Examining the Regulatory Changes Made to Medicare in Response to COVID-19

Examining the Regulatory Changes Made to Medicare in Response to COVID-19

Life as we know it has effectively ended with the surge of the COVID-19 pandemic. Expectedly, the healthcare industry bore and is still bearing the brunt of its effects. To accommodate these effects, several major changes were made to the current Medicare regulations as a federal health insurance program.

As your trusted insurance advisor in Troy, Michigan, allow me to walk you and your family through the changes made and discuss with you what these entail, how it looks applied right now, and what the future holds with these changes implemented among beneficiaries like you.

  • So, what were the changes for exactly?

    Spearheaded by Congress and the Trump administration, these changes which encompassed legislative, regulatory, and sub-regulatory levels were primarily made to allow flexibility in the agency’s processes. It allowed healthcare providers, Medicare Advantage plans holders, and Part D plan holders to relax the rules in-place, enable patients to receive treatment in other care settings such as their homes, community facilities, and other expansion sites, and to receive reimbursements for telemedicine services, among others.

    It is worth noting that the changes were made with the outlook of them being made permanent should the current policies prove to be effective.

  • Who is affected by these changes?
    Virtually every beneficiary is affected by these policy changes. If we’re talking about the specifics, however, of the 212 policies modified, 55 of the policy actions were directed to the conditions of participation requirements for Medicare providers, 40 tackled payment systems, and 35 were meant for provider capacity and workforce.
  • What are the possible consequences of these changes?
    Under normal circumstances, any change in regulation requires the completion of an established notice-and-comment rulemaking process. This process allows stakeholders to raise questions and opinions to help the agency come up with the best possible course of action. Without this safeguard, opportunities for fraud, overuse, and abuse have higher chances of happening.
  • What do all these mean for you?
    As a provider of insurance plan in Michigan at American Insurance Advisors, I must emphasize that the changes made are necessary measures to counter the effects of the pandemic and to prevent further damages. And, as with any change, there will be pros and cons to it.

For instance, with alternative care sites, beneficiaries will have the ability to choose their preferred place to receive care. On the downside, they may be unprepared with the costs of an alternative care site.

Another policy change, waiving several requirements on payment systems and quality programs has the beneficial effect of maintained or expanded access to providers. However, this also opens the gates for chances of reduced quality care and higher cost-sharing fees which you could have used for your life insurance contributions.

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