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One of the deficit reduction proposals being discussed to achieve savings from Medicare is to introduce new cost-sharing for home health care. As a means to ward off such potential home health co-payments, some instead suggest capping Medicare payment for episodes of care, effectively limiting the duration of time individuals could access home health services. … Read more

In November, the Office of Inspector General (OIG) issued a report entitled, "Improvements are Needed at the Administrative Law Judge Level of Medicare Appeals."  The report can be found at https://oig.hhs.gov/oei/reports/oei-02-10-00340.pdf.   In the report, the OIG interprets the overall percentage of fully favorable decisions awarded to appellants by Administrative Law Judges (ALJs) as evidence that … Read more

The Center for Medicare Advocacy has represented Medicare beneficiaries since 1986. As one of the few advocacy organizations in the nation solely serving Medicare beneficiaries, we strongly oppose home health episodic payment caps or any other such defined payment limits. The counterpart to this notion, caps on outpatient therapy, has created significant barriers to necessary … Read more

Despite Medicare's remarkable success as a health and economic lifeline for American families, proposals to dramatically alter the program have resurfaced in the context of deficit reduction. While not a new idea, proponents of increasing Medicare's eligibility age from 65 to 67, or higher, have put the proposal in the spotlight recently as policymakers search … Read more

In October 2012, the Center for Medicare Advocacy announced the settlement of the “Improvement Standard” class action lawsuit, Jimmo vs. Sebelius. For more than thirty years, the wrongful interpretation of the Medicare statue led to the illegal denial of Medicare coverage and health care for tens of thousands of Medicare beneficiaries on the grounds that … Read more

On July 30, 2012, as part of proposed rulemaking on the outpatient prospective payment system, the Centers for Medicare & Medicaid Services (CMS) asked for public comment on potential policy options related to "observation status."[1] What is Observation Status? Observation status refers to the classification of a patient in an acute care hospital as an … Read more

Although passage of the Affordable Care Act (ACA) has achieved considerable savings for the Medicare program, Medicare is still being targeted by policymakers looking to negotiate a large "grand bargain" deficit-reduction package. Many of the proposals to achieve Medicare savings would shift costs from the federal government to Medicare beneficiaries As the debt and deficit … Read more

Over two years after becoming law, the Affordable Care Act (ACA) continues to improve health care and lower costs for millions of Americans, including those who rely on Medicare. The recent election was key to the future of the landmark legislation, which will expand access to health care coverage and work to improve quality of … Read more

Medicare: Just the Facts! Misinformation about Medicare and the Affordable Care Act is widespread and increasing as the election nears.  Below, we try to dispel misinformation and base discussions on a factual foundation.  Spread the word. Help set the record straight! The Fact Here's Why The Affordable Care Act does NOT cut Medicare for beneficiaries. … Read more

Attorneys from the Center for Medicare Advocacy, Vermont Legal Aid and the Centers for Medicare & Medicaid Services (CMS) have agreed to settle the "Improvement Standard" case, Jimmo v. Sebelius.[1] A proposed settlement agreement[2] was filed in federal District Court on October 16, 2012.  When the judge approves the proposed agreement, a process that may … Read more