Medicare and the Bipartisan Budget Act of 2018

October 24,2019

 

While structured mainly around government spending and the federal budget, the Bipartisan Budget Act of 2018 included several items that directly affect Medicare.

American flag with money and medicine and a stethoscope

Medicare program changes

The legislation, passed in February 2018, is affecting Medicare and Medicare beneficiaries in some of the following ways.

  • A two-year funding extension was granted to community-based organizations to conduct outreach and enrollment for low-income Medicare beneficiaries. These organizations include State Health Insurance Assistance Programs (SHIPs), Area Agencies on Aging, Aging and Disability Resource Centers and the National Center for Benefits and Outreach Enrollment.

  • The Medicare Part D “donut hole” will close completely for brand-name drugs in 2019, one year earlier than originally scheduled. The donut hole, which represents a temporary coverage gap of prescription medications, will also get smaller for generic drugs in 2019 before disappearing in 2020.

  • The Medicare Part B payment limit on outpatient physical, occupational and speech therapy is now permanently lifted.

  • Speech generating devices are now categorized as durable medical equipment, which makes them more commonly covered by Medicare for qualified beneficiaries.  

  • The Children’s Health Insurance Program (CHIP) is extended by four years, from 2024 to 2027.

  • Community health centers will receive federal funding for two years. Many Medicare beneficiaries use these facilities to obtain health care.

  • Medicare Advantage (Medicare Part C) plan services and benefits will increase for qualified beneficiaries with complex medical conditions. The change includes expanded supplemental benefits, improved access to telehealth services and a permanent designation for Medicare Advantage Special Needs Plans.

  • The number of days required for coverage of home health care services was reduced from 60 days to 30, and associated therapy thresholds have been eliminated. In addition, the Medicare Independence at Home Demonstration was extended by two years.

Review the congressional text to further explore some of the Medicare changes that will result from the landmark legislation.

Medicare Part B and Part D premium increases

To offset some of the changes brought on by the Bipartisan Budget Act of 2018, Medicare Part B and Part D premiums will increase in 2019 for high-income beneficiaries.

The legislation also reduces the Affordable Care Act’s Prevention & Public Health Fund by $1.35 billion over 10 years.

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