CMS Issues Proposed Revisions to Medicare Enrollment Periods, ESRD medication coverage

On April 27th, the Centers for Medicare and Medicaid Services issued a proposed rule in the Federal Register that would directly affect people who received Title II Social Security disability benefits and qualify for Medicare benefits. Several proposals are contained within CMS’s notice. First, “for individuals who become eligible for Medicare on or after January 1, 2023, and enroll in Part B during the last 3 months of their [Initial Enrollment Period] IEP, entitlement would begin the first day of the month following the month in which they enroll.” Current rules tie the Medicare entitlement date to the specific month of enrollment. The later you enroll, the longer the delay before entitlement begins. This rule is more equitable.

Another welcome proposed change: “Effective January 1, 2023, . . . certain individuals whose Medicare entitlement based on [End Stage Renal Disease] ESRD would otherwise end after a successful kidney transplant [will] continue enrollment under Medicare Part B only for the coverage of immunosuppressive drugs.” This is a big deal. Under current law, “entitlement to Medicare Part A and eligibility to enroll under Part B for ESRD beneficiaries ends with the 36th month after the month in which the individual receives a successful kidney transplant.”

Two other proposals — to simplify enrollment forms, and to modernize state payment of Medicare premiums — are designed to improve the customer experience when dealing with Medicare.

Supreme Court, SSI, and Puerto Rico

In an 8-1 opinion, the Supreme Court has ruled that residents of Puerto Rico and other U.S. territories are not entitled to Supplemental Security Income (SSI) benefits.

Congress has long maintained different federal tax and benefits programs for residents of the Territories than for residents of the 50 States. For example, residents of Puerto Rico are typically exempt from most federal income, gift, estate, and excise taxes. See 48 U. S. C. §734; see, e.g., 26 U. S. C. §§933, 2209, 4081–4084. But just as not every federal tax extends to residents of Puerto Rico, so too not every federal benefits program extends to residents of Puerto Rico.

The Court held that the equal protection component of the due process clause of the Fifth Amendment did not require Congress to make SSI benefits available to residents of U.S. territories. Justice Sonia Sotomayor filed the lone dissent.

New Social Security Website in the Works

The Social Security Administration (SSA) has released a beta version of its new website to be brought online later this year. SSA says invites the public to visit the website and “use the ‘Feedback’ button on the right side of the screen to tell us what you think. You can visit the website on your computer, tablet, and smartphone.”

Because the new website is a work in progress, some links may open webpages on the current SSA.gov. And there is not yet a Spanish-language version.

SSA hopes the new website will be “simpler and easier to use.”

The Disabled and Covid-Era Policies

From Time:

During the height of the pandemic, political leaders made a number of decisions that helped the poor and disabled. Now as those policies end, those who advocate on behalf of people with disabilities are fighting against a return to normal. They are asking officials to “make permanent some of the systemic tweaks that helped make everything from employment and health insurance to housing and schooling more accessible to all Americans during the pandemic.” In particular, they want:

widespread access to COVID treatments and testing; improved ventilation systems; flexible masking policies that ramp up when necessary; and a slew of economic proposals, including paid sick leave, affordable housing and measures to help people secure disability benefits. They want, in other words, to embrace the pandemic-era shifts that allowed people with disabilities, who are more than twice as likely to live in poverty as nondisabled people, to engage more fully in many parts of society.

Some studies suggest that 10-30% of people who contract COVID-19 end up with Long Covid. Some of those folks will likely need ongoing economic and medical aid in the future, leading to changes in the Social Security disability benefits system.