The U.S. Centers for Medicare and Medicaid Services (CMS) has issued a rule that it states will increase access to telehealth for seniors in Medicare Advantage (MA) plans, expand the types of supplemental benefits available for beneficiaries with an MA plan who have chronic diseases, provide support for more MA options for beneficiaries in rural communities, and expand access to MA for patients with End Stage Renal Disease (ESRD).
CMS is finalizing a minor policy modification to the Special Supplemental Benefits for the Chronically Ill (SSBCI). Previously, CMS limited the chronic conditions an enrollee must have to be eligible under SSBCI to those conditions outlined in the Medicare Managed Care Manual (Chapter 16b). However, because other chronic conditions may meet the statutory definition of a chronic condition outside of Chapter 16b, CMS is allowing plans to target other chronic conditions beginning in contract year 2021.
CMS’s rule also includes proposals to enhance the MA and Part D Star Ratings system to further increase the impact that patient experience and access measures have on a plan’s overall Star Rating.