On June 24, 2011, the Centers for Medicare & Medicaid Services (CMS), in conjunction with the Internal Revenue Service (IRS) and the Employee Benefits Security Administration (EBSA), released amendments to a set of interim final rules regarding claims and appeals review processes that were originally published in July 2010.[1] The rules and amendments implement requirements … Read more →

  Congress continues to propose Medicare changes that will have severe repercussions for beneficiaries and their families. Policymakers and pundits are feeding the media and the public misinformation about Medicare. The truth is, most people with Medicare are low-income and most pay more for health care than other insured Americans.  Nonetheless, Medicare Works. For 46 years it … Read more →

This week, Congress passed, and the President signed, the Budget Control Act of 2011.  The bill raises the nation's debt ceiling and makes debt and deficit reductions in federal spending over the next 10 years.[1] Between now and Thanksgiving 2011, a new Joint Committee of Congress will be tasked with seeking $1.2 to $1.5 trillion … Read more →

This week, Congress passed, and the President signed, the Budget Control Act of 2011.  The bill raises the nation's debt ceiling and makes debt and deficit reductions in federal spending over the next 10 years.[1]  Between now and Thanksgiving 2011, a new Joint Committee of Congress will be tasked with seeking $1.2 to $1.5 trillion … Read more →

Monday, August 8, 2011 – 2:00 P.M., Eastern Time  Call-in Number: 1 (888) 206-2266  Pass Code: 1050263# NOTE: We ask people calling from the same location to gather around one telephone.  This frees up lines and holds down costs. ______________________ Special topic presentation:  implications and effects of the debt-ceiling deal on medicare and beneficiaries ______________________  AGENDA Welcome … Read more →

The Medicare Secondary Payer (MSP) program authorizes the Centers for Medicare & Medicaid Services (CMS) to recover compensation payments from beneficiaries who have private insurance that should be primarily responsible for their medical expenses.[1] In a class action lawsuit brought by Medicare beneficiaries and their attorney to challenge certain harsh MSP collection practices, a federal … Read more →

The Centers for Medicare & Medicaid Services (CMS) recently announced several new initiatives focused on improving care for people who are eligible for both Medicare and Medicaid (dual eligibles). Two initiatives relate to providing fully integrated services to dual eligibles, through both capitation and fee-for-service structures.  A third initiative addresses preventing unnecessary hospitalizations of nursing home … Read more →

Next week, the House of Representatives is scheduled to vote on a proposal that will directly impact and harm Medicare beneficiaries, Social Security recipients, and others that rely on critical safety net programs. The Goodlatte-Walsh Balanced Budget Amendment, H.J.Res.1, will come to a vote Wednesday, July 20. The bill requires Congress to pass a balanced … Read more →

Introduction The Affordable Care Act includes a provision establishing a Center for Medicare and Medicaid Innovations (CMMI) that is authorized to test models to reduce Medicare and Medicaid expenditures while preserving or improving quality for beneficiaries of those two programs. The provision includes appropriations of $5 million for fiscal year 2010 and $10 billion for … Read more →

One year ago on July 1, 2010, Secretary of Health and Human Services Kathleen Sebelius announced the availability of new insurance coverage for individuals who were denied insurance because they had a pre-existing condition.[i]  These plans, called Pre-Existing Condition Insurance Plans (PCIPs), were created by the Affordable Care Act of 2010 (ACA). [ii]  As required … Read more →