In 2008, Congress enacted MIPPA to improve Medicare’s accessibility and affordability for low-income and rural beneficiaries through federal grants and various reforms.

In 2008, Congress passed the Medicare Improvements for Patients and Providers Act (MIPPA), also known as Public Law 110-275. It was most recently reauthorized and extended through August 2026.

This comprehensive legislation introduced changes to the Medicare program and provided federal funding through Section 119 to organizations that help support and educate Medicare beneficiaries with lower incomes and those living in rural areas about ways to lower healthcare costs.

The U.S. government distributes MIPPA funding to each state based on that state’s Medicare population. Read on to learn about MIPPA, the reasons for its passage, and how it impacted Medicare.

MIPPA primarily enables the U.S. government to grant funds to the State Health Insurance Assistance Program (SHIP), Area Agency on Aging (AAA), and Aging and Disability Resource Center/No-Wrong-Door System (ADRC/NWD).

These organizations use this additional MIPPA funding to reach Medicare beneficiaries with lower incomes or those living in rural regions, helping them access resources that reduce their healthcare costs while on Medicare. This includes helping eligible beneficiaries enroll in programs like Extra Help or the Medicare Savings Program (MSP).

MIPPA funding also supports the National Center for Benefits Outreach and Enrollment (NCBOE), which develops technological tools and resources to help beneficiaries enroll more efficiently in Medicare and claim their benefits.

In addition, MIPPA made some changes to the structure, function, and benefits of the various Medicare plans and parts, with the goal of lowering financial and logistical barriers to coverage.

Some of the changes that affected Medicare because of MIPPA include:

Original Medicare (parts A and B)

  • reduced mental health cost-sharing to help lower cost barriers to mental health care access for Medicare beneficiaries.
  • added additional preventive services
  • expanded benefits for people living with end stage renal disease (ESRD)
  • extended the Qualifying Individual (QI) MSP and raised asset limits for MSP eligibility
  • streamlined healthcare operation by blocking intended cuts to doctor-related fees, encouraging electronic prescriptions, and incentivizing doctor quality reporting
  • allowed beneficiaries to continue using any approved supplier of durable medical equipment (DME)

Medicare Advantage (Part C)

  • made payments to private Medicare Advantage (MA) plans more equitable by adjusting for the cost of medical education
  • encouraged Private Fee-For-Service (PFF) plans to create provider networks so that it’s easier for you to find a provider that works for you within your plan’s network
  • eliminated the Medicare Advantage Stabilization Fund, which was used to encourage regional Preferred Provider Organizations (PPOs) to offer MA plan options, redirecting these funds to preserve Medicare’s financial stability and support other programs

Medicare Part D

  • eliminated the Medicare Part D late-enrollment penalty for people enrolled in Extra Help
  • required all Medicare Part D plans to cover some drugs from certain protected categories
  • prohibited certain types of marketing and sales practices by Medicare Advantage and Part D insurers
  • excluded the value of life insurance policies and assets from the calculations of resources used to determine eligibility for Extra Help

Medigap

Since it was enacted in 2008, MIPPA has assisted more than a million low-income Medicare beneficiaries in discovering programs that can help reduce their healthcare and prescription expenses.

For example, as of 2025, enrollment in Extra Help has dropped from 13.7 million to 13.1 million. This was the first decline in enrollment since 2007, the year before MIPPA was implemented.

Similarly, data from the Centers for Medicare & Medicaid Services (CMS) shows that enrollment in MSPs had increased annually between 2007 to 2011. In addition, according to a 2012 survey from the United States Government Accountability Office, at least 28 states attributed this increase to MIPPA.

That said, given the passage of nearly two decades since the law was initially passed, and the multitude of factors that may affect access to healthcare and benefits among Medicare beneficiaries, it can be difficult to make a broad assessment of the law’s impact.

For instance, according to more recent data, enrollment in MSPs remained relatively low as of 2024.

Analysis from the Office of Behavioral Health, Disability, and Aging Policy shows that MIPPA’s mental health cost changes had mixed results. While Medicare beneficiaries briefly increased their use of mental health professionals and medications and saw reduced out-of-pocket costs, outpatient mental health visits remained largely unchanged long term.

Researchers believe that other challenges, such as transportation difficulties, limited provider availability, or stigma around treatment for mental health, might still be making it hard for people to get the care they need.

Today, MIPPA continues to serve critical functions, but more long-term research is necessary on the impact of these various initiatives.

Under MIPPA, healthcare providers offering imaging services must be accredited by the American College of Radiology (ACR), the Intersocietal Accreditation Commission (IAC), or The Joint Commission (TJC).

The Strengthening Medicare for Patients and Providers Act (H.R. 2474) and MIPPA are different laws.

MIPPA focused on making Medicare benefits more accessible and affordable for people with low income, while the Strengthening Medicare for Patients and Providers Act focused on improving Medicare payment policies for doctors to stabilize them and help manage the increasing costs of running a medical practice.

In 2008, Congress passed the Medicare Improvements for Patients and Providers Act (MIPPA) and has since extended it through 2026. This law aims to enhance Medicare’s accessibility and affordability for low income and rural beneficiaries.

MIPPA provides federal grants to support programs assisting older adults on Medicare in enrolling in cost-saving initiatives. It also created reforms in various Medicare components, such as adding preventive services and expanding certain coverage.