Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) VICAP Fall Training October 23, 2008 Kathy Nguyen C

1. Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) VICAP Fall Training October 23, 2008 Kathy Nguyen CMS Health Insurance Specialist

2. The Medicare Improvement for Patients & 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

3. The Medicare Improvement for Patients & 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

4. The Medicare Improvement for Patients & 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

5. The Medicare Improvement for Patients & 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

6. The Medicare Improvement for Patients & 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