The Centers for Medicare and Medicaid Services wants to make it easier for millions of older adults and people with disabilities to attain Medicare coverage.
The agency issued a final rule Monday that aims to streamline the enrollment and renewal process for Medicare Savings Programs by reducing administrative burdens on states and eligible individuals.
Related: CMS proposes big changes to Medicaid, CHIP enrollment
More than 10 million low-income Medicare beneficiaries have their premiums and cost-sharing covered by Medicare Savings Programs. But complex application and verification processes have kept some from enrolling, CMS said. Only about half of eligible people are enrolled in Medicare Savings Programs, according to data from Medicaid and CHIP Payment and Access Commission.
CMS projects that an additional 860,000 beneficiaries will enroll as a result of the regulation.
Under the final rule, Medicare beneficiaries who receive Supplemental Security Income will be automatically enrolled in the qualified Medicare beneficiary eligibility group, which assists with premiums and cost-sharing.
The final rule will also require states to use Medicare Part D low-income subsidy data when making a savings program eligibility determination.
CMS said the regulation will save older adults and people with disabilities about 19 million hours in paperwork per year and reduce the administrative burden on states by more than 2 million hours annually. The final rule is expected to cost the federal government and states an estimated $26.16 billion in additional healthcare spending from 2025 through 2029.
“This final rule will help hundreds of thousands of people access healthcare while also freeing up already limited income for food, housing and other life necessities,” CMS Administrator Chiquita Brooks-LaSure said in a news release.
The rule takes effect Nov. 17, but many of the provisions have compliance dates of April 1, 2026. CMS said it doesn’t want the regulation's implementation to interfere with the challenges states face as they reassess Medicaid eligibility.
The agency received 7,000 comments on its proposal, released in August 2022, to simplify the application and enrollment processes for Medicaid, the Children's Health Insurance Program and the Basic Health Program. CMS said it will release a second final rule on the topic in 2024.
