Medicare Prescription Drug, Improvement, and Modernization Act of 2003

1 / 18
About This Presentation
Title:

Medicare Prescription Drug, Improvement, and Modernization Act of 2003

Description:

Medicare Prescription Drug, Improvement, and Modernization Act. of 2003 ... Medicare-Approved Drug Discount Card. New Preventive Benefits. Prescription Drug Benefit ... – PowerPoint PPT presentation

Number of Views:302
Avg rating:3.0/5.0
Slides: 19
Provided by: CMS179

less

Transcript and Presenter's Notes

Title: Medicare Prescription Drug, Improvement, and Modernization Act of 2003


1
Medicare Prescription Drug, Improvement, and
Modernization Act of 2003
Department of Health Human Services
December 30, 2003
2
MEDICARE TODAY
  • 41 million beneficiaries
  • 284 billion in expenditures
  • Need for supplemental coverage

3
RATIONALE FOR REFORM
  • More choices and better benefits
  • Modernize Medicare to reflect changes to the
    health care system
  • Improve access to care

4
KEY COMPONENTS OF THE LAW
  • Medicare-Approved Drug Discount Card
  • New Preventive Benefits
  • Prescription Drug Benefit
  • Medicare Advantage Program
  • Assistance for Rural and Other Providers to
    strengthen access to care for people with
    Medicare

5
MEDICARE-APPROVEDDRUG DISCOUNT CARD
  • Estimated savings of 1025 on many drugs
  • Enrollment as early as May 2004
  • 600 to provide immediate relief to certain
    low-income people with Medicare

6
Available January 2006
NEW MEDICAREPRESCRIPTION DRUG BENEFIT
  • 250 beneficiary deductible
  • Medicare will pay 75 of drug costs up to 2,250.
    The beneficiary will pay 25 of these costs
  • Beneficiary will pay100 of drug costs between
    2,250 and 3,600 in out-of-pocket spending
  • After 3,600, Medicare will pay approximately 95

7
Extra Help for People with Low Income
  • People below 100 of the Federal poverty level
    will be entitled to Medicare and full Medicaid
    coverage
  • Income limits will be set in 2005
  • Other people with low income and limited assets
    will get help paying premiums and deductibles

8
MEDICARE ADVANTAGE PROGRAM
  • New Medicare Advantage program with better
    benefits and more choices
  • Payments to Medicare Advantage plans to increase
    in 2004

9
MEDICARE ADVANTAGE PROGRAM
  • Important new plan choices begin in 2006
  • Most important new option - Regional preferred
    provider organizations (PPO). PPOs are among the
    most common and popular plans right now for
    Americans not eligible for Medicare.

10
ASSISTANCE FOR RURAL PROVIDERS
  • 25 billion in increased reimbursement
  • Improve access to doctors, hospitals, ambulances,
    and home health care for people in rural areas

11
PAYMENTS TO NON-RURAL PROVIDERS
  • Part A
  • Part B

12
OTHER IMPORTANT PROVISIONS
New Preventive Benefits Available January 2005
  • Welcome to Medicare Physical Exam for New
    Enrollees
  • Cardiovascular Screening Blood Tests
  • Diabetes Screening Tests

13
OTHER IMPORTANT PROVISIONS
  • Contracting reform
  • HHS to conduct appeals process
  • Changes in Medigap coverage
  • Competition program
  • Income-related Part B premium

14
COMMUNICATING WITH THE PUBLIC
  • Beneficiaries
  • Providers
  • Congress
  • Governors and State Legislators
  • Advocates
  • Other stakeholders

15
OPEN DOOR
16
SOME MAJOR IMPLEMENTATION DATES
  • January 2004 Increase payments to rural
    hospitals Physician payments increased
  • March 2004 Increased Medicare Advantage payment
    rates
  • Enrollment as early as May 2004 Drug Discount
    Card
  • January 2005 Preventive benefits Physician
    scarcity bonus payments
  • January 2006 Prescription Drug Benefit
    Regional Medicare Advantage Plans (PPOs)

17
FOR MORE INFORMATION
  • 1-800-MEDICARE
  • www.medicare.gov
  • www.cms.hhs.gov

18
(No Transcript)
Write a Comment
User Comments (0)