Upcoming Medicare Additions for Treatment for Opioid Use Disorder

Julie CarterMedicare WatchLeave a Comment

The Centers for Medicare & Medicaid Services (CMS) recently finalized a rule that expands Medicare coverage for Opioid Use Disorder (OUD). Recent legislation, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, established a pathway for this more comprehensive Medicare coverage of OUD services. Beginning on January 1, 2020, Medicare Part B will cover OUD treatment—including methadone for Medication Assisted Therapy (MAT)—furnished by an Opioid Treatment Program (OTP) under a bundled payment mechanism. This means a significant improvement in access to OUD care for people with Medicare, including for those who are dually eligible for Medicaid. Read More...

Court Blocks Sweeping Rule that Would Negatively Impact Patient Access to Care

Julie CarterMedicare WatchLeave a Comment

This week, a federal court blocked a Trump administration rule that would have allowed health plans and providers to refuse to provide certain types of care they disagreed with on moral or religious grounds. Set to take effect on November 22, the rule would have permitted individuals to deny care even in circumstances where performing the refused service was a significant portion of their jobs, and even where the refusal could prevent patients from receiving the service altogether. Read More...

New Report Details High Out-of-Pocket Costs for Some with Medicare

Lindsey CopelandMedicare WatchLeave a Comment

A new analysis from the Kaiser Family Foundation (KFF) underscores these challenges. According to the report, people with Original Medicare spent an average of $5,460 out of their own pockets for health care in 2016. Nearly half of this spending was for services outside of Medicare, such as LTSS (32%) and dental care (14%). The other half was largely devoted to meeting beneficiary cost-sharing obligations, including for provider-based care (22%) and prescription drugs (21%). Read More...

CMS Extends Needed Relief for People with Medicare Mistakenly Enrolled in Marketplace Plans

Fred RiccardiMedicare WatchLeave a Comment

This week, the Centers for Medicare & Medicaid Services (CMS) announced in guidance the phase out and extension of a critical relief pathway for current and former Marketplace enrollees who mistakenly delayed their Medicare Part B enrollment. Eligibility for this policy will sunset on June 30, 2020. Under this time-limited policy—known as equitable relief—people who are eligible for Medicare and have Marketplace Read More...