Medicare Announces New Quality Measures for Special Needs Plans

Private Medicare special needs plans now have new quality improvement measures they must adhere to according to a recent announcement by The Centers for Medicare & Medicaid Services (CMS). These types of special needs plans (SNP) cover patients who have severe or disabling chronic conditions, are dually eligible for Medicare and Medicaid, and are oftentimes institutionalized. SNPs will be assessed on meeting an individual with special needs’ care requirements, including developing tailored plans for care and having a team of providers to implement it

In 2012 all SNPs will have to be approved by the National Committee on Quality Assurance. CMS wants to monitor the strengths and weaknesses of SNPs with these new requirements. By 2013, private Medicare plans that help low income patients who are dually eligible must enter into contracts with state Medicaid agencies.

For patients with Alzheimer’s disease and their families, this news is encouraging and stands to improve the quality of care for this disorder that affects millions of elderly Americans. September is World Alzheimer’s Month and highlights the fact that the condition involves very expensive health care, coordination of government benefits, and an extended network of family and friends to support the individual and his or her caregivers.

A part of the CMS changes also eliminates Medicare prescription drug Part D enrollment penalties for patients who delay enrollment. Also, insurance agents and Medicare Advantage and Part D brokers have more regulations against switching coverage plans and giving out marketing gifts.

The New York special needs law firm Littman Krooks LLP has extensive experience with individuals with Alzheimer’s disease and helping their families take advantage of government benefits as well as proactively protect assets and plan for long-term care needs. Their New York City, White Plains or Fishkill Special Needs attorneys are skilled in assisting people with chronic conditions and disabilities. To learn more about New York special needs planning, visit

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