HAP Workshops and Reception at SHIP Directors Conference
HAP Conference Call Update
Recent Shifts in 2010 Medicare & You Handbook and Call Letter

Opportunity for SHIPs to Share Feedback
CMS Publishes PFFS Provider Network County List

New Head of Health and Human Services Confirmed
Procedure Update for Part D Denials and Shortages
Stimulus Checks for Nursing Home Residents
New Volunteerism Legislation: The Serve America Act

Looking Back at Best Practices

This month HAP would like to highlight SHIP Best Practices from the past year. Check out our Best Practices webpage to see all the great work SHIPs are doing to assist Medicare beneficiaries.

Test your knowledge about the History of SHIPs

Try this month's quiz!

No HAP Call

There will be no Conference Call in May. Please join us Wednesday, June 17, for our next session.

We welcome your comments and suggestions. Email us at SHIPhelp@hapnetwork.org.

HAP HAPpenings

HAP Workshops and Reception at SHIP Directors Conference
HAP is offering certification, volunteer training, and research skill-building workshops at the 15th Annual SHIP Directors Conference held later this month in Baltimore, Maryland. Each workshop builds on HAP's current programs and is intended to help participants develop their own strategies and action plans through an interactive learning environment. Check out the abstracts for the HAP sessions below:

And don't forget to join us at the HAP-sponsored reception the evening of May 27th. We look forward to seeing you!

HAP Conference Call Update
HAP is in the midst of gearing up for the SHIP Directors Conference and will not be holding a conference call in May. We invite SHIPs to join our call in June when we will return to talk about a new and exciting topic relevant to SHIPs' work.

Remember, if you have ideas for future conference call or webinar topics email us at SHIPhelp@hapnetwork.org. In the meantime, visit our Conference Call webpage to see what's ahead.

If you missed previous calls, you can listen to them online.

Recent Shifts in 2010 Medicare & You Handbook and Call Letter
In recent months, HAP has provided CMS with comments on a number of resources central to the Medicare program, including the draft 2010 Call Letter to Medicare Advantage and Part D plans and the draft 2010 Medicare & You handbook for beneficiaries. HAP and others in the beneficiary advocacy community feel that the 2010 drafts of both documents reflect a qualitative shift because of the enhanced protections they provide for beneficiaries.

Medicare Drug Benefit Tool

The newly updated Medicare Drug Benefit Tool from Families USA can help estimate the cost of prescription drugs for beneficiaries, including those also eligible for Medicaid.

HAP is a project of Families USA.

For example, the draft 2010 Call Letter requires plans to provide additional specifics about their formulary restrictions. This will promote more informed decision-making by beneficiaries, allowing them to choose the best Part D plan. In addition, the draft 2010 Medicare & You handbook takes a more neutral and even-handed approach when discussing Medicare Advantage plans and Original Medicare.

We appreciate your feedback throughout the comment periods. Your input helps us formulate the suggestions we give to CMS, which in turn, helps CMS make their resources as beneficiary-friendly as possible. If you have any questions about the comments process, please contact us at SHIPhelp@hapnetwork.org, or visit our website for HAP’s previous submitted comments.

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CMS News

Opportunity for SHIPs to Share Feedback
HAP recently participated in CMS's quarterly National Medicare Education Program (NMEP) meeting where we, along with other advocates, learned more about recent CMS initiatives, including the future of the Medicare & You handbook and collaboration efforts to reduce hospital admissions. HAP was also able to reacquaint ourselves with CMS Office of the Medicare Ombudsman (OMO).

Launched back in April 2008, the OMO's Inquiries and Complaints resource webpage is an online resource developed specifically for beneficiaries on the appeals and complaints processes. If you haven't already visited this webpage, found within the Medicare website, we encourage you to check it out. We also encourage you to share any feedback that you have on how the OMO can improve this resource, such as other tip sheet content ideas or practical tools that may be helpful to beneficiaries and to your work. Please send your comments to SHIPhelp@hapnetwork.org.

HAP will continue advocating on your behalf, and we look forward to detailing your needs for CMS's consideration.

CMS Publishes PFFS Provider Network County List
In early April, CMS posted on its website a list of counties where Medicare Advantage (MA) Private-Fee-for-Service (PFFS) plans must form provider networks by 2011. The Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 requires PFFS plans to meet MA network access rules in geographic areas where two more network plans, such as PPOs, are also available.

This CMS list names more than 2,400 counties in 48 states, Puerto Rico, and the District of Columbia that are affected by the rule; Alaska and Vermont are not affected. The 2,417 counties included on the list represent about three-fourths of the total number of counties in the United States. HAP will continue to update you with any additional information on how this may affect SHIP counselors and beneficiaries as we learn more.

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Interesting Items

New Head of Health and Human Services Confirmed
The U.S. Senate confirmed Gov. Kathleen Sebelius of Kansas as Secretary of Health and Human Services on April 28, 2009. Ms. Sebelius brings eight years of experience as her state's insurance commissioner, as well as six years as a governor running a state Medicaid program.

The Centers for Medicare & Medicaid Services (CMS) sit within the Department of Health and Human Services.

Procedure Update for Part D Denials and Shortages
SHIPs may have heard the recent news about generic drug shortages for Toprol XL, a common medication taken for high blood pressure. When there is a shortage of a generic drug and the brand is available, it is in the beneficiary’s best interest for the Part D plan to allow the pharmacy to fill the prescription with the brand name at the price of the generic version.

CMS does not currently provide guidance on this issue, but they are looking into the situation and would like to know if beneficiaries are experiencing rejections by their plans for brand name coverage. HAP is asking SHIPs to share any problems their clients may be encountering so we can forward your comments to CMS, and help inform guidance development activities on this issue.

For beneficiaries in this situation, SHIP counselors may appeal for coverage and also advise beneficiaries to file a complaint with CMS. For more information on the Part D appeals process, visit HAP's Medicare Drug Coverage: Exceptions and Appeals webpage.

Stimulus Checks for Nursing Home Residents
Almost all long-term care residents will receive a one-time $250 payment as part of the stimulus recovery package. The payments are intended for nursing home residents, not the long-term care facilities where they reside. Last month, HAP's eNewsletter included information on the one-time $250 economic recovery payment from the federal government that begins going out in May to people who receive Social Security and Supplemental Security Income (SSI) benefits.

Nursing home resident exceptions may include those SSI beneficiaries who receive benefits at a reduced rate of $30 because they live in a medical treatment facility and Medicaid pays over 50 percent of the cost of their care.

For more information, see SSA's FAQ on the economic recovery payments.

New Volunteerism Legislation: The Serve America Act
President Obama recently signed legislation that will increase volunteer opportunities, build volunteer infrastructure, and encourage more people to serve. A number of provisions in the legislation could benefit SHIPs, including the expansion of the AmeriCorps program and funding to help states and non-profits better recruit, manage, and support their volunteers.

We’ll keep you updated as more details become available. In the meantime, you can visit HAP’s Volunteer Program Development Resource Center for tips and tools to help with your SHIP volunteer program.

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