America's Benefit Specialist July 2023

MEDICARE MATTERS

will have access to the information to conduct studies, fur thering knowledge of how these drugs can potentially help people. CMS is working with multiple organizations that are getting ready to open their own registries. More information will be released as they come on line. The approach is consistent with CMS’ National Coverage Determination. To get Medicare coverage people will need to 1) be enrolled in Medicare Part B, 2) be diagnosed with mild cognitive impairment or early dementia caused by Alzhei mer’s disease, and 3) have a qualified physician participating in a registry, including the options above, with an appropriate clinical team and follow-up care. These criteria are in addition to any label requirements the FDA specifies. Registries are common tools in clinical settings that have successfully gathered information on patient outcomes for

decades. There is strong precedent for using registries to gather more information on a newly approved treatment. For example, when the FDA granted traditional approval to the transcatheter aortic valve replacement (TAVR), CMS re quired the clinicians and hospitals to participate in a registry to track outcomes. Information gathered from that registry has since been used to further inform Medicare coverage determinations, and to help people and their clinicians make better decisions about whether TAVR is the best treatment for them. Other registries for drugs that may slow the progression of Alzheimer’s disease may become available in the coming weeks and months. Information will be available at www. cms.gov/Medicare/Coverage/Coverage-with-Evidence- Development.

THE ALZHEIMER’S ASSOCIATION STATEMENT ON CMS ANNOUNCEMENT The Alzheimer’s Association recognizes that the Centers for Medicare & Medicaid Services has announced a conceptual approach to fulfill its commitment to immediate coverage of FDA traditionally approved Alzheimer’s treatments. We continue to believe that registry as a condition of coverage is an unnecessary barrier.

In the latest Healthcare Business Strategy report, Mark Farrah Associates reported Medicare Supplement plans covered over 13.7 million seniors as of December 31, 2022. Many leading managed care organizations, Blues plans, regional plans and multiline carriers compete in the Medicare Supplement space. Medicare Supplement plans collectively earned approx imately $33.9 billion in premiums and paid out $28.3 billion in claims during 2022. The aggregate loss ratio Registries are important tools to gather much needed real-world evidence to transform and improve patient care, but registries should not be a requirement for coverage of a FDA-approved treatment. We look forward to learning more details from CMS and we are hopeful for the future of healthcare access for our constituents. However, we remain concerned that the re quirement of clinicians to register and enter data will create unnecessary hurdles. In its announcement, CMS said it will have a nationwide CMS-facilitated portal and other future registries may also qualify. Additional information about the data submission, registry requirements and details about how patients and physicians can enroll is still needed.

ANALYZING THE 2022 MEDICARE SUPPLEMENT MARKET

(incurred claims as a percent of earned premiums) was 83.6% as of December 2022. MFA’s assessment of standardized plan type preferences for 2022 found Plan F, the most comprehensive design, enrolled approximately 5.3 million members. Enrollment gains were also significant in standardized plan type G with a year-over-year increase of over 490,000 new members. To read the free full text of “Medicare Supplement Enrollment Down Slightly in 2022,” visit www.markfarrah. com.

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