Medicare Improvements for Patients and Providers Act

Medicare Improvements for Patients and Providers Act  (MIPPA)

Overview of MIPPA

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On July 15, 2008, Congress enacted the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), Pub. Law 110-275. MIPPA is a multi-faceted piece of legislation containing several important provisions that directly changed the Medicare program and allocated federal funding (through Section 119) for State Health Insurance Assistance Programs (SHIPs), Area Agencies on Aging (AAAs), Aging and Disability Resource Centers (ADRCs), and to a technical resource center, which is run by the National Council on Aging (NCOA), to provide outreach to low-income Medicare beneficiaries to increase enrollment in Medicare low-income assistance programs. One major goal of MIPPA is the continued improvement of Medicare access and affordability for low-income beneficiaries.

MIPPA has undergone six rounds of funding since its enactment in 2008. All states are allocated funding based on a formula that takes into account each state’s Medicare population. The most current MIPPA reauthorization comes from the Bipartisan Budget Act of 2018, Pub. Law 115-123, enacted on February 9, 2018. This legislation extends MIPPA funding for outreach and enrollment for two years, through fiscal year 2019. The authorizing legislation for MIPPA funding includes:

ADvancing States’ Work to Further MIPPA Outreach 


COVID-19 is a long-lasting and complex disaster situation involving a public health emergency and an economic crisis, with particularly acute impacts for older adults, people with disabilities, and others with certain health conditions. States are responding with changes in policies and procedures to ensure individuals have access to public benefit programs (e.g. Medicare Savings Programs, LIS/Extra Help, SNAP, and LIHEAP). During the COVID-19 crisis, ADvancing States is working with our state membership to identify changes that states have made to their systems for connecting individuals to benefits and to explore options, developments, and challenges in responding to the COVID-19 pandemic. The following resources have been developed in response to COVID-19:

Benefits Access and Enrollment During COVID-19: Findings from State Aging and Disability Agencies

Process and Application Changes to Benefit Enrollment Systems During COVID-19: Findings from State Aging and Disability Agencies

Nutrition Initiatives During COVID-19: Findings from State Aging and Disability Agencies

Outreach Tools

Making Connections with the Disability Community

In collaboration with national stakeholders in the aging and disability networks and with feedback from local Centers for Independent Living, ADvancing States has developed and disseminated outreach materials to promote Medicare low-income subsidies to beneficiaries with disabilities.

These outreach materials include posters to educate Medicare beneficiaries with disabilities about low-income subsidies. The posters include an editable space wherein outreach professionals may add contact information for their preferred referral source. The posters are available here:

Available Medicare Savings
Get Help with your Medicare Costs!
I’m Working but I Still Can’t Afford My Medicare Costs…
The Medicare Low-Income Subsidies Quick Reference Tool

Media Campaign

ADvancing States developed a call for collaboration media campaign intended to educate and ultimately enroll more people in the Medicare Low-Income Subsidy programs. ADvancing States partnered with national and state disability organizations to reach people with one or more impairments that qualify for disability benefits.

An overview of resources for outreach and creative ways to publicize information for consumers used in the campaign is available here.


ADvancing States has a series of infographics that are widely used by state members and the aging and disability networks for outreach and education purposes. The newest infographic in the series provides information on coverage and costs for low-income Medicare beneficiaries. The infographic describes people on Medicare, financial needs among beneficiaries, programs supporting low-income beneficiaries, and ways to improve access. Click here to access the infographic. Contact ADvancing States if you would like hard copies.

Promising Practices

Identifying and Disseminating Promising Practices for MIPPA Outreach

ADvancing States collaborates with several national stakeholders in the Aging and Disability Networks to gather information about local-level MIPPA outreach from the I&R Network, ADRCs, AAAs and CILs. Based on information gathered, ADvancing States develops educational materials highlighting promising practices in MIPPA outreach. The MIPPA initiative also collaborates with the I&R Center at ADvancing States to gather data about the role of aging and disability agencies and I&R/A professionals in benefits education and outreach.

Promising Practice Profiles:
Engaging Consumers Through Fun and Interactive Games
Tools to Simplify Benefits Information for Staff
System for Providing Comprehensive Eligibility Information
Increasing Outreach by Building Partnerships
Increasing ADRC Employees’ Awareness of Medicare “Help” Programs

Practices Across the Country:
Information and Referral/Assistance's (I&R/A) Role in Connecting Clients to Benefits

Innovations in Benefits Outreach National Contest:
In 2019, ADvancing States and NCOA hosted and Innovations in Benefits Outreach National Contest to identity promising practices in benefits outreach to older adults and persons with disabilities. The New Jersey Department of Human Services, Division of Aging Services and Feeding the Gulf Coast were awarded for their promising practices. View the video interviews below to learn more about their practices to reach more individuals potentially eligible for benefits such as the Medicare low-income subsidies, SNAP, and LIHEAP.

New Jersey Department of Human Services, Division of Aging Services
Feeding the Gulf Coast


The Role of MIPPA: Helping Older Adults and Individuals with Disabilities Afford Medicare

ADvancing States iQ is our online learning center that offers free educational courses on topics related to the aging and disability networks. A course is available on “The Role of MIPPA: Helping Older Adults and Individuals with Disabilities Afford Medicare”. This module provides participants with information about MIPPA, the Medicare program, and the Medicare low-income subsidies. The module also provides key referral resources for additional program information and enrollment assistance.

To access the MIPPA course, please visit

MIPPA Legislation 

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) brought important improvements to the Medicare system. MIPPA is a complicated piece of legislation, running over 275 pages. Not all provisions are discussed on our MIPPA Legislation page; rather, the brief overview aims to discuss pertinent areas that are of particular importance to states and low-income beneficiaries. Topics included are:

  1. Changes affecting beneficiaries with limited incomes and resources
  2. Medicare Advantage changes
  3. Medigap changes
  4. Changes to Therapy and Psychiatric costs and coverage caps