Trump and CMS Announce Expansion to Medicare Advantage & Part D for Medicare Beneficiaries

The Trump Administration has announced that the Centers for Medicare & Medicaid Services (CMS) has finalized new requirements that will positively affect Medicare beneficiaries. The changes to Medicare Advantage and Part D (prescription coverage) include:

  • An increase in access to telehealth for seniors in Medicare Advantage (MA) plans.
  • Expansion of the types of supplemental benefits available for beneficiaries with an MA plan who have chronic diseases.
  • Provided support for more MA options for beneficiaries in rural communities, and expansion to access to MA for patients with End Stage Renal Disease (ESRD).

Together, CMS and the Trump Administration move forward to advance Protecting and Improving Medicare for Our Nation’s Seniors (PNHP) and Advancing American Kidney Health, as well as other CMS strategic initiatives.

“CMS’s rapid changes to telehealth are a godsend to patients and providers and allows people to be treated in the safety of their home,” said CMS Administrator Seema Verma. “The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”

Building on telehealth equals more coverage

The Trump Administration originally enhanced telehealth mainly to access telehealth so beneficiaries can get care at home instead of traveling to a healthcare facility. The new ruling encourages MA plans to increase their telehealth benefits and increase plan options for beneficiaries living in rural areas. 

CMS is giving MA plans more flexibility to count telehealth providers in certain specialty areas such as:

  • Dermatology
  • Psychiatry
  • Cardiology
  • Ophthalmology
  • Nephrology
  • Primary Care
  • Gynecology
  • Endocrinology
  • Infectious Diseases 

This flexibility will encourage plans to enhance their benefits to give beneficiaries access to the latest telehealth technologies and increase plan choices for beneficiaries residing in rural areas.

This new ruling allows beneficiaries with ESRD more coverage choices in the Medicare program. Previously, beneficiaries with ESRD were only allowed to enroll in MA plans in limited circumstances. 

The new ruling gives beneficiaries with ESRD access to more affordable Medicare coverage options that may include extra benefits such as health and wellness programs, transportation, or home-delivered meals that are not available in Medicare Fee-For-Service starting in 2021.

Star ratings system

CMS is also finalizing proposals to enhance the Medicare Advantage and Part D star ratings system to further increase the impact that patient experience and access measures have on a plan’s overall Star Rating. 

The star ratings system helps people with Medicare, their families, and their caregivers understand and compare the quality of health and drug plans being offered to them. Like most consumer products, the best indicators of quality are how its consumers feel about their product, or in this instance, coverage experience. 

The commitment of CMS to its patients is being made evident during this time of pandemic and fragility of the American economy. They are committed to improving the incentives for Medicare plans to focus on what patients value and feel is most important. 

Additionally, CMS adopted a series of changes in the March 31, 2020, Interim Final Rule with Comment Period (CMS-1744-IFC) for the 2021 and 2022 Star Ratings to accommodate challenges arising from the COVID-19 public health emergency.

Trump in need of the senior vote

The expansion of Medicare appears to be on the forefront of President Trump’s mind, as he announced his plans to lower Medicare copays for insulin to a maximum of $35 a month, if re-elected as President, earlier last month. In hopes to gain the older American vote, Trump is making Medicare a top priority in his re-election campaign.

An AP-NORC poll this month found warning signs for Trump with older voters. Fifty-four percent of adults 60 and older said they disapproved of how Trump is handling his job as president, while 45 percent approved.

“I hope the seniors are going to remember it,” Trump said in hopes to gain the crucial votes of older Americans that he would need to be re-elected.

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