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MIPPA Act:
Changes Effective January 2009


The Medicare Improvements for Patients and Providers Act (MIPPA), signed into law on July 15, 2008, encompasses significant changes and opportunities for Medicare beneficiaries, particularly those who are low-income. The following MIPPA changes take effect Jan. 1, 2009.

Medicare Part B

Medicare Part D

Medicare Advantage

Medicare Savings Programs


Medicare Part B

Preventive Benefits

  • Beneficiaries new to Medicare now have twelve months after their initial Medicare Part B eligibility to receive their “Welcome to Medicare ” physical exam (extended from the first six months of Medicare Part B eligibility).

NOTE: The annual Part B deductible does not apply to this initial physical exam, and MIPPA has added new services to the exam, including BMI assessment and end-of-life planning.

Outpatient Therapy Services

  • The effective date of the exceptions process for outpatient therapy caps is extended through December 31, 2009.

NOTE: This extension includes physical therapy, speech therapy, and occupational therapy.

Rental Payment for Oxygen Supplies and Equipment

Medicare Advantage

Special Needs Plans (SNPs)

  • Authority for SNPs is extended through December 31, 2010.

Cost Plans

  • Cost Plan contracts are extended through December 31, 2009.

Medicare Part D

Low-Income Subsidy

  • The late enrollment penalty is eliminated for all LIS eligible individuals.

Coverage for Anti-Cancer Drugs

  • The standards for determining whether Part D will cover specific anti-cancer drugs now include additional medical compendia.

Medicare Savings Programs

Qualified Individual (QI) Program

  • The QI program, which assists Medicare beneficiaries with incomes between 120% and 135% of the federal poverty levels and limited assets, is extended through December 31, 2009.

The changes noted above take effect January 1, 2009. There are additional changes from MIPPA that take effect at later dates. For a complete list of other MIPPA changes, visit HAP's September Conference Call page.

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