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Ilene Stein is currently Assistant Legislative Director and formerly the Associate Director of Health Policy for the Service Employees International Union (SEIU),  a union of 2 million workers, including one million workers in the healthcare industry.  At SEIU, she works on a range of issues but primarily focuses on healthcare workforce and policy advocacy. Previously, … Read more

January 16, 2018 Via Electronic Submission to www.regulations.gov Seema Verma, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-4182-P P.O. Box 8013 Baltimore, MD 21244-8013 Re: CMS-4182-P – Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019 Dear Administrator … Read more

Center Executive Director Judith Stein with the 2017 Sen. Jay Rockefeller Lecturer, Sen. Sherrod Brown of Ohio. Don't Miss It! The Center for Medicare Advocacy’s 5th annual National Voices of Medicare Summit & Senator Jay Rockefeller Lecture will connect leading experts and advocates to discuss best practices, challenges and successes in efforts to improve access … Read more

ARE YOU ENROLLED IN MEDICARE? DID YOU GET A NOTICE FROM DSS SAYING YOU ARE LOSING YOUR MEDICARE SAVINGS PROGRAM BENEFITS (QMB, SLMB, ALMB) IN JANUARY 2018 DUE TO THE BUDGET CUT? ______________ If so, you should know this is happening because of a drastic cut that was included in the state budget that was … Read more

November 27, 2017 Submitted Electronically to www.regulations.gov Centers for Medicare & Medicaid Services Department of Health and Human Services Room 445-G Hubert H. Humphrey Building 200 Independence Avenue SW Washington, D.C. 20201 Attn:   CMS-9930-P             NPRM Notice of Benefit and Payment Parameters for 2019 Thank you for the opportunity to comment on the proposed HHS … Read more

November 20, 2017 Via Electronic Submission CMMI_NewDirection@cms.hhs.gov Seema Verma, Administrator Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, DC 20201 RE: Request for Information on Innovation Center New Direction Dear Administrator Verma: The Center for Medicare Advocacy (Center) is pleased to provide the Centers for … Read more

November 22, 2017 Division of Nursing Homes Survey and Certification Group Center for Medicare & Medicaid Services 7500 Security Blvd. Baltimore, MD 21244 Re: Revised Policies regarding the Immediate Imposition of Federal Remedies-FOR ACTION (S&C: 18-01-NH) Submitted electronically: dnh_triageteam@cms.hhs.gov. Dear David, Karen, Evan, Lisa, and CMS colleagues,    The Center for Medicare Advocacy (Center) is … Read more

Below is a joint statement from Judith Stein, executive director, Center for Medicare Advocacy, and Joe Baker, president, Medicare Rights Center, regarding the Tax Cuts and Jobs Act. As organizations that share a commitment to promoting access to affordable, high-quality health care for older adults, people with disabilities, and their families, we have significant concerns with … Read more

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Sabotage of ACA Must Stop Action Needed The U.S. Department of Health and Human Services (HHS) recently released its draft FY 2018- 2022 Strategic Plan. While one of HHS’ stated objectives is to “Improve American’s access to health care and expand choices of care and service options,” we are instead seeing a systematic effort to … Read more

Senate Holds Single Hearing on Bill to Strip Coverage from Millions – Act Now

Graham-Cassidy is Still A Threat Senate Holds Single Hearing on Bill to Strip Health Coverage from Millions Action Still Needed! Today the Senate Finance Committee is holding the only Senate "hearing" on the Graham-Cassidy bill. The bill would, among other things, cause tens of millions of people to become uninsured, eliminate the ACA’s expansion of Medicaid, … Read more

September 25, 2017 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1672-P P.O. Box 8016 Baltimore, Maryland  21244-8016 Submitted electronically to: http://www.regulations.gov Re:      Federal Register Volume 82 No. 144 Medicare and Medicaid Programs: CY 2018 Home Health Prospective Payment System Rate Update and Proposed CY 2019 Case-Mix Adjustment Methodology … Read more

CMA Alert – Graham Cassidy is Just Worse; SNF Disaster Requirements; More

Graham-Cassidy: It’s Just Worse Center for Medicare Advocacy and Medicare Rights Center Send Joint Letter to Congress Opposing Graham-Cassidy Center Submits Statement On SNF Requirements for Senate Aging Committee Hearing Graham-Cassidy: It’s Just Worse Despite an enormous public outcry that eventually doomed this summer’s attempt at repealing the Affordable Care Act and decimating Medicaid, legislators … Read more

United States Senate Special Committee on Aging Hearing September 20, 2017 Statement Submitted by the Center for Medicare Advocacy The Center for Medicare Advocacy (Center) thanks the Senate Special Committee on Aging for holding the September 20th hearing examining “policies and procedures for sheltering in place, evacuating, and relocating our most vulnerable citizens before disaster … Read more

Medicare Hospital Outpatient & Observation Status Toolkit

Supported by             The John A. Hartford Foundation   Patients may find themselves in the hospital, receiving medical services, tests, and treatment, sometimes for many days, but learn they are considered outpatients, in Observation Status, not admitted inpatients. This is understandably confusing for patients and families – and difficult for … Read more

September 11, 2017 Administrator Seema Verma Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1676-P P.O. Box 8016, Baltimore, MD 21244-8013. Re: CMS-1676 Submitted electronically: http://www.regulations.gov Dear Administrator Verma: The Center for Medicare Advocacy (Center) is pleased to provide the Centers for Medicare & Medicaid Services (CMS) comments on the 2018 … Read more

Welcome and Housekeeping  (David Lipschutz, Moderator)  Jimmo Implementation Update (Judy Stein, Ali Bers)  Corrective Action Plan Completed New CMS webpage: https://www.cms.gov/Center/Special-Topic/Jimmo-Center.html Jimmo Webinar – September 27 at 3pm EDT.  Register at: https://register.gotowebinar.com/register/4716521538610996739 Update on Home Health Access Initiative Project (Kathy Holt)  Proposed rule re: payment (comments due 9/25) Joint Webinar with National Association for Home … Read more

August 9, 2017 Thomas E. Price Secretary Department of Health and Human Services Seema Verma Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Room 445-G, Hubert H. Humphrey Building 200 Independence Ave., S.W. Washington, D.C.  20201 Re: CMS-1686-ANPRM.  Advance Notice of Proposed Rulemaking with Comment.  Medicare Program; Prospective Payment System … Read more

 

Featuring Guest Presenter Carol Regan, Community Catalyst Welcome and Housekeeping  (David Lipschutz, Moderator)  Health Reform: Update (Carol Regan, Community Catalyst, and David Lipschutz)  Overview of Senate Debate Impact on Older Adults, Medicare (David Lipschutz) Impact on Medicaid, Dual Eligibles (Carol Regan) Litigation Update   (Ali Bers) Jimmo (Improvement standard) Barrows (formerly Bagnall) (Observation) Sherman (Lower level … Read more

Senator Collins Is Right to Oppose the Senate’s Version of Trumpcare By Judith Stein The Senate has released the previously secret details of its healthcare legislation – and they are not good. The Better Care Reconciliation Act (BCRA) of 2017 hurts our nation’s healthcare system as a whole and our most vulnerable citizens in particular. … Read more

Senate Releases Draft of Bill to Undermine Health Coverage: Stop the “Better Care Reconciliation Act”

The wait is finally over. Senate Republicans have released a "discussion draft" of their health care bill, The Better Care Reconciliation Act of 2017. This language is the culmination of secret drafting by a few Republican Senators, and it is as harmful to millions of Americans and as mean as we expected. Said Center for Medicare Advocacy … Read more

Senator Richard Blumenthal Field Hearing Regarding the American Health Care Act June 19, 2017 Testimony of Judith Stein In Opposition to the AHCA and the Secret Senate Process Senator Blumenthal, thank you for holding this hearing. I am Judith Stein, founder and Executive Director of the Center for Medicare Advocacy. The Center is a national … Read more

The Senate is Secretly Working to Gut Health Care – Bill Could Pass Soon!

In May, the House of Representatives passed the American Health Care Act (AHCA). The AHCA is so severe that the President is calling it “mean” and says the Senate should make it more generous and kind. (CNN Politics, 6/14/2017) The House bill is certainly not kind or generous. It would roll back protections in the … Read more

Why is the Senate “Health Care” Bill a Secret?

A small group of Senators are working in secret to repeal the Affordable Care Act, decimate Medicaid, and undermine Medicare. The details of the bill are unknown but the conclusions are certain: Over 20 million people will lose health coverage Millions of nursing home patients will lose health coverage Rural hospitals and community health centers … Read more

A ten-part CMA Issue Brief Series examining the growing crisis in access to Medicare home health coverage and necessary care, and outlining the Center for Medicare Advocacy’s work to address these issues. We invite you to follow this Issue Brief Series, and submit Medicare home health stories to the Center at http://www.medicareadvocacy.org/submit-your-home-health-access-story/.

UNITED STATES HOUSE OF REPRESENTATIVES COMMITTEE ON WAYS & MEANS, SUBCOMMITTEE ON HEALTH HEARING ON "THE CURRENT STATUS OF THE MEDICARE PROGRAM, PAYMENT SYSTEMS, AND EXTENDERS” WRITTEN TESTIMONY SUBMITTED BY CENTER FOR MEDICARE ADVOCACY May 18, 2017 Introduction The Center for Medicare Advocacy, founded in 1986, is a national, non-partisan education and advocacy organization that … Read more

CMA Alert – May 17, 2017

  1. Senate Must Reject Health Bill Passed by the House 2. CMS Considers New Medicare Reimbursement System for Skilled Nursing Facilities: If Implemented, Would Gut Therapy 3. Steve Gleason Enduring Voices Act Introduced 4. Oral Health Update – "The Painful Truth About Teeth" (Washington Post)     Senate Must Reject Health Bill Passed by … Read more

Examining Bipartisan Medicare Policies that Improve Care for Patients with Chronic Conditions May 16, 2017 Hearing before the Senate Committee on Finance Statement for the Record Center for Medicare Advocacy 1025 Connecticut Avenue, N.W., Suite 709 Washington, DC  20036 The Center for Medicare Advocacy, founded in 1986, is a national, non-partisan education and advocacy organization … Read more

Welcome and Housekeeping  (David Lipschutz, Moderator)  Health Reform: House Passes American Health Care Act (AHCA) (David Lipschutz)  What’s in AHCA Impact on Affordable Care Act, Medicaid and Medicare Next up: the Senate Update on Home Health Access Initiative Project (Kathy Holt)  Speech Generating Devices (SGDs) (Kathy Holt) Steve Gleason Act            Observation Status (Toby Edelman) Medicare … Read more

(The Center received this story in May, 2017) “I suffer from the motor form of an autoimmune disorder called chronic inflammatory Demyelinating Polyneuropathy (CIDP).  The treatment for this involves bi-monthly six-hour infusions of IVIG (Gammaguard). In April 2010 after approximately two years of infusions, I was informed by my insurance company, Anthem BCBS, that I … Read more

HEALTH REFORM: HOUSE PASSES AMERICAN HEALTH CARE ACT (AHCA) On May 4, 2017, the U.S. House of Representatives passed the American Health Care Act (AHCA) by a vote of 217-213.  The bill will now be taken up by the Senate. American Health Care Act (AHCA): Impact on the Affordable Care Act, Medicare and Medicaid The … Read more

AHCA Vote Today – Act Now! #ProtectOurCare and #RejectRepeal

Even amended, AHCA is a bad Bill. AHCA still guts protections for people with pre-existing conditions. Funds provided through the latest last-ditch amendment would cover only a fraction of the people with pre-existing conditions who would face discrimination by insurers. It would still leave 15 million people with pre-existing conditions with no added protection from … Read more

It’s Back – You Asked for Better and They Made it Worse! Call Today!

#ProtectOurCare and #RejectRepeal The latest effort to revive the so-called American Health Care Act and repeal the Affordable Care Act is worse than the first.  Americans want quality, affordable health coverage and care for everyone – including older people and people with pre-exisiting conditions. They are committed to the Affordable Care Act, Medicaid and Medicare. … Read more

April 24, 2017 VIA ELECTRONIC SUBMISSION PartCDcomments@cms.hhs.gov Seema Verma, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Baltimore, MD 21244 Re:                  2017 Transformation Ideas – Response to Request for Information re: Medicare Advantage and Part D Dear Administrator Verma: The Center for Medicare Advocacy (Center) is pleased to provide … Read more

For decades, Alfred J. Chiplin, Jr. (Chip) has been a beloved and admired leader in the elder law, disability and health care rights communities. To honor Chip’s long-term advocacy and commitment to civility and justice for all members of society, the Center for Medicare Advocacy has established an award in his honor. The Alfred J. … Read more

Welcome and Housekeeping  (David Lipschutz, Moderator)  Litigation Update   (Ali Bers) Jimmo (Improvement standard) Barrows (formerly Bagnall) (Observation) Sherman (Lower level Medicare appeals) Other updates The Fight to Protect the ACA, Medicare and Medicaid – Updates (David Lipschutz)  House proposal: American Health Care Act (AHCA Impact on Affordable Care Act, Medicaid and Medicare Other health reform … Read more

LITIGATION UPDATE Barrows v. Price (formerly Bagnall v. Sebelius, Barrows v. Burwell), No. 3:11-cv-1703 (D. Conn.) (Observation Status). In November 2011, the Center for Medicare Advocacy and Justice in Aging filed a proposed class action lawsuit on behalf of individuals who have been denied Medicare Part A coverage of hospital and nursing home stays because … Read more

March 3, 2017 VIA ELECTRONIC SUBMISSION AdvanceNotice2018@cms.hhs.gov Cynthia G. Tudor, Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Baltimore, MD 21244 Re:  Advance Notice of Methodological Changes for Calendar Year 2018 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2018 Call Letter Dear … Read more

 

Welcome and Housekeeping  (David Lipschutz, Moderator)  The Fight to Protect the ACA, Medicare and Medicaid – Updates (David Lipschutz and Kata Kertesz)  Affordable Care Act (ACA) Congressional action Advocacy/coalition action Outlook for Medicare and Medicaid Observation Status (David Lipschutz) Recent HHS OIG Report confirms that long outpatient stays in hospitals increasing Update on NOTICE Act … Read more

THE FIGHT TO PROTECT THE ACA, MEDICARE AND MEDICAID The President-Elect and Republican leaders in Congress have promised to repeal, and at some point, “replace” the Affordable Care Act.  They also plan to gut the Medicaid program by imposing block granting or per-capita caps.  Speaker Ryan, Trump’s nominee for HHS Secretary Rep. Price, and many … Read more

  Happy Thanksgiving! Giving Thanks Today and every day the Center for Medicare is grateful for our partners and supporters who help us open doors to health care for the 55 million people who rely on Medicare.  We are grateful to earlier generations who designed and launched Medicare to help all American families.  Sadly, our … Read more

Welcome and Housekeeping  (David Lipschutz, Moderator)  The Election’s Potential Impact on Medicare (David Lipschutz)  Affordable Care Act Medicare Structural Changes Including premium support/vouchers New Nursing Home Requirements of Participation (Toby Edelman) Overview of final rule Positive changes Prohibition against facilities’ use of mandatory pre-dispute arbitration agreements and ensuing litigation What’s missing Including staffing requirements Review: … Read more

MOVING FORWARD WITH HOPE It’s no surprise that the election has left many of us worried and disoriented.  But we’ll regroup. We may not understand where we’ve landed, but we’ll acclimate and march forward – with hope. We hope the new administration will realize how today’s families are balancing – often barely – all the … Read more

No. 3:15-cv-1468-JAM, filed October 9, 2015 Issue: Whether the extremely high denial rates (98% and higher) at the redetermination and reconsideration stages of administrative review for home health care claims violate the Medicare statute and the Due Process Clause.  Relief sought: Declaratory and injunctive relief requiring the Secretary to correct the existing system of lower … Read more

No. 3:15-cv-01397 (DJS), filed September 22, 2015 Issue: Whether the Secretary violated the Medicare statute and the Due Process Clause by not recognizing that Vitamin B-12 injections represent a per se skilled nursing service and therefore the service should have been covered, and, in general, by failing to recognize the right to coverage for per se … Read more

No. 5:14-cv-269 (D.Vt.), filed Dec. 19, 2014 Issue: Whether the failure of the Secretary to apply the “prior favorable homebound decision” rule, which accords “great weight” to previous administrative decisions establishing homebound status, violates the Medicare regulations, as implemented by the Medicare Program Integrity Manual, and the Due Process Clause. Relief Sought: Declaratory and injunctive … Read more

No. 3:14-cv-01230 (D.Conn.), filed August 26, 2014 Issue: Whether the consistent failure of administrative law judges (ALJs) to issue decisions within 90 days of the request for ALJ review (with an average delay now approaching 500 days) violates the Medicare statute and the Due Process Clause. Relief sought: Declaratory and injunctive relief prohibiting the Secretary from … Read more

No. 11-cv-17 (D.Vt.), filed January 18, 2011 Issue: Whether the "Improvement Standard", which operates as a rule of thumb to terminate or deny Medicare coverage to beneficiaries who are not improving, violates substantive and procedural requirements of the Medicare statute, the Administrative Procedure Act, and the Freedom of Information Act, and the Due Process Clause of … Read more