- CMS to Clarify Medigap Section of the Medicare.gov Plan Finder Tool
- CMS Proposes Rollback of Emergency Preparedness Requirements to Reduce “Burdens” for Nursing Home Providers
Concerned that Medicare beneficiaries could reject proper consideration of Medigap supplement plans because of undefined and significantly high costs listed in an “Estimated Annual Cost” column for Medigaps in the Medicare.gov CMS Plan Finder tool, the Center for Medicare Advocacy (the Center) requested CMS define costs that are included in the “Estimated Annual Cost” column. The cost column is embedded in a chart that addresses only Medigap information as supplemental coverage for traditional Medicare, but the “Estimated Annual Cost” numbers provided by CMS substantially exceed the cost of Medigap plans.
CMS agreed with the Center that additional language clarifying total costs in the Medigap section of the Plan Finder tool would be useful. CMS further stated there will be new language explaining that these “Estimated Annual Costs” include total out-of-pocket costs, not just Medigap premiums. “Estimated Annual Costs” are derived from a CMS document titled CY 2019 Medicare Plan Finder Out-Of-Pocket Cost Estimates Methodology. The calculations for “Estimated Annual Costs” include all possible Medicare and non-Medicare related health costs such as non-Medicare covered long term care and all dental costs.
The Center will continue to work with CMS and other beneficiary advocates to ensure Medicare beneficiaries are fully informed as they make important decisions about their choices for receiving Medicare benefits in 2019.
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On September 20, 2018, CMS issued a notice of proposed rulemaking (NPRM) to revise the emergency preparedness program requirements. Most notably, the proposed rule would allow nursing homes to review their emergency preparedness programs and to train staff to carry out those plans every two years rather than annually. The HHS Office of the Inspector General has previously indicated that poorly developed or outdated emergency preparedness programs have resulted in deficient responses to emergencies.
The Center for Medicare Advocacy and the Long Term Care Community Coalition (LTCCC) strongly believe nursing home residents will be at a greater risk of harm and even death if the emergency preparedness requirements were to be rolled back. To read our comments opposing CMS’s proposal, please see https://www.medicareadvocacy.org/center-and-ltccc-comments-on-snf-emergency-preparedness/.
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