The Bipartisan Budget Act of 2018, signed into law on February 9, did more than end the brief government shutdown. Included in the bill were several key health provisions. Here’s a look at what these changes mean for Medicare.
According to the summary of the bill, the section on health provisions extends or revises various Medicare programs and payment rules. It cuts annual funding for the Medicare Improvement Fund, as well as for the Medicaid Improvement Fund.
It also “modifies Medicare provisions related to supervision requirements, home-health claims, intensive cardiac-rehabilitation programs, telehealth, accountable care organizations, medical records, accreditation, physician self-referral, speech-generating devices, fraud and abuse, coverage of certain testing services, hospital transfers to hospice, ambulance transports, certain outpatient therapy services, long-term care hospital payments, and biosimilar products.”
Several sections impact Medicare Advantage specifically. The bill reauthorizes and revises special-needs plans and expands testing of the Value-Based Insurance Design Model. It also modifies provisions for quality ratings, supplemental benefits and telehealth.
Medicare Rights Center
Medicare Rights Center, a non-profit organization, has reviewed the bill and offered its analysis of the changes to Medicare.
Medicare Rights Center supports several provisions, including the following:
- The bill will help close the so-called donut hole sooner by requiring certain drug manufacturers to provide larger discounts to Medicare Part D beneficiaries.
- The bill helps fund Medicare outreach and enrollment activities for two more years.
- The bill repeals the Medicare therapy caps, which put a payment cap on outpatient physical, occupation and speech therapies.
- The bill provides permanent coverage for speech generating devices.
Although Medicare Rights Center has expressed approval of the decision above, the non-profit organization opposes two aspects of the bill:
- The bill increases Medicare premiums. Some beneficiaries can expect to pay more for Medicare Part B and Medicare Part D under the bill.
- The bill does not address certain issues, notably the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act. The BENES Act would restructure enrollment and coverage periods and establish notification requirement, all with the intent of improving the enrollment process and reducing the number of people forced to pay stiff penalties due to missed deadlines. You can read more about the BENES Act here.