What is MIPPA and why is it important?
The Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 is a multi-faceted piece of legislation related to Medicare. One important provision of MIPPA was the allocation of federal funding (through Section 119) for State Health Insurance Assistance Programs (SHIPs), Area Agencies on Aging (AAAs), and Aging and Disability Resource Centers (ADRCs) to help …
What is the Medicare Improvements for patients and Providers Act MIPPA?
The Medicare Improvements for Patients and Providers Act of 2008 — usually called MIPPA — provides grants to states and tribes. MIPPA funds are used for outreach and as financial assistance to help eligible Medicare beneficiaries reduce their premiums and deductibles.
How much does MIPPA outreach get funded?
The Medicare Improvements for Patients and Providers Act (MIPPA) program code is 3905300. Program Description. MIPPA, Signed into law July 2008, MIPPA provides funding to help Medicare beneficiaries apply for two valuable benefits: the Low-Income Subsidy "Extra Help" (LIS/Extra Help); and the Medicare Savings Program (MSP). ...
What is the Medicare Improvement for patients and providers program?
On July 15, 2008, Congress enacted into law the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), Pub. Law 110-275. MIPPA is a multi-faceted piece of legislation that contains several important provisions that directly change the Medicare program. These changes include suspended payment cuts to health care providers, changes in the asset and …
What is Mippa accreditation?
The Medicare Improvements for Patients and Providers Act (MIPPA) calls for all providers of CT, MRI, breast MRI, nuclear medicine, and PET exams that bill under Part B of the Medicare Physician Fee Schedule to be accredited by Jan. 1, 2012, in order to receive payment for the technical component of these services.
When was Mippa created?
July 15, 2008MIPPA became law on July 15, 2008, after Congress overrode a presidential veto on H.R. 6331. The bill was originally passed by the House on June 24, 2008, under suspension of the rules by a vote of 355 to 59.Jul 23, 2008
What does Macra stand for?
Medicare Access and CHIP Reauthorization Act of 2015The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a bipartisan legislation signed into law on April 16, 2015.Apr 1, 2022
What is the purpose of MIPPA?
The Medicare Improvement for Patients and Providers Act (MIPPA) program supports states and tribes through grants to provide outreach and assistance to eligible Medicare beneficiaries to apply for benefit programs that help to lower the costs of their Medicare premiums and deductibles. MIPPA grants provide targeted funding ...
What is MIPPA funding?
MIPPA funding supports the National Center for Benefits Outreach and Enrollment (NCBOE) which provides technical assistance to States, AAAs, and other community service providers to provide outreach and benefits enrollment assistance, particularly to older individuals with greatest economic need, for federal and state programs. The NCBOE: 1 Maintains and updates web-based decision support and enrollment tools and integrated, person-centered systems designed to inform older individuals about the full range of benefits for which the individuals are eligible; 2 Utilizes cost-effective strategies to find older individuals with greatest economic need and enroll the individual in the programs for with they are qualified; 3 Creates and supports efforts for ADRCs, and other public and private state and community-based organizations, including faith-based organizations and coalitions, to serve as benefit enrollment centers for the programs; 4 Develops and maintains an information clearinghouse on best practices and cost-effective methods for finding and enrolling older individuals with greatest economic need; and 5 Provides training and technical assistance on effective outreach, screening, enrollment, and follow-up strategies.
Where are MIPPA grantees located?
MIPPA grantees are located in all states, Puerto Rico, Guam, and the District of Columbia.
What does CMS mean for Medicare?
The Center s for Medicare and Medicaid Services (CMS) recommends beneficiaries speak with their healthcare providers to find out how often certain exams and screenings are needed to stay healthy.
What is ACL in Medicare?
ACL coordinates outreach between grantees, CMS and the Aging Network to ensure that local service providers and partners have access to materials and resources that will help them to assist Medicare Beneficiaries, their families and caregivers.
Does Medigap cover Part B?
While Medigap plans could cover Part B cost sharing, not everyone is able to afford Medigap. MIPAA aligned Part B’s coinsurance for mental health care with other types of visits starting in 2014, after a phase-in period that began in 2010.
Does Medicare cover mental health?
Medicare Advantage plans must provide some level of mental health parity because their benefit packages have to be “actuarially equivalent” to Original Medicare, although these insurers can and often do apply a speciality co-pay to mental health treatment. (Lifetime Part A coverage for inpatient care in a psychiatric hospital is still limited ...
What is MIPPA 165?
MIPPA regulations require that all contracts between States and MA organizations include a provision documenting the cost-sharing protections that are covered under the SNP. These cost-sharing protections pertain to the protections for which enrollees are entitled to under Title XIX of the Social Security Act, including enrollee liability protections. In addition, MIPPA 165 requires that, as of January 1, 2010, a SNP may not subject any full-benefit dual eligible or qualified Medicare beneficiary4 enrolled in the plan to any cost-sharing that exceeds the amount of cost-sharing that would be permitted under Title XIX if the beneficiary was not enrolled in the SNP. Documentation of all cost-sharing protections must be included in any contract between a State and an MA organization.
How many contracting requirements are there under MIPPA?
The following sections present the eight contracting requirements put forth under MIPPA as well as various options States may wish to adopt in order to meet these requirements.
What is the MIPPA requirement for dual SNPs?
As expressed in MIPPA Requirement 1 (requiring the contract to document the MA organization’s responsibility to provide or arrange for Medicaid benefits), State contracts for Dual SNPs are likely to vary widely in the scope of covered Medicaid benefits. Requirement 3 accounts for this variability by requiring that the contract include information on benefit design and administration related to all Medicaid benefits covered under the SNP as well as document the benefits for which the MA organization is responsible for providing or arranging. If the list of services is an attachment, it must be referenced in the body of the contract per the July 17, 2009 HPMS memo. As the party responsible for providing care coordination, the Dual SNP needs to be fully aware of all the services entitled to its dually eligible enrollees as well as the party responsible for covering each service. This knowledge is essential to the Dual SNP’s ability to coordinate the member’s benefits and prevent overlapping services. Possible scenarios include:
How does SNP verify eligibility for medicaid?
Per Section 20.11 of Chapter 2 of the Medicare Managed Care Manual, the SNP may confirm Medicaid eligibility through receipt of a copy of the enrollee’s current Medicaid card or a letter from the State Medicaid agency confirming the enrollee’s eligibility for Medicaid. Under this option, the SNP is still responsible for verifying Medicare eligibility through the process described in Option 1 as well as re-determining the enrollee’s Medicaid eligibility (determined through enrollee documentation, submission of enrollee data to the State for verification, or other approved method) at least as frequently as the State performs this re-determination.
Does Medicaid have a SNP?
Existing contracts between States and Medicaid managed care organizations – including contracts mandating that the Medicaid managed care organization also offer a Medicare Advantage SNP – generally limit the scope of eligibility verification to eligibility for Medicaid. However, these contracts do provide insight on how a future contract could be structured to include a detailed provision – required by CMS – for the State Medicaid agency to provide the MA organization with access to real-time information verifying the eligibility of enrolled dual eligible members. The following paragraphs express several possible options for how this requirement may be satisfied.
What is Medicare Part A and Part B?
This section describes the various categories of individuals who are entitled to Medicare Part A and/or Part B and are eligible for some form of Medicaid benefit7. Collectively, they are known as dual eligibles.
Does the SNP have to verify Medicare eligibility?
Under this option, the SNP is still responsible for verifying Medicare eligibility through the BEQ process or MARx query, as well for as re-determining the enrollee’s Medicaid eligibility (determined through enrollee documentation, submission of enrollee data to the State for verification, or other approved method) at least as frequently as the State performs this re-determination.
