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Medicare Update n4a Aging Policy Briefing April 28, 2014 Stacy Sanders Federal Policy Director

Medicare Update n4a Aging Policy Briefing April 28, 2014 Stacy Sanders Federal Policy Director. Heard on the helpline. Denials and appeals Transitions to Medicare Affordability. A look back…. Agreement on physician payment reform Bipartisan, bicameral legislation introduced

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Medicare Update n4a Aging Policy Briefing April 28, 2014 Stacy Sanders Federal Policy Director

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  1. Medicare Updaten4a Aging Policy BriefingApril 28, 2014Stacy SandersFederal Policy Director

  2. Heard on the helpline • Denials and appeals • Transitions to Medicare • Affordability

  3. A look back… • Agreement on physician payment reform • Bipartisan, bicameral legislation introduced • Repeals Sustainable Growth Rate (SGR) formula • Replaces with value-based payment system • Some agreement on critical extenders • Qualified Individual (QI) program • Low-income outreach and enrollment funds • No agreement on offsets • Concern about shifting costs to beneficiaries

  4. A look back… • Part C and Part D proposed rule • Enhanced plan oversight and monitoring • Consolidated Part D plan choices • Increased transparency on drug pricing • Diminished protected drug classes • In the end, much of the rule will not be finalized • Part C and Part D call letter • Medicare Advantage payment rates • New policy on network changes

  5. In the here and now... • Welcome to election season! • New policy unlikely • Still, Medicare will be in the news • Candidates running on Obamacare • Medicare Advantage a central theme • House Budget premium support plan • 2014 Medicare Trustees Report

  6. A look ahead… • Medicare physician payment reform (again) • SGR patch + extenders expire in March 2015 • Same beneficiary concerns: extenders + offsets • Outcome hinges on costs and offsets • A fix for observation status (S. 569 + H.R. 1179) • Improving Access to Medicare Coverage Act • Broad consensus among varied stakeholders • Questions remain on cost

  7. A look ahead… • Transitions to Medicare • 10,000 Baby Boomers eligible each day • New transitions from the Affordable Care Act • Cause for higher costs and gaps in coverage • Proposal to restructure cost sharing • Combined Part A and Part B deductible • Coupled with Medigap changes • For the sake of savings, results in cost shifting

  8. Key takeaways… • Be truth tellers • Define a proactive agenda • Identify needed beneficiary improvements • Establish a vision for comprehensive reform • Advocate for savings that do no harm • Raise awareness of economic insecurity • 25 million with $23,500 or less per year • 25 million with $63,100 or less in savings • Health care costs already too high for many

  9. Visit us at www.medicarerights.org • Call our helpline at 1-800-333-4114 • Sign up for Medicare Watch • Learn online at Medicare Rights University • Like us on Facebook • Follow us at @medicarerights

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