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The Centers for Medicare & Medicaid Services (CMS) announced plans to expand its focused surveys on resident assessments and nurse staffing for nursing facilities nationwide (but not in all facilities), beginning in early fiscal year 2015.  Expanded surveys should lead to more accurate reporting of quality measures and staffing data on the federal website Nursing … Read more

The open enrollment period for health insurance coverage for 2015 under the Affordable Care Act (ACA) begins November 15, 2014, and ends on February 15, 2015. More information on the ACA health insurance Marketplace is available at: https://www.healthcare.gov/ Plans With Automatic Enrollment Some individuals who are currently enrolled in a health plan through the Marketplace … Read more

November 13, 2014 Late November begins a time for gatherings with family and friends – Thanksgiving and Chanukah, soon followed by Christmas and New Years. Nursing home residents often want to participate in these gatherings but may worry they will lose Medicare coverage if they leave the facility to do so. Residents and their families … Read more

CMS Rescinds Restrictive Policy and Will Reconsider Technological Advances CMS announced yesterday that it has begun the process of updating its Medicare coverage policy for Speech Generating Devices (SGDs). A new SGD National Coverage Determination (NCD) is expected to be completed by July 31, 2015.  While CMS considers a new coverage rule for SGDs, it … Read more

Medical Equipment Suppliers' Ongoing Opposition to the Competitive Bidding Program and Consequences for Beneficiaries Report prepared by Mario Ramsey, Center for Medicare Advocacy Summer Health Policy Fellow Summary Under Medicare Part B, Medicare will pay for wheelchairs, hospital beds, some walkers; Certain customized items; prosthetic and orthotic devices; capped rental items; oxygen and oxygen equipment. … Read more

Submitted electronically via PartCandDStarRatings@cms.hhs.gov November 3, 2014 Centers for Medicare & Medicaid Services Department of Health & Human Services Attention: CMS-6050-P P.O. Box 8013 Baltimore, MD 21244-8013 Re: Request for Information regarding Data on Differences in Medicare Advantage (MA) and Part D Star Rating Quality Measurements for Dual-Eligible versus Non-Dual Eligible Enrollees To Whom It … Read more

Report prepared by Mario Ramsey, Center for Medicare Advocacy Summer Health Policy Fellow I.                   Introduction Since the introduction of the Competitive Bidding Program (CBP), trade organizations––representing the billion dollar Durable Medical Equipment Prosthetics Orthotics and Supplies (DMEPOS) industry––have been opposed to Medicare's congressionally mandated competitive bidding program.  In keeping with this opposition, supplier organizations were … Read more

Twenty-one months after winning a national class action lawsuit that sought to overturn Medicare's practice of denying skilled maintenance care to patients who did not meet an "improvement standard," plaintiff Glenda Jimmo is finally receiving Medicare coverage for skilled home health maintenance care benefits she was denied in 2007. A federal court case in Vermont … Read more

Signed into law by President Obama in 2010, a primary goal of the Affordable Care Act (ACA) is to provide health insurance for citizens who lack such coverage. This alert is designed to guide new and returning consumers on accessing the ACA’s exchanges and purchasing an appropriate policy through them. One way the ACA provides … Read more

SGD@MedicareAdvocacy.org CMS is currently reviewing its SGD policies. We are hopeful that CMS will revise these policies to allow SGD users to keep their speech when they’re admitted into health care facilities and be able to use their SGDs to communicate with the outside world. However, in the event CMS does not reach an acceptable … Read more