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Medicare Improvements for Patients and

Providers Act of 2008 (MIPPA)

VICAP Fall TrainingOctober 23, 2008

Kathy NguyenCMS Health Insurance Specialist

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The Medicare Improvement for The Medicare Improvement for Patients & Providers Act, 2008Patients & Providers Act, 2008

History• H.R. 6331 introduced in the House on

June 20, 2008; passed on June 24 by a vote of 355-59

• Senate failed to act on June 26• Payment cuts scheduled to go into

effect July 1• CMS delayed processing claims at fee-

cut level until July 15• Senate passed package on July 9 after

cloture vote of 69-30• President Bush vetoed bill on July 15• Congress overrides veto on same day;

bill becomes law

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The Medicare Improvement for The Medicare Improvement for Patients & Providers Act, 2008Patients & Providers Act, 2008

MIPAA Highlights• Maintains physician payments• Reinstates therapy cap exceptions process• Reduces beneficiary copayment for mental

health services• Additional preventive services to be

considered– “Welcome to Medicare” initial physical

examination period extended to first 12 months of new bene eligibility; no longer counted toward deductible in 2009

• Requires all Medigap carriers to offer C and F

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The Medicare Improvement for The Medicare Improvement for Patients & Providers Act, 2008Patients & Providers Act, 2008

Other MIPAA Highlights• Benzodiazepines and barbiturates will be

covered under Part D for certain conditions

• Increase in low-income assistance for Medicare beneficiaries

• Permanently waives Part D late enrollment penalty for LIS-eligible individuals

• Increases SSA assistance with Medicare Savings Program applications

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The Medicare Improvement for The Medicare Improvement for Patients & Providers Act, 2008Patients & Providers Act, 2008

Medicare Advantage and Prescription Drug Plan Marketing Provisions

• Prohibits unsolicited direct contact• Prohibits cross-selling• Enforces scope of appointment• Limits sales/marketing in healthcare

settings• Prohibits sales/marketing at educational

events• Prohibits meals• Limits nominal gifts

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The Medicare Improvement for The Medicare Improvement for Patients & Providers Act, 2008Patients & Providers Act, 2008

Medicare Advantage and Prescription Drug Plan Marketing Provisions

• Prohibits co-branding• Requires state appointed agents/brokers• Defines agent/broker training and testing• Defines agent/broker compensation• Requires plan reporting of terminated

agents• Eliminates File & Use Eligibility