The Kaiser Family Foundation (KFF) recently released a report titled “Spending on Medicare Advantage Quality Bonus Payments Will Reach at Least $12.8 Billion in 2023” by Jeannie Fuglesten Biniek, Anthony Damico, and Tricia Neuman (August 9, 2023); … [Read more...] about Medicare Advantage Plans Receive Bloated Bonus Payments with Little to Show for It
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Growing Chorus to Protect and Expand Traditional Medicare
As overpayments to MA plans receive increased attention, along with some of the barriers to accessing care faced by MA enrollees, such as inappropriate use of prior authorization, there is growing recognition among both policymakers and the public … [Read more...] about Growing Chorus to Protect and Expand Traditional Medicare
New Studies on Mental Health and Substance Use Disorder Access Highlight the Need for Parity in Medicare
As our country continues to face a mental health crisis and overdose epidemic, increasing access to mental health and substance use disorder treatment must be a significant priority for policymakers, patients, providers, and advocates. These … [Read more...] about New Studies on Mental Health and Substance Use Disorder Access Highlight the Need for Parity in Medicare
Make Your Voices Heard!
Please Respond to CMS Request for Information About the Importance of Home Health AidesCMS has provided an important opportunity for beneficiaries, and their advocates, to convey experiences and concerns about the devastating lack of access to … [Read more...] about Make Your Voices Heard!
One-Year Anniversary of Medicare Prescription Drug Law: Beneficiaries Already Saving Money but Drug Industry Fights Progress
August 16, 2023 marked the one-year anniversary of the Inflation Reduction Act of 2022 (IRA) being signed into law by President Biden. As outlined in a previous CMA Alert (March 2, 2023), the IRA law includes historic prescription drug provisions … [Read more...] about One-Year Anniversary of Medicare Prescription Drug Law: Beneficiaries Already Saving Money but Drug Industry Fights Progress
CMS Request for Information Regarding Self-Administered Drugs – Center for Medicare Advocacy Calls for Reform
The Social Security Act permits Medicare Part B to pay for drugs and biologicals that are not usually self-administered by the patient and furnished as “incident to” a physician's service. As a result, drugs that are “usually self-administered” are … [Read more...] about CMS Request for Information Regarding Self-Administered Drugs – Center for Medicare Advocacy Calls for Reform
CMS Reimbursement Rules for Skilled Nursing Facilities Disappoint Residents’ Advocates
In final rules that provide the annual update to Medicare Part A reimbursement for skilled nursing facilities (SNFs), the Centers for Medicare & Medicaid Services (CMS) increases Part A reimbursement by approximately $1.4 billion (4.0%), a higher … [Read more...] about CMS Reimbursement Rules for Skilled Nursing Facilities Disappoint Residents’ Advocates
Make Your Voices Heard! Please Respond to CMS Request for Information About the Importance of Home Health Aides
CMS has provided an important opportunity for beneficiaries, and their advocates, to convey experiences and concerns about the devastating lack of access to Medicare-covered home health aides, especially for individuals living with chronic and … [Read more...] about Make Your Voices Heard! Please Respond to CMS Request for Information About the Importance of Home Health Aides
Congressman Joe Courtney and Bipartisan Colleagues Reintroduce Observation Status Bill
Congressman Joe Courtney (D, CT) and a bipartisan group of colleagues reintroduce Improving Access to Medicare Coverage Act of 2023, H.R. 5138, a bill to ensure that patients qualify for post-hospital Medicare-covered care in a skilled nursing … [Read more...] about Congressman Joe Courtney and Bipartisan Colleagues Reintroduce Observation Status Bill
Two Cases Involving Centers Health Care, a New York State Nursing Home Chain
Nursing home owners and operators and their trade associations argue that they need more money to provide care to residents. Litigation against and by Centers Health Care, a New York State-based nursing home chain, shows a different story: how much … [Read more...] about Two Cases Involving Centers Health Care, a New York State Nursing Home Chain