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The Center for Medicare Advocacy (“Center”), a non-profit law organization, has an immediate, full-time opening for a position with our computerized case processing team. HOURS:   9am – 5pm, Monday – Friday PURPOSE OF POSITION:   The person holding this position is responsible for the day-to-day operation of the organization’s computerized case processing and tracking system. This … Read more

The Kaiser Family Foundation (KFF) has published a report entitled “Comparison of Consumer Protections in Three Health Insurance Markets: Medicare Advantage, Qualified Health Plans and Medicaid Managed Care Organizations.” The report is authored by Center Senior Policy Attorney David Lipschutz, former Center Policy Attorney Andrea Callow (now at Families USA) and Karen Pollitz, MaryBeth Musumeci … Read more

For the last several years, the Center has been trying to address the problem of Observation Status in the hospital, which can affect both what Medicare beneficiaries pay for hospital stays, and their coverage of subsequent care in a nursing facility.  For the last several sessions of Congress, bills have been introduced to try to … Read more

Today, March 26, the House of Representatives passed the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2).  While the Center for Medicare Advocacy believes it’s in the best interest of Medicare beneficiaries to find a permanent solution to the broken physician payment formula called the “Sustainable Growth Rate” (SGR), this Bill is not … Read more

Today the Senate releases its budget, which like the companion House budget released yesterday, appears to have significant cuts to the Medicare program.  Yet again, yesterday’s House budget includes a proposal to create a “premium support” – or voucher – option for future Medicare beneficiaries, starting in 2024. Medicare vouchers would convert much of Medicare … Read more

Unless Congress takes action by March 31, 2015, doctors who treat Medicare patients will see a 21% payment cut due to the current physician payment formula called the "sustainable growth rate" or "SGR."  Lawmakers have deferred the cuts prescribed by this 1997 reimbursement formula 17 times. These “patches” have been temporary because Congress has not … Read more

On March 11, 2015, the Diane Rehm program on National Public Radio hosted a discussion of the revisions to the Centers for Medicare & Medicaid Services’s (CMS’s) Five Star Quality Rating System for nursing homes.[1] Patrick Conway, CMS Chief Medical Officer and Deputy Administrator for Innovation and Quality began the show by describing the changes.  … Read more

Last week’s Alert discussed the Centers for Medicare & Medicaid Services’ (CMS’s) National Partnership to Improve Dementia Care and the Government Accountability Office’s (GAO) recent report on antipsychotic drugs.[1]  The CMS Partnership and the GAO reported different numbers of nursing home residents receiving antipsychotic drugs.  Some of the differences appear to reflect the different databases … Read more

Every year, the Centers for Medicare and Medicaid Services (CMS) releases a draft of payment, performance and other rules that apply to Medicare Advantage (MA) and Part D plans that choose to participate in the Medicare program in the following calendar year. Commonly referred to as the “Call Letter,” this document is first released in … Read more

In order to prescribe medications for their Part D patients, a new federal rule requires physicians, including psychiatrists and other prescribers of Part D drugs, to be enrolled in Medicare in an approved status, or to formally opt out of Medicare.  The original start date for this rule was June 1, 2015 but the actual … Read more