Withdrawal of Change to Medicare Special Election Period for Disasters
Relevant to: PDP, OEC, Part D
Each week, we scan the latest CMS memos to find the most important ones that apply for PACE programs. Below is a summary of what you need to know.
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Introduction
CMS has decided to withdraw the December 3, 2024, memo concerning changes to the Special Election Period for beneficiaries affected by government-declared disasters. The initial memo proposed that affected individuals contact 1-800-MEDICARE to utilize the Disaster/Emergency SEP, set to take effect April 1, 2025. However, this change will not be implemented, and current enrollment procedures will stay in effect. Further guidance on the SEP enrollment process will be issued in the future.
Key Dates and Deadlines
This memo includes key dates regarding policy announcements.
- March 20, 2025: Date of Memo
- December 3, 2024: Date of Withdrawn Memo Announcement
- April 1, 2025: Initially Proposed Effective Date for the Withdrawn Change
PACE Compliance
The memo in question does not directly pertain to PACE (Programs of All-Inclusive Care for the Elderly) compliance as it focuses on Medicare Advantage Organizations and Prescription Drug Plans’ enrollment processes related to the Special Election Period (SEP) for disaster or emergency situations. However, for entities involved in the delivery of services under these programs, it’s important to stay informed about enrollment process changes, as they may indirectly affect operational and coordination efforts.
As this memo announces the withdrawal of a proposed change, there are no new compliance actions required at this time specific to the PACE program related to this SEP adjustment. Instead, the continuation of existing procedures applies, meaning that if PACE organizations have participants potentially eligible for Medicare Advantage services under a Disaster/Emergency SEP, they should continue to use current enrollment processes and forms without changes.
For any related PACE procedures that might be impacted due to emergency situations, PACE organizations should remain vigilant and adapt as per updates from the Centers for Medicare & Medicaid Services (CMS).
Required Actions
This memo announces the withdrawal of a previous memo and informs plans about the continuation of the Special Election Period (SEP) process.
- Continue to accept applications using the Disaster/Emergency SEP until further guidance is provided.
- Use MARx submission with SEP reason code “01” and OEC crosswalk S reason code “DST.”
- Submit any questions to the Enrollment and Eligibility Policy Mailbox or the MA-PD Help Desk.
FAQs
- “What is the Special Election Period (SEP) for Individuals Affected by Disasters or Emergencies?”
- “Why was the memo regarding the change in SEP usage withdrawn?”
- “How can beneficiaries currently use the Disaster/Emergency SEP?”
- “What are the implications of the withdrawn memo for Medicare Advantage Organizations?”
- “Will there be new guidance on the SEP enrollment process in the future?”
