CMS Proposes Changes to Eliminate Medicare Coverage Delays

Becker's Hospital Review - April 22, 2022
CMS proposed a rule change April 22 that would eliminate delays in Medicare coverage and extend coverage of
immunosuppressive drugs for certain beneficiaries.

Four things to know:
  1. Medicare coverage would begin the month after sign-up for those enrolling in the last three months of their initial enrollment period or in the general enrollment period.
  2. Under current rules, those who enroll for coverage during the last three months of their initial eligibility period begin coverage two or three months after they sign up. Those who sign up in the Jan. 1-March 31 general enrollment period begin coverage July 1.
  3. CMS is also proposing a special enrollment period that would provide those who meet certain conditions and missed a Medicare enrollment period an opportunity to enroll without having to wait for a general enrollment period or being subjected to a late enrollment penalty.
  4. The proposal would extend immunosuppressive drug coverage under Part B for certain individuals whose Medicare entitlement based on end-stage renal disease would otherwise end 36 month after receiving a successful kidney transplant.