Ritter Insurance Marketing, Craig Ritter

Health Care Reform Bill Changes Enrollment Options for Chronic Special Needs Plans

UPDATE – I need to check with the final bill language to verify this.  I think this may not have been included in the final version.  See FINAL BILL.

The reconciled Health Care Reform bill will ELIMINATE the option for Medicare Beneficiaries to enroll in Chronic Illness Special Needs Plans during lock in.

Here is a link to the Text of the Reconciliation Bill (at the bottom). See section 1176 on page 1409.

Here is the text copied and pasted:

SEC. 1176. LIMITATION ON ENROLLMENT OUTSIDE OPEN
15 ENROLLMENT PERIOD OF INDIVIDUALS INTO
16 CHRONIC CARE SPECIALIZED MA PLANS FOR
17 SPECIAL NEEDS INDIVIDUALS.
18 Section 1859(f)(4) of the Social Security Act (42
19 U.S.C. 1395w–28(f)(4)) is amended by adding at the end
20 the following new subparagraph:
21 ‘‘(C) The plan does not enroll an individual
22 on or after January 1, 2011, other than during
23 an annual, coordinated open enrollment period
24 or when at the time of the diagnosis of the dis
ease or condition that qualifies the individual as

an individual described in subsection
2 (b)(6)(B)(iii).’’.

Posted by filed under Medicare Advantage, News .

  • David Dietz

    Mike:

    Craig let me know this morning that he has not found anything in the bill that would effect the Dual Eliglble SNP enrollment periods.

    • Mike

      David,

      Thanks for the reply and info.

      Mike

  • Mike

    Craig,

    Interesting that they would limit enrollment period for Chronic Care Special Needs Plans. Did you notice anything in the bill that addressed Dual special needs plans enrollment periods? I did read somewhere in the bill that Dual special needs plans are extended through 2013 or 2014(not sure which) but nothing mentioned about a monthly continuous SEP for this group like there is now.

    Also, I can’t see them eliminating SEP’s as many people are always moving in or out of service area, losing group coverage, have LIS, or are enrolled in SPAP’s like PACE or PACE NET in Pennsylvania.


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