In 2012, the Affordable Care Act expanded the Part D Extra Help Program, also known as the Low-Income Subsidy (LIS), so that dual eligibles enrolled in certain Home and Community-Based Services (HCBS) should not be charged any co-pays for Part D covered drugs. However, since 2012, some California duals enrolled in Community-Based Adult Services (CBAS) and in San Mateo’s Multipurpose Senior Services Programs (MSSP) have been improperly charged co-pays. The Centers for Medicare & Medicaid Services (CMS) and California’s Department of Health Care Services (DHCS) is beginning to work with Part D and Medicare Advantage plans so that these dual eligibles are properly assessed co-pays and retroactively reimbursed for any improper amounts collected.
Justice in Aging created an FAQ for advocates to answer key questions about the implementation of these refunds.
