2023 Archives: Health and Family

AARP correspondence to lawmakers and regulators

AARP Government Affairs

Comments

Published January 13, 2023

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

December

L: On December 14, 2023, AARP endorsed the Improving Measurements for Loneliness and Isolation Act sponsored by Representatives Mike Flood (R-NE) and David Trone (D-MD) and Senator Pete Ricketts (R-NE). The bill would establish a working group to formulate recommendations for standardizing the measurements of loneliness and isolation, an important step to help address isolation and loneliness and consistent with recommendations of the U.S. Surgeon General and the National Academies of Sciences, Engineering, and Medicine. (Senate PDF) (House PDF).

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L = letter; C = comment; S = statement for the record

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L: COMPLETE Care Act: On December 11, 2023, AARP endorsed the Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act. The bill was introduced by Rep. Michelle Steel (R-CA) and Rep. Daniel Kildee (D-MI) in the House, and Sen. Catherine Cortez Masto (D-NV) and Sen. John Cornyn (R-TX) in the Senate. The COMPLETE Care Act temporarily increases Medicare reimbursement rates related to behavioral health integration (BHI) to help cover start-up costs for primary care providers who implement BHI models, like the Community Care Model or the Primary Care Behavioral Health Model. By providing patients with coordinated care in a familiar setting, these strategies have been proven to increase access to mental health care, reduce wait times for treatment and improve patient outcomes. (PDF House) (PDF Senate).

L: Improving Access to Mental Health Act: On December 11, 2023, AARP endorsed the Improving Access to Mental Health Act of 2023, sponsored by Rep. Barbara Lee (D-CA) and Rep. Brian Fitzpatrick (R-PA) in the House and Sen. Debbie Stabenow (D-MI) and Sen. John Barrasso (R-WY) in the Senate. The legislation allows clinical social workers (CSWs) to provide their full scope of practice to Medicare beneficiaries in nursing facilities, including diagnosing and treating mental health disorders, providing psychosocial care, and performing Health and Behavioral Assessment and Intervention (HBAI) services. The bill will provide better coordination of care and increase the pool of providers who are able to provide behavioral and mental health treatment to older adults in institutional settings. (PDF House) (PDF Senate).

November

L: On November 28, 2023, AARP endorsed the Medicare Economic Security Solutions Act, introduced by Rep. Katie Porter (D-CA) and Rep. Young Kim (R-CA). The bill would limit the amount and duration of Medicare Part B late-enrollment penalties. Currently, people who delay enrolling in Medicare face an additional premium of 10% for every 12 months they go without creditable health coverage, and the penalty would last for as long as they have Medicare. The bill would cap the penalty at 15% and twice the duration of non-coverage. (PDF)

S: AARP sent a statement for the record to the Senate Finance Committee’s Subcommittee on Health regarding their November 14, 2023, hearing on making telehealth coverage in Medicare permanent. AARP’s comments present the perspective and priorities of older Americans to ensure access to high quality and high value health care via telehealth. (PDF)

L: On November, 14, 2023, AARP sent a letter to Senators Jacky Rosen (D-NV) and Lisa Murkowski (R-AK) endorsing the Provider Training in Palliative Care Act. The bill would help increase the number of providers in our country who are trained in palliative care by allowing participants in the National Health Service Corps to defer their service for up to one year to get specific training in palliative care. For people with serious illnesses and their families, palliative care can help provide much-needed relief from symptoms and the stress that goes with them. Unfortunately, too often, people who need this kind of care cannot get access due to shortages of trained providers. That is why it is so important to increase training for primary care professionals in palliative care, especially in underserved areas. (PDF)

C: On November 13^th, AARP submitted comments to the Administration for Community Living on the first-ever federal regulations for adult protective services (APS) programs. AARP applauds the goal of establishing common definitions for the national APS system to improve information sharing, data collection, and standardization between and within states. AARP outlines improvements in our comment letter and strongly supports the proposed rule’s establishment of state policies and procedures to “incorporate principles of person-directed services and planning and reliance on least restrictive alternatives.” Any final rule should require that states investigate alleged abuse, neglect, and exploitation in all residential settings, including long-term care facilities and other congregate living arrangements. (PDF)

L: On November 9, 2023, AARP sent a letter to Representatives Marc Molinaro, Debbie Dingell, Brian Fitzpatrick, Don Davis, and Susie Lee endorsing the bipartisan Friendly Calls for Our Seniors Act. The bill would offer grants to states to provide regular and weekly telephone calls to older adults and adults with disabilities who are at risk of social isolation or loneliness, and who do not have supportive assistance. This would help increase social connections for older adults and connect them to resources in their communities. (PDF)

L: On November 8, AARP endorsed the bipartisan Lowering Costs for Caregivers Act of 2023. This bill would allow for any family caregiver who owns a pre-tax health expense payment account (HSAs, FSAs, HRAs, and Archer MSAs) to use the dollars in that account for the qualified medical expenses associated with either their parents or parents-in-law – in addition to the individual’s spouse and dependents, as allowed under current law. If enacted, it would be an important step to help alleviate the financial challenges that millions of family caregivers experience every day, especially the increasing number of “sandwich generation” caregivers who are simultaneously caring for their parents and their own children. (PDF)

C: On November 6^th, AARP submitted comments to the Centers for Medicare & Medicaid Services (CMS) on their proposed rule to establish minimum federal staffing standards for nursing homes participating in Medicare and Medicaid. AARP strongly supports a long overdue federal minimum staffing standard that requires America's nursing homes to have enough staff to provide the hands-on quality care residents need. Any final rule should preserve important provisions in the proposed rule and also include certain improvements to strengthen it to ensure the highest quality care for residents. AARP outlines such improvements in our comment letter. Federal staffing standards should be sufficient from an evidence-based perspective to support resident health and safety. Given its importance to health and safety, any exemptions to minimum federal standards should be narrow and limited in scope, designed in a manner to truly be an exception and not simply a loophole that can be abused to avoid staffing requirements. AARP strongly supports the proposed requirement to ensure a registered nurse (RN) is onsite in nursing homes 24 hours a day, 7 days per week. It is important to clarify, however, that the RN onsite is providing direct resident care. We also support full transparency around Medicaid and Medicare payments and improving facility assessments. Standards to ensure nursing homes are adequately staffed will help give family caregivers peace of mind, knowing their loved ones are getting the quality of care they deserve. (PDF)

L: On November 2, 2023, AARP sent a letter to Senators Maggie Hassan and Mike Braun in support of the Medication Affordability and Patent Integrity Act (S. 2780). Currently, some drugmakers game the patent system by submitting only partial information to the U.S. Patent and Trademark Office or the Food and Drug Administration so they can extend their monopoly periods on brand name drugs. The legislation would crack down on this anti-competitive practice by requiring drug companies to certify that they are not withholding information from these agencies for purposes of gaining marketing approval or patent protection. This will help get generics and biosimilar drugs onto the market sooner, increasing access to safe, affordable drugs and lower costs for consumers and taxpayers. (PDF)

L: On November 2, 2023, AARP sent a letter to Representatives Ann Kuster and Diana Harshbarger in support of the Medication Affordability and Patent Integrity Act (H.R. 5429). Currently, some drugmakers game the patent system by submitting only partial information to the U.S. Patent and Trademark Office or the Food and Drug Administration so they can extend their monopoly periods on brand name drugs. The legislation would crack down on this anti-competitive practice by requiring drug companies to certify that they are not withholding information from these agencies for purposes of gaining marketing approval or patent protection. This will help get generics and biosimilar drugs onto the market sooner, increasing access to safe, affordable drugs and lower costs for consumers and taxpayers. (PDF)

October

L: On October 24, 2023, AARP sent a letter to Senators Edward Markey (D-MA) and Shelley Moore Capito (R-WV) endorsing the bipartisan Alleviating Barriers for Caregivers Act. This bill would help reduce red tape for family caregivers in Medicare, Medicaid, Social Security programs, and CHIP. It could help save family caregivers valuable time and reduce the stress they face in their caregiving role. (PDF)

S: On October 24, 2023, AARP submitted a Statement for the Record for the October 18 Senate Finance Committee hearing titled “Medicare Advantage Annual Enrollment: Cracking Down on Deceptive Practices and Improving Senior Experiences.” The Statement focuses on deceptive marketing practices of Medicare Advantage (MA) plans during Medicare Open Enrollment and offers recommendations to improve the overall consumer experience of enrollment in a Medicare Advantage plan. As enrollment in MA continues to outpace traditional Medicare, increased vigilance to protect consumers from troubling marketing practices will become even more important to help ensure that older adults are best equipped to make informed decisions about the coverage that will best meet their needs. (PDF)

L: On October 18, 2023, AARP sent a letter to Representative Spanberger (D-VA) and Representative Nunn (R-IA) expressing support for the Drug-Price Transparency for Consumers (DTC) Act of 2023. This bill would require drug manufacturers to include the monthly price of certain drugs in direct-to-consumer advertisements. AARP’s letter notes that this bill is another step to hold big drug companies accountable and empower patients to make informed decisions when faced with ubiquitous drug advertising. (PDF)

C: On October 5, 2023, AARP responded to a request for information from the House Ways & Means Committee regarding improving access to health care in rural and underserved areas. Residents in rural communities face significant health disparities, and worse health outcomes, across numerous measures and conditions, when compared to urban areas. Lack of access to services is a driver of these disparities. Our comments highlighted the crucial role family caregivers play in providing care in underserved areas, as well as the need for a larger nursing workforce to provide access to care for older Americans. We also discussed how telehealth can play an important part in care delivery, as well as the need to incorporate oral care into overall health care. (PDF)

L: On October 4, 2023, AARP endorsed the Right to Medicare Act, sponsored by Representative Ritchie Torres (D-NY) and Representative Nicole Malliotakis (R-NY). The bill would prevent employer retiree health coverage sponsors from involuntarily forcing seniors to shift away from traditional Medicare coverage in favor of Medicare Advantage and instead allow seniors to opt into that coverage change if they choose. This ensures that beneficiaries have control over their own health plan coverage while expanding options that may not have previously been available. (PDF)

C: On October 2, 2023, AARP submitted comments in response to the Centers for Medicare and Medicaid Services’ (CMS) Medicare Drug Price Negotiation Program Patient-Focused Listening Sessions. These sessions are an opportunity for Medicare beneficiaries, caregivers, and other interested parties to share input about the ten drugs selected for the first round of Medicare price negotiations. AARP's comments note how quickly brand-name drug prices have increased, highlight the negative impact that high drug prices have on older adults’ health and financial security, and share stories of patients' struggles to afford the specific drugs selected for negotiation. (PDF)

C: On October 2, 2023, AARP submitted comments on the Requirements to Mental Health Parity and Addiction Equity Act (MHPAEA), issued jointly by the Department of Labor, Treasury Department, and Department of Health and Human Services (HHS). These requirements provide insurance plans and issuers with additional guidance on non-quantitative treatment limitations (NQTLs). As rates of mental health and SUD among older adults continue to rise, AARP is committed to ensuring patients and beneficiaries are able to access the treatment they need. Under MHPAEA, NQTLs cannot be applied more strictly to mental health and substance abuse disorder (SUD) benefits compared to medical/surgical benefits. The proposed rule clarifies what insurance plans and issuers must include in their annual comparative analyses of mental health/SUD benefits and medical/surgical benefits to demonstrate coverage parity. The rule also requires plans and issuers to collect data on NQTLs to make ensure NQTLs are no more restrictive when applied to mental health/SUD benefits, both in writing and in practice. (PDF)

September

S: On Tuesday, September 26, AARP submitted a statement for the record to the Senate Committee on the Budget in advance of its hearing on Medicare financing. Medicare continues to provide critical health coverage for older Americans, and measures to address Medicare’s long-term financial outlook are necessary to protect access to high quality care and prevent adding costs to current and future Medicare beneficiaries. AARP urged the Committee to work to find a combination of policy reforms to the program’s finances and payments that maximize the value of every dollar spent. (PDF)

C: On September 20^th, AARP submitted comments on the Medicare Prescription Payment Plan (MPPP) program to the Centers for Medicare and Medicaid Services (CMS). This program was created as part of the 2022 federal prescription drug law, and will provide Medicare enrollees with the option to spread their Rx cost-sharing expenses out over the course of the year. This will bring financial relief and flexibility for older Americans, particularly those who have high Rx cost-sharing earlier in the plan year. While the program is open to anyone with Medicare Part D, CMS will be developing tools that will help Part D enrollees decide whether the program is right for them. AARP’s comment letter was supportive and offered suggestions on education and outreach materials for Part D enrollees, as well as suggestions on how to leverage existing resources to reach those who may benefit from the MPPP program. (PDF)

L: On September 19, 2023, AARP sent a letter to Representative Adam Schiff in support of H.R. 4134, the Updated Drug Labeling for Patient Safety Act. The bill would establish a process for generic drug manufacturers to update their labels with new information on serious side effects as it becomes known. This would give generic drug makers the same ability to update their labeling as currently exists for manufacturers of brand name drugs. AARP believes generic drugs are one of the safest and most effective ways for consumers to lower their prescription drug costs, and this legislation would help ensure that consumers have the most up-to-date safety information about the generic drugs they are taking. (PDF)

L: On September 19, 2023, AARP sent a letter to Senator Chris Van Hollen in support of the Patient Safety and Generic Labeling Improvement Act. The bill would establish a process for generic drug manufacturers to update their labels with new information on serious side effects as it becomes known. This would give generic drug makers the same ability to update their labeling as currently exists for manufacturers of brand name drugs. AARP believes generic drugs are one of the safest and most effective ways for consumers to lower their prescription drug costs, and this legislation would help ensure that consumers have the most up-to-date safety information about the generic drugs they are taking. (PDF)

L: On September 18, 2023, AARP sent a letter to leadership of the House Ways & Means, Energy & Commerce, and Education & the Workforce Committees, expressing support for H.R. 5378, The Lower Costs, More Transparency Act. This bill would increase price transparency in the health care system, implement site-neutral payment policies in Medicare, establish new requirements for pharmacy benefit managers, and makes other changes to help consumers afford care. (PDF)

L: On September 11, 2023, AARP, with 59 other signatories, submitted comments on the Medicare Physician Fee Schedule proposed rule for 2024 to the Centers for Medicare & Medicaid Services (CMS). The comments from 60 signatories strongly support the CMS proposal to pay for caregiver training services in the proposed rule and urge retention of these provisions in the final rule. The letter also weighs in on some aspects of the provisions. AARP has long advocated for caregivers to be better incorporated into Medicare and health care delivery, and these payment codes will encourage providers to better integrate and support family caregivers. (PDF)

C: On September 11, AARP submitted comments on the Medicare Physician Fee Schedule proposed rule for 2024. AARP’s comments focus primarily on the proposal for Medicare to reimburse providers for offering Caregiver Training Services. AARP has long advocated for caregivers to be better incorporated into Medicare and health care delivery, and these payment codes will encourage providers to better integrate and support family caregivers. AARP also commented on proposals regarding coverage for telehealth, dental services, and behavioral health. (PDF)

C: On September 11, AARP submitted comments on the Medicare Hospital Outpatient Prospective Payment System for 2024. AARP’s comments focus on coverage for intensive outpatient services. Such services are used when regular and consistent care is needed but not in an inpatient or facility setting. We provide feedback on mental and behavioral health services and incorporating family caregivers. (PDF)

C: On September 11, AARP submitted comments to the Centers for Medicare & Medicaid Services (CMS) in support of the proposed rule to roll back the previous Administration’s expansion of short-term, limited-duration health insurance plans. These plans were never intended to cover a person for more than 3 months and these plans lack critical consumer protections meant to expand access and make coverage more affordable, such as the Affordable Care Act’s prohibition on denial of coverage for preexisting conditions and the 3:1 age rating limit that prevents enrollees 50-64 from paying more than three times that of the lowest priced premium. (PDF)

August

C: On August, 28, 2023 AARP submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed Medicare home health payment proposed rule. AARP’s comments focus on monitoring the effects of the implementation of the Patient Driven Groupings Model (PDGM), the request for information regarding access to home health aide services, support for family caregivers, aspects of home health quality reporting and value-based purchasing, health, and changes to the provider and supplier enrollment requirements related to hospice. (PDF)

L: On August 25, 2023, AARP endorsed H.R. 542, the Elizabeth Dole Home Care Act, sponsored by Representative Julia Brownley and Representative Jack Bergman. The legislation would expand access to current VA programs providing care at home and provide for improved coordination among VA’s home- and community-based services and with Medicare’s Program for All-Inclusive Care for the Elderly (PACE). The bill also improves transitions and access to services for veterans and family caregivers denied or discharged from the VA Program of Comprehensive Assistance for Family Caregivers, creates a centralized website for VA’s caregiving resources, and increases respite care for veteran and military caregivers. (PDF)

L: On August 22, 2023, AARP endorsed the Improving Access to Medicare Coverage Act (H.R. 5138) led by Rep. Joe Courtney (D-CT), Glenn “GT’ Thompson (R-PA), Suzan DelBene (D-WA), and Ron Estes (R-KS). This bill would count the time a Medicare beneficiary spends in observation toward the three-day inpatient hospital stay requirement for Medicare coverage of skilled nursing facility care. The legislation would help some people with Medicare get the skilled nursing facility care they need and help reduce unnecessary, large out-of-pocket expenses for them. (PDF)

L: On August 17, 2023, AARP endorsed the Patients Before Middleman (PBM) Act (S.1967) led by Sen. Robert Menendez (D-NJ) and Sen. Marsha Blackburn (R-TN). Currently, some pharmacy benefit manager (PBM) fees are linked to drug prices, which could incentivize PBMs to cover high-priced drugs instead of lower-priced alternatives. This bill would de-link PBM compensation from drug prices and instead require Medicare Part D plans to pay PBMs using flat-dollar service fees. This will help reduce potentially misaligned incentives and help reduce costs for Medicare Part D enrollees. (Senate–PDF)

L: On August 17, 2023, AARP sent a letter to Chair Ron Wyden and Ranking Member Mike Crapo of the U.S. Senate Committee on Finance expressing support for the Modernizing and Ensuring PBM Accountability Act. This bill would de-link PBM compensation from drug prices and instead require Medicare Part D plans to pay PBMs using flat-dollar service fees. It would also increase transparency and accountability in the prescription drug supply chain, which will help inform other efforts to lower costs for consumers and taxpayers. (Senate–PDF)

L: On August 17, 2023, AARP endorsed the Pharmacy Benefit Manager (PBM) Transparency Act of 2023 (S.127) led by Sen. Maria Cantwell (D-WA) and Sen. Chuck Grassley (R-IA). This bill would prohibit “spread pricing,” where a PBM charges insurance plans more for a prescription drug that what they pay the pharmacy and keep the difference. It would also prohibit PBMs from retroactively reducing or “clawing back” payments made to pharmacies. The bill would increase transparency and accountability in the prescription drug supply chain, which will help inform other efforts to lower costs for consumers and taxpayers. (Senate–PDF)

L: On August 14, 2023, AARP endorsed the Improving Care and Access to Nurses (I CAN) Act of 2023 (H.R. 2713) led by Rep. David Joyce (R-OH), Rep. Suzanne Bonamici (D-OR), Rep. Jennifer Kiggans (R-VA), and Rep. Lauren Underwood (D-IL). This bill would update rules to reflect best practices enabling Medicare and Medicaid beneficiaries to have direct access to Advance Practice Registered Nurses and other licensed clinicians. Optimizing the existing health care workforce will help improve access and availability for people needing care. (House-PDF) On August 15, AARP also endorsed the Senate companion bill, S. 2418, introduced by Sen. Jeff Merkley (D-OR) and Sen. Cynthia Lummis (R-WY). (Senate-PDF)

L: On August 14, 2023, AARP endorsed the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) 2.0 Act (S. 1687) led by Senator Bob Casey (D-PA) and Sen. Todd Young (R-IN). This bill would require the Social Security Administration to notify people of their approaching Medicare eligibility each year from age 60 to age 64. Early notification and reminders about Medicare enrollment will help reduce confusion and delays among people becoming eligible for Medicare at age 65. (Senate-PDF)

C: On August 14, 2023, AARP submitted comments to the Administration for Community Living (ACL) within the Department of Health and Human Services on their notice of proposed rulemaking titled "Older Americans Act: Grants to State and Community Programs on Aging, Indian Tribes for Support and Nutrition Services, Supportive and Nutritional Services to Older Hawaiian Natives, and Allotments for Vulnerable Elder Rights Protection Activities”. AARP applauded ACL for modernizing the OAA regulations which have not been substantially updated since 1988. AARP's comments focused on support for family caregivers, caregiver assessments, state and area plans on aging, equity, modernizing aging network capacity, nutrition flexibility and modernization, lessons learned from COVID-19, and elder abuse protections. (PDF)

July

L: On July 12, 2023 AARP endorsed the Caregiver Outreach and Program Enhancement (COPE) Act, sponsored by Representative Jen Kiggans and Representative Chrissy Houlahan. The COPE Act establishes a grant program to award funding to organizations that support the mental health and well-being veteran and military caregivers enrolled in the VA’s Program of Comprehensive Assistance for Family Caregivers (PCAFC). Grant applicants must have a detailed plan to address veterans and caregivers in underserved communities, and the VA will be required to provide notice to caregivers participating in the PCAFC on grant recipients. The bill also requires the VA and GAO to provide Congress with a report on the mental health of veteran and military caregivers, the availability and accessibility of mental health treatment for veteran and military caregivers, and information onthe grant program and its outcomes. H.R. 3581 (PDF)

L: On July 12, 2023, AARP sent a letter to Representative Don Bacon and Representative Chris Pappas expressing support for the Autonomy for Disabled Veterans Act. The bill would increase the amounts available under the VA’s Home Improvement and Structural Alterations (HISA) Grant program to $10,000 for veterans with a service-connected disability and $5,000 for veterans with a disability that is not service-connected. The legislation would allow veterans to make necessary adaptations for wheelchairs, medical equipment, and to improve accessibility throughout the veteran’s home. Finally, H.R. 2818 would adjust the amounts available under the HISA Grant on an annual basis to account for inflation. H.R. 2818 (PDF)

C: On July 3, 2023, AARP submitted comments to the Centers for Medicare & Medicaid Services (CMS) on Medicaid Managed Care programs as part of a proposed rule to enhance quality of care. AARP’s comments focus on ensuring that older adults on Medicaid managed care plans have access to services and settings that address health-related social needs, the need for meaningful, usable quality-rating information on a state’s managed care website, and the need to incorporate direct program feedback from Medicaid enrollees and their family caregivers. (PDF)

C: On July 3, 2023, AARP submitted comments to the Centers for Medicare & Medicaid Services (CMS) on a proposed rule about ensuring access to Medicaid services, including home and community-based services (HCBS). AARP’s comments focus on expanding access to Medicaid funded services including home care or HCBS for older adults and people with disabilities, improving quality, supporting family caregivers, payment adequacy, and providing program input and transparency. (PDF)

June

L: On June 26, 2023, AARP endorsed the Search Engines Examine (SEE) Care Compare Act sponsored by Senators Mike Braun (R-IN) and Debbie Stabenow (D-MI). Many are unaware of the resources available on the Care Compare website, which includes information about doctors, hospitals, home health agencies, nursing homes, and more, to help consumers select a provider that meets their needs. This bill would make the Care Compare website and the resources it provides easier to find online by reviewing and updating search engine optimization practices. (PDF)

L: On June 26, 2023, AARP sent a letter to Chairwoman Debbie Stabenow and Ranking Member John Boozman of the U.S. Senate Committee on Agriculture, Nutrition & Forestry, and to Chairman Glenn Thompson and Ranking Member David Scott of the U.S. House Committee on Agriculture urging Congress to work together in a bipartisan manner to find ways to strengthen food assistance efforts and eliminate barriers to accessing existing nutritional programs, including through: Reducing red tape and administrative barriers that limit SNAP participation; enhancing benefits for participants; protecting against harmful cuts or changes to eligibility requirements; and strengthening other major federal nutrition assistance programs. (PDF)

L: On June 15, 2023, AARP endorsed the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023. The CONNECT for Health Act expands telehealth access in Medicare by removing geographic and originating site restrictions for care and making it easier for Medicare beneficiaries to use telehealth services. This bipartisan, bicameral bill has the broadest base of support for making telehealth a permanent part of Medicare. Senate (PDF) and House (PDF).

C: On June 9, AARP submitted comments to CMS regarding the proposed Medicare Inpatient Prospective Payment System for FY24. This annual rule establishes how hospitals get paid under the Medicare program, including what quality metrics and standards of care they must adhere to. AARP’s comments focus on improving quality of care and incorporating family caregivers. (PDF)

May

C: On May 31, 2023, AARP submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the Fiscal Year 2024 Medicare Skilled Nursing Facility (SNF) payment proposed rule. AARP’s comments focus on the SNF Quality Reporting Program, the SNF Value-Based Purchasing Program, health equity, important opportunities to strengthen the recognition, inclusion, and support of family caregivers in Medicare, the impact of the Patient Driven Payment Model (PDPM) on beneficiaries’ access to appropriate SNF services, and the process regarding waiver of a hearing and reduction of civil money penalties for nursing homes. AARP comments aim to improve the final rule for current and future nursing home residents and their family caregivers. (PDF)

L: On May 31, 2023, AARP sent a letter to Representative Elissa Slotkin, Representative Bryan Steil, Representative David Trone, and Representative Ann Kuster expressing support for the Expanding Veterans’ Options for Long-Term Care Act. This bill would establish a three-year pilot program to assess the effectiveness of providing assisted living services to eligible veterans. The feedback and experience of participating veterans would also be examined. The legislation also includes important provisions regarding the pilot’s structure, including the availability of services in rural or highly rural areas, provider participation in Medicaid, inspections and standards for facilities, and continuity of care for veterans when the pilot program ends. (PDF)

C: On May 30, 2023, AARP submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the Fiscal Year 2024 Medicare hospice payment proposed rule. AARP’s comments respond to two requests for information – one on health equity under the hospice benefit and one on hospice utilization, non-hospice spending, ownership transparency, and hospice-election decision-making -- as well as address opportunities to identify, include, and support family caregivers. (PDF)

L: AARP, with 83 other signatories, sent a letter to President Biden recognizing the April 18, 2023 Executive Order that includes support for family caregivers. The letter discusses the challenges they face and urges continued action and advancement of policies to support family caregivers. (PDF)

L: On May 10, 2023, AARP endorsed the Chronic Care Management Improvement Act of 2023 (HR 2829), sponsored by Rep. Jeff Duncan (R-SC) and Rep. Suzan DelBene (D-WA). Medicare allows providers to bill for “Chronic Care Management” (CCM), which are primarily non-face-to-face services performed behind the scenes to coordinate care for people with certain chronic conditions. Providers can bill for this code on a monthly basis. As part of Medicare, though, the beneficiary is responsible for 20% of the bill. While only a few dollars out-of-pocket each month, the coinsurance amount can add up over time. Moreover, the beneficiary may be unaware these services are being performed because they occur out of sight. This legislation waives the cost-sharing requirement for the CCM code. (PDF)

L: On May 1, 2023, AARP sent a letter to the Centers for Medicare & Medicaid Services (CMS) sharing feedback on items and questions related to family caregivers and the Hospital at Home (HaH) programs under the Acute Hospital Care at Home (AHCaH) waiver. AARP hopes our feedback will be useful in CMS’ work on the study regarding these HaH programs and in implementing the President’s recent Executive Order on Care. AARP also urged CMS to incorporate the family caregiver considerations in this AARP PPI paper into HaH programs to benefit beneficiaries and their family caregivers. (PDF)

L: On May 1, 2023, AARP, along with 40 organizations, sent a group letter to all U.S. Senators urging the Senate to immediately act on legislation to lower drug prices through increased competition, transparency, and accountability. The letter specifically notes bipartisan bills in the Senate that strengthen the patent system by banning anti-competitive tactics from big drug companies, require drug companies to disclose and justify high prices, and require more transparency and accountability to better ensure pharmacy benefit managers act in the best interests of patients and consumers. The letter comes as various Senate and House committees are considering bills related to prescription drugs and Senate leadership has indicated the desire to bring a package of drug laws to the Senate floor soon. (PDF)

April

C: On April 17, 2023, AARP submitted comments to the Administration for Children and Families (ACF) in support of a proposed rule that would allow states to set separate licensing standards for relative and kinship foster family homes. Nearly 3 million children are currently being raised by “grandfamilies” or “kinship families,” in which they are raised by grandparents or other extended family members rather than by their parents. This proposed rule can help increase access to necessary supports for the thousands of families who need them, making it possible for more children to remain with their families during challenging times. AARP appreciates ACF’s ongoing commitment to supporting all children in foster care and the adults who care for them. (PDF)

L: On April 14, 2023, AARP sent a letter to Senator Grassley (R-IA) and Senator Durbin (D-IL) expressing support for the Drug-Price Transparency for Consumers (DTC) Act of 2023. This bill would require drug manufacturers to include the monthly price of certain drugs in direct-to-consumer advertisements. AARP’s letter notes that this bill is another step to hold big drug companies accountable and empower patients to make informed decisions when faced with ubiquitous drug advertising. (PDF)

C: On April 14, 2023, AARP submitted comments to the Centers for Medicare & Medicaid Services (CMS) on initial guidance for the Medicare Drug Price Negotiation Program that was enacted as part of the major prescription drug pricing law in 2022. AARP's comments focus on the need for strong implementation of the program by achieving the lowest possible maximum fair price for each selected drug, maintaining transparency throughout the process, ensuring consumer protection, and robust oversight. (PDF)

S: On April 12, 2023, AARP submitted a statement for the record to the Senate Finance Committee regarding a March 29 Health Care Subcommittee hearing on oral health access. AARP’s letter calls for greater access to dental care for older Americans through Part B Medicare coverage. Better oral health care has been shown to improve overall health outcomes and to better manage costly chronic conditions. (PDF)

C: On April 10, 2023, AARP submitted comments to the Centers for Medicare & Medicaid Services (CMS) on a proposed rule to implement Section 6101 of the Patient Protection and Affordable Care Act (ACA) regarding disclosure of nursing home ownership and additional disclosable parties information. AARP appreciates that CMS has issued a new proposed rule to implement these provisions. AARP urges CMS to strengthen this proposed rule and issue a long overdue final rule to implement Section 6101 of the ACA. (PDF)

L: On April 3, 2023, AARP endorsed the National Nursing Workforce Center Act of 2023 (H.R.2411/S.1150) sponsored by Reps. Blunt Rochester (D-DE) and Kim (R-CA), and Senators Merkley (D-OR), Tillis (R-NC), Kelly (D-AZ), and Wicker (R-MS). The bipartisan legislation would support our national nursing workforce through better information gathering and coordinating of policies at the state and federal levels. (Senate – PDF) (House – PDF).

S: On April 3, 2023, AARP submitted a statement for the record to U.S. House Veterans Affairs Subcommittee on Health Chair Mariannette Miller-Meeks and Ranking Member Julia Brownley in support of passage of H.R. 542, the “Elizabeth Dole Home- and Community-Based Services for Veterans and Caregivers Act of 2023.” AARP’s statement urges the Subcommittee on Health to pass H.R. 542 and addresses the importance of supporting military and veteran family caregivers, expanding access to services that help veterans live in their homes and communities, and supporting the paid workforce. (PDF)

March

L: On March 30, 2023, AARP sent a letter to Senator Tammy Baldwin, Senator Mike Braun, and Senator Tina Smith expressing support for S.935, the Fair Accountability and Innovative Research (FAIR) Drug Pricing Act of 2023. This bill would require drug manufacturers to notify the U.S. Department of Health and Human Services (HHS) and submit a transparency and justification report before increasing the price of certain drugs, and whenever a new drug launches with an especially high list price. AARP’s letter notes that this bill is another step to hold big drug companies accountable for their egregious price hikes and will give consumers and policymakers the necessary information to fight back. (PDF)

L: On March 17, 2023, AARP submitted comments responding to a Senate Health, Education, Labor, & Pensions Committee request for information regarding health care workforce shortages. The RFI follows a hearing the committee held to examine ways to increase health care workforce participation and improve access to providers. AARP’s comments highlight the role, importance, and need for caretakers who are often overlooked by the health care system – family caregivers, nurses, and home health aides. As Americans age, it is increasingly important to support and sustain the providers who are most in contact with individuals. (PDF)

S: On March 15, 2023, AARP provided a statement for the record to U.S. Senate Special Committee on Aging Chairman Bob Casey and Ranking Member Mike Braun for a hearing titled “Uplifting Families, Workers, and Older Adults: Supporting Communities of Care.” Families in search of long-term care services, including care at home, now enter a world that is confusing, costly, under-regulated, and lacking in transparency. Too often, those families feel forced into institutional settings, while individuals who end up in nursing homes often yearn to stay in their homes near family and friends. Finding care at home is extremely challenging: families often must desperately cobble together a patchwork of care and services they need. AARP’s statement covered the topics of Supporting Family Caregivers, Home Care, and the Paid Direct Care Workforce. (PDF)

L: On March 13, AARP submitted comment to CMS on a proposed rule aimed at improving the Medicare Advantage (MA) prior authorization system. AARP has been advocating for improvements to the MA prior authorization system since the March 2022 HHS Inspector General report stating that MA beneficiaries were denied prior authorization requests at a higher rate than those in traditional Medicare. The improvements include data transparency requirements, improved wait times for prior authorization decisions, and improved electronic communications between insurance carriers and medical providers. (PDF)

L: On March 10, 2023, AARP sent a letter to the Centers for Medicare and Medicaid Services providing comments on the initial guidance of requirements and procedures for the new Medicare Prescription Drug Inflation Rebate Program created by federal law in 2022. AARP's comments express strong support for the program and note the ways in which the program will bring down prescription drug prices for individuals on Medicare. The letter notes CBO's estimate that the lower drug prices that result from the inflation rebate provision will also lead to declines in spending on other Medicare-covered services due to increased drug adherence. (PDF)

L: On March 3, 2023 AARP sent a letter to the Centers for Medicare and Medicaid Services providing comments on the proposed Advance Notice of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies. AARP's comments express support for improvements to Part D coming in 2024, including eliminating any cost-sharing for consumers in the catastrophic phase of coverage and expanding eligibility for the Low-Income Subsidy (“Extra Help”) program, which assists people with limited incomes and resources to pay their out-of-pocket prescription drug costs in Medicare. These improvements are part of the new federal prescription drug pricing law that AARP supported in 2022, and the letter encourages CMS to enhance its outreach and education efforts so Medicare beneficiaries are informed about the ongoing improvements to their coverage. Regarding MA payment rates, the letter also reaffirms AARP's principles of assuring consumers a robust choice of both traditional Medicare and MA, striving to keep both options strong and on a level playing field. (PDF)

February

L: On February 24^th, 2023, AARP sent a letter to Chairman Jon Tester and Ranking Member Jerry Moran of the U.S. Senate Committee on Veterans’ Affairs expressing support for the Expanding Veterans’ Options for Long-Term Care Act. This bill would establish a three-year pilot program to assess the effectiveness of providing assisted living services to eligible veterans. The feedback and experience of participating veterans would also be examined. The legislation also includes important provisions regarding the pilot’s structure, including the availability of services in rural or highly rural areas, provider participation in Medicaid, inspections and standards for facilities, and continuity of care for veterans when the pilot program ends. (PDF)

L: On February 16, 2023, AARP sent a letter to Senate Majority Leader Chuck Schumer and Senate Republican Leader Mitch McConnell expressing support for five bills aimed at increasing prescription drug competition and price transparency that recently passed the Senate Judiciary Committee with bipartisan support (S.79, S.113, S.142, S.148, and S.150). AARP's comments focus on the need to prohibit anticompetitive practices by big drug companies that prevent or delay consumer access to less expensive generic and biosimilar drugs (PDF)

C: On February 13, 2023 AARP sent a letter to the Centers for Medicare and Medicaid Services providing comments on the proposed Contract Year 2024 Policy and Technical Changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit Program (Part D). AARP believes that all Medicare beneficiaries, whether they participate in traditional Medicare or Medicare Advantage, should have a genuine choice among coverage options and quality providers. (PDF)

January

L: On January 31, 2023, AARP sent a letter to Chairwoman Cathy McMorris Rogers and Ranking Member Frank Pallone, Jr. of the U.S. House Committee on Energy and Commerce expressing deep concerns about H.R. 382 the Pandemic is Over Act. AARP notes the devastating impact that the COVID-19 pandemic continues to have on older adults and urges that the PHE should continue until cases have been reduced and there is an orderly transition in place to ensure all Americans can get the care they need. The letter also urges continued support for requiring nursing home staff vaccinations. (PDF)

C: On January 30, 2023, AARP submitted comments to the Centers for Medicare and Medicaid Services (CMS) on the Affordable Care Act (ACA) Proposed Notice of Benefit and Payment Parameters for 2024. AARP’s comments are supportive of the proposals set forth in the Notice and applauds the continued efforts of CMS to expand access to, and enrollment in, quality, affordable, health insurance coverage ̶ especially for the more than 5 million Americans aged 50-64 who get their coverage through an exhange. AARP’s comments specifically supported requiring agents, brokers, or web-brokers assisting with enrollment and/or financial assistance applications through the various marketplaces to document that application information has been reviewed and confirmed to be accurate by the consumer prior to submission, clarifying that only one person in a household (including a dependent) would need to qualify for a Special Enrollment Period (SEP) in order for the entire family to qualify, expanding the window of notification of a life event from 60 days to 90 days, more options for Standardized Plans, increased access to standalone dental plans, and the establishment of two new Essential Community Provider (ECP) categories to better serve the needs of enrollees. (PDF)

L: On January 27, 2023 AARP sent a letter to the Centers for Medicare & Medicaid Services to provide comments on New Mexico’s Centennial Care five-year Medicaid 1115 Demonstration Waiver renewal request (hereafter “1115 waiver renewal request”). AARP’s comments focused most specifically on the Medicaid home and community-based services (HCBS or home care) enhancements serving older adults and adults with physical disabilities generally under the state’s Community Benefit (CB) program. (PDF)

L: On January 13, 2023 AARP sent a letter to U.S. Senators Bill Cassidy, Thomas Carper, Tim Scott, Mark Warner, John Cornyn and Robert Menendez responding to their request for information regarding “dual eligible” enrollees—that is, individuals enrolled in both Medicare and Medicaid—and possibilities to better coordinate and improve their care. AARP shares their interest in not only improving the data and knowledge base regarding the needs of dual eligibles, but in using this information to improve the quality and effectiveness of their care as well as the various payment and care models that have been tested to optimize their lives. (PDF)

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