MedPAC Approves Recommendations That Would Increase Participation In Medicare Programs For Low-Income Beneficiaries, CQ HealthBeat Reports

Main Category: Medicare / Medicaid / SCHIP
Article Date: 10 Dec 2007 - 10:00 PDT

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The Medicare Payment Advisory Commission on Thursday approved a set of recommendations for Medicare programs that provide financial assistance to lower-income beneficiaries and for Medicare special needs plans, CQ HealthBeat reports.

During the first day of a two-day meeting, commissioners approved a recommendation to have Congress stipulate that the HHS secretary make Medicare prescription drug benefit claims available "regularly and in a timely manner" to certain federal agencies "for purposes of program evaluation, public health and safety." MedPAC also approved recommendations that would:

• Urge Congress to mandate that the Social Security Administration screen applicants for Medicare Part D's low-income subsidy to determine if beneficiaries also are eligible for the Medicare Savings Programs and then to enroll those that qualify;
  
  
• Urge the HHS secretary to increase funding to State Health Insurance Assistance Programs to enable the programs to better identify and enroll qualified individuals; and
  
  
• Urge Congress to raise MSP income and asset eligibility to match the eligibility for Medicare Part D's low-income subsidy program, which is higher than MSP levels. If eligibility for both programs were the same, SSA offices would be able to screen and enroll beneficiaries at the same time, according to commissioners.

MedPAC commissioners approved several recommendations for SNPs, which serve dual eligibles, beneficiaries who are institutionalized and patients with severe chronic diseases or conditions. One SNP recommendation would urge Congress to extend the authority to limit program enrollment, set to expire in December 2008, for an additional three years under conditions set out in other recommendations approved on Thursday.

One of the recommendations said that the HHS secretary should establish additional performance measures for SNPs and evaluate the plans on these measures every three years. In addition, MedPAC recommended that the HHS secretary provide beneficiaries and others with information that compares SNPs' benefits and quality measures with those of Medicare Advantage plans and traditional Medicare. MedPAC also recommended that SNPs that serve dual eligibles work more closely with states to improve coordination with Medicaid. MedPAC also said Congress should mandate that SNPs enroll at least 95% of their target population (Carey, CQ HealthBeat, 12/6).

Draft Payment Recommendations
In related news, MedPAC on Thursday released a draft recommendation to Congress that fiscal year 2009 Medicare payments for inpatient and outpatient care be increased at a rate equal to the change of the "market basket" index, which Medicare uses to measure the costs of delivering treatment, CQ HealthBeat reports. An additional MedPAC recommendation would freeze Medicare payments to skilled nursing facilities at current levels because profit levels have been in the double digits for the past six years, according to MedPAC staff Carol Carter.

MedPAC Chair Glenn Hackbarth said that the draft recommendation is a beginning point of discussion and might undergo revisions. The commission in Jan. 2008 will vote on the final language of the recommendations, which will then become part of a report to Congress submitted in March (Reichard, CQ HealthBeat, 12/6).

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