HAP’s eNewsletter: June 2008
|
I. HAP HAPpenings
- If You’re Free Today at 3 pm ET - Join HAP’s SHIP-to-SHIP Call on LIS
- We’re Hiring - Director of Outreach and Communications
- If You Missed It - View HAP’s SHIP Conference Presentations Online
- New HAP Tools on MSAs
- Putting a Face to a Name
- What You Need to Know about DMEPOS Competitive Bidding
II. Highlights from CMS
- CMS to Distribute the Second of Three Installments in SHIP Funding
- Be on Lookout for LIS Media Ads in Your Community!
- Revised ABNs Will Be Used Soon
III. Items of Interest
- Oregon SHIP Director Testifies at Senate Aging Hearing
- DHHS Recommends Two LTC Specific Changes to CMS
- Report Highlights LIS and Part D Partnership Opportunities
|
I. HAP HAPpenings
If You’re Free Today at 3 pm ET - Join HAP’s SHIP-to-SHIP Call on LIS
Join HAP’s conference call this afternoon at 3:00 pm ET to share your experiences and learn how SHIPs across the country are reaching out to Medicare beneficiaries who are potentially eligible for the low-income subsidy (LIS). Email us at shiphelp@hapnetwork.org for the call-in information.
Receive invitations to our monthly conference calls in advance of the call by joining the HAP community or listen to the call online the following Monday.
We’re Hiring - Director of Outreach and Communications
HAP is looking for a Director of Outreach and Communications. This new director will lead HAP’s efforts to strengthen the SHIP network and advocate on systemic issues affecting SHIPs and Medicare beneficiaries.
Ideally, we would love to fill this position with a go-getter from the SHIP network. If you want to live in our nation’s capital and are committed to working toward a strong SHIP network, we invite you to email a cover letter and resume by June 30 to
infohap@hapnetwork.org (please note job title in subject line).
If You Missed It - View HAP’s SHIP Conference Presentations Online
It was wonderful seeing so many of you at the SHIP Directors Conference in Baltimore. For those of you we missed, we are pleased to offer the presentations and case studies from HAP’s two workshops, Helping Beneficiaries with Billing Issues and Communications Planning for Busy Leaders, on our Web site.
We would be happy to answer any questions you have about this material or help you modify these presentations for your own program. Please email us at shiphelp@hapnetwork.org.
New HAP Tools on MSAs
Medicare Medical Savings Accounts (MSAs) are gradually edging onto the scene for SHIPs across the country. In 2008, MSA plans became available in almost every county. Many SHIPs are less familiar with this new type of Medicare Advantage plan and are beginning to face the impact of MSAs in their communities.
MSAs are an MA plan modeled after private-market Health Savings Accounts (HSAs), which were created in 2003, though there are key differences between HSAs and MSAs. HAP has created a slideshow as a training resource for SHIPs on Medicare Savings Accounts, and the FAQ Resource Center has a new section that provides specific details on MSAs.
Additional information about MSAs, including a list of MSA plans available in each state, is available on the CMS Web site.
Putting a Face to a Name
Check out our new staff page, which now features pictures of each HAP team member.
What You Need to Know about DMEPOS Competitive Bidding
In May, CMS announced the names of the 325 contracted suppliers in 10 communities that will provide durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) as part of the new DMEPOS Competitive Bidding Program. Required by the MMA, this program aims to lower prices significantly by requiring beneficiaries to obtain certain DMEPOS items from contract suppliers. CMS expects the competitive bidding process will reduce Medicare spending on these DMEPOS items by about 26 percent, which should translate into a beneficiary savings of between 14 and 43 percent depending on the supply.
Since Medicare will no longer pay for DMEPOS items obtained from a non-contract supplier, SHIPs should be prepared to assist beneficiaries through the implementation period. The competitive bidding program will affect beneficiaries who obtain DMEPOS items in the initial 10 communities, and it will be expanded to 70 additional areas in 2009. Letters explaining the program were mailed to beneficiaries in the initial 10 communities in early June.
HAP has summarized answers to common questions about the DMEPOS Competitive Bidding Program in a new tool. Additional information on the new program is available from CMS at www.cms.hhs.gov/DMEPOSCompetitiveBid. As always, we welcome your questions, comments, and concerns. Simply email us at shiphelp@hapnetwork.org.
Back to the top
II. Highlights from CMS
CMS to Distribute the Second of Three Installments in SHIP Funding
The Centers for Medicare & Medicaid Services (CMS) recently announced that it will distribute a second installment of $15 million to the SHIPs in June 2008. This funding is part of the $54.3 million allocated by Congress in late 2007 under the Medicare, Medicaid and SCHIP Extension Act of 2007. Read more about the other installments and how this increase in funds came about at HAP’s SHIP Funding Resource Center.
Be on Lookout for LIS Media Ads in Your Community!
CMS recently launched its 2008 Spring LIS Outreach Campaign (May 26-August 4) and outreach toolkit aimed at ultimately increasing the number of applications submitted to SSA for the Medicare Part D LIS. The campaign will target individuals without Medicare Part D coverage who may potentially qualify for the LIS, specifically Hispanics, Koreans, and African-Americans.
Five cities will host faith-based events to reach African-Americans (Memphis, Philadelphia, St. Louis, Los Angeles, and Dallas), while the Hispanic population will be targeted through print and radio ads. Please contact your CMS Regional Office for more information.
To learn more about what other SHIPs are doing to improve LIS outreach, join us on June 18 at 3:00 pm ET for HAP’s LIS conference call, or listen to the call online the following Monday.
Revised ABNs Will Be Used Soon
On March 3, CMS announced it will implement a revised Advance Beneficiary Notice of Noncoverage (ABN). An ABN makes beneficiaries liable for the cost of a service if Medicare denies payment on the grounds that the service was not medical necessity. The revised form replaces the existing general ABN (ABN-G) that physician offices, outpatient clinics, and other providers use. It also replaces the ABN-L used by laboratories for physician-ordered lab tests.
The revised ABN has a new title that more clearly conveys the document’s purpose. It also includes a new option that allows beneficiaries to choose to receive an item or service and pay for it out of pocket rather than have the provider submit a claim to Medicare. CMS is allowing a six-month transition period. All providers must use the new ABN (CMS-R-131) starting on September 1, 2008.
Back to the top
III. Items of Interest
Oregon SHIP Director Testifies at Senate Aging Hearing
On May 22, the Senate Special Committee on Aging held a hearing on Seniors at Risk: Improving Medicare for Our Most Vulnerable.
Lisa Emerson, SHIP Director for Oregon Senior Health Insurance Benefits Assistance (SHIBA) Program, testified that beneficiaries have concerns with the restrictive and confusing nature of the income and asset requirements for the Low-Income Subsidy (LIS). In addition, beneficiaries in her state receive conflicting information about the LIS from Private Fee-for-Service Plan representatives, Medicare, and SSA. Lisa concluded her testimony by emphasizing the need for increased federal funding in order to meet CMS SHIP performance standards.
You can watch the hearing online and read brief analyses of other important meetings at HAP’s What’s HAPpening information center.
DHHS Recommends Two LTC Specific Changes to CMS
A recent report from the Department of Health and Human Services, Office of the Inspector General recommends that CMS work with drug plans to create formularies that meet the needs of beneficiaries in long-term care facilities. In addition, the report urges CMS to improve the prior authorization process and strengthen efforts to accurately identify and fully subsidize dual eligibles. The recommendations are based on a survey of nursing home administrators, medical directors, and directors of operations for long-term care pharmacies on the availability of Medicare Part D drugs to dual eligibles in nursing homes.
Additional findings outlined in a memorandum to the Acting Administrator for CMS discussed concerns about the role of nursing homes and long-term care pharmacies in aiding dual eligibles with choosing a Part D plan. The report found that roles in this process vary between institutions and that the practices of some may not comply with CMS guidelines.
Report Highlights LIS and Part D Partnership Opportunities
A May report prepared for the Medicare Payment Advisory Committee (MedPAC) by researchers at Georgetown University and NORC at the University of Chicago provides insight into the experiences of Medicare beneficiaries and providers with Part D and the low-income subsidy.
Beneficiaries and physicians report being satisfied with Part D. However, pharmacists are less satisfied and report being caught in the middle when prescriptions cannot be filled. Another finding was that physicians generally do not know about LIS, and while pharmacists are more likely to know about it, they are less likely to discuss it with customers because they do not want to offend them. While many SHIPs have developed strong relationships with physicians and pharmacists, the additional increase in SHIP funding may help SHIPs strengthen existing partnership and perhaps build new ones.
Back to the top | Back to HAP's Homepage
