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Feds Adopt NAIC Standard For Medigap

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The Centers for Medicare and Medicaid Services has set a Medicare supplement model developed by the National Association of Insurance Commissioners as a national standard.

A Medigap model approved recently by the NAIC, Kansas City, Mo., is now the “applicable NAIC Model Regulation” for purposes of applying the Medicare Improvements for Patients and Providers Act of 2008, officials at CMS, an arm of the U.S. Department of Health and Human Services, wrote in a notice published in the Federal Register.

In the notice, CMS officials also discuss how the Genetic Information Nondiscrimination Act of 2008 affects the Medicare supplement program.

The NAIC’s Medicare Supplement Insurance Minimum Standards Model Act, approved by the NAIC in March 2007, updates Medicare supplement standards that the NAIC originally set in 1979 and has revised over the years to reflect market and legislative changes, CMS officials write in the Federal Register notice.

The latest model eliminates some Medicare supplement plans, and it also requires carriers that want to offer the no-frills Medicare Supplement Plan A option to also offer a Plan C or Plan F option.

The NAIC also added hospice benefits to all Medicare Supplement plan options, and removed “preventive and at-home recovery” benefits, because of a belief that those benefits are confusing and duplicate benefits that are now part of the standard Medicare Part B physician and outpatient services benefits package.

In another section of regulations published in the CMS notice, the CMS has applied GINA requirements to Medicare supplement insurance policies.

Medicare supplement insurers cannot require individuals to undergo genetic tests, except for research purposes or for deciding whether to pay claims.

Medicare supplement insurers also cannot use genetic information in the underwriting or pricing process.


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