Beginning in 2020, Medicare Advantage organizations will be able to offer “non-primarily health related” items and services to certain beneficiaries through Special Supplemental Benefits for the Chronically Ill (SSBCI) established in the Bipartisan Budget Act of 2018. CMS has given plan sponsors broad discretion in developing non-medical services that were previously not allowed in MA plan bids and is allowing them to target certain benefits to individuals’ conditions and needs, but a working group of diverse stakeholders suggests that a set of “guiding principles” is needed to ensure the successful implementation of new SSBCI. While the new benefit category provides MAOs with an “unprecedented degree of flexibility” to address social determinants of health, it “also creates challenges around benefit clarity, equity and manageability,” observes the new report, “A Turning Point in Medicare Policy: Guiding Principles for New Flexibility Under Special Supplemental Benefits for the Chronically Ill.”
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