New CMS rule to enable immediate coverage for FDA-designated ‘breakthrough’ devices

Medicare

The agency has finalized a rule that allows it to provide immediate Medicare coverage for FDA-approved products that are deemed “breakthrough devices.” The new coverage process would enable seniors to get access to these devices more quickly, but some provider and payer groups are concerned that this could cause patient harm.

A Dozen Facts About Medicare Advantage in 2020

Medicare Advantage enrollment has grown rapidly over the past decade, and Medicare Advantage plans have taken on a larger role in the Medicare program. More than 24 million Medicare beneficiaries (36%) are enrolled in Medicare Advantage plans in 2020. This data analysis provides updated information about Medicare Advantage enrollment trends, premiums, and out-of-pocket limits. It also includes analyses of Medicare Advantage plans’ extra benefits and prior authorization requirements. The analysis also highlights changes pertaining to Medicare Advantage coverage that have occurred in 2020 in response to the COVID-19 crisis.

Who Didn’t Get a Second Shingrix Shot? Implications for Multidose COVID-19 Vaccines

As the U.S. prepares for nationwide distribution of vaccines to combat COVID-19, some are asking whether people who get the first of two doses will return to complete the series in order to be fully immunized. This analysis draws on Medicare Part D prescription drug claims data for the herpes zoster vaccine Shingrix, which also requires two doses, to shed light on this potential challenge of the leading COVID-19 vaccine candidates.

Medicare Advantage 2021 Spotlight: First Look

For 2021, the average Medicare beneficiary has access to 33 Medicare Advantage plans, the largest number of options available in the last decade, and can choose from plans offered by eight firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 54 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental fitness, dental, vision, and hearing benefits. In addition, virtually all will also offer telehealth benefits in 2021.

Lower Flu Vaccination Rates Among Black, Hispanic, and Low-Income Seniors Suggest Challenges for COVID-19 Vaccination Efforts

People 65 and older, who have been hardest hit by COVID-19 in terms of hospitalizations and deaths, are also at high risk of severe flu illness and are more likely to die of the flu than younger people. This analysis explores variation in the rate of flu vaccination among adults ages 65 and older covered by Medicare, and reasons cited for not getting vaccinated, based on data from the 2018 Medicare Current Beneficiary Survey.

State Actions to Sustain Medicaid Long-Term Services and Supports During COVID-19

As the COVID-19 pandemic continues, states have taken a number of Medicaid policy actions to address the impact on seniors and people with disabilities, many of whom rely on long-term services and supports (LTSS) to meet daily needs and are at increased risk of adverse health outcomes if infected with coronavirus.