New Law Brings Relief to Medicare Advantage Patients With Chronic Conditions

February 2018

Medicare Advantage patients suffering from chronic conditions are set to find some relief thanks to a new law.

The bipartisan CHRONIC Care Act of 2018 passed through Congress, was signed by President Donald Trump and became law in February, as part of the Bipartisan Budget Act of 2018. CHRONIC is an acronym that stands for “Creating High-Quality Results and Outcomes Necessary to Improve Chronic” (care).

What is the CHRONIC Care Act?

The law expands coverage for those who have chronic illness and other functional limitations. Some of the measures specific to Medicare Advantage plans (also called Medicare Part C) include:

  • Allowing Medicare Advantage plans greater flexibility in their coverage of “non-medical” benefits such as bathroom grab bars or wheelchair ramps.
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  • Expanding the range of telehealth services available to Medicare Advantage beneficiaries. “Telehealth” involves health care services that are provided remotely through electronic means such as videoconferencing with a doctor or receiving remote patient monitoring.
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  • Improved coordination of services for Medicare Advantage patients who have a Special Needs Plan.

Some additional measures include the expansion of telehealth services to people suffering from kidney disease or stroke symptoms. The law also establishes a new program in which Accountable Care Organizations can incentivize patients by paying them up to $20 per visit for attending primary care appointments. An Accountable Care Organization is a group of health care providers or hospitals who team together to provide coordinated care to people on Medicare.

The need for home health care

Historically, Medicare has provided little coverage for services that can be provided remotely. But traveling to a doctor’s office can be difficult for someone with a chronic condition and can expose a weak immune system to a waiting room full of sick patients. The telehealth measures in the CHRONIC Care Act were put in place to address this concern. 

The efforts to improve home health care extend to those who are enrolled in the Independence at Home Program. This program provides chronically ill and disabled patients house calls from nurses and doctors. The new law will increase the number of patients eligible for the program from 10,000 to 15,000, while also boosting the length of time a medical practice can participate in the program from five years to seven.

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