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Department of Health and Human Services (HHS) Extends Medicare Coverage to Same-Sex Couples

The U.S. Department of Health & Human Services (“HHS”) announced last week that same-sex married couples can now qualify for Medicare Part A and Part B special enrollment periods and reductions in late enrollment penalties.

This policy change results from the groundbreaking 2013 Supreme Court ruling in United States v. Windsor that Section 3 of the Defense of Marriage Act (“DOMA”), which defined marriage as a union between one man and one woman, was unconstitutional.  Because of this ruling, Medicare is no longer prevented by DOMA from recognizing same-sex marriages for determining entitlement to, or eligibility for, Medicare.

HHS Secretary Kathleen Sebelius stated that the Medicare changes will help “to clarify the effects of the Supreme Court’s decision and to ensure that all married couples are treated equally under the law.”

Medicare’s website encourages individuals who are in, or are a surviving spouse of, a same-sex marriage, to apply for Medicare if they think that they might be eligible.  Individuals in civil unions or domestic (or life) partnerships are not considered spouses for these purposes.

Secretary Sebelius added that HHS is “working together with [the Social Security Administration (“SSA”)] to process these [enrollment] requests in a timely manner to ensure all beneficiaries, regardless of sexual orientation, are treated fairly under the law.”

Additional information for same-sex couples who might be eligible for Medicare is available here.

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The health industry is a complex system, and reimbursement is the lifeblood. Reduction in payments from governmental and commercial payors affects providers, suppliers, manufacturers, and all others across the health care continuum.

Regulatory approval and accreditation is the heart of the system. For many, delay in licensure and other regulatory approvals can threaten financing and corporate viability. Accreditation of residency training programs is essential to the vitality of academic medical centers and teaching hospitals.

Restructuring is a fact of life in this dynamic...

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