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Advising the Congress on Medicare issues
MedPAC > Recommendations > Medicare Advantage special needs plans (2)

Medicare Advantage special needs plans (2)

March 15, 2013

The Congress should:

  • allow the authority for chronic care special needs plans (C–SNPs) to expire, with the exception of C–SNPs for a small number of conditions, including end-stage renal disease, HIV/AIDS, and chronic and disabling mental health conditions;
  • direct the Secretary, within three years, to permit Medicare Advantage plans to enhance benefit designs so that benefits can vary based on the medical needs of individuals with specific chronic or disabling conditions; and
  • permit current C–SNPs to continue operating during the transition period as the Secretary develops standards. Except for the conditions noted above, impose a moratorium for all other C–SNPs as of January 1, 2014.

Topics: Beneficiaries and coverage and Part C (Medicare Advantage).