InComm Healthcare & Affinity · Heart Health Essential Fatty Acids – Fish Oil, Flax, GLA, etc. Guidance New guidance allows for products that are medically appropriate and recommended

Medicare Catalog Update Memorandum P a g e | 1

memo InComm Healthcare & Affinity

To: All Medicare Catalog Users

From: Tiffany Roach, Senior Director Operations & Product

CC: IHA Business Development, Implementation & Operations

Date: July 2, 2018

Re: Important Product Eligibility Notice Standard Medicare Catalog Changes Effective Date: January 1, 2019

IHA regularly reviews guidance and regulations from CMS as it relates to OTC product eligibility to ensure that our clients, and your valued cardholders, are receiving high quality and compliant service from your OTC Network card programs. This year, we reviewed multiple sources of documentation from CMS and other sources and determined that an expansion of item eligibility should be implemented for our Standard Medicare Catalog effective January 1, 2019.

As always, if you have any questions, please reach out to your account manager for assistance.

2019 Standard Medicare Catalog:

Item Inclusion Updates This catalog will replace the current Medicare catalog in place. Following is a list of items that will be added to the catalog effective January,1, 2019.

Category Sub Category Finest Category Digestive Health Digestive Aids Digestive Health Prebiotics & Probiotics Cold & Allergy Respiratory Treatments Vaporizers, Humidifiers & Accessories Cold & Allergy Respiratory Treatments Mixed/Miscellaneous Respiratory Treatments Diabetes Care Diabetes Nutritionals & Wellness Diabetes Supplements Diabetes Care Diabetes Health & Personal Care Diabetes Skin Care & External Pain Relief Physical Fitness & Exercise Equipment Physical Fitness Pedometers, fitness trackers

Eye & Ear Care Reading Glasses & Magnifying Glasses Reading Glasses Eye & Ear Care Reading Glasses & Magnifying Glasses Magnifying Glasses


Category Sub Category Finest Category Eye & Ear Care Reading Glasses & Magnifying Glasses Mixed/Miscellaneous Reading Glasses &

Magnifying Glasses Eye & Ear Care Ear Care Hearing Aids Eye & Ear Care Ear Care Lipoflavonoids Vitamins & Supplements Specialty Supplements Joint Health (incl. Glucosamine) Vitamins & Supplements Specialty Supplements Menopause Support (Soy) Vitamins & Supplements Specialty Supplements CoQ10 Only (UBIQUINOL) Vitamins & Supplements Specialty Supplements Heart Health & Essential Fatty Acids (Fish Oil,

Flax, GLA, etc.) Vitamins & Supplements Specialty Supplements General Health Prebiotics & Probiotics Electrical & Audio Batteries Hearing Aid Batteries (Standard & High

Performance) Home Health Care Bathroom Safety Bathtub Safety & Accessories Home Health Care Bathroom Safety Bathtub & Toilet Rails & Frames Home Health Care Bathroom Safety Elevated Toilet Seats & Accessories Home Health Care Bathroom Safety Grab Bars & Handles Home Health Care Bathroom Safety Sitz Baths & Bidets Home Health Care Bathroom Safety Hand Held Showers Home Health Care Bathroom Safety Mixed/Miscellaneous Bathroom Safety Home Diag &Patient Aids For Daily Living

Patient Aids For Daily Living Bathing & Oral Hygiene Aids

Home Diag &Patient Aids For Daily Living

Patient Aids For Daily Living Mixed/Miscellaneous Patient Aids For Daily Living


Patient Aids For Daily Living Night lights


Patient Aids For Daily Living Mobility Safety: Stair rails, stair treads, temporary mobility ramps


Patient Aids For Daily Living Grooming & Dressing Aids


Patient Aids For Daily Living Medical Alert IDs & Devices


Patient Aids For Daily Living Medicine Dosers, Pillboxes, Organizers & Reminders


Patient Aids For Daily Living Reachers, Grippers & Lifts


Patient Aids For Daily Living Reading, Writing & Telephone Aids

Participating Merchant Network No changes to your participating network will be required with the new Standard Medicare 2019 Catalog.

Next Steps To have all your current Medicare programs use the New 2019 Medicare Standard Catalog, there is nothing to do. This catalog will now be the default Medicare Catalog and will apply to all OTC Network Medicare Card Programs effective January 1, 2019.


Materials Update & Communications If you have materials that will be changing for 2019, it is recommended that you update the content referencing item eligibility in your current package for use beginning January 1, 2019. Alternatively, you can create an insert to be sent out with your current package to facilitate a wind down of inventory you may have.

In addition, we can display a message on your admin and member portals as a reminder about this change to catalogs as well. Reach out to your Account Manager if interested.

Attachments: IHA 2019 Medicare Catalog Expansion_Final.xlsx: Complete Current Catalog & 2019 Additions IHA Medicare Catalog 2019_Final.pdf: Outlines the catalog additions, our research and reference materials

© Hamacher Resource Group, Inc. | Proprietary and Confidential

Prepared for

June 2018


New Categories for Medicare OTC Network

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CMS guidelines for 2019 Medicare Part C have expanded to include items which prevent, as well as diminish, the impact of injuries or health conditions.

Supplemental benefits under this interpretation must be medically appropriate and recommended by a licensed provider.

2019 Category eligibility expansion

This presentation provides an overview of the changes needed to meet the new guidelines. Following the Changes section are callouts from documentation supplied by CMS providing the guidance used to modify the Medicare Part C catalog.



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Categories: Reading Glasses

Magnifying Glasses

Hearing Aids/Hearing Amplification

Hearing Aid Batteries

Bathing & Oral Hygiene Aids

Night Lights

Medical Alert IDs & Devices

Guidance

New guidance allows for products that compensate for physical impairments.

Mobility Safety: Stair rails, stair treads, temporary mobility ramps

Eating & Drinking Aids

Grooming & Dressing Aids

Medicine Dosers, Pillboxes, Organizers & Reminders

Reachers, Grippers & Lifts

Reading, Writing & Telephone Aids



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Categories: Bathtub Safety & Accessories

Bathtub & Toilet Rails & Frames

Elevated Toilet Seats & Accessories

Grab Bars & Handles

Sitz Baths & Bidets

Hand Held Showers

Guidance

New guidance allows for products that compensate for physical impairments.



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Categories: Vaporizers, Humidifiers & Accessories

Mixed/Miscellaneous Respiratory Treatments

Diabetes Skin Care & External Pain Relief

Diabetes Supplements

Pedometers, fitness trackers

Guidance

New guidance allows for products that reduce healthcare utilization.



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Categories: Digestive Health Probiotics and Prebiotics

Guidance

New guidance allows for products that are medically appropriate and recommended by a licensed provider.

NIH – Preliminary research that some probiotics are helpful in preventing diarrhea caused by infections and antibiotics and improving symptoms of irritable bowel symptoms.

Prebiotics are selectively fermented components allowing specific changes in the composition and/or activity of microorganisms in the gastrointestinal tract, beneficial for host’s health and wellbeing.



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Categories: CoQ10 (Ubiquinol)

Guidance


Mayo Clinic - CoQ10 supplements might be beneficial for treating conditions such as congestive heart failure and Parkinson's disease. CoQ10 is considered safe, with few side effects. However, be sure to take this supplement under your doctor's supervision.

NIH- CoQ10 supplements may benefit some patients with cardiovascular disorders. Researchers have also looked at the effects of CoQ10 for drug-induced muscle weakness, reproductive disorders, cancer, and other diseases. However, results from these studies are limited and not conclusive.



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Categories: Heart Health

Essential Fatty Acids – Fish Oil, Flax, GLA, etc.

Guidance


Mayo Clinic - Omega-3 fatty acids are essential for good health. Fish oil also appears to contain almost no mercury, which can be a cause for concern in certain types of fish. While generally safe, too much fish oil can increase your risk of bleeding and might suppress your immune response. Take fish oil supplements under a doctor's supervision.

NIH- High doses of omega-3s can reduce levels of triglycerides.

Omega-3 supplements may help relieve symptoms of rheumatoid arthritis.



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Categories: Lipoflavinoids

Guidance


NIH – Concluded that dietary supplements should not be recommended to treat tinnitus but could have a positive outcome on tinnitus reactions in some people.

Mayo Clinic - There's little evidence that alternative medicine treatments work for tinnitus. However, some alternative therapies that have been tried for tinnitus include:

Acupuncture

Hypnosis

Ginkgo biloba

Zinc supplements

B vitamins



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Categories: Joint Health Supplements, including Glucosamine

Guidance


Mayo Clinic - Research on glucosamine use for specific conditions shows:

Osteoarthritis: Oral use of glucosamine sulfate might provide some pain relief for people with osteoarthritis of the knee, hip or spine.

Rheumatoid arthritis. Early research suggests that oral use of glucosamine hydrochloride might reduce pain related to rheumatoid arthritis when compared with placebo, an inactive substance. However, researchers didn't see an improvement in inflammation or the number of painful or swollen joints.



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Categories: Menopause Supplements

Guidance


Mayo Clinic - Plant estrogens (phytoestrogens). These estrogens occur naturally in certain foods. There are two main types of phytoestrogens — isoflavones and lignans. Isoflavones are found in soybeans, lentils, chickpeas and other legumes. Lignans occur in flaxseed, whole grains, and some fruits and vegetables.

Whether the estrogens in these foods can relieve hot flashes and other menopausal symptoms remains to be proved, but most studies have found them ineffective. Isoflavones have some weak estrogen-like effects, so if you've had breast cancer, talk to your doctor before supplementing your diet with isoflavone pills.

The herb sage is thought to contain compounds with estrogen-like effects, and there's good evidence that it can effectively manage menopause symptoms.


Supporting Documentation

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The following pages contain excerpts from the CMS communications regarding the changes for 2019.

Final changes for 2019 as part of the Medicare Managed Care Chapter 4 (OTC benefits section) have not been published and may impact final eligibility.


Announcement of Calendar Year (CY) 2019 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter page 207

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CMS modifying eligibility for maintenance items



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Primarily healthcare related – diagnose, prevent or treat



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Recommended by a licensed provider


Reinterpretation of “Primarily Health Related” for Supplemental Benefits

April 27, 2018 CMS Memo

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Home & Bath Safety Items are eligible for 2019


Reinterpretation of “Primarily Health Related” for Supplemental Benefits

April 27, 2018 CMS Memo

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Aids for daily living and fitness

Documents

InComm Healthcare & Affinity · Heart Health Essential Fatty Acids – Fish Oil, Flax, GLA, etc. Guidance New guidance allows for products that are medically appropriate and recommended