CMS Releases Proposed Medicare Eligibility and Coverage Changes (SNF/AL)

The Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a proposed rule entitled, Medicare Program; Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and Other Revisions to Medicare Enrollment and Eligibility Rules. The Notice of Proposed Rulemaking (NPRM) includes proposed changes to Medicare eligibility, including elimination of the Medicare coverage waiting period under specific circumstances, as well as new Special Enrollment Periods (SEP).

The NPRM also proposes extending months of immunosuppressive drugs for kidney transplant patients, simplification of Medicare enrollment forms and proposes to update various regulations that affect a state’s payment of the Medicare Part A and B premiums on behalf of low-income individuals (often known as “state buy-in”).

These changes could better align the regulations with federal statute, policy and operations that have evolved over time.

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