Press Release             

Contact: Paul Precht
Director of Policy and Communications

Akiko Takano
Deputy Director of Communications

February 25, 2010

Consumer Group Releases Report on State Implementation of Low-Income Reforms
--Report Identifies Problems; Highlights Need for Additional State, Federal Action--

New York, NY—The Medicare Rights Center today released a preliminary report on state implementation of reforms to Medicare Savings Programs—Medicaid-administered programs that help pay cost-sharing for low-income people with Medicare—that are required under the Medicare Improvements for Patients and Providers Act (MIPPA) of 2020.

“This report is preliminary, but the problems it identifies highlight the urgent need for the Centers for Medicare & Medicaid Services (CMS) to proactively oversee how states are implementing these important reforms to programs for low-income people with Medicare. By collecting state implementation plans, policymakers can identify where states are falling short, and make sure that Congress’s goal of facilitating enrollment into Medicare Savings Programs is being fulfilled,” Medicare Rights Center President Joe Baker said. “These are tough economic times for older adults and people with disabilities. The federal government and the states need to do everything they can to ensure low-income people with Medicare get the assistance they need.”

The report, Warning Signs: Preliminary Report Highlights Problems with State Implementation of MIPPA Low-Income Reforms, looks at how states are implementing MIPPA requirements to align the asset test for MSP with the asset test for Extra Help, the low-income subsidy under Part D that helps pay drug premiums and copayments. Under MIPPA, Extra Help applicants will have verified income and asset data transferred by the Social Security Administration (SSA), which administers Extra Help, to state Medicaid departments to initiate an MSP application. The report also examines how states are processing MSP applications that are generated by data from SSA.The two provisions are designed to streamline and increase enrollment in MSPs, which have historically had low enrollment by eligible low-income people with Medicare.

The report, which surveyed 15 states, found evidence of shortcomings in state implementation of these MIPPA provisions. Specifically, some state Medicaid departments continue to cite the asset thresholds that expired at the end of 2009, instead of the new asset levels that took effect on January 1, 2010. In addition, states vary greatly in how they are processing SSA-generated MSP applications. While some states are using the verified income and asset data to screen and enroll applicants into MSP, others have procedures that erect bureaucratic obstacles to MSP enrollment.

The report also recommends that CMS follow up on guidance it issued on MIPPA implementation last week. While the guidance represents an important first step, Medicare Rights believe states need greater clarity from CMS on the minimum requirements for implementation of the MIPPA low-income provisions, as well as advice on adopting best practices in implementing these reforms.

The report is available at

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Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.


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