CMS Proposes Revised Medicare Enrollment Rules

Sections 120 and 402 of the Consolidated Appropriations Act, 2021 (CAA) made two key changes to Medicare enrollment rules.

First, Medicare coverage will become effective the month after enrollment for individuals enrolling in the last three months of their initial enrollment period or in the General Enrollment Period, thereby reducing any potential gaps in coverage. Currently, if individuals enroll in Medicare in the last three months of their Initial Enrollment Period or in the General Enrollment Period, they may have to wait several months for Medicare coverage to begin.

Second, the proposed rule also establishes a new immunosuppressive drug program that would extend Medicare immunosuppressive drug coverage to certain individuals who have had a kidney transplant. If finalized, the proposed rule would promote accessibility to vital life-saving drugs.

This rule, if finalized, would become effective January 1, 2023, and implement changes made by the CAA

Press Release: https://www.cms.gov/newsroom/press-releases/cms-proposes-updates-reduce-barriers-coverage-simplify-medicare-enrollment-and-expand-access

Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/implementing-certain-provisions-consolidated-appropriations-act-2021-and-other-revisions-medicare-1

Federal Register: https://www.cms.gov/files/document/cms-4199-p.pdf