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CMA Alert – SNF Enforcement Halted; Know Your Medicare Appeals; Ultimate Health Care Sabotage; More

This Week In Health Care Sabotage New Fact Sheet – Expedited v. Standard Medicare Appeals: Not Knowing the Difference Could Cost You Your Appeal Rights CMS Halts Enforcement, as Requested by the Nursing Home Industry This Week In Health Care Sabotage Medicare Enrollment Periods Medicare Open Enrollment Ends Tomorrow, December 7. There is only one day left … Read more

In October of 2016, the Obama Administration issued a Final Rule regarding the Requirements of Participation (RoP) for nursing homes. The Final Rule was issued, in part, because the regulations had “not been comprehensively reviewed and updated since 1991.”[1] Under the Final Rule, the revisions to the RoP were to be implemented over three phases: … Read more

The Plan: Pass a Devastating Tax Bill, Balloon the Deficit, then Gut the Social Programs We Rely On Jimmo Update: Court Orders CMS to Modify Special Jimmo Webpage ACA and Medicare Enrollment Periods End Soon Changes to Notice of Qualified Medicare Beneficiary (QMB) Status The Plan: Pass a Devastating Tax Bill, Balloon the Deficit, then … Read more

Reports indicate that state surveyors cite nursing home deficiencies at a “no harm” scope and severity level 95 percent of the time. Unfortunately, this has a profound impact on a nursing home resident’s quality of care and quality of life. CMS data provide clear evidence that residents are actually being harmed by such deficiencies, despite the … Read more

Help Stop the Devastating Tax Bills. Call Congress Now!

When most of the country was asleep this Saturday, the Senate passed its version of a so-called tax “reform” bill. The senate bill undermines the Affordable Care Act and provides massive tax cuts for large corporations and wealthy people. It would explode the federal deficit, setting the stage for an immediate Medicare cut and future … Read more

Nursing Home Enforcement: Center Submits Comments on CMS’s Draft Guidance Regarding the Immediate Imposition of Remedies Comments Submitted on Center for Medicare and Medicaid Innovation (CMMI) Center Submits Comments on HHS Notice of Benefit and Payment Parameters for 2019 Nursing Home Enforcement: Center Submits Comments on CMS’s Draft Guidance Regarding the Immediate Imposition of Remedies … Read more

Home for the Holidays: Leaving the Nursing Home During a Medicare-Covered Stay 2018 Medicare Cost Sharing REMINDER: Medicare Enrollment Continues through December 7th Tax Bill Facing Vote in the Senate Next Week – Time to Talk Turkey! Home for the Holidays: Leaving the Nursing Home During a Medicare-Covered Stay Late November begins a time for … Read more

November 21, 2017 Late November begins a time for gatherings with family and friends – Thanksgiving, soon followed by the December holidays. Nursing home residents often want to participate in these gatherings but may worry that they will lose Medicare coverage if they leave the facility to do so. Residents and their families and friends … Read more

As families around the country prepare to gather with loved ones for the Thanksgiving holiday, the House passed a tax bill that would threaten the health and economic security of many low-income and middle-class families. This Thanksgiving, talk turkey about taxes! It’s not too late to protect our health care and our families. Here's what … Read more

Tax Cut Bill Just Got Worse. Health Care at Risk. This Week in Sabotage CMS Steering to Medicare Advantage Administration And Nursing Home Industry: Lockstep in Deregulating Nursing Facilities & Reducing Resident Protections Tax Cut Bill Just Got Worse.  Health Care at Risk. Free Webinar Series Next Webinar: Hospital Observation Status Update January 24, 2018 … Read more

  FOR IMMEDIATE RELEASE November 15, 2017 Contact: Center for Medicare Advocacy – Matt Shepard: 860-456-7790, mshepard@MedicareAdvocacy.org Medicare Rights Center – Mitchell Clark: 212-204-6286, mclark@medicarerights.org Tax Cut Bill Just Got Worse.  Health Care at Risk. As the House and Senate rush to make changes to their versions of the bill, it keeps getting worse and worse, … Read more

Alert – Spotlight on Medicare Home Health Care; Tax Cuts Set Stage for Medicare/Medicaid Cuts; ACA News

Medicare Home Health Coverage is Not a Short-Term, Acute Care Benefit ─ Congress Acted in 1980 to Provide for Longer-Term Coverage Final Home Health Rules and Interpretive Guidance: Proposed Payment Model Rescinded Advocates Oppose House Tax Cuts Bill that Would Set the Stage for Deep Cuts to Medicare & Other Programs This Week in Sabotage … Read more

CMA Alert – It’s Enrollment Season; CMS Reissues HH Booklet; “Homebound” Case Settlement; More

It's Health Care Enrollment Season NEW! CMS Again Reissues Improved Medicare Home Health Booklet THIS Week In ACA Sabotage… Happy Anniversary SSI Medicare "Homebound" Class Action Settled – Fairness Hearing Set for January 11, 2018 It's Health Care Enrollment Season Free Webinar Series Next Webinar: Social Security Disability Insurance (SSDI) Part 2 – Overview of Benefits for … Read more

Federal Judge Fails to Protect Affordable Care Act Subsidies

October 26, 2017 – At least for now, a federal court failed to protect the Affordable Care Act subsidies ended by the president’s executive order.   The Judge denied a request from 18 states and Washington, DC to stop the administration from scrapping the cost-sharing reduction subsidies that are paid to insurance companies to help … Read more

CMA Alert – Remember You CAN Choose Original Medicare; Equitable Relief; This Week’s Sabotage News

You Can Choose Original Medicare: CMS Over-Emphasizes Private Medicare Advantage Plans in Open Enrollment Roll-Out CMS Extends Equitable Relief  CMA Joins 30 Organizations in Amicus Brief in Support of Court Challenge to Trump ACA Sabotage And THIS Week in ACA Sabotage… Auto-Enrollment… And No Time to Switch More Repeal Disguised as Reform You Can Choose Original … Read more

Ben Belton

Posted in Article

Ben Belton, Former Senior Advisor to the Acting Commissioner, Social Security Administration, is the first recipient of the the Alfred J. Chiplin, Jr., Social Justice & Advocacy Award. Ben most recently served in the administration of President Barack Obama as a Senior Advisor to the Acting Commissioner of the Social Security Administration (SSA). In that role, he oversaw … Read more

CMA Alert, October 18, 2017 – Nursing Home Rights Roundup; ACA Stabilization; More

This Week in ACA Sabotage Bipartisan Agreement on ACA Stabilization Package Nursing Home Rights Roundup CMS Signals End of Campaign to Reduce Unnecessary Use of Antipsychotic Drugs In Nursing Homes; Claim of Success is Grossly Overstated OIG Report about Nursing Home Complaints Leaves Questions Unanswered Congressional Letter Asks for Revision and Delay of Nursing Home … Read more

CMA Alert – Open Enrollment Tips; ACA Sabotage; More

Medicare Annual Enrollment Period Begins October 15: Look Before You Leap This Week in ACA Sabotage  Breast Cancer Awareness Month International Day of Older Persons Medicare Annual Enrollment Period Begins October 15: Look Before You Leap Free Webinar Series Next Webinar: Social Security Disability Insurance (SSDI) Part 1 – History/Myths/Who is Served October 18, 2017 … Read more

CMA Alert – Changes to Help QMBs; Home Health Updates; ACA Sabotage

CMS Changes Will Help Ensure Low Income Beneficiaries Are Not Illegally Billed CMS Reissues Improved Medicare Home Health Booklet Dispelling a Myth: Medicare Home Health Coverage is NOT a Short Term, Post-Acute Care Benefit The ACA Sabotage Continues CMS Changes Will Help Ensure Low Income Beneficiaries Are Not Illegally Billed The Centers for Medicare and … Read more

Proposed Home Health Rules Harm the Most Vulnerable Beneficiaries We Called It: Continued Sabotage of the ACA “Equitable Relief” Ends this Week – Sign Up for Medicare Part B Proposed Home Health Rules Harm the Most Vulnerable Beneficiaries In July, CMS proposed new payment, case-mix adjustment and quality reporting rules that will make it harder … Read more

World Alzheimer’s Day 2017 – September 21

The Center for Medicare Advocacy joins Alzheimer’s organizations, caregivers, people with Alzheimer’s and their families, on World Alzheimer’s Day, to raise awareness about this devastating disease. Alzheimer’s is the most common form of dementia.  It devastates families and communities, and is one of the costliest chronic conditions to manage. According to the Alzheimer’s Association, there … Read more

Despite an enormous public outcry that eventually doomed this summer’s attempt at repealing the Affordable Care Act and decimating Medicaid, legislators seem to be lining up behind yet another bad bill. In fact, the Graham-Cassidy bill is even worse than earlier rejected bills. The Graham Cassidy bill[1]: Permits states to waive rules on premium ratings … Read more

The U.S. Senate Special Committee on Aging held a hearing on "Disaster Preparedness and Response: The Special Needs of Older Americans" today. The hearing came on the heels of Hurricanes Harvey and Irma, which resulted in the deaths of at least nine nursing home residents in Florida. Chairman Collins began the hearing by acknowledging the … Read more

URGENT:  ACA Repeal Effort Renewed Through Graham-Cassidy Bill. This is Not a Drill – Action Needed!

Just when we thought Congress was moving on from failed efforts to “repeal and replace” the Affordable Care Act (ACA), momentum is quietly building to try again, through yet another legislative effort – the Graham-Cassidy bill.  We need to stop this bill in its tracks. While some Senators are engaging in positive, bipartisan talks to … Read more

Today the United States Senate is a study in contrasts: on the same day that one Senator introduces a bill seeking universal health insurance coverage, another pair of Senators introduce yet another bill to gut the Affordable Care Act and roll back insurance coverage for millions. At one end of the spectrum, Senator Bernie Sanders … Read more

Abbey, Duane. “Inpatient Versus Outpatient: The Real Issue.” RAC Monitor. 06 March 2014. http://www.racmonitor.com/rac-enews/1618-inpatient-versus-outpatient-the-real-issue.html (site visited September 21, 2016). The author writes that there aren’t any well-established guidelines for Recovery Audit Contractors (RACs) when they review observation-related Medicare appeals. When there are disagreements, RACs can be directed to specific criteria. Unfortunately, Medicare RACs lack such … Read more

CMA Alert – Congress Returns, Still Threatening Health Care; ACA Sabotage; More

Congress is Back – And Health Care Remains Under Threat Administration Continues Sabotage of ACA Center for Medicare Advocacy Welcomes Dara Valanejad Congress is Back – And Health Care Remains Under Threat As Congress returns from the August recess, members face a full agenda of issues they must tackle ranging from the federal budget, to … Read more

CMA Alert –  OIG Warns of Abuse in SNFs; Ted Kennedy, Jr. Joins CMA Advisory Board; “Jimmo” Corrective Action Plan

HHS OIG Warns of Potential Elder Abuse in Skilled Nursing Facilities Connecticut State Senator Ted Kennedy, Jr. Joins Center for Medicare Advocacy Advisory Board Jimmo Corrective Action Plan Completed HHS OIG Warns of Potential Elder Abuse in Skilled Nursing Facilities Last week, the HHS Office of Inspector General (OIG) issued an Early Alert, warning of … Read more

CMA Alert – Joint Replacement Model Undermines Care;  OTC Hearing Aids Legislation Passed; More

Care is Compromised Under CMS’s Comprehensive Care for Joint Replacement (CJR) Model: A Case In Point Over-the-Counter (OTC) Hearing Aid Act Signed into Law Severe Harm if ACA Cost-Sharing Payments End Care is Compromised Under CMS’s Comprehensive Care for Joint Replacement (CJR) Model: A Case In Point On a Friday this past March, “Ms. T”, … Read more

CMA Alert – Critical Issue Roundup: MA Overpayment; HH Payment; Observation; More

Former CMS Administrator Comments on Medicare Advantage Overpayments Proposed Home Health Rules – Payments Drive Delivery of Care, Harming Beneficiaries Observation Status Harms Low-Income Medicare Beneficiaries Poll: Americans Favor Making the ACA Work Former CMS Administrator Comments on Medicare Advantage Overpayments In Austin Frakt’s August 7, 2017 The Upshot blog in the New York Times … Read more

CMA Alert – SNF Update: Comments on Reimbursement; Civil Money Penalties Weakened

Center for Medicare Advocacy Submits Comments on CMS’s Proposed Redesign of Medicare Reimbursement for Skilled Nursing Facilities  As Sought By Nursing Home Industry, CMS Changes Guidance to Reduce Civil Money Penalties for Nursing Facility Deficiencies Center for Medicare Advocacy Submits Comments on CMS’s Proposed Redesign of Medicare Reimbursement for Skilled Nursing Facilities  In an Advance … Read more

CMA Alert – Home Health Care Crisis; SSDI Anniversary

The Home Care Crisis: An Elder Justice Issue (Part 5 of a Ten-Part Series) Happy 61st Anniversary SSDI The Home Care Crisis: An Elder Justice Issue This is Part Five of a ten-part CMA Issue Brief Series examining the growing crisis in access to Medicare home health coverage and necessary care – and outlining the … Read more

This is Part Five of a ten-part CMA Issue Brief Series examining the growing crisis in access to Medicare home health coverage and necessary care – and outlining the Center for Medicare Advocacy’s work to address these issues. We invite you to follow this Issue Brief Series and submit Medicare home health stories to the … Read more

As Medicare’s Anniversary Approaches, the Fight for Health Care Continues Beware of a New Social Security Scam As Medicare’s Anniversary Approaches, the Fight for Health Care Continues On July 30, Medicare will turn 52 years old.  As we honor this program that provides stable coverage to over 57 million older adults and individuals with disabilities, … Read more

CMA Alert – Senate Health Bill, Again; Medicare Trustees Report; HH CoPs; More

Here We Go Again: Senate Health Repeal Bill Released Today, Vote Planned for Next Week Medicare Trustees Project Increase in Solvency Delay of New Medicare Home Health Conditions of Participation Advocacy News from the Capitol Here We Go Again: Senate Health Repeal Bill Released Today, Vote Planned for Next Week After backing off of plans … Read more

Making permanent the law that provides access to Speech Generating Devices for Medicare beneficiaries The Bill was introduced in the Senate (S.1132) and House (H.R.2465) in May 2017. In the House, H.R. 2465 was referred to the Energy and Commerce Committee and the Ways and Means Committee. On May 19th, the Bill was referred by … Read more

Congress is on recess, but we can’t be – the health care repeal debate continues!  In their home states and through tough, ongoing negotiations, Senators are making up their minds about the future of the ACA, Medicaid, and Medicare.  This CMA Alert provides updated “Myths & Facts” about the most recent potential changes to the … Read more

Congress Leaves for the July 4th Recess, Health Care Repeal Remains a Threat – Continue to Make Your Voice Heard

We got a reprieve this week when Senate Majority Leader Mitch McConnell delayed a planned vote on the Better Care Reconciliation Act of 2017 (BCRA).  Like the bill that passed in the House, BCRA would repeal the Affordable Care Act, decimate Medicaid, and weaken Medicare. The battle over health repeal is not over. Sen. McConnell … Read more

Health Care Repeal Vote Postponed But the Fight is Not Over

Yesterday, Senate leadership announced that a vote on the Senate health care bill – the Better Care Reconciliation Act (BCRA) – would be postponed until after the July 4 recess.  In the coming weeks, Leader McConnell will try to wrangle together enough votes to pass the BCRA by offering relatively small “fixes” to placate various … Read more

Health Care Repeal Vote Postponed – But Keep the Pressure On

Senate leadership today announced that a vote on the Senate health care repeal bill would be postponed until after the July 4 recess. While this shows that the efforts of all those who have called and written to tell the truth about this awful legislation are working, it is not the end. We saw this happen in the … Read more

Real People Will be Harmed by House & Senate Health Repeal Bills

The House passed its bill, the American Health Care Act (AHCA), in May. Last week, the Senate unveiled its ACA repeal bill, called the Better Care Reconciliation Act of 2017 (BCRA). The Senate plans to vote on the bill this week. Although there are some minor differences between AHCA and BCRA, as noted by the Center on … Read more

CMA Alert – The Fight Continues; Home Health Access Issues; World Elder Abuse Awareness Day

1. Medicare Home Health Crisis – Misleading and Inaccurate CMS Medicare Home Health Publications 2. Senate Plans to Vote to Gut Health Care Next Week – Act Now to Stop These Cuts! 3. World Elder Abuse Awareness Day Misleading and Inaccurate CMS Medicare Home Health Publications This is Part Four of a ten-part CMA Issue … Read more

The Senate bill is still a secret, but what we’ve learned isn’t good.  Senate leadership is pushing for a vote by the end of next week. While some information about policy changes is leaking out, such as the Medicaid payment rates referenced below, the bill is still a secret – no text, no hearings, no … Read more

This is Part Four of a ten-part CMA Issue Brief Series examining the growing crisis in access to Medicare home health coverage and necessary care – and outlining the Center for Medicare Advocacy’s work to address these issues. We invite you to follow this Issue Brief Series and submit Medicare home health stories to the … Read more

This is Part Four of a ten-part CMA Issue Brief Series examining the growing crisis in access to Medicare home health coverage and necessary care – and outlining the Center for Medicare Advocacy’s work to address these issues. We invite you to follow this Issue Brief Series and submit Medicare home health stories to the … Read more

Last week, Center for Medicare Advocacy Chiplin Senior Fellow Ben Belton participated in a 2017 World Elder Abuse Awareness Day (WEAAD) commemoration at the United Nations (UN) in New York. This year’s WEAAD theme, “Understand and End Financial Abuse of Older People: A Human Rights Issue” highlighted the need to protect older people from the … Read more

CMA Alert – Harmful Proposed SNF Rules; Welcome Chiplin Senior Fellow Ben F. Belton

1. Administration Proposes Allowing Nursing Homes to Require Pre-Dispute Arbitration Clauses as a Condition of Admission 2. CMS Extends Comment Period for New Medicare Skilled Nursing Reimbursement System Until August 25, 2017 3. The Center Welcomes Chiplin Senior Fellow Ben F. Belton Administration Proposes Allowing Nursing Homes to Require Pre-Dispute Arbitration Clauses as a Condition … Read more

On May 4, 2017, the Centers for Medicare & Medicaid Services (CMS) published an Advance Notice of Proposed Rulemaking setting out options that CMS is considering to replace the Medicare reimbursement system for skilled nursing facilities (SNFs).[1]  The Center for Medicare Advocacy’s Alert described the proposal at length and the ways it would change financial … Read more

In 2016, the Obama Administration promulgated final regulations that revised and updated the Requirements of Participation, the federal standards of care that nursing facilities must meet in order to be eligible to receive Medicare or Medicaid reimbursement.[1]  The Obama rules explicitly prohibit facilities from entering into pre-dispute mandatory arbitration agreement with a resident or resident … Read more

CMA Alert – AHCA Still Looms; MA Disenrollment By Health Status

1. AHCA’s Impact on Older Adults 2. Government Oversight Agency Urges CMS to Examine Medicare Advantage Disenrollment by Health Status 3. Tell the Senate to Drop the AHCA AHCA’s Impact on Older Adults The Center for Medicare Advocacy is part of a broad coalition of stakeholders fighting to protect the Affordable Care Act (ACA), Medicare … Read more