CMS defends 'passive enrollment' into dual eligible demonstration programs

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Government officials say safeguards are in place to prevent dually eligible Medicare and Medicaid beneficiaries from losing access to care when they enroll in demonstration projects.

Beneficiaries are “passively” or automatically enrolled in managed care demonstrations, which the Alliance of Specialty said could be harmful in a letter to Centers for Medicaid & Medicaid Services Acting Administrator Marilyn Tavenner.

The enrollment method “raises serious concerns that existing Medicare patient protections may be eroded, potentially leading to inadequate provider networks and restricted access,” the letter states. A report published this week in Health Affairs raises similar concerns.

But in a presentation at the National Medicare-Medicaid Payment Summit last week, Melanie Bella, director of CMS's Medicare-Medicaid Coordination Office, defended the method, saying that it eliminates administrative hassles.

“What is driving us behind these models is not cost savings,” she said, “but it is to provide better person-centered care,” Bella said, according to the Bureau of National Affairs.

Click here for the Health Affairs report and here to read the ASM letter.


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