The Centers for Medicare & Medicaid Services published a proposed regulation on Monday that would help qualifying low-income individuals get assistance in paying their premiums for the Medicare prescription drug plan.
The proposal provides an option for Medicare prescription drug plan sponsors to offer a separate prescription drug premium amount for individuals receiving low-income subsidies, subject to certain conditions.
Medicare beneficiaries with limited income and resources, and those who are dually eligible for both Medicare and Medicaid may qualify for extra assistance in paying for their Part D premium and cost-sharing through low-income subsidies provided by Medicare, CMS said.
According to the proposed rule, CMS would allow prescription drug plan sponsors to offer a reduced premium amount for LIS-eligible individuals to ensure that at least five drug plan sponsors in every region would have a drug plan with a premium at or below the premium subsidy amount.
Premiums for Medicare prescription drug coverage are based on prescription drug plan bids that project the cost for providing coverage for the following year; costs can change from year to year. Based on the bids, as required by law, CMS calculates the amount of the premium that will be paid by Medicare for low-income beneficiaries in each region.
As a result of premium and subsidy changes, the premium for any individual Part D plan can be fully covered by the subsidy in one year and not the following year, according to CMS.
"Through this proposed rule, we are seeking comment on a means of reducing the number of beneficiaries subject to random reassignment while maintaining the integrity of the annual bid process," said CMS Acting Administrator Kerry Weems. "We expect changes adopted in the final rule to be effective in the 2009 benefit year."
The proposed rule will be published in the Federal Register on January 8, and the final rule is expected to be issued on March 28 to ensure that the final policy is included in the Part D Rate Announcement on April 7. This will give Part D sponsors time to account for the policy as they calculate their Part D bids, which are due on June 2.