This week, the Center for Medicare Advocacy (CMA) released an issue brief that examines the details and legal underpinnings of several proposed and upcoming changes to the Medicare Advantage (MA) program. Designed to be a resource for advocates and attorneys, CMA’s analysis combines several disparate sources of MA changes, including recently signed legislation, regulatory rulemaking, and sub-regulatory guidance. It also predicts some of the consequences of these changes on, among other things, beneficiary decision-making and informed choice.
The brief outlines the changes to MA made in the Balanced Budget Act of 2018 (BBA), in the Part C and D final rule issued earlier this year, and in the Final Call Letter for 2019. These changes increase flexibility for MA plans in several ways, including:
- expanding what supplemental benefits plans may choose to offer (effective in 2019 for changes from the C & D final rule and effective in 2020 for changes from the BBA ),
- allowing plans to treat beneficiaries differently based on health status, allowing companies to offer more plan choices,
- streamlining the process for a sponsor to enroll a newly-eligible Medicare beneficiary who was previously enrolled in that company’s non-MA plan, and
- creating expanded enrollment opportunities.
With so many significantly overlapping changes, this report provides a comprehensive and thorough analysis – listing together the various flexibilities and freedoms MA plans will have in the coming years. Medicare Rights continues to monitor and analyze how these regulatory trends and practical changes will affect people with Medicare and those who help them navigate coverage decisions. As part of this process, we will be releasing consumer-friendly education tools and policy analysis in the coming weeks on the anticipated changes to MA plans, beneficiary tools and resources, Medicare and the opioid crisis, and Medicare enrollment periods.
We also remain actively engaged in the implementation of these regulatory developments, to ensure the beneficiary perspective is considered and embedded in any changes to the program. We recognize that some of the new policies may not ultimately benefit people with Medicare, and we will continue to monitor the use and potential abuse of these new rules.