Medicare

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Calendar Year (CY) 2023 Medicare Physician Fee Schedule Final Rule

This week CMS issued a final rule for the Calendar Year 2023 Physician Fee Schedule which includes updates and policy changes for Medicare payments and other Part B issues. Some of the changes include expanding access to behavioral health services by allowing certain health practitioners to provide and manage a beneficiary’s behavioral health needs; extending several telehealth services that are temporarily available for the COVID-19 public health emergency at least through calendar year 2023; and clarifying payment for dental examinations and treatments in more circumstances, such as prior to organ transplants and certain cardiac procedures beginning in calendar year 2023.

Short URL: http://www.advancingstates.org/node/74200

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Biden-Harris Administration Makes More Medicare Nursing Home Ownership Data Publicly Available, Improving Identification of Multiple Facilities Under Common Ownership

On September 26, 2022, in an effort to improve nursing home transparency, safety, quality, and accountability, the U.S. Department of Health and Human Services made additional data publicly available that provides information about the ownership of all Medicare-certified nursing homes. This data will give state licensing officials, state and federal law enforcement, researchers, and the public the ability to identify common owners of nursing homes across multiple locations. This data can help to identify the performance of facilities under common ownership, including owners affiliated with multiple nursing homes with a record of poor performance.

Short URL: http://www.advancingstates.org/node/74137

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Beneficiary Experience, Affordability, Utilization, and Quality in Medicare Advantage and Traditional Medicare: A Review of the Literature

The Kaiser Family Foundation's new report, “Beneficiary Experience, Affordability, Utilization, and Quality in Medicare Advantage and Traditional Medicare: A Review of the Literature,” details their findings from an analysis of 62 studies published since 2016 comparing traditional Medicare to Medicare Advantage. The analysis reviewed beneficiary experience, affordability, service utilization, and quality measures. According to the report, the review “found few differences between Medicare Advantage and traditional Medicare that are supported by strong evidence or have been replicated across multiple studies. Both Medicare Advantage and traditional Medicare beneficiaries reported similar rates of satisfaction.

Short URL: http://www.advancingstates.org/node/74122

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How Will the Prescription Drug Provisions in the Inflation Reduction Act Affect Medicare Beneficiaries?

This brief highlights key provisions of the federal Inflation Reduction Act of 2022, recently signed into law by President Biden. The law includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government, beginning in 2023. This brief examines the potential impact of these provisions for Medicare beneficiaries nationally and by state.

Short URL: http://www.advancingstates.org/node/74076

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July 2022 Data Book on Medicare Spending

On July 19, 2022 MedPAC released its July 2022 Data Book on Health Care Spending and the Medicare Program. This publication provides data on Medicare spending, demographics of the Medicare population, beneficiaries’ access to care, and Medicare program quality. Section 4 (pages 31-38) covers dually eligible individuals and includes information on the percentage of Medicare spending for this population, demographic data, health status, and service use. Within this section, states may be specifically interested in Chart 4-4: Demographic differences between dual-eligible beneficiaries and non-dual-eligible beneficiaries, 2019.

Short URL: http://www.advancingstates.org/node/74047

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The Biden Administration Announces a New Model to Improve Cancer Care for Medicare Patients

On Monday, June 27, 2022 the Biden Administration announced a new model aimed at improving cancer care for Medicare patients and lowering health care costs. CMS’ Center for Medicare and Medicaid Innovation designed the Enhancing Oncology Model (EOM) to test how to improve health care providers’ ability to deliver patient-centered care and consider patients’ unique needs. The model will focus on supporting patients, caregivers, and survivors, while addressing inequities and providing patients with treatments that address their individual needs.

Short URL: http://www.advancingstates.org/node/73997

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CMS Announces User-Friendly Medicare Website

On May 18, 2022 CMS announced several updates to the Medicare.gov website that make it easier for millions of people to access information to compare and select health and drug coverage and find providers. The updated website features timely initiatives and messages on the homepage and highlights key tasks and information most frequently sought by people with Medicare, people nearing Medicare eligibility, and their families.

Short URL: http://www.advancingstates.org/node/73933

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Informational Bulletin: Opportunities to Increase Enrollment in Medicare Savings Programs

On Monday, CMS published an Informational Bulletin describing ways for states to help eligible individuals enroll in the Medicare Savings Programs (MSPs), making health care more accessible and affordable. The MSPs cover Medicare Part A and B premiums and cost sharing for individuals with low income. In 2021, over 10 million individuals were enrolled in an MSP.

Short URL: http://www.advancingstates.org/node/73237

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Investing in Medicaid HCBS is Good for Medicare

Justice in Aging's new fact sheet, Investing in Medicaid HCBS is Good for Medicare, explains why investing in Medicaid HCBS is good for people with Medicare and the Medicare program. Robust funding for Medicaid HCBS would expand access to services, helping people with Medicare who are dually eligible for Medicaid avoid hospitalizations and other costly care.

Short URL: http://www.advancingstates.org/node/73168

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CMS Translates Medicare & You Handbook into Chinese, Vietnamese, and Korean

CMS announced the 2022 Medicare & You Handbook will be available in Chinese, Vietnamese, and Korean, as well as English and Spanish. Medicare & You is a resource designed to help Medicare enrollees make decisions about their coverage. The new Chinese version, along with Spanish, large print, audio book, and braille versions of Medicare & You are available on Medicare.gov.

Short URL: http://www.advancingstates.org/node/73111

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