For weeks, consumers were worried about potential Medicare Part B increases of more than 50 percent. This past week, President Obama signed a new budget agreement that limits those increases for both the premiums and deductibles for 2016.
You may recall that for 30 percent of Medicare beneficiaries, their premiums could have soared to more than $150 from $105. This was because of higher than projected Medicare costs this year, no cost of living adjustment (COLA) for Social Security recipients and the fact that these people – the 30% – would be forced to carry the financial burden of 100% of recipients. Close to 70% of beneficiaries who have their Part B premium deducted from their Social Security check were already “held harmless” and protected from increased Part B premiums.
There will still be increases for the 30%, but it will be closer to $120 versus the $150. That’s still high, but the Part B deductible, or amount people have to pay out of pocket before their coverage begins, was also set to increase to about $223. The new budget deal reduces the projected deductible to $167.
The final numbers for the Part B premium and deductible should be released in the coming days.
For now, the Centers for Medicaid and Medicare Services have released final details on payments to doctors, hospitals and other healthcare entities. There are new rules that reward quality and patient centered care. On a side note, it’s interesting that anyone receives additional rewards for doing their jobs.
CMS Acting Administrator Andy Slavitt said during a presser when the rules were released, “CMS is pleased to implement the first fee schedule since Congress acted to improve patient access by protecting physician payments from annual cuts. These rules continue to advance value-based purchasing and promote program integrity, making Medicare better for consumers, providers, and taxpayers.”
The New Rules
One of those new rules includes allowing doctors to bill Medicare for conversations about advanced care plans. The rule also provides additional needed clarification regarding how physicians should determine whether a patient should be admitted as an impatient to a hospital using a ‘two midnight rule’ to guide, but not supplant, professional judgment.
Another new rule has to do with end of life care and preferences. Studies have found that 40 percent of Americans ages 65 and older do not have advanced directives nor have they written down their own wishes for end-of-life medical treatment. Each year, there are around 2.5 million people who die and three-quarters of them are older than 65. Close to 25 percent of traditional Medicare spending for is for services provided to Medicare beneficiaries in their last year of life and this number has been consistent for more than two decades. Many who die have multiple serious and complex conditions. Medicare will now allow for discussions that physicians and other health professionals have with their patients regarding end-of-life care and their preferences. Physicians and other health professionals can now bill Medicare as a separate service. Previous Medicare coverage rules only allowed reimbursement for advance care planning under very limited circumstances.
Have more questions about the new Medicare rules? You can visit Medicare.gov and as always, we invite you to contact our offices to discuss these and other important estate planning issues.