In a letter sent on February 9, 2021 to the U.S. Department of Health and Human Services (HHS) Acting Secretary Norris Cochran, the Center for Medicare Advocacy and the Medicare Rights Center urged the Biden Administration to take swift action to strengthen Medicare, Medicaid, and the Affordable Care Act.
While both organizations have issued lengthy policy recommendations to the new Administration (see the Center for Medicare Advocacy’s Transition Memo here), the letter outlines matters requiring immediate attention, including the issues raised below (links to previous writings by the Center are included where relevant).
In order to ensure that all Medicare-eligible individuals can access their earned Medicare benefits during the COVID-19 pandemic, we urged HHS to:
- Reinstate and strengthen COVID-19 Medicare Enrollment Flexibilities, similar to those provided to Affordable Care Act plans in an Executive Order issued on January 28;
- Define “Hospital Inpatient” to counteract the harm caused by hospital “outpatient observation status” (see here); and
- Implement Telehealth Flexibilities concerning Speech Generation Devices (SGDs), to prevent people who need such devices from having to access in-person care (see here).
With respect to Medicare outreach and enrollment, we urged HHS to launch implementation of the Beneficiary Enrollment Notification and Simplification (BENES) Act and guarantee objectivity in consumer tools that in recent years have inappropriately steered people towards enrollment in Medicare Advantage (MA) plans (see here).
In order to stop harmful and often last-minute policies issued by the Trump Administration, our organizations called on HHS to include the following actions as part of their regulatory review process:
- Immediately pause the New “Geo” Demonstration Model and the Medicaid Managed Care Organization (MCO)-based Direct Contracting Entity Model, both of which are being rushed despite important unanswered questions and issues (see here);
- Revise the Medicare Part D Model that weakens the protected drug classes guarantee—an important consumer protection;
- Suspend expansion of the Medicare Home Health Value-Based Purchasing Model (HHVBP), which limits access to home care for those with longer term and chronic conditions (see here);
- Rescind provisions of the final 2021 Medicare Part C & D rule, which, among other things, further complicates the Part D benefit by adding another specialty drug tier, and weakens the distinction between educational and marketing events (see here); and
- Rescind the SUNSET Rule, which puts an arbitrary expiration date on almost all regulations issued by HHS (see here).
With respect to policies outside of Medicare, the organizations urged HHS to ensure access to Healthcare.gov, revoke changes to Medicaid Maintenance of Effort (MOE) requirements, and restore Medicaid safeguards.
February 11, 2021 – D. Lipschutz