In November's Issue:
HAP HAPpenings
- HAP eAlerts Now Available in New Archive
- Don't Forget to Keep Track of Successes During AEP!
- HAP Expands Online Medicare Library to include Medigap
- SHIPTools Debuts New Virtual Forum Feature
- CMS Offers Proposed Rules for Medicare Advantage and Part D
CMS News
- 2010 Medicare Premiums Are Announced
- New Program to Assist Low-Income Beneficiaries at the Pharmacy
- UPDATE: WellCare Suspension Lifted
Interesting Items
- Medicare Fraud in the News
- Health Reform and Medicare Beneficiaries: More Resources and Information
- Illinois Governor Honors SHIP, Declares SHIP Week
- Now More than Ever, Older Americans Living in Poverty
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HAP's Extra Hand |
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New Tool to Help Walk through CMS Policy on QMB and Medicare Cost-Sharing | | |
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When will the SHIP Resource Guides be updated?
HAP's Resource Guides, developed for SHIPs to supplement your new and on-going SHIP counselor trainings, are slated for updates now and will be shared with the HAP community in January 2010.
Stay tuned!
Share Issues that Your Clients Encounter during AEP
HAP's Issue Log in the Troubleshooting Medicare project can help SHIPs capture and share the persistent and systemic issues their clients encounter during Annual Enrollment Period (AEP).
SHIPs can use the Issue Log to record and share information about a particular issue affecting a client, track client issues over time, and learn about the issues that other counselors are seeing in the field. Please contact us to get a username and password for the Issue Log now. |
HAP HAPpenings
HAP eAlerts Now Available in New Archive
HAP launches its newest Web feature this month: the eAlert Archive. The eAlert archive is designed to complement our eNewsletter archive. This new section of our Web site puts all of the electronic communications previously sent to members of the HAP community at your fingertips.
The eAlerts are sorted by both HAP content area, such as Medicare education, and by the date the eAlert was sent to HAP community members. The archive can be accessed by clicking on the eAlert button located at the top of our Web site.
If you have any questions, please contact us.
Don't Forget to Keep Track of Successes During AEP!
As you head into the Annual Enrollment Period (AEP) on November 15, don't forget to keep track of what goes well. Take note when your volunteers develop a winning partnership, for example with a community organization at a SHIP enrollment event, or when they make an especially meaningful difference in the lives of your clients. Personal stories and anecdotes help to illustrate the strengths of your volunteer management strategy and program. You can use the stories later to celebrate your SHIP’s successes by recognizing current volunteers, or to recruit new volunteers for next year's enrollment period.
To help you get started, try using this template to document your volunteer success stories. It includes space to record details as well as memorable quotes from volunteers, clients, or partners. Use some of the quotes in your next volunteer recruitment campaign — and see the results!
HAP Expands Online Medicare Library to include Medigap
With your help, HAP has updated and expanded our online Medigap resources to better meet the training and education needs of your SHIP. Located within our Medicare library and relevant to the Annual Enrollment Period (AEP), it includes Medigap tools, references, as well as a Medigap state regulation locator to help trace the additional Medigap rights and opportunities available to beneficiaries in your states.
In addition to general Medigap references, we also recognize that SHIPs need a tool that explains the specific changes to the program as a result of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008. HAP has developed a brief Q&A that reviews what the MIPPA changes mean for Medigap policies and Medicare beneficiaries come June 1, 2010. During the AEP, beneficiaries may ask how their current Medigap policy will be affected in 2010 and whether they will still have the same benefits. The Q&A addresses questions, like this one, to help you field any concerns from your clients about their Medigap coverage.
Have feedback or suggestions on future Medigap tools that would be helpful to your program? Contact us.
SHIPTools Debuts New Virtual Forum Feature
SHIPTools, HAP's Web-based management system designed for SHIPs by SHIPs, now allows volunteers and counselors to come together in HAP's virtual Forum to discuss issues and ask questions of one another across a program. This new feature is part of the SHIPTools application and is designed to complement how SHIPs currently use SHIPTools for volunteer management, training, and National Performance Reporting (NPR).
SHIP staff and volunteers can use these forums to connect with one another and share information, client or community stories, and to ultimately better serve Medicare beneficiaries across your program.
If you'd like to take a test drive of SHIPTools, or take the opportunity to create a virtual forum, please contact us.
CMS Offers Proposed Rules for Medicare Advantage and Part D
On October 22, the Centers for Medicare and Medicaid Services (CMS) released in the Federal Register proposed rules that detail significant changes to both the Medicare Advantage (MA) and Medicare Prescription Drug Coverage (Part D) programs. Public comments to these proposed rules are due December 8. As with past regulations and guidance, HAP will submit comments in support of SHIPs' work and with consideration of the needs of Medicare beneficiaries.
The proposed rules from CMS cover eight primary goals, three of which appear most relevant to the critical work SHIPs do. These goals include increasing efforts to ensure that only appropriate organizations are allowed to provide coverage to Medicare beneficiaries, strengthening beneficiary protections, and offering plans with meaningful differences.
HAP is committed to bringing the SHIP perspective to the table, and we welcome any suggestions SHIPs can share with us.
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UPDATE: WellCare Suspension Lifted
On November 3, CMS removed the sanctions that have prevented WellCare from the marketing of and enrollment in all WellCare plans since March 2009. WellCare may begin marketing immediately, and they will be permitted to enroll beneficiaries in plans throughout the Annual Enrollment Period (AEP).
Despite this announcement, CMS says that WellCare plans will not receive any LIS-eligible beneficiaries being reassigned for 2010. The Plan Finder currently does not list details about WellCare plans, as of the publication date. CMS has not indicated whether they will update the Plan Landscapes to include these additional plans. |
CMS News
2010 Medicare Premiums Are Announced
After much anticipation from the SHIP and partner community, the Social Security Administration (SSA) confirmed on October 15 that there will be no cost of living adjustment (COLA) in 2010. For Medicare beneficiaries this means no increase in their monthly Social Security benefits. And it also means that approximately 27 percent of Medicare beneficiaries will see their monthly Part B premium increase in 2010, starting at the increased baseline of $110.50.
The beneficiaries affected by this increase include those new to Medicare in 2010, dual-eligibles (though Medicaid will pay the higher premium on behalf on the dual), and those paying the higher Part B premium because of an income-related surcharge. For the other 73 percent of beneficiaries, the Medicare Part B monthly premium will remain the same as in 2009 — $96.40.
As you meet with Medicare beneficiaries during the Annual Enrollment Period (AEP), consider HAP's recently updated Medicare Premiums and Cost-Sharing fact sheet to help explain the changing numbers for 2010 to clients. This fact sheet covers the Part B premium amounts, the Part A and Part B deductibles, as well as the Medicare Part A and Part B cost-sharing amounts for 2010, and is available in printable form to use during counseling sessions.
For more information related to 2010 updates, check out HAP's 2010 AEP Toolkit.
New Program to Assist Low-Income Beneficiaries at the Pharmacy
CMS recently announced a new system to help beneficiaries who receive the low-income subsidy (LIS) improve access to their prescription drugs when they have no Part D plan enrollment. The program, called the Limited Income Newly Eligible Transition (LI NET) program, will replace the current Point of Sale (POS) system effective January 1, 2010. The LI NET program will provide coverage for eligible beneficiaries through a temporary Prescription Drug Plan (PDP) plan operated by Humana.
All beneficiaries with Extra Help who are not enrolled in Part D plans qualify for immediate coverage at the pharmacy through the LI NET system. All other beneficiaries with LIS have access to temporary (and retroactive) coverage with Humana, followed by prospective random enrollment into a Part D plan. Full-benefit dual-eligible and SSI-only beneficiaries will have retroactive coverage up to at least 36 months, while all other beneficiaries with LIS have retroactive coverage for 30 days.
For more information on the LI NET program, see CMS's LI NET General Information PowerPoint presentation also available on its Web site. If you have questions or comments about the LI NET program and its impact on your work, please feel free to contact us.
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Interesting Items
Medicare Fraud in the News
Preventing fraud and abuse can save the Medicare program as a whole millions of dollars every year. With Medicare fraud increasingly in the news, now is a good time to make a difference by helping to identify those who commit fraud and abuse.
SHIPs across the country are taking steps to remind beneficiaries about their role in preventing fraud and how they can protect themselves. If your state doesn't already have Medicare fraud-prevention strategies and tools in place, try customizing proven practices from other states. The Alabama SHIP has developed a Medicare Protection Toolkit that SHIP counselors use to educate beneficiaries across the state about Medicare fraud and abuse prevention.
Additional national resources:
- SMP Resource. Funded by the U.S. Administration on Aging (AoA) and supported by the National Consumer Protection Technical Resource Center, the SMP Web site offers many resources to help learn how to avoid, detect, and prevent health care fraud.
- Medicare's Stop Medicare Fraud. The Department of Health & Human Service's (HHS) Web site contains resources on Medicare's efforts to prevent and combat fraud, including information for beneficiaries.
Health Reform and Medicare Beneficiaries: More Resources and Information
SHIPs are likely to hear questions from clients during AEP about how health care reform will affect them. Clients may be curious about improvements to Medicare benefits, such as reducing the Part D prescription drug coverage gap, or doughnut hole.
The Kaiser Family Foundation has put together a set of resources to help explain the latest developments in health care reform, including a glossary of key terms and concepts.
Families USA* has also developed a fact sheet, Help for People with Medicare, to describe some of the benefits proposed for Medicare beneficiaries under health reform legislation, including improvements to the doughnut hole, eliminating copayments for preventive care, and additional assistance for people with limited incomes.
*HAP is an independently funded project of Families USA, a national nonprofit, nonpartisan organization.
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Illinois Governor Honors SHIP, Declares SHIP Week
Illinois Governor Pat Quinn declared November 2-6, 2009, as SHIP Week to salute the program's work in helping Medicare beneficiaries navigate the many plan choices and options in the state. He highlighted the nearly 300,000 hours of counseling provided by SHIP volunteers in Illinois since the program's start in 1988 and the savings to consumers of more than $56 million.
For more, click here. Congratulations, Illinois SHIP! |
Now More than Ever, Older Americans Living in Poverty
Recent figures on poverty confirm what SHIPs already know and are experiencing firsthand in your work to help poor and vulnerable Medicare populations. The Census Bureau has released alternate income and poverty estimates for 2008 that show that more than 47 million Americans were living in poverty last year. Of that, more than 7 million were aged 65 or older, higher than previously believed. At the same time, the lack of adjustment to cost of living (COLA) in 2010 means that beneficiaries will not see an increase in their Social Security benefits in the coming year. Now, more than ever, beneficiaries need additional help in securing assistance that allows them to get critical health care and prescription drug coverage benefits.
HAP's 2010 Annual Enrollment Period (AEP) Toolkit contains essential tools and resources on the low-income subsidy (LIS). And if you missed it last month, HAP's October eNewsletter includes references to enhanced opportunities to screen Medicare consumers for food stamps and other benefits.
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New Tool to Help Walk through CMS Policy on QMB and Medicare Cost-Sharing
In our September eNewsletter, HAP released the Getting Started: What SHIPs Need to Know Q&A to help SHIPs understand why beneficiaries enrolled in the Qualified Medicare Beneficiary (QMB) program are exempt from Medicare cost-sharing charges.
HAP continues to hear from SHIPs on the topic of the QMB and Medicare cost-sharing. In response, we've developed a resource that traces the protections for Qualified Medicare Beneficiaries to the sources in law and guidance. This resource, Moving Forward: A Guide to CMS Policy on Cost-Sharing for Qualified Medicare Beneficiaries, takes a deeper look at the background of QMBs and Medicare cost-sharing. It walks you through the legislative and regulatory history — from the Balanced Budget Act (BBA) of 1997 that strengthened cost-sharing protections for QMBs, all the way up to the February 2008 Centers for Medicare and Medicaid Services (CMS) memo to Regional Medicaid Administrators making it clear that QMBs are not liable for these Medicare cost-sharing amounts.
HAP encourages SHIPs to use the Moving Forward guide and its corresponding glossary to strengthen your program's knowledge of the protection behind the QMB program. HAP will continue to follow the issue, and soon we will share counseling guides to further help your work with counseling and assisting QMB clients.
Please contact us if you have any questions about this new resource, or if your program is continuing to see examples of this system-wide issue in your area. |
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