Medicare Compliance & Reimbursement

M+COs get another benefit option.

Health plans often have a hard time encouraging Medicare beneficiaries to enroll in their Medicare+Choice product lines - but a new regulation from the Centers for Medicare & Medicaid Services could help make things just a little bit easier. Published in the Nov. 28 Federal Register, the reg permits M+C organizations to offer a reduction in the Part B premium as an additional benefit under their M+C plans. To reduce - or eliminate - an enrollee's Part B premium, the M+CO must accept a reduction of its monthly capitation payment. Eighty percent of the payment reduction can then be applied to reducing enrollee's Part B premiums. The premium reduction can't exceed the beneficiary's actual premium obligation, CMS specifies, and must be offered to all enrollees. The reg is intended "to make M+C more attractive to Medicare beneficiaries and increase enrollment in M+C plans," CMS says. To see the rule, go to www.access.gpo.gov/su_docs/fedreg/a031128c.html. Lesson Learned: M+COs now have an additional benefit in their arsenal of selling points for Medicare beneficiaries.