MHA Today | October 31, 2022

CMS released a final rule that implements changes included within the Consolidated Appropriations Act of 2021. The rule “makes it easier for people to enroll in Medicare and eliminates delays in coverage.”

Specifically, the final rule revises the effective dates of coverage and gives the Secretary of HHS the authority to establish new special enrollment periods for traditional Medicare. The rule also extends immunosuppressive drug coverage under Medicare Part B for certain individuals whose Medicare entitlement is based on end-stage renal disease. Additionally, the rule includes final regulations related to Medicare enrollment forms and state buy-in payments, as well as limits retroactive liability of states and defines the state plan as meeting the requirement for agreement with CMS.

According to CMS’ updated Medicare enrollment report, the number of Medicare beneficiaries totaled 64.8 million as of July 2022. Of the total, 53.9% were enrolled in original Medicare and 46.1% were enrolled in a Medicare Advantage product.

In Missouri, the number of beneficiaries enrolled in Medicare totaled 1.3 million. Of the Missouri total, 52.2% were enrolled in original Medicare and 47.8% were enrolled in MA. The shift from original Medicare to MA from 2017 to July 2022 is significant.