qualified Individual (QI) Program Extended
• CMS Memo Allows a Grace Period for LIS Recipients
• List of PFFS Marketing Events Available Online
• Congress Questions Equity Firms Management of Nursing Homes

III. Items of Interest

• Drug Plans Reach Out to Beneficiaries to Increase Extra Help Enrollment
• Medicare Advantage Plans Were Overpaid by $35 million, GAO Reports
  

I. HAP HAPpenings
HAP Tool: Part D Training Manual
HAP recently released a comprehensive, national Medicare Part D Training Manual, originally developed in partnership with the Maine SHIP.

HAP Tool: Part D Marketing Dos and Don’ts
HAP's new Part D Marketing Tool can be used by SHIP counselors to help beneficiaries identify the differences between fraudulent and suitable marketing tactics. The tool also distinguishes between the marketing rules for providers and plan representatives and includes contacts in the case of suspected fraud or abuse.

HAP Tool Available: 2008 PDP Chart for Your State
In response to tremendous SHIP interest, HAP will continue to offer the service of creating a state-specific PDP chart for your program. An example of the Tennessee state chart is available our website.

If you would like to work with HAP to create a state-specific chart for your program, please contact us at shiphelp@hapnetwork.org.

HAP Welcomes Radha Choudary
HAP is pleased to announce the addition of Radha Choudary to our team. Radha is the Web Tools Project Manager for SHIPTools, a web-based management system developed to help SHIP programs collect, capture, and calculate national performance reporting, train team members, and support beneficiary outreach activities.
 
Radha comes to HAP with a background in website design and development. She will be responsible for the day-to-day operations of SHIPTools in some states that are using the system.
Welcome Aboard Radha!

II. Highlights from CMS
Medicare Advantage Plans Not Renewing Contracts UPDATED LINK!
CMS reports that 16,062 beneficiaries across the U.S. will be affected by 43 Medicare Advantage Plans not renewing their contracts for 2008. See CMS's list for more information regarding specific plans.

Medicare & You 2008
Medicare beneficiaries should receive the general "Medicare & You 2008" handbook in the mail soon.

Qualified Individual (QI) Program Extended
Legislation recently passed that will allow the Qualified Individual (QI) program to continue through the end of 2007. The program pays the Part B premium (currently $93.50/month) for qualified beneficiaries and entitles them to the full Part D low-income subsidy. There are approximately 1.5 million people who receive QI benefits.

HAP has a variety of new tools describing Medicare Savings Programs in more depth, as well as how beneficiaries can qualify and apply for them.

CMS Memo Allows a Grace Period for LIS Recipients
An October 22 CMS memo reminds plans that they can allow a 3-month grace period for the collection of premiums and cost-sharing for individuals who:

• Will no longer automatically qualify for the low-income subsidy (LIS) in 2008, and 
• Are able to demonstrate that they have applied for LIS.

If a beneficiary does not re-qualify for LIS, the beneficiary will be responsible for any premiums and cost-sharing expenses accrued during the grace period. Therefore, if beneficiaries lose their LIS eligibility effective January 1, 2008, they should determine which plan provides them with the most affordable coverage with or without LIS.

There is a Special Enrollment Period (SEP) from January 1, 2008 through March 31, 2008 in which beneficiaries can enroll in a plan that may cost less. Additional information regarding this SEP can be found in Section 30.4.4 of Chapter 2 of the Medicare Managed Care Manual and Section 20.3.8 of the PDP Guidance on Eligibility, Enrollment, and Disenrollment.

List of PFFS Marketing Events Available Online
Medicare Advantage Private Fee-For-Service Plans (PFFS) are required to submit a list of their planned marketing events to CMS, which will be available to SHIPs online at the SHIPTalk.org website. The list of marketing events will be updated monthly and SHIPs are encouraged to report any events not listed using CMS's online system.

Visit HAP's new PFFS Resource Center for a variety of tools and resources.
The Boston Globe provides a summary of PFFS plans in a recent article.

Congress Questions Equity Firms Management of Nursing Homes
If you see fluctuations in nursing home care in your state, please contact your Representatives. Congress is watching this issue due to a recent New York Times article about how private equity firms are managing nursing homes.

• House of Representatives
• Senate

III. Items of Interest
Drug Plans Reach Out to Beneficiaries to Increase Extra Help Enrollment
In September 2007, CMS announced that in 2008, nearly 500,000 beneficiaries will lose their “deemed status,” which makes them automatically eligible for Part D low-income subsidies. In order to help these low-income beneficiaries who lost their automatic qualification for subsidies, 13 Part D plan sponsors contracted with a DC area consulting firm to reach out to 85,000 Part D enrollees to help them regain their deemed status or re-enroll for low-income subsidies. The plans participating in this outreach are financing this effort.

HAP’s Medicare Drug Coverage area has more information about the low-income subsidy for Part D.

Medicare Advantage Plans Were Overpaid by $35 million, GAO Reports
On October 16, 2007, the Subcommittee on Health and the Subcommittee on Oversight held a
joint hearing that specifically focused on the report by the Government Accountability Office (GAO) entitled Medicare Advantage: Required Audits of Limited Value.