Medicare

CMS on Tuesday (Sept. 29) lowered the thresholds for testing nursing home staff for COVID-19, basing its new methodology on the number of tests done in the county as well as COVID-19 positivity rates as opposed to just the latter.

Democratic presidential candidate Joe Biden’s proposal to reform the Affordable Care Act’s tax credits by removing the so-called “subsidy cliff” would reduce health care costs for nearly all current marketplace enrollees, according to a Kaiser Family Foundation analysis out just prior to the first presidential debate.

CMS says it is pleased Congress is working to change the repayment terms of Medicare loans to providers and to mitigate Part B premium hikes as part of the continuing resolution that the Senate is set to take up Tuesday (Sept. 29), after key Democrats wrote to the agency raising concerns with lack of clarity on provider repayment, the effects of the program on Medicare premiums and the overall amount of Part B loans given to providers.

Only some seniors will receive the president’s $200 Medicare Part D cards for copays before the election because it will take months to issue the cards, White House officials said Friday (Sept. 25).

The average monthly Medicare Advantage premium is expected to drop by just under $3.00 in 2021 compared to this year, CMS said Thursday (Sept. 24), coming to $21.00 per month.

Congress is expected to soon send to the president a continuing resolution to fund the government through Dec. 11 that also includes funding extensions for several Medicare and Medicaid programs, a delay in cuts to Medicaid disproportionate share hospitals, and an extension for repayment and lowered interest for certain COVID-19 provider relief payments, among other health care riders.

CMS on Tuesday (Sept. 22) announced it will expand Medicare prior authorization for repetitive, scheduled, non-emergency ambulance transportation nationwide after a demonstration saved Medicare about $650 million over four years while preserving access and quality.

The White House Office of Management and Budget on Monday (Sept. 21) started reviewing the second part of the Medicare Advantage and Part D rate notice and pay policies for 2022, though the Trump administration potentially could be out of office when that regulation is released.

Administration officials haven’t figured out how to make coronavirus vaccinations free to Medicare fee-for-service beneficiaries, though HHS Deputy Chief of Staff for Policy Paul Mango said they would pay no more than $3.50.