2018 Archives: Health and Family

The following documents related to health care concerns of people 50-plus are presented in reverse chronological order.

December

C: On December 31, 2018 AARP sent a letter to Centers for Medicare and Medicaid Services’ Administrator Seema Verma providing comments on the Proposed Rule for the CY 2020 and 2021 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-For-Service, Medicare Prescription Drug Benefits, and PACE programs.  AARP has worked to improve access and quality in Medicare and Medicare Advantage, and to ensure the beneficiary’s perspective is part of care delivery. AARP has also supported the use of telehealth to increase access to services and providers, to align Medicare and Medicaid to better coordinate care and simplify access to protections for particularly vulnerable elderly, and to continue to support high quality health care.  (PDF)

C: On December 31, 2018 AARP provided a comment letter to Seema Verma, Administrator at the Centers for Medicare and Medicaid Services concerning an advance notice of proposed rulemaking on the Center’s International Pricing Index Model (IPI) for prescription drugs covered by Medicare Part B.  In the letter, AARP expressed general support for the Center for Medicare & Medicaid Services’ (CMS) interest in testing payment changes for certain Medicare Part B drugs with the goal of lowering costs for the program and its beneficiaries. Given recent prescription drug price and spending trends, it is imperative that policymakers find ways to address program spending without reducing beneficiary access to necessary treatments. Thoughtful efforts to move in this direction are far preferable to the unsustainable escalations in beneficiary and taxpayer spending that would accompany maintaining the status quo. (PDF)

C: On December 17, 2018 AARP submitted comments to Secretary Alex Azar of the U.S. Department of Health and Human Services and Secretary Steven Mnuchin of the U.S. Department of the Treasury concerning 1332 waiver guidance released on October 24, 2018.  AARP expressed serious concerns that the guidance issued by the Centers of Medicare and Medicaid Services and the Department of the Treasury could lead to the erosion of the core consumer protections of the Affordable Care Act (ACA). (PDF)

C: On December 17, 2018 AARP submitted a comment letter to Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS) concerning a proposed rule to require drug price transparency in certain consumer advertisements.  In the letter, AARP expressed support for efforts to increase price transparency for prescription drugs, including CMS’s proposal to require drug manufacturers to include the price of certain drugs in televised direct-to-consumer (DTC) advertisements. (PDF)

C: On December 11, 2018 AARP submitted written comments to the Division of Regulations, Legislation and Interpretation of the Wage and Hour Division of the U.S. Department of Labor.  AARP’s comments were related to the Department of Labor’s proposed rule that would allow 16 and 17-year old workers to operate power-driven patient lifts by themselves in health care facilities, in reversal of its 2011 policy.  AARP expressed concern that the proposed rule could put older individuals and nursing facility residents (collectively, “patients”) at risk of severe injury or possibly worse. (PDF)

L: On December 11, 2018, AARP sent a letter to all U.S. Senators and Representatives in support of the conference report accompanying the Agriculture Improvement Act of 2018 (H.R. 2).  The farm bill agreement would protect critical nutritional assistance for millions of Americans, including  older Americans, and support healthy aging. AARP urged a vote in favor of the adoption of the farm bill conference report. (PDF)

November

C: On November 19, 2018 AARP sent a comment letter to Administrator Seema Verma at the Centers for Medicare & Medicaid Services concerning a proposed rule regarding regulatory provisions to promote program efficiency, transparency, and burden reduction. AARP’s comments focus on the emergency preparedness provisions and selected other provisions impacting individuals and their family caregivers. (PDF) 

L: On November 14, 2018 AARP sent a letter to congressional leadership expressing strong opposition to any attempts to roll back the improvements made to Medicare Part D in the Bipartisan Budget Act (BBA).  These critical reforms will help to reduce out-of-pocket costs for beneficiaries and must be maintained. (PDF)

L: On November 14, 2018, AARP sent a letter to the Chairmen and Ranking Members of the Senate Committee on Agriculture, Nutrition, & Forestry, and the House Committee on Agriculture expressing specific views on the Agriculture Improvement Act of 2018.  Specifically, AARP stressed the importance of protecting older Americans from food insecurity, and opposed any effort that would make it harder for older Americans to access the Supplemental Nutrition Assistance Program (SNAP). (PDF)

September

C: On September 26, 2018 AARP submitted a comment letter to CMS Administrator Seema Verma concerning the South Dakota Medicaid 1115 Waiver Demonstration proposal.  In the letter, AARP expressed concerns that South Dakota’s Medicaid proposal will apply to an estimated 1,300 “parents and caretaker relatives eligibility group” who have very low incomes, up to 57 percent of the Federal Poverty Level (FPL). As such, many of the changes proposed in South Dakota’s 1115 waiver proposal would adversely impact a significant number of Medicaid enrollees. (PDF)

C: On September 24, 2018 AARP submitted a comment letter to CMS Administrator Seema Verma concerning the proposed changes to the Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs for calendar year 2019.  (PDF)

L: On September 21, 2018 AARP sent a letter to congressional leaders in opposition to efforts to roll back the Medicare Part D donut hole provisions included in the recently enacted Bipartisan Budget Act (BBA) of 2018.  AARP is very concerned that there are attempts to weaken these donut hole improvements in upcoming opioid legislation. Reversing the progress made under current law will increase prescription drug costs for older Americans while providing a windfall of billions of dollars to the drug industry. (PDF)

L: On September 13, 2018, AARP sent a letter to Chairman Kevin Brady of the U.S. House of Representatives, Committee on Ways and Means concerning the medical expense deduction.  AARP thanked the Chairman for including an extension of the current 7.5 percent threshold for the medical expense deduction in the Protecting Family and Small Business Tax Cuts Act (H.R. 6760).  AARP also indicated that a short extension seems inconsistent with the committee’s overall efforts to make individual tax reforms permanent. In that regard, AARP asked that, like all other individual income tax provisions in your proposed legislation, the medical expense deduction be made permanent. (PDF) 

L: On September 13, 2018, AARP along with 35 other organizations sent a coalition letter to Chairman Kevin Brady of the U.S. House of Representatives, Committee on Ways and Means concerning the medical expense deduction.  The undersigned coalition organizations thanked the Chairman for including an extension of the current 7.5 percent threshold for the medical expense deduction in the Protecting Family and Small Business Tax Cuts Act (H.R. 6760).  The coalition also indicated that a short extension seems inconsistent with the committee’s overall efforts to make individual tax reforms permanent. In that regard, the coalition asked that the medical expense deduction be made permanent. (PDF)

C: On September 10, 2018 AARP submitted a letter to Administrator Seema Verma of the Centers for Medicare and Medicaid Services commenting on the revision to the payment policies under the Physician Fee Schedule and other revisions to Medicare Part B for calendar year 2019.  AARP commented on various issues including the expansion of telehealth services in Medicare, updating the documentation requirements for clinicians to enable them to use their time more productively and focus on the things that are most important to each individual, the inclusion of two additional Consumer Assessment of Healthcare Provider and Systems (CAHPS) survey measures in the Medicare Shared Savings Program quality scoring for accountable care organizations, and concerning individuals knowing the financial costs of the health care they receive, and that price information can be a useful tool for consumers to make informed decisions about their care. (PDF)

L: On September 6, 2018 AARP along with the Alliance for Retired Americans, the Center for Medicare Advocacy, Justice in Aging, the Medicare Rights Center and Patients for Affordable Drugs Now sent a letter to the leadership of the U.S. Senate and House of Representatives expressing strong support for maintaining the Medicare Part D donut hole provisions that were included in the recently enacted Bipartisan Budget Act of 2018. These critical reforms will help to reduce out-of-pocket costs for beneficiaries, especially those who face the highest prescription drug costs. (PDF)

August

L: On August 22, 2018, thirty-three organizations – including AARP – signed and sent a group letter to the U.S. Senate Committee on Agriculture, Nutrition, and Forestry and the U.S. House Committee on Agriculture expressing their views as the Agriculture Improvement Act of 2018 (also known as the Farm Bill) enters into conference.  The undersigned organizations urged the farm bill conference committee to work in a bipartisan manner to produce an agreement that protects and strengthens our nation’s nutrition assistance programs and rejects any provisions that would create additional barriers for individuals and families struggling with food insecurity. (PDF)

C: On August 17, 2018, AARP submitted further comments to the Centers for Medicare & Medicaid Services concerning the proposed Kentucky HEALTH 1115 Demonstration Waiver modifications.  In the letter, AARP expressed strong concerns and questions about the 1115 Demonstration Waiver being sought by Kentucky. AARP has commented previously at both the state and federal levels on Kentucky’s initial waiver application. (PDF)

L: On August 8, 2018, AARP wrote to certain members of Congress expressing strong opposition to efforts to roll back the Medicare Part D donut hole provisions that were included in the recently enacted Bipartisan Budget Act (BBA) of 2018. (PDF)

C: On August 3, 2018, AARP sent a comment letter to Administrator Seema Verma of the Center for Medicare and Medicaid Services concerning Utah’s 1115 Primary Care Network (PCN) Demonstration Waiver Amendment #15.  In the letter, AARP expresses several concerning aspects of Amendment #15, each having the potential to worsen health outcomes, create significant financial hardship for many Utah Medicaid beneficiaries in need of coverage, increase administrative costs to the state, and result in increased uncompensated care costs for Utah’s health providers. (PDF)

July

L: On July 30, 2018 AARP sent a letter to U.S. Senators Richard Durbin and Chuck Grassley endorsing the Senators’ amendments to the Fiscal Year 2019 (FY19) Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Bill that would require the Food and Drug Administration (FDA) to compel drug manufacturers to include the price of their drugs in direct-to-consumer advertisements (DTC).  AARP strongly supports efforts to increase price transparency for prescription drugs. Prescription drugs often come to market with incredibly high launch prices, and those prices continue to increase over time. (PDF)

L: On July 26, 2018 AARP expressed its views to the U.S. Senate and House as the Agriculture Improvement Act of 2018 enters into conference.  In the letter, AARP noted that millions of Americans, including older Americans, rely on the Supplemental Nutrition Assistance Program (SNAP) to put food on the table. AARP urged the conference to work in a bipartisan manner to produce a conference agreement that protects SNAP and rejects creating additional program barriers for individuals and families struggling with food insecurity. (PDF)

C: On July 25, 2018 AARP sent a comment letter to Seema Verma, Administrator for the Centers for Medicare and Medicaid Services (CMS) concerning the proposed “Medicare Pre-Claim Review Demonstration for Home Health Services.”  CMS proposes a five-year demonstration in Illinois, Ohio, North Carolina, Florida, and Texas in which all home health agencies would choose between 100 percent pre-claim review, 100 percent post-payment review, or not undergoing such reviews but receiving a 25 percent payment reduction for all claims submitted for home health services. Providers selecting this third option may be eligible for review by Recovery Audit Contractors (RACs).  While AARP supports CMS’ goals of developing improved procedures to identify, investigate, and prosecute fraud and protecting Medicare from improper payments, AARP is very concerned about the impact of this proposed demonstration on Medicare beneficiaries and their families and urges CMS to reconsider the parameters of this demonstration. (PDF)

L: On July 20, 2018 AARP sent a letter to Senator Susan Collins, Chair and Senator Robert Casey, Ranking Member of the Senate Special Committee on Aging responding to a bipartisan request for input regarding guardianship.  In the letter, AARP addressed specific questions about guardianship posed by the committee.  AARP also expressed its commitment to advocating for comprehensive guardianship and power of attorney reforms to help protect vulnerable adults and provide their family caregivers with the tools they need to make important decisions for their loved ones as quickly as possible regardless of where they live. (PDF)   

C: On July 16, 2018 AARP sent a comment letter to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar commenting on the HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs.  In the letter, AARP commented that it shares HHS’ goal of reducing prescription drug prices and costs while ensuring beneficiary access to appropriate medications. Older Americans’ health and financial well-being are increasingly affected by high and growing drug prices, and AARP appreciates HHS’s ongoing efforts to find new ways to address this challenge. AARP strongly believes that it is critical that any proposals to lower prescription drug costs don’t simply shift the costs around in the health care system without addressing the root problem: the prices set by pharmaceutical companies. (PDF)

June

L: On June 27, 2018 AARP sent a letter to the U.S. Trade Representative, Ambassador Robert Lighthizer concerning the renegotiated text of the North American Free Trade Agreement.  In the letter, AARP expressed its strong desire that the renegotiated text not include harmful provisions that would reduce competition in the prescription drug market and increase prescription drug costs for American consumers. (PDF)

L: On June 26, 2018 AARP sent a letter to the U.S. Senate Majority Leader Mitch McConnell and Minority Leader Charles Schumer sharing it’s views on the Agriculture Improvements Act of 2018.  AARP expressed its support for the protections and improvements made to the Supplemental Nutrition Assistance Program (SNAP) and other aspects of the bill.  AARP also urged the Senate to maintain the authorization of $635 million for the Puerto Rico Nutrition Assistance Program (NAP) for FY 2019 for an additional two years, FY 2020 and FY2021. (PDF)

C: On June 25, 2018, AARP submitted written comments to the Centers for Medicare and Medicaid Services concerning the Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2019 Rates, and other issues.  AARP’s comments on the Medicare impatient prospective payment systems proposed rule focus on quality reporting and price transparency. (PDF)

C: On June 21, 2018 AARP submitted a comment letter to the Centers for Medicare and Medicaid Services on a proposed rule concerning the Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNF) Proposed Rule for FY 2019, SNF Value-Based Purchasing Program, and SNF Quality Reporting System.  AARP’s comments focused on the provisions regarding changes to the case-mix methodology in the SNF prospective payment system (PPS), the SNF Quality Reporting Program, and interoperability and electronic health information exchange. (PDF)

C: On June 21, 2018 AARP submitted a comment letter to the Centers for Medicare and Medicaid Services on a proposed rule concerning the Medicare Program; FY2019 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements.  AARP expressed some concerns over the public reporting of additional quality measures on the website Hospice Compare, and expressed opposition to the proposed new removal factor for previously adopted hospice quality reporting program measures.  (PDF)

L : On June 21, 2018 AARP sent a letter to the entire U.S. House of Representatives urging them to vote NO on H.R. 2, the Agriculture and Nutrition Act of 2018.  In its current form, this bill would have a negative impact on the millions of Americans, including older Americans, who rely on the Supplemental Nutrition Assistance Program (SNAP).  SNAP is the nation’s largest federal nutrition program and is an important safety net for the 43 million Americans who rely on the program.  (PDF)

C : On June 20, 2018 AARP submitted written comments to the Centers for Medicare and Medicaid Services concerning the Medicare Program; Inpatient Rehabilitation Facility (IRF) Prospective Payment System for Fiscal Year 2019.  AARP’s comments specifically focus on two issues – telehealth and enabling IRFs to expand their use of non-physician practitioners to fulfill some of the requirements that rehabilitation physicians are currently required to complete. (PDF)

L: On June 14, 2018 AARP CEO Jo Ann Jenkins sent a letter to congressional leadership concerning the Medicare Part D donut hole provisions that were included in the recently enacted Bipartisan Budget Act (BBA) of 2018.  AARP strongly supports the important Part D donut hole reforms that were included in the recently enacted Bipartisan Budget Act of 2018. This includes closing the donut hole one year earlier and requiring higher manufacturer discounts on brand name prescription drugs for beneficiaries who are in the coverage gap. (PDF)

L: On June 12, 2018, AARP sent a letter to Chairman Pat Roberts and Ranking Member Debbie Stabenow of the U.S. Senate Committee on Agriculture, Nutrition and Forestry concerning the Agriculture Improvements Act of 2018, also known as the Farm Bill.  Specifically, AARP sent this communication to express its support for the protections and improvements made to the Supplemental Nutrition Assistance Program (SNAP) contained in the legislation, particularly as they relate to the millions of Americans, including older Americans, who rely on this program. (PDF) 

L : On June 8, 2018 AARP sent a letter to the Centers for Medicare and Medicaid Services, Center for Clinical Standards and Quality concerning reports and evidence of dangerous conditions in nursing homes across the country.  In the letter, AARP expressed concerns with recent regulatory and administrative actions taken by the Centers for Medicare & Medicaid Services, as well as potential future actions under consideration, that could weaken the quality of care and quality of life for our country’s approximately 1.3 million nursing home residents. (PDF)

C: On June 5, 2018 AARP submitted written comments to the Centers for Medicare & Medicaid Services (CMS) concerning the Florida Section 1115 Waiver Amendment Request.  In the letter to CMS, AARP expressed concern for Florida’s proposal to limit retroactive eligibility to the month of Application, noting that it would adversely impact a large number of Florida’s Medicaid recipients, including individuals who rely on Medicaid for long-term services and supports.  Our comments went on to say that eliminating retroactive coverage would likely lead to diminished access to needed care, and lead to worse health outcomes. (PDF)

May

C: On May 25, 2018, AARP sent a comment letter to the Center for Medicare and Medicaid Innovation to provide feedback on a Request for Information on Direct Provider Contracting (DPC) Models.  In the letter, AARP expressed a commitment to ensuring older Americans have affordable access to high-quality, high-value health care. In particular, AARP has worked to improve quality and cost in Medicare, and ensure the beneficiary’s perspective is part of care delivery.  The letter further stated that as Medicare transitions towards greater use of alternative payment models (APMs), it is essential that the individual and family-caregiver perspective is incorporated into new models of care. (PDF)

L: On May 16, 2018, AARP sent a letter to all members of the U.S. House of Representatives opposing H.R. 2, the Agriculture and Nutrition Act of 2018.  In its current form, this bill would have a negative impact on the millions of Americans, including older Americans, who rely on the Supplemental Nutrition Assistance Program (SNAP).  SNAP is the nation’s largest federal nutrition program and is an important safety net for the 43 million Americans who rely on the program. (PDF)

April

C: On April 23, 2018, AARP sent a comment letter to U.S. Department of Health and Human Services Secretary Alex Azar, U.S. Department of Labor Secretary R. Alexander Acosta, and U.S. Department of the Treasury Secretary Steven Mnuchin concerning the Tri-Agency’s proposed rule that would expand the availability of short-term limited duration (STLD) health plans by removing the current 3-month policy limitation and expanding the duration of these plans to 364 days.  In this letter, AARP expressed its strong concerns that this proposal would dramatically undermine the existing individual market – and lead to higher insurance premiums -- by encouraging an influx of plans that need not meet the Affordable Care Act’s (ACA) consumer protection threshold. (PDF)

L: On April 17, 2018 AARP sent a letter to the Chairman and Ranking Member of the U.S. House Committee on Agriculture concerning the bill H.R.2, the Agriculture and Nutrition Act of 2018.  In this letter, AARP urged the committee to modify H.R. 2 to avoid the negative impact the current bill would have on the millions of Americans, including older Americans, who rely on the Supplementation Nutrition Assistance Program (SNAP). (PDF)

L: On April 10, 2018 AARP sent a letter to Chairman Roberts and Ranking Member Stabenow of the Senate Committee on Agriculture, Nutrition and Forestry as well as Chairman Conaway and Ranking Member Peterson of the House Committee on Agriculture concerning the Supplemental Nutrition Assistance Program (SNAP) as part of the 2018 Farm Bill reauthorization.  In the letter, AARP provided a number of specific recommendations to the committee as it moves forward in constructing the bill to ensure that the bill protect and strengthen SNAP -- not add new barriers -- and expand opportunities for qualifying households to have access this critical program. (PDF)

March

L: On March 22, 2018 AARP sent a letter to Congressional leadership concerning the provisions in the FY2018 Omnibus Appropriations Bill.  We thanked them for the provisions that will be of special importance to the health and income security of older Americans.  For example, the bill does not change Medicare Part D donut hole improvements that were recently enacted. Nearly 11 million Medicare beneficiaries fall into the donut hole each year. This is a victory for the millions of older Americans who struggle to afford the drugs they need as prescription drug costs continue to rise.  The bill also increases funding for the Social Security Administration, the Administration on Aging, Housing for the Elderly and Housing Choice Vouchers.  (PDF)

L: On March 14, 2018 AARP sent a letter to Congressional leadership expressing views on the FY2018 omnibus appropriations bill currently under debate.  AARP urged Congress to protect the important headway recently made to address rising prescription drug costs, and oppose any efforts to roll back the progress made that would increase these costs for beneficiaries, take action to strengthen the Affordable Care Act (ACA) marketplaces and protect affordability and coverage for millions of Americans, including the six million 50-64 year olds that get their coverage through these marketplaces, and finally to provide additional support for programs important for older Americans. (PDF)

C: On March 6, 2018 AARP submitted a comment letter to U.S. Secretary of Labor, Alexander Acosta concerning a proposed rule that would expand the availability of association health plans (AHPs) by expanding the definition of “employer” under section 3(5) of ERISA.  AARP expressed concerns that the proposed rule’s expansion of AHPs could put consumers at risk of fraud and abuse, preempt state consumer protections and oversight of these insurance products, and greatly increase the likelihood that working Americans, especially those age 50-64, would face higher insurance premiums and loss of access to critical health insurance coverage. (PDF)

January

C: On January 16, 2018 AARP submitted comments in a letter to Seema Verma, Administrator for the Centers for Medicare & Medicaid Services.  The comments are in response to the Proposed Rule for the CY 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan,
Medicare Fee-for-Service, Medicare Prescription Drug Benefits and PACE programs. (PDF)