Category Archives: Paying for Care

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.

April Events

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April 16, 2024 – EQRS New User Training. Find details and registraton at https://mycrownweb.org/pcw_lems/april-2024-new-user-training/.

April 25, 2024 – Webinar on De-Escalation & Communication in a Behavioral Health Setting presented by the National Association on Mental Illness (NAMI) – Seattle, and the Northwest Mental Health Technology Transfer Network (MHTTC Network), online. Designed for direct service providers and staff who work with clients and community members. Learn what contributes to emotionally escalated interactions, ways to assess the situation, and practical strategies to defuse and de-escalate to support the health and safety of everyone involved. Find details and register at https://mhttcnetwork.org/event/de-escalation-communication-in-a-behavioral-health-setting/. Find more NAMI Seattle events at https://namiseattle.org/events/upcoming-events/ (scroll down for the complete calendar), and more MHTTC Network events at https://mhttcnetwork.org/training-and-events-calendar/.

KDIGO has released an extensive list of resources to accompany their new CKD Guideline, including seven “Top Ten Takeaways” resources for nephrologists, pediatricians, and PCPs; an Executive Summary; and a Data Supplement. Find these resources, and a link to the KDIGO 2024 CKD Guideline itself, at https://kdigo.org/guidelines/ckd-evaluation-and-management/.

CMS has released a final rule that will protect and improve access to Medicaid, CHIP, and BHP. The Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes rule will remove red tape and barriers to enrollment, update and build on the Affordable Care Act’s (ACA’s) coverage protections. Find more information at https://www.cms.gov/newsroom/press-releases/biden-harris-administration-finalizes-rule-expanding-access-care-and-increasing-protections-people.

More March Events – Transplant Financials and New CDC Kidney Website

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March 27, 2024: NKF Transplant Financials Webinar on Financial Considerations in Kidney Transplant: The Process, Barriers, Strategies & Resources, in the “Lunch & Learn” Series, for all dialysis professional staff. Find details and register at https://cme.kidney.org/spa/courses/resource/r629-financial-considerations-in-kidney-transplant-the-process-barriers-strategies–resources.

March 29, 2024: Comment Deadline for Feedback on Draft of New CDC Website on CKD. Review the Draft and comment at https://beta.cdc.gov/kidney-disease/.

HDC/Lori Hartwell’s Proposal for Increasing Home Dialysis, with her Invitation to Comment. See https://homedialysis.org/news-and-research/blog/588-do-we-need-a-new-model-to-reward-people-who-do-home-dialysis.

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.

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.

December Events

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Updated NTP Training Materials: Health Insurance Marketplace® Basics PowerPoint; Marketplace to Medicare: What You Can Expect PowerPoint. Visit CMSnationaltrainingprogram.cms.gov/resources to view all CMS training materials.

New/Updated CMS Products: Medicare & the Health Insurance Marketplace®; Medicare: Getting Started; Medicare & Home Health Care. Order CMS products in bulk at the product ordering website.

ESRD QIP CY2024 Final Rule: See https://www.cms.gov/newsroom/fact-sheets/calendar-year-2024-end-stage-renal-disease-esrd-prospective-payment-system-pps-final-rule-cms-1782-f.

December 4, 2023: Deadline for Final PY2024 ESRD QIP PSRs and PSCs, available from EQRS, to be prominently posted in English and Spanish. See https://qualitynet.cms.gov/esrd/esrdqip/resources#tab2 for instructions, and https://cmsqualitysupport.servicenowservices.com/qnet_qa, or 866-288-8912 5am-5pm PST Mon-Fri, or qnetsupport-esrd@cms.hhs.gov for assistance.

December 5, 2023: Donate Life NW Webinar 201 on The Science Behind Organ Donation, online, https://www.donatelifenw.org/civicrm/event/info?reset=10037&id=10037.

December 12, 2023: EQRS New User Training, online, https://mycrownweb.org/pcw_lems/december-2023-new-user-training/.

December 31, 2024: Deadline for NWRD Annual Conference Poster, Exhibitor Applications, https://www.nwrdonline.org/conference-overview.

January 4, 2024: Donate Life Orientation 101 on New Ambassador Training, online, https://www.donatelifenw.org/civicrm/event/info?reset=10031&id=10031.

January 15, 2024: Registration Opens for NWRD Annual Conference, https://www.nwrdonline.org/conference-overview.

January 16, 2024: Donate Life Webinar 301 on School Programs, online, https://www.donatelifenw.org/civicrm/event/info?reset=10046&id=10046.

March 7-8, 2024: NWRD Annual Conference, Portland OR, https://www.nwrdonline.org/conference-overview. See Conference poster below.

9/7 CMS Webinar on Medicaid/CHIP Renewals for Native American & Alaska Native Populations

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CMS will present a September 7, 2023 webinar on Medicaid and CHIP Renewals: Reaching Out to American Indian and Alaska Native Populations. RSVP at https://cms.zoomgov.com/webinar/register/WN_-uRUL8P0QFW2_iRCvfqT8g. For more information and toolkits, including links to English and Spanish resources on Reaching Kids and Families, Disenrolled patients, and Asian American, Native Hawaiian and Pacific Islander, Hispanic/Latino, Black American, Aging & Disability, and Rural Populations, see https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/medicaid-and-chip-renewals-outreach-and-educational-resources/index.html.

New Medicare Plan for Part D Installment Payments

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CMS has proposed a new plan whereby Part D participants can opt to pay their annual drug payments in monthly installments. CMS has published a draft of the proposal, and solicited Comments by September 20, 2023. Find more information at:

6/28+ CMS Medicare/CHIP Renewal Training for Educators

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CMS will present a June 28, 2023 Train-the-Trainer webinar that will walk through a set of slides that CMS partners can download and use to educate other people in their communities about Medicaid and CHIP renewals. The goal is to prevent anyone from inadvertently losing their Health Insurance. Find more information at https://www.medicaid.gov/resources-for-states/downloads/renewals-call-to-action.pdf, and register at https://cms.zoomgov.com/webinar/register/WN_qma5AvyBQWCTB0vbNF3lTA. The webinar will be repeated on July 26, August 23, September 27, October 15, and December 6, 2023.

No Surprises Act re Medical Expenses

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CMS has published new web pages explaining the No Surprises Act, which aims to help protect healthcare consumers from billings that substantially exceed estimates, and from being overcharged by out-of-network providers. Find the portal to these pages in English at https://www.cms.gov/medical-bill-rights and in Spanish at https://www.cms.gov/derechos-facturas-medicas. Find the following additional resources at: