Category Archives: Medicare Coverage

New April Events

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April 16-17, 2024 – Medicare National Training Program (NTP) Webinars on Understanding Medicare. April 16 covers enrollment, eligibility, SSA and CMS roles, Part A Hospital Insurance, Part B Medical Insurance, and Medigap policies. April 17 covers Part D Drug Coverage, Advantage Plans, and other useful information and resources. You may register for either or both days, at https://cmsnationaltrainingprogram.cms.gov/live-events?keys=understanding+Medicare. Previous webinars are recorded and may be found at https://cmsnationaltrainingprogram.cms.gov/past-events.

April 24, 2024: Webinar for Dialysis Professionals on Supporting Patients to Improve their Transplant Candidacy. Part of the NKF Navigating Transplant: A Guide to Empowering Your Patients series for FAs, MDs, Nurse Managers, Dietitians, and SWs. For more information and registration, see the poster below or https://cme.kidney.org/spa/courses/resource/r634-supporting-your-patients-to-be-the-best-psychosocial-candidate-for-transplant-/mooc/home/default. Direct questions to celine.koh@kidney.org.

More March-April Events

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March EQRS Newsletter Available at https://mycrownweb.org/2024/03/march-2024-newsletter-now-available/, with information on the 2744 ESRD Annual Survey, March 14 EOCT Town Hall, Care Compare Update, New EQRS Dashboard Reports, New EQRS Medication Reconciliation Reporting Field, ESRD QIP Information, How to Route Questions, and ESRD Data Submission Deadlines.

March 14, 2024:

March 16, 2024: Comment Deadline for Medicare Part D Guidance Part 2 – Guidance to help Medicare Part D enrollees manage drug costs, PART 2. Find details at https://www.cms.gov/files/document/medicare-prescription-payment-plan-draft-part-two-guidance.pdf.

April 16-17, 2024: CMS NTP Understanding Medicare 2-Day Webinar – Find more information and register at https://cmsnationaltrainingprogram.cms.gov/live-events.

March 19, 2024: CMS EQRS New User Training – Find details and register at https://mycrownweb.org/pcw_lems/march-2024-new-user-training/.

Final CMS Guidance to help Medicare Part D enrollees manage drug costs – https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-07-mlnc#_Toc160622795.

Current Medicare Status of Blood Tests for Organ Transplant Rejection – https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-07-mlnc#_Toc160622796.

Preview of New 2728 Form

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CMS has finalized the updated version 2023 Form CMS-2728, which can be viewed and downloaded from https://www.cms.gov/medicare/cms-forms/cms-forms/cms-forms-items/cms008867.

Please Note: The End Stage Renal Disease (ESRD) Quality Reporting System (EQRS) will continue to generate the current version 2018 Form CMS-2728. The use of any Form CMS-2728 other than what is available in EQRS is not authorized until otherwise instructed. Communication on when the new version will automatically generate and be available in EQRS will be forthcoming from CMS.   

For additional information and resources on the Form CMS-2728 updates, register for and attend the March 14, 2024, ESRD Outreach, Communication, and Training (EOCT) Town Hall event. Register at https://attendee.gotowebinar.com/register/7713799083884657493. For more information on the March Town Hall see https://mycrownweb.org/2024/02/march-2024-town-hall-announce/. 

For assistance with EQRS technical issues, contact the CCSQ Service Center at 866-288-8912, qnetsupport-esrd@cms.hhs.gov, or https://cmsqualitysupport.servicenowservices.com/ccsq_support_central, Mon-Fri 5am-5pm Pacific Time. For assistance with general EQRS and ESRD QIP questions, contact the ESRD QIP Team at https://cmsqualitysupport.servicenowservices.com/qnet_qa?id=ask_a_question

3/1 CY2025 Part D Revisions

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CMS has released Advanced Notice of revised Medicare Part D drug coverage Payment Policies, and will accept comments on the revisions until March 1, 2024. Find details at https://www.cms.gov/newsroom/fact-sheets/2025-medicare-advantage-and-part-d-advance-notice-fact-sheet (sections 17ff) and https://www.cms.gov/files/document/draft-cy-2025-part-d-redesign-program-instruction.pdf. 

A Fact Sheet on the draft Redesign Program Instructions (https://www.cms.gov/files/document/draft-cy2025-part-d-redesign-program-instruction-fact-sheet.pdf) summarizes the changes as:

  • A newly defined standard Part D benefit design consisting of three phases: annual deductible, initial coverage, and catastrophic coverage;
  • The lower annual out-of-pocket threshold of $2,000;
  • The sunset of the Coverage Gap Discount Program and establishment of the
    Manufacturer Discount Program; and
  • Changes to the liability of enrollees, sponsors, manufacturers, and CMS in the new
    standard Part D benefit design.

The changes respond to the provisions of the Inflation Reduction Act of 2022. The CY2025 Advanced Notice also applied to Medicare Advantage Plans.

1/10+ January+ Events

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  • January 24, 2024: NKF Navigating Transplant, the first Zoom session in a series of Transplant-focused “Lunch& Learn” Sessions for Dialysis Professionals – Ready, Set, Go… Referring Dialysis Patients for Kidney Transplant Evaluation. Find more information and register to earn 1.0 free CE credits at http://tinyurl.com/NKFreadysetgo. See also the second poster below.

October+ Events

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9/15+ New Announcements

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  • September 27-28, 2023: Medicare National Training Program Medicare Open Enrollment Period 2023 Bootcamp. Details will be published in mid-September. For recordings of past events and current catalog of resources, see https://cmsnationaltrainingprogram.cms.gov/full-catalog.

Medicare Notes re Part B Insulin and Continuing Insurance After Transplant

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The February 16, 2023 issue of the CMS mlnconnects online newsletter contains two notes of interest to ESRD patients and practitioners:

Medicare Part D Insulin Price Cap

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Medicare has updated their bulletin on Part D Insulin coverage to explain the details of the new $35 per month price cap that took effect January 1, 2023, including instructions for getting refunds for higher charges in the initial months when implementation lagged policy. For details see https://www.medicare.gov/coverage/insulin (English) and https://es.medicare.gov/coverage/insulin (Spanish).

More January+ News and Events

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