CMS proposes Medicare enrollment, coverage changes
The Centers for Medicare & Medicaid Services Friday released a proposed rule that would implement provisions in the Consolidated Appropriations Act of 2021 that revise the effective dates of coverage in traditional Medicare; authorize special enrollment periods for certain eligible individuals; and extend Part B coverage for immunosuppressive drugs for kidney transplant patients.
Beginning Jan. 1, 2023, coverage for individuals enrolling in traditional Medicare during the last three months of their initial enrollment period or during the general enrollment period would begin one month after enrollment, CMS said. The rule also would create SEPs for individuals impacted by an emergency or disaster; who can demonstrate that their employer or health plan materially misrepresented information related to timely enrolling; formerly incarcerated individuals; after termination of Medicaid eligibility; and other exceptional conditions.
Beginning this October, individuals with end stage renal disease who do not have other health insurance could enroll in Medicare Part B coverage for immunosuppressive drugs beyond the 36-month post-transplant period.
Among other changes, the rule also would require states to specify their policy for paying Medicare Part A and B premiums on behalf of low-income individuals in their Medicaid plan; and limit states’ liability for retroactive Part B premiums to 36 months for certain full-benefit dually eligible beneficiaries.
CMS will accept comments on the proposed rule for 60 days after its publication in the Federal Register.