1. Improving the lives of older Americans MIPPA Changes Impacting People with Medicare FamiliesUSA Health Action Conference January 2010

2. © 2007. Copyright NCOA LIS & MSP -- Asset eligibility alignment The Qualified Medicare Beneficiary (QMB), Specified Low- Income Beneficiary (SLMB) and Qualifying Individual (QI) programs will have the same asset (resource) level as full LIS, In 2010, these levels are $6,600 for a single individual and $9,910 for a married couple. At least $1,500 (individual)/$3,000 (married couple) must be excluded from counted assets for MSP Generally states have stricter rules for excluding monies for burial than LIS, usually requiring that the funds be kept in a separate and identifiable account – check with your Medicaid office Some states have already raised MSP asset levels above the federal floor, or have eliminated an asset test Examples: AL, AZ, DC, DE, ME, MS, NY, VT, and CT What could your state do? Effective January 1, 2010

3. © 2007. Copyright NCOA LIS & MSP -- Changes to the LIS eligibility criteria Cash surrender value of life insurance will no longer be counted as an asset for LIS eligibility States may choose to continue counting the cash surrender value of life insurance as an asset in determining MSP eligibility Effective January 1, 2010

4. © 2007. Copyright NCOA LIS & MSP -- Changes to the LIS eligibility criteria (continued) In-kind support and maintenance (ISM) will no longer be counted as income for LIS eligibility A few states still count ISM in deciding about entitlement for MSPs Does your state? If yes, can you get that changed? Effective January 1, 2010

5. © 2007. Copyright NCOA LIS & MSP -- Changes to the LIS application New question added (question 15) regarding the transmittal of data from SSA to state Medicaid agency to start an MSP application Your clients should only check the box if they wish to OPT OUT of this process Effective January 1, 2010

6. © 2007. Copyright NCOA LIS & MSP -- Estate recovery for MSP States are prohibited from recovering Medicaid expenditures for Medicare premiums and cost- sharing paid under MSPs from the estates of deceased Medicaid/MSP recipients Effective January 1, 2010

7. © 2007. Copyright NCOA LIS & MSP -- Part D Late Enrollment Penalties People with LIS are excused from paying Part D plan late enrollment penalty premiums This provision put into the law current CMS policy Related notes: QMB waives any otherwise applicable Medicare Parts A and B late enrollment penalty premiums SLMB and QI waive any Part B late enrollment penalty premiums Already in effect

8. © 2007. Copyright NCOA LIS & MSP: Transmission of LIS data from SSA to States LIS and MSP application provisions: Social Security Administration will transmit the information on LIS applications to state Medicaid agencies, starting with LIS applications filed on January 2, 2010 State Medicaid agencies must treat the data SSA transmits as the start of an MSP application Effective January 1, 2010 Since it takes SSA around 14 days to process most LIS applications, states should expect the first data transmissions by the third week in January 2010 Do you know if your state is getting these data?

9. © 2007. Copyright NCOA LIS & MSP -- New model MSP application CMS has developed a new model MSP application States are encouraged, but not required to use it Will be available in 10 languages -- Arabic, Chinese, French, Haitian-Creole, Farsi, Korean, Spanish, Tagalog, Russian, and Vietnamese. Translated model MSP applications are available online on CMS and SSA web sites Is your state using this simple, easy-to-complete application, or something more complex?

10. © 2007. Copyright NCOA LIS & MSP -- Extension of QI The QI program was extended, but only through the end of 2009 Already in effect NOTE: The American Recovery & Reinvestment Act (ARRA) extends QI even further – through December 31, 2010 Health Care Reform extended it further – what now???

11. © 2007. Copyright NCOA Resources MIPPA & Your Clients, National Center for Benefits Outreach & Enrollment Webinar, December 2009, http://www.mymedicarecommunity.org/showthread.ph p?t=4476 http://www.mymedicarecommunity.org/showthread.ph p?t=4476 CMS limited income and resources web page http:///www.cms.hhs.gov/limitedincomeandresources http:///www.cms.hhs.gov/limitedincomeandresources SSA fact sheet on MIPPA changes – in English http://www.socialsecurity.gov/pubs/10040.html http://www.socialsecurity.gov/pubs/10040.html SSA fact sheet on MIPPA changes – in Spanish http://www.socialsecurity.gov/espanol/10934.html http://www.socialsecurity.gov/espanol/10934.html

12. © 2007. Copyright NCOA Contact Hilary Sohmer Dalin Associate Director, Benefits National Council on Aging (202)479-6626 Hilary.dalin@ncoa.org www.MyMedicareCommunity.org www.CenterforBenefits.org