Part D Premiums, Medicare Data Sharing, Special Needs Program Extension
Executive Summary
CMS Policy
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CMS Policy CMS will base its calculation of the 2009 national average monthly Medicare Part D bid on actual plan enrollment, the agency says in a Feb. 22 advance notice of change. Calculations in previous years have been based only partially on enrollment weighting, due to concerns with trying to limit annual changes in Part D premiums. However, the agency will continue to calculate the regional low-income benchmark premium amount for 2009 based only in part on actual enrollment. MedPAC Views In its March 2008 report to Congress on Medicare payment policy, the Medicare Payment Advisory Commission recommends that Congress require HHS to make Part D claims data available regularly and in a "timely" manner to congressional support agencies and selected federal agencies for program evaluation. The commission has expressed disappointment that a CMS rule on Part D data sharing has languished since it was proposed in 2006 (1 (Also see "Part D Claims Data Sharing: Lack Of Progress Gets MedPAC’s Attention" - Pink Sheet, 12 Nov, 2007.), p. 24). MedPAC also urges that the authority for Medicare Advantage special needs plans be extended for three years to allow for more "rigorous" evaluation of their benefits. SNPs were established by the Medicare Modernization Act to focus on coordinated care for Medicare/Medicaid dual eligibles, individuals who are institutionalized, or those with severe or disabling chronic conditions. Such plans must include a drug benefit. Authorization is set to expire at the end of 2008. On The Hill Senate Finance Committee Chairman Max Baucus, D-Mont., introduced White House-drafted legislation Feb. 25 to reduce Medicare spending, including a provision that higher-income seniors pay a larger Part D premium. He called the "Medicare Funding Warning Act" "ill-conceived" at the time of introduction. A similar item is in the president's proposed fiscal 2009 budget (2 (Also see "Budget Pushes For ESA Bundling, Repeats Medicaid AMP Proposal" - Pink Sheet, 11 Feb, 2008.), p. 7). Under MMA, the White House must propose, and the Finance chairman must introduce, legislation to pare Medicare spending if general revenues finance at least 45 percent of Medicare. The 45 percent trigger was first hit last year. |