Hello, MIPPA grantees,

While we are still absorbing the changes to Medicare coming in 2024, please know that CMS recently issued a proposed rules that will impact Medicare beneficiaries starting in 2025.  On November 6, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a Notice of Proposed Rulemaking (NPRM) regarding Medicare Parts C and D, among other topics.  CMS also issued a fact sheet summarizing the major provisions of the NPRM. On November 15, CMS issued the official, published version of that NPRM in the Federal Register. Comments are due no later than January 5, 2024.

NCOA would like to highlight grantee and beneficiary experiences yet again in our upcoming response to the proposed rulemaking to make our arguments. We will be sending out a grantee survey in the coming weeks that provides an opportunity to speak directly to CMS about beneficiary experiences that are related to the proposals. When we surveyed the network for the CY 2024 Parts C and D proposed rule, so many of you provided stories about beneficiary experiences that we used to great extent in our comment letter. NCOA will again use your comments as much as possible.

Some of the highlights of the CY 2025 proposed rule include proposals that would:

• Prohibit third-party marketing organization and plan contracts “that may interfere with the agent's or broker's ability to objectively assess and recommend the plan that best fits a beneficiary's health care needs; set a single compensation rate for all plans; revise the scope of items and services included within agent and broker compensation”;
• Establish greater transparency around supplemental benefits in Medicare Advantage;
• Require Medicare Advantage plans to conduct an equity evaluation of prior authorizations;
• Allow individuals dually eligible to enroll and disenroll into an integrated product once a month rather than quarterly and creating a new enrollment period to allow for the monthly enrollment;
• Limit the number of D-SNPs offering plans in the same service area;
• Limit broker compensation; and
• Limit out-of-pocket cost sharing for PPO D-SNPs;

The NPRM also includes an:

• RFI on how to make improvements to Medicare Plan Finder for D-SNPs;

Disclaimer

The information contained in this communication from the sender is confidential. It is intended solely for use by the recipient and others authorized to receive it. If you are not the recipient, you are hereby notified that any disclosure, copying, distribution or taking action in relation of the contents of this information is strictly prohibited and may be unlawful.

This email has been scanned for viruses and malware, and may have been automatically archived by Mimecast Ltd, an innovator in Software as a Service (SaaS) for business. Providing a safer and more useful place for your human generated data. Specializing in; Security, archiving and compliance. To find out more Click Here.