Navigating the Latest in Legislative & Regulatory Updates

 

The Friday Five for April 5, 2024*:

• Streamlining Enrollment in CHIP & Medicaid
• Medicaid Unwinding SEP Extended
• Short-Term Medical Insurance Changes
• Final CY 2025 Part D Redesign Program
• 2025 CY MA and Part D Rate Announcement

 

*Note: This episode was recorded prior to the release of the CY 2025 MA and Part D Final Rule. Stay tuned for more information! 

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Streamlining Enrollment in CHIP & Medicaid:

Biden-Harris Administration Builds on the Success of the Affordable Care Act by Streamlining Enrollment in Medicaid and CHIP Coverage: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-builds-success-affordable-care-act-streamlining-enrollment-medicaid-and

Medicaid Program; Streamlining the Medicaid, Children's Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes: https://www.federalregister.gov/documents/2024/04/02/2024-06566/medicaid-program-streamlining-the-medicaid-childrens-health-insurance-program-and-basic-health

 

Medicaid Unwinding Extended:

HHS Takes Additional Actions to Help People Stay Covered During Medicaid and CHIP Renewals: https://www.cms.gov/newsroom/press-releases/hhs-takes-additional-actions-help-people-stay-covered-during-medicaid-and-chip-renewals

Medicaid Enrollment and Unwinding Tracker: https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/

 

Short-Term Medical Insurance Changes:

Biden-Harris Administration Protects Consumers from Low-Quality Coverage by Limiting “Junk” Health Plans: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-protects-consumers-low-quality-coverage-limiting-junk-health-plans

Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage: https://public-inspection.federalregister.gov/2024-06551.pdf

Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage (CMS-9904-F) Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/short-term-limited-duration-insurance-and-independent-noncoordinated-excepted-benefits-coverage-cms#_ftn1

STLDI Final Rules to Affect Short-Term Medical & Hospital Indemnity Plans: https://ritterim.com/blog/stldi-final-rules-to-affect-short-term-medical-and-hospital-indemnity-plans/

 

Final CY 2025 Part D Redesign Program:

Final CY 2025 Part D Redesign Program Instructions Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/final-cy-2025-part-d-redesign-program-instructions-fact-sheet

 

2025 CY MA and Part D Rate Announcement:

2025 Medicare Advantage and Part D Rate Announcement: https://www.cms.gov/newsroom/fact-sheets/2025-medicare-advantage-and-part-d-rate-announcement

CMS Finalizes Payment Updates for 2025 Medicare Advantage and Medicare Part D Programs: https://www.cms.gov/newsroom/press-releases/cms-finalizes-payment-updates-2025-medicare-advantage-and-medicare-part-d-programs

Fact Sheet: 2024 Medicare Advantage and Part D Rate Announcement: https://www.cms.gov/newsroom/fact-sheets/fact-sheet-2024-medicare-advantage-and-part-d-rate-announcement 

Medicare Moves Toward Election Season Clash With Insurers: https://www.thinkadvisor.com/2024/04/02/medicare-moves-toward-election-season-clash-with-insurers/

Payers say MA rate cut puts affordable care at risk: https://www.fiercehealthcare.com/ai-and-machine-learning/medicare-advantage-rate-cut-remains-feds-keep-pressure

 

Resources:

5 Alternative Apps to Replace Google Podcast: https://link.chtbl.com/ASGF20240329

BOI Reporting for LLCs & ACA Enrollment Updates: https://link.chtbl.com/ASGF20240105

Halfway Through Medicaid Unwinding: https://link.chtbl.com/ASGF20240216

Health Care Provisions in Biden's 2025 Budget: https://link.chtbl.com/ASGF20240315

 

References:

Federal Register Website: https://www.federalregister.gov/

Medicare Advantage Communication Requirements: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-422/subpart-V

Medicare Marketing Guidelines: https://www.cms.gov/medicare/health-drug-plans/managed-care-marketing/medicare-guidelines

Part D Communication Requirements: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-423/subpart-V

 

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