CMS recently published information on its website about the dental services that Medicare will and will not cover. Although dental services are generally excluded from coverage under the Medicare statute, the agency clarifies in this guidance that … [Read more...] about CMS Publishes Guidance on Medicare Dental Coverage
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Ongoing Scrutiny of Medicare Advantage Plans
At a time when Medicare Advantage (MA) enrollment has surpassed 50% of the Medicare population, overpayments to MA plans now exceed $75 billion annually (see, e.g., CMA Alert, June 22, 2023) and access to care problems, including inappropriate use of … [Read more...] about Ongoing Scrutiny of Medicare Advantage Plans
Join! July 13 Virtual Rally for Nurse Staffing Standards in Nursing Facilities
The National Consumer Voice for Quality Long-Term Care, the AFL-CIO, and SEIU will host a virtual rally on July 13, at 2:00 pm ET, to call for strong federal nurse staffing standards in nursing facilities. Speakers at Safe Staffing in Nursing Homes … [Read more...] about Join! July 13 Virtual Rally for Nurse Staffing Standards in Nursing Facilities
CMS to Review Five Medicare Claims from Each Skilled Nursing Facility
The Comprehensive Error Rate Testing (CERT) program projects an improper Medicare Part A payment rate to skilled nursing facilities (SNF) of 15.1% in 2022, nearly double the 7.79% improper payment rate in 2021, and the highest improper payment rate … [Read more...] about CMS to Review Five Medicare Claims from Each Skilled Nursing Facility
Newly Revised CMS Home Health Benefit Brochure
The Center for Medicare Advocacy (the Center) is grateful to the Center for Medicare & Medicaid Services (CMS) for revising a CMS Medicare home health brochure issued earlier this year. The Center identified some concerns about the brochure’s … [Read more...] about Newly Revised CMS Home Health Benefit Brochure
Supreme Court Victory for Court Access and Nursing Home Residents
Court Upholds Right of Residents in Publicly-Owned Nursing Facilities to Sue for Violations of the Nursing Home Reform LawThe U.S. Supreme Court upholds the right of nursing home residents in publicly-owned nursing facilities to file lawsuits … [Read more...] about Supreme Court Victory for Court Access and Nursing Home Residents
Medicare Enrollment Numbers
The Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare on January 5th. As of March 2023, 65,748,297 people are enrolled in Medicare, an increase of almost 100,000 since the last report in September. … [Read more...] about Medicare Enrollment Numbers
Home for the Holidays | Leaving the Nursing Home During a Medicare-Covered Stay
Summer brings various holidays and family vacations. 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. Over the years, the Center for Medicare … [Read more...] about Home for the Holidays | Leaving the Nursing Home During a Medicare-Covered Stay
New Research Outlines Extent of Medicare Advantage Overpayments: It’s Much Worse Than We Thought
On June 13, 2023, the USC Schaeffer Center for Health Policy & Economics published a white paper titled “Medicare Advantage Enrolls Lower-Spending People, Leading to Large Overpayments” by Steven M. Lieberman, Samuel Valdez, PhD and Paul … [Read more...] about New Research Outlines Extent of Medicare Advantage Overpayments: It’s Much Worse Than We Thought
CMS Report Highlights Quality of Care Concerns in MA
A recent report released by the Centers for Medicare & Medicaid Services (CMS) Office of Minority Health, Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability, … [Read more...] about CMS Report Highlights Quality of Care Concerns in MA