CMS has given its Medicare Advantage (MA) plans, also known as Part C, more liberties and a few mandates, including issuing ID cards to patients thanks to the April 12 final rule.
The rule solidified changes to the prescription drug Part D and MA programs effective in 2013 as required by health reform.
MA plans can now limit coverage of DME supplies to “preferred” brands and manufacturers as long as the plan ensures patients have access to all categories of DME products. CMS found that DME plans were already limiting products by brand on some level and decided to make it official.
The fine print: Patients will be given a grace period to keep DME when switching plans and can appeal an MA plan’s denial of DME supplies based on brand or manufacturer.
But there is one provider favorite buried in the rule: MA plans are now all required to issue ID cards to their members. While some plans already hand out IDs, the rule says, the new mandate ensures that they all do, giving providers easy access to vital plan information.
Here’s what CMS wants on the new ID cards for Medicare Advantage PPO or PPFS plans:
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A statement that Medicare Limiting Charges apply;
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An address for the plan's Web site;
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A customer service number; and
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The individual identification number for each enrollee, to clearly identify that he or she is a member of the plan.
For more information or to view the rule in its entirety, please visit http://tinyurl.com/c72ehcq.