Thursday, February 22, 2024
- Limitation on Recoupment of Medicare Overpayments
- Pulmonary Rehabilitation, Cardiac Rehabilitation, & Intensive Cardiac Rehabilitation Expansion of Supervising Practitioners
News
CMS Issues Additional Guidance on Program to Allow People with Medicare to Pay Out-of-Pocket Prescription Drug Costs in Monthly Payments
CMS released the second part of draft guidance (PDF) for the Medicare Prescription Payment Plan that outlines requirements for Medicare Part D plan sponsors, including outreach and education requirements, pharmacy processes, and operational considerations, for the program’s first year, 2025. The draft guidance is part of the implementation of President Biden’s prescription drug law, the Inflation Reduction Act, which will help reduce the burden of high upfront out-of-pocket prescription drug costs for seniors and people with disabilities with Medicare prescription drug coverage by allowing them to spread out costs over the year rather than requiring they pay in one lump sum.
CMS is seeking comments from the public on the draft part two guidance. Comments received by March 16, 2024, will be considered during development of the final guidance. Send comments to PartDPaymentPolicy@cms.hhs.gov with the following subject line: “Medicare Prescription Payment Plan Guidance – Part Two.”
More Information:
Compliance
Medical Services Authorized by the Veteran’s Health Administration: Avoid Duplicate Payments
In a report, the Office of the Inspector General found that Medicare paid providers for medical services authorized and paid for by Veteran Administration community care programs, resulting in duplicate payments of up to $128 million. We don’t pay for services authorized under Veteran’s Health Administration benefits.
More information to bill correctly:
- Medicare Secondary Payer (PDF) booklet
- Medicare Overpayments (PDF) fact sheet
- Section 50.1.1 Medicare Benefit Policy Manual, Chapter 16 (PDF)
MLN Matters® Articles
Limitation on Recoupment of Medicare Overpayments
Learn about limits on recouping overpayments (PDF) effective July 1, 2024, including:
- When to request an extended repayment plan or choose an immediate recoupment
- How we pay interest
Pulmonary Rehabilitation, Cardiac Rehabilitation, & Intensive Cardiac Rehabilitation Expansion of Supervising Practitioners
Learn about updates to pulmonary, cardiac, and intensive cardiac rehabilitation services (PDF) effective January 1, 2024, including expanding the types of practitioners who may supervise these services.
Your Medicare Administrative Contractor will adjust claims you bring to their attention.
Publications
Health Equity Services in the 2024 Physician Fee Schedule Final Rule
Learn about 4 services (PDF) to help address health-related social needs:
- Caregiver training
- Social determinants of health risk assessment
- Community health integration
- Principal illness navigation
Subscribe to the MLN Connects® newsletter, or read past editions.
View the Medicare Learning Network® Content Disclaimer and Department of Health & Human Services Disclosure.
The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health & Human Services (HHS).
