Safety Net Plans Seek ‘Hold Harmless’ Policies From CMS

As the COVID-19 pandemic continues to shake up the health care system — and disproportionately impact vulnerable patients such as dual eligibles enrolled in Medicare-Medicaid Plans (MMPs) or Special Needs Plans (SNPs) — the Association for Community Affiliated Plans (ACAP) is calling on CMS to extend a multitude of flexibilities that will allow such plans to access the resources they need to continue serving at-risk members.

These plans “are bearing the brunt of the pandemic specifically because their enrollees are more at risk,” wrote ACAP CEO Margaret Murray in a Sept. 3 letter to Center for Medicare Principal Deputy Administrator and Director Demetrios Kouzoukas. ACAP’s not-for-profit health plans collectively provide coverage to 20 million Medicaid, CHIP, dual-eligible and exchange enrollees, and they enroll more than one-third of the total MMP membership nationwide. “Overall, we are asking CMS to hold MMPs and SNP harmless to mitigate the effects of COVID-19 on plan operations,” she wrote, adding that how some changes are applied may vary by geographic region.

© 2021 MMIT

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues, including drug benefits and specialty pharmacy, for more than a decade. She served as editor of Drug Benefit News (the predecessor to Radar on Drug Benefits) from 2004 to 2005 and again from 2011 to 2016, and now manages Radar on Medicare Advantage. Lauren graduated from Vassar College with a B.A. in English.

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