U.S. Sen. Marco Rubio, R-Fla., joined senators from both sides of the aisle last week to urge the Centers for Medicare & Medicaid Services (CMS) to conduct an outreach campaign to educate clinicians, Medicare beneficiaries with cognitive impairment, and their families on the assessment and care planning services currently available to them.
Rubio joined U.S. Sens. Debbie Stabenow, D-Mich., Susan Collins, R-Maine, Ed Markey, D-Mass., Shelley Moore Capito, R-WV, and Bob Menendez, D-NJ, and more than 25 other senators in signing the letter to CMS Administrator Seema Verma.
The letter is below:
Dear Administrator Verma:
As bipartisan cosponsors of the Improving HOPE for Alzheimer’s Act (S.880), we write today asking the Centers for Medicare & Medicaid Services (CMS) to conduct an education and outreach campaign to ensure that clinicians, Medicare beneficiaries with cognitive impairment, and their families are aware of the assessment and care planning services currently available to them.
As you know, more than five million Americans are living with Alzheimer’s and, without significant action, nearly 14 million Americans will have Alzheimer’s by 2050. Caring for those with Alzheimer’s will cost an estimated $290 billion in 2019, with Medicare and Medicaid bearing $195 billion–67 percent–of that figure. As the research community continues to search for a disease modifying therapy and better symptomatic treatments, CMS must do all it can to ensure the best quality of care and quality of life for those living with Alzheimer’s. Care planning is central to that effort.
Dementia-specific care planning can lead to fewer hospitalizations, fewer emergency room visits, and better medication management. It allows diagnosed individuals and their caregivers to access medical and non-medical treatments, clinical trials, and support services available in the community, resulting in a higher quality of care and life for those with the disease. Alzheimer’s and related dementias also complicate the management of other chronic conditions, so care planning is key to better care coordination and management of comorbid conditions.
That is why were we were very supportive of CMS’s decision in 2017 to implement our bipartisan HOPE for Alzheimer’s Act by creating a new Medicare benefit (CPT code 99483) that provides for assessment and care planning for people living with cognitive impairment, including those living with Alzheimer’s and related dementias. Unfortunately, based on a recent analysis of utilization data, less than one percent of seniors eligible to receive this benefit actually accessed it in 2017.
While use of the code grew as more people became aware of the benefit, greater education and outreach is needed to increase access to comprehensive care planning services. The recently introduced Improving HOPE for Alzheimer’s Act (S. 880), would help achieve that goal by requiring the Department of Health and Human Services to (1) educate clinicians on the existence and importance of Medicare’s care planning benefit; and (2) report to Congress on the barriers to individuals receiving care planning services and how to increase their use. While this bill has already garnered significant bipartisan support, we urge CMS to use its existing authority to conduct a timely education and outreach campaign to increase awareness of and access to code 99483. We also ask that you list the efforts CMS has taken to date to make clinicians and beneficiaries aware of this benefit, including the results of those efforts.
Your leadership is critical to ensuring seniors living with cognitive impairment, including those with Alzheimer’s and other dementias, have access to comprehensive care planning services. Thank you for your attention to this important issue, and we ask that you respond by November 1, 2019. We look forward to working with you to increase the quality of care and quality of life for millions of families across the country.