Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)
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Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) VICAP Fall Training October 23, 2008 Kathy Nguyen CMS Health Insurance Specialist PowerPoint PPT Presentation


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Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) VICAP Fall Training October 23, 2008 Kathy Nguyen CMS Health Insurance Specialist. The Medicare Improvement for Patients & Providers Act, 2008. History

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Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) VICAP Fall Training October 23, 2008 Kathy Nguyen CMS Health Insurance Specialist

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Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)

VICAP Fall Training

October 23, 2008

Kathy Nguyen

CMS Health Insurance Specialist


The Medicare Improvement for Patients & Providers Act, 2008

History

  • H.R. 6331 introduced in the House on June 20, 2008; passed on June 24 by a vote of 355-59

  • Senate failed to act on June 26

  • Payment cuts scheduled to go into effect July 1

  • CMS delayed processing claims at fee-cut level until July 15

  • Senate passed package on July 9 after cloture vote of 69-30

  • President Bush vetoed bill on July 15

  • Congress overrides veto on same day; bill becomes law


The Medicare Improvement for Patients & Providers Act, 2008

MIPAA Highlights

  • Maintains physician payments

  • Reinstates therapy cap exceptions process

  • Reduces beneficiary copayment for mental health services

  • Additional preventive services to be considered

    • “Welcome to Medicare” initial physical examination period extended to first 12 months of new bene eligibility; no longer counted toward deductible in 2009

  • Requires all Medigap carriers to offer C and F


The Medicare Improvement for Patients & Providers Act, 2008

Other MIPAA Highlights

  • Benzodiazepines and barbiturates will be covered under Part D for certain conditions

  • Increase in low-income assistance for Medicare beneficiaries

  • Permanently waives Part D late enrollment penalty for LIS-eligible individuals

  • Increases SSA assistance with Medicare Savings Program applications


The Medicare Improvement for Patients & Providers Act, 2008

Medicare Advantage and Prescription Drug Plan Marketing Provisions

  • Prohibits unsolicited direct contact

  • Prohibits cross-selling

  • Enforces scope of appointment

  • Limits sales/marketing in healthcare settings

  • Prohibits sales/marketing at educational events

  • Prohibits meals

  • Limits nominal gifts


The Medicare Improvement for Patients & Providers Act, 2008

Medicare Advantage and Prescription Drug Plan Marketing Provisions

  • Prohibits co-branding

  • Requires state appointed agents/brokers

  • Defines agent/broker training and testing

  • Defines agent/broker compensation

  • Requires plan reporting of terminated agents

  • Eliminates File & Use Eligibility


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