No. 09-cv-134-TUC-DCB (D.Ariz.), filed March 10, 2009.  Appeal filed June 30, 2011 (No. 11-16606, 9th Cir.).   Issue: Whether the Secretary's aggressive methods for attempting to collect payments under his Medicare Secondary Payer (MSP) program, directed at beneficiaries and their attorneys, violates the Medicare statute and the Due Process Clause.   Relief sought: Declaratory and … Read more →

No. CV 08-2309-PHX-ROS (D.Ariz.), filed December 18, 2008. Appeal filed March 6, 2012 (No. 12-15478, 9th Cir.). Issue: Whether the Secretary's exclusion of coverage for dental care in extraordinary circumstances where the care is necessary to treat a medical condition violates the Medicare statute and policy provisions, and the Equal Protection Clause. Relief Sought: Declaratory judgment … Read more →

No. 11-1703 (D.Conn.), filed November 3, 2011 Issue: Whether the Secretary's policy of allowing hospitalized Medicare beneficiaries to be placed in "observation status," rather than formally admitting them, deprives them of their Part A coverage in violation of the Medicare statute, the Administrative Procedure Act, the Freedom of Information Act, and the Due Process Clause.  … Read more →

No. 09-1706 (C.D.Cal.), filed September 8, 2009.  Appeal filed January 28, 2011 (No. 11-55175, 9th Cir.) Issue: Whether the absence of an administrative appeals process for the denial of services by a hospice violates the Medicare statute and the Due Process Clause. Relief Sought: Declaratory and injunctive relief requiring an administrative appeals process. Updated: April 17, … 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 →