Recently, a bipartisan group of Senators unveiled a plan to overhaul our nation's immigration system, a key portion of which aims to provide a pathway to citizenship for the 11 million undocumented immigrants living in the United States, including older immigrants. Access to affordable health care is a serious issue for lawfully present and undocumented … Read more

The role of private managed care in Medicare and Medicaid has been growing at a rapid pace in recent years. The Center for Medicare Advocacy has written widely on the dangers of turning these successful community health care programs over to profit-driven private insurers.  Despite the efforts of the Center and other advocacy groups, however, … Read more

In its most recent report on nursing home payments and quality, February 2013, the Office of Inspector General (OIG), Department of Health and Human Services (HHS) reports that many skilled nursing facilities (SNFs) failed to provide adequate care planning and discharge planning to residents and provided "egregious" care to some residents, yet were paid by … Read more

Yesterday, President Obama unveiled his Fiscal Year 2014 Budget.[1]   It contains significant changes to the Medicare program – including some that would strengthen the program's fiscal stability, and some that would weaken the program and shift costs to beneficiaries.  On the one hand, it offers serious improvements to strengthen Medicare's financial footing: proposals that allow … Read more

And Proposals for the Future of Medicare   Welcome and Housekeeping  (David Lipschutz, Moderator)  Presentation:  Medicare’s Administrative Review Process – Ongoing Due Process Concerns & Possible Solutions  (Margaret Murphy and Gill Deford) ​Reports from the Field: What are your experiences? Presentation: Proposals to Redesign Medicare’s Benefit Structure – (David Lipschutz) Legislative Update:  The Federal Budget and … Read more

The Medicare program can be confusing for those trying to navigate the differences between Parts A, B, C, and D.  Since the program's inception in 1965, changes made to the program have made it a more complex system for beneficiaries, particularly with the introduction of private insurance plans to the Medicare program.  Medicare beneficiaries can … Read more

The Center for Medicare & Medicaid Services (CMS) recently issued proposed rules and an interim CMS Ruling to allow  hospitals to bill Medicare Part B after a Part A claim is denied. 78 Fed. Reg. 16,632 (March 18, 2013).[1]  These actions address some financial concerns of hospitals about “observation status;” but they do not help … Read more

Increasingly, hospital patients throughout the country are learning they are considered outpatients, on "observation status," not inpatients, although they have stayed many days and nights and been treated IN a hospital. The Center has written extensively about this practice and is pursuing litigation to challenge it in federal court.  Among the harmful consequences of observation … Read more

It has been three years since the landmark Affordable Care Act (ACA) was signed into law on March 23, 2010.[1]   As the law approaches full implementation, ACA has already increased access to needed health services, reduced costs and improved care for millions.  Yet, as this progress continues and the law's most impactful provisions near implementation, … Read more

The Affordable Care Act (ACA) is beginning to rein in Medicare Advantage (MA) overpayments by bringing MA payment more in line with what traditional Medicare spends on a given beneficiary.  The insurance industry is not only fighting this payment reform, but has launched a campaign against a 2.3% reduction in payment projected for 2014.[1]   This … Read more