National Women’s Health Week is a health observance coordinated by the U.S. Department of Health and Human Services’ Office on Women's Health (OWH). Kicking off each year on Mother’s Day, it empowers women to make their health a priority and encourages them to take the following steps to improve their physical and mental health and lower their risks of certain diseases:

  • Visit a health care provider for a well-woman visit (checkup), preventive screenings, and vaccines.

LeadingAge also asked CMS to provide more detail on the types of benefits a MA plan may offer under the new Special Supplemental Benefits for Chronically Ill policy and clarification on how these customized, person-centered benefits will be authorized.  Additional comments were offered recommending ways for CMS to reduce provider burden by: 1) ensuring automation of crossover claims for dual eligibles enrolled in MA plans (currently, available in Medicare FFS and Special Needs Plans); and 2) eliminating duplicative reporting of basic provider information(e.g., name, address, NPI and license

.The new Special Supplemental Benefits for the Chronically Ill (SSBCI) likely holds the most interest for long term services and supports, housing and home and community-based service providers but lacks the detail around the services that can be provided. In 2020, MA plans will have the new option to offer “non-primarily health-related” supplemental benefits to chronically ill enrollees. These benefits do not need to be uniform across a population (e.g. all diabetics) and can vary based on each individual enrollee’s specific medical condition and needs.

New Rules:  The passage of legislation in 2018, such as the Bipartisan Budget Act of 2018 which contained provisions of the CHRONIC Care Act, will lead to changes in the types of benefits Medicare Advantage (MA) plans may offer in 2020 and beyond and what is expected of both MA and Special Needs Plans (SNPs).  CMS closed 2018 with the publication of a series of proposed and final rules that will govern MA, SNPs, and Medicaid managed care plans for 2020 and beyond. 

The meeting brought together researchers, service providers, health plans, government officials, consumers, and their advocates around the central question of what is next for integrated care programs serving Medicare-Medicaid enrollees, those people who have coverage through both public health care programs.

CMS’s new interpretation appears to recognize the importance of these services for certain MA plan enrollees while making clear that not every enrollee in an MA plan will be eligible to receive them without a designated need.  CMS identified the following list of specific services as allowable supplemental benefits meeting CMS’s new expanded definition of “primarily health related”:


Subscribe to population health