Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and other Revisions to Medicare Enrollment and Eligibility Rules (CMS-4199-P)

(Source – cms.gov/newsroom)

On April 22, 2022 the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to implement sections of the Consolidated Appropriations Act, 2021 (CAA) that would simplify Medicare enrollment rules and extend coverage of immunosuppressive drugs for certain beneficiaries. Section 120 of the CAA makes changes to Traditional Medicare by revising the effective dates of coverage and giving the Secretary of the Department of Health and Human Services (the Secretary) the authority to establish new special enrollment periods (SEPs) for individuals who meet exceptional conditions. Section 402 of the CAA extends immunosuppressive drug coverage under Part B for certain individuals whose Medicare entitlement based on end-stage renal disease (ESRD) would otherwise end 36-months after the month in which they received a successful kidney transplant provided they do not have certain other health coverage. This rule also proposes other non-CAA related changes to improve state payment of Medicare premiums, and a technical change related to how enrollment forms are referenced in regulations. Continue reading here…

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