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Monday, February 13, 2012– 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. AGENDA Welcome and Housekeeping  (David Lipschutz, Policy Attorney, Center for Medicare Advocacy, Moderator)   Legislative Update  (David Lipschutz, CMA) … Read more

This year brings another election season, another Congressional session, and another opportunity to fortify Medicare, both for those who rely on it now and for future generations. Medicare has been strengthened during the past few years.  However, dangerous rhetoric and schemes to weaken and dismantle the program threaten the health and economic security of millions … Read more

Joining five other national organizations that represent the interests of elderly and disabled people, the Center for Medicare Advocacy filed an amicus brief on January 30 in the United States Supreme Court supporting a position of the federal government in the Affordable Care Act (ACA) litigation.[1]  The brief does not address the constitutionality of the … Read more

Medicare's limitation on liability (LOL) protections[1] apply when a provider believes that an otherwise covered Medicare item or service will be denied because the item or service is not reasonable and necessary[2] or is for custodial care.[3] In order to shift liability to the beneficiary, a provider is required to notify a beneficiary in advance … Read more

Balance Billing is Prohibited.  Period. New Guidance released jointly by the Center for Medicaid and CHIP Services (CMCS) and the Medicare-Medicaid Coordination Office (MMCO) once again highlights and advises about an issue that has created hardships for low-income people using Medicare and challenges for advocates trying to help them. The jointly-issued Guidance includes a link … Read more

Nursing Facilities Participating in Advancing Excellence Still Among Worst Performers Many nursing facilities that are identified by the federal government as among the facilities providing the poorest quality of care to residents in the country – the Special Focus Facilities (SFFs) – participate in the nursing home industry's voluntary quality improvement campaign, Advancing Excellence in … Read more

Effective January 1, 2012, Medicare Part D plan enrollees who are unable to obtain a prescription drug at the pharmacy are now, in most instances, entitled to a written notice explaining how they can contact their Part D plan in order to initiate an appeal.  On February 2, 2012, CMS announced that the final model … Read more

On November 29, 2011, CMS announced its decision to include coverage for obesity screening and counseling services for Medicare beneficiaries.[1] This new coverage for Medicare beneficiaries is another tool aimed at emphasizing prevention and wellness by CMS, which has already implemented coverage of certain preventive services and screenings as part of the Affordable Care Act.[2] … Read more

The payroll tax extension that finally became law on December 23, 2011 includes many provisions that will help Medicare beneficiaries and lower income families (Temporary Payroll Tax Cut Continuation Act of 2011, H.R. 3765; no public law number assigned yet). The payroll tax in question is a reduction in Social Security payroll tax paid by … Read more

Each month, the Centers for Medicare & Medicaid Services (CMS) identifies nursing facilities that are among the facilities providing the poorest care to their residents, as determined by federal deficiencies cited in the prior three years.   These facilities, called Special Focus Facilities (SFFs), receive special attention from state survey agencies – at least two surveys … Read more