In 2012, the Affordable Care Act expanded the Part D Extra Help (also known as the Low-Income Subsidy “LIS”) program such that dual eligibles enrolled in certain Home and Community-Based Services (“HCBS”) programs should not be charged any co-pays for Part D drugs. Despite the change in the law, dual eligibles enrolled in Community Based Adult Services (“CBAS”) and some in the Multipurpose Senior Services Program (“MSSP”) have been improperly charged co-pays since 2012. The number of impacted individuals is around 30,000. Starting this year, the Centers for Medicare & Medicaid Services (“CMS”) is beginning to properly assess co-pays and retroactively reimburse them, and dual eligibles will begin receiving reimbursements in the next several weeks. This webinar will discuss what advocates need to know during this process, including:
An overview of the relevant Part D Extra Help (“LIS”) rules;
-Identifying different populations impacted;
-A summary of the co-pay and reimbursement processes;
-The timeline for reimbursements and template notices beneficiaries will receive; and
-How to assist beneficiaries, including the Best Available Evidence Rule.
Who should participate:
Advocates who serve dual eligibles enrolled in CBAS and/or MSSP, dual eligibles in other HCBS programs, and who are interested in learning more about Part D LIS.
Denny Chan, Senior Staff Attorney, Justice in Aging
This webinar took place on February 25, 2020.