In spite of the coronavirus emergency, TSCL is continuing its fight for you to protect your Social Security, Medicare, and Medicaid benefits. We've had to make some adjustments in the way we carry on our work, but we have not, and will not stop our work on your behalf
Without any fear of contradiction, we can tell you that there was a lot of important news coming out of Washington this week. There was also important and very disturbing news coming from cities and states across the nation.
The bill passed by the Senate and the House was the third in a series of economic stimulus bills hurriedly passed by Congress in response to the coronavirus pandemic. There is talk of a fourth stimulus bill, but the Senate has recessed until April 20 so that bill may be down the road a little way.
While this report is longer than usual, we've tried to give you the highlights of the issues that affect seniors. But because it's such a massive bill we might miss a few things or have to change our understanding of the legislation when there's been more time to digest the bill.
Issues that affect seniors in the Congressional bill passed this week
For individual taxpayers, the relief measure includes direct payments of $1,200 for each adult and $500 for each child, with the payment phasing out for individuals making more than $75,000 per year and couples making more than $150,000.
Those without income, or with income solely from government benefits, like seniors on Social Security, are eligible.
Individuals making above $99,000 and couples making more than $198,000 receive no payment.
In the days leading up to the passage of the bill President Trump was advocating for a cut in the payroll tax, which is the tax that funds Social Security and Medicare. TSCL opposed that idea because both programs are already on a path to insolvency in the not-too-distant future. Cutting or eliminating the payroll tax, even if only temporarily, would bring the date of insolvency even closer, with no plan on how to shore up the programs other than the ever-increasing calls by some politicians to cut benefits.
Under this legislation, the employers’ portion of the payroll tax is deferred for this year. Half of it will then come due in 2021 and the other half in 2022. So, unless a business would fold before those due dates, the money would eventually be put back into the programs.
In addition, the measure appropriates funds to cover any shortfall in revenue to the Social Security and disability insurance trust funds and Social Security Equivalent Benefit Account that might result from the suspension of the tax this year.
TSCL is very happy to see this last aspect of the legislation in order that the trust fund is not further diminished.
Cuts in Medicare and Medicaid temporarily suspended
May seniors were not aware that there were and still are cuts scheduled to be made in certain aspects of Medicare and Medicaid this year and in the future.
However, this new legislation will suspend automatic Medicare payment cuts to hospitals and doctors from May 1 through Dec. 31 of this year.
Because of that, however, it extends for one year, through 2030, broader cuts in funding currently in law which reduced Medicare payments by 2% annually, including $15.3 billion for fiscal 2020. The point being that Medicare payments to health care providers will continue to be cut every year through 2030.
Hospitals will receive a 20% increase in their Medicare payments for treating a patient with Covid-19 during the coronavirus emergency.
There are other measures in the bill that give financial relief and/or help regarding certain Medicare payments to hospitals and other health-care related services and equipment that will benefit many seniors.
Funding for several Medicare provisions scheduled to expire May 22 will be extended through Nov. 30, including:
- State health insurance assistance programs.
- A contract with the National Center for Benefits and Outreach Enrollment.
- Area Agencies on Aging.
- Aging and Disability Resource Centers.
The package also would extend until Dec. 1 funding for a floor on the geographic index used to calculate provider payment rates under Medicare.
The legislation will extend through Nov. 30 the Money Follows the Person demonstration grant program, and a protection against spousal impoverishment when a married individual is receiving home and community-based services.
The measure also delays until Dec. 1 a scheduled $4 billion reduction in Medicaid funding for disproportionate share hospitals (DSH), which have large numbers of low-income and uninsured patients.
Expands telehealth that can help seniors
The legislation will remove a requirement from the first coronavirus response measure that a doctor had to have treated a patient within the last three years to use expanded telehealth authorities under Medicare.
Federally qualified health centers and rural health clinics can furnish telehealth service to beneficiaries in another location during the coronavirus emergency and be reimbursed at a rate that is similar to the national average for comparable services under the Medicare physician fee schedule.
Individuals receiving home dialysis wouldn’t need to have periodic in-person assessments to qualify for telehealth services during the coronavirus emergency. Face-to-face encounters for re-certifying eligibility for hospice care could be conducted via telehealth during the emergency period instead of in person.
Medicare Part B, which provides general medical insurance, will fully cover a Covid-19 vaccine without any cost-sharing. Drug plans would have to allow Part D prescription drug beneficiaries to receive a 90-day supply of medication during the public health emergency.
The requirement that patients at inpatient rehab facilities receive at least 15 hours of therapy per week during the emergency period will be waived. It also will direct HHS to waive a payment adjustment for long-term care hospitals that don’t have at least a 50% discharge payment percentage.
In addition, the legislation will:
- Allow physician assistants and nurse practitioners to order home health services for Medicare beneficiaries.
- Allow state Medicaid programs to cover home and community-based services that are provided in acute-care hospitals.
- Delay by 30 days a requirement in the second coronavirus response package that a state maintain premiums to receive the 6.2 percentage point increase in Medicaid funding.
Upgrades the health care system in case of future virus epidemics
While not applying specifically to seniors, the bill will expand the Strategic National Stockpile to include personal protective equipment and supplies such as swabs used for Covid-19 testing.
It also provides that manufacturers of drugs that are critical to public health during an emergency will have to notify the FDA of supply chain interruptions for active pharmaceutical ingredients. Device manufacturers will have to make similar disclosures.
Makers of covered drugs, active ingredients, and related devices will have to maintain risk management plans for facilities to evaluate supply risks.
Drug makers will also have to report annually on the amount of each drug they create for commercial distribution. The FDA could require the information to be submitted during a public health emergency.
While these last measures, and there are others too numerous to list here, are too late for this health crisis, we are glad to see them put into place. In the past decade or two new viruses have appeared that we do not have immunity against, but we were lucky that, until now, our scientists were able to quickly combat them without the need for our nation to take the drastic actions we are now experiencing.
The over-the-counter drug industry is about to get overhauled.
Congressional lawmakers tucked a long-stalled package of reforms to the multi-billion-dollar Over-The-Counter drug industry into its $2 trillion coronavirus stimulus package after the industry argued that it could play a key role in the country’s coronavirus response.
Here's the information we've received from Bloomberg News on the new measure:
“The bill just passed by Congress will modify the FDA’s regulatory framework for nonprescription drugs and establish user fees to support the new process. The user fees would be authorized from fiscal 2021 through 2025 and include facility fees and fees for administrative order requests.
“The measure would create an administrative order process for determining whether a nonprescription drug is 'generally recognized as safe and effective. It would include opportunities for public comment and dispute resolution. There would also be expedited procedures for drugs that pose an imminent public health hazard and for safety labeling changes.
“Final orders that are issued in response to a drug maker request would include 18 months of exclusivity.”
Just what that means regarding how it will affect individuals is a bit unclear at this point. When TSCL gets more information about this new change we will pass it along.
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Prescription Drug Relief and Surprise Billing measures get left out
High on TSCL's list of legislative priorities this year has been passage of legislation to reduce the cost of prescription drugs and legislation to stop the unfair practice of surprise medical billing.
Unfortunately, because of the coronavirus pandemic and the subsequent emergency legislation that has been passed in response, it appears that legislation dealing with both issues is dead for this year.
Congressional advocates of legislation to deal with these two issues were looking to use the extension of the federal community health centers and the National Health Service Corps programs as a vehicle for other health legislation.
However, both programs were given short-term extensions in the new legislation which will likely delay and could doom efforts to pass surprise medical billing and drug pricing legislation in coming months.
Nonetheless, TSCL will continue our fight for legislation to deal with these issues, regardless of how long it takes.
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Government Issues Fraud Warning
The U.S. Department of Health and Human Services Office of Inspector General is alerting the public about fraud schemes related to the novel coronavirus (COVID-19).
Scammers are offering COVID-19 tests to Medicare beneficiaries in exchange for personal details, including Medicare information. However, the services are unapproved and illegitimate.
Fraudsters are targeting beneficiaries in several ways, including telemarketing calls, social media platforms, and door-to-door visits. These scammers use the coronavirus pandemic to benefit themselves, and beneficiaries face potential harms. The personal information collected can be used to fraudulently bill Federal health care programs and commit medical identity theft. If Medicare or Medicaid denies the claim for an unapproved test, the beneficiary could be responsible for the cost.
- Beneficiaries should be cautious of unsolicited requests for their Medicare or Medicaid numbers.
- Be suspicious of any unexpected calls or visitors offering COVID-19 tests or supplies. If your personal information is compromised, it may be used in other fraud schemes.
- Ignore offers or advertisements for COVID-19 testing or treatments on social media sites.
- A physician or other trusted healthcare provider should assess your condition and approve any requests for COVID-19 testing.
- If you suspect COVID-19 fraud, contact National Center for Disaster Fraud Hotline (866) 720-5721 or email@example.com
For progress updates or for more information about these and other bills that would strengthen Social Security and Medicare programs, visit the Bill Tracking section of our website or follow TSCL on Twitter.