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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

As discussed in last week’s Alert, the current Medicare Annual Enrollment Period lasts until December 7th.[1]  During this time period, Medicare beneficiaries can choose a Medicare Advantage (Part C) or Part D plan for 2013.  This Alert discusses Part C and D plan quality ratings for 2013, and special enrollment periods related to these ratings.  … Read more

DEMOCRATIC HOUSE STEERING AND POLICY COMMITTEE FORUM SAVING MEDICARE FOR TODAY AND IN THE FUTURE October 2, 2012 _____________________ Leader Pelosi and members of the Committee, thank you for holding this important Forum and for honoring me with the opportunity to appear before you. I am Judith Stein, founder and executive director of the Center … Read more

On April 6, 2012, the Centers for Medicare & Medicaid Services (CMS) issued Transmittal 17, which revises and creates new procedures for the review of quality of care concerns[1] by Quality Improvement Organizations (QIOs).[2] Effective May 7, 2012, the new procedures apply to QIO review of the quality of services "among different cases and settings … Read more

As a result of the Budget Control Act, which outlined mandatory cuts to both defense and non-defense discretionary programs in the event a Congressional committee could not agree to a deficit-reduction package, programs impacting the HIV community and funding are expected to be affected. According to the AIDS Institute, over $500 million would be cut … Read more