Helaine I. Fingold, Member of the Firm in the Health Care & Life Sciences practice, in the firm’s Baltimore office, was quoted in Stat News, in “CMS Delays Rule Requiring Medicare Advantage Insurers to Remind Members of Unused Benefits,” by Tara Bannow. (Read the full version – subscription required.)
Following is an excerpt:
Medicare is delaying implementation of a Biden-era rule that would have made Medicare Advantage plans notify members about their unused supplemental benefits — services such as vision and dental. …
Meanwhile, transparency into whether people use the benefits is nonexistent. That’s partly because Medicare has lacked the technical capacity to collect some of the records, but the agency has made improvements in that area. Beginning this year, Medicare is requiring Medicare Advantage insurers to submit data on their members’ use of supplemental benefits. It’s the first time the agency has had such a requirement, but MedPAC has said the data won’t be public for years and it won’t be broken out by insurer.
Helaine Fingold, an attorney at Epstein Becker Green focused on federal health insurance regulations, said it seems counterintuitive that Medicare would continue to require that information be reported to the agency but not to individual members.
“If they can do the reporting and the reporting is happening, why can’t they do the communication?” Fingold said. “It’s not clear to me if there is a problem with the reporting as well. That is not a problem I’ve heard or that CMS has spoken to.”
Supplemental benefits can be a broad range of things — even home improvement funds and over-the-counter drugs — so it could be that insurers are struggling to compile the information for people, Fingold said.
