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On October 28^th, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Program: Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and other Revisions to Medicare Enrollment and Eligibility final rule. This rule includes several provisions related to dually eligible individuals and will impact states, including changes to (a) extend the Medicare Savings Programs (MSPs) to cover premiums and cost sharing for individuals enrolling in the new Medicare immunosuppressive drug benefit, (b) beginning January 1, 2024, limit retroactive Medicare Part B premium liability for states to 36 months, and (c) retire the old stand-alone buy-in agreements and specify that the provisions of a state buy-in agreement shall be set forth in the states Medicaid state plan.

This rule also creates a new Medicare special enrollment period (SEP) for individuals losing Medicaid eligibility and who did not enroll in Medicare on time. The most salient content begins under the section headers SEP to Coordinate with Termination of Medicaid Coverage, Modernizing State Payment of Medicare Premiums, and Ensuring Coverage under the Medicare Savings Programs. CMS encourages stakeholders to review the rule, and will be providing an overview to states next week. You can find the rule here: https://www.federalregister.gov/public-inspection/2022-23407/medicare-program-implementing-certain-provisions-of-the-consolidated-appropriations-act-2021-and