E-alert

The Medicare Savings Programs and Extra Help are important programs designed to help low-income Americans afford Medicare coverage. Many people who are eligible for these programs are not yet enrolled. Each May, the Social Security Administration (SSA) sends letters to 2 million low-income Medicare beneficiaries, informing them about the Medicare Savings Programs and how they can help with Medicare costs. These include the Qualified Medicare Beneficiary (QMB), Specified Low-income Medicare Beneficiary (SLMB), and Qualifying Individual (QI) programs.

On March 11, 2021, the Centers for Medicare & Medicaid Services (CMS) released the updated State Phased-Down (SPD) Billing Guide. The Medicare Prescription Drug Improvement and Modernization Act of 2003 (Medicare Modernization Act or MMA) established the Medicare Part D prescription drug benefit. As a result, Medicare became the primary payer for most prescription drugs for full-benefit dually eligible individuals.

February 2021 Integrated Care Updates

On April 24, 2019, CMS released a State Medicaid Director Letter that invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial Alignment models; (2) managed fee-for-service Financial Alignment models; and (3) state-specific models.