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CMA Alert – Center Comments on “Junk Plans;” Report Examines Oral Health; Observation Status in the News

The Sabotage of Health Care Continues – Center Comments on "Junk Plans" State of Decay: Report Examines Oral Health for Older Americans NPR Observation Status Story: How Medicare's Conflicting Hospitalization Rules Cost Me Thousands Of Dollars The Sabotage of Health Care Continues – Center Comments on "Junk Plans" p>This week, the Center working with other … Read more

April 23, 2018 Via Electronic Submission: Regulations.gov U.S. Department of Health and Human Services 200 Independence Avenue S.W. Washington, DC 20201 RE: Comments on Short-Term, Limited-Duration Insurance Proposed Rule (CMS-9924-P) The Center for Medicare Advocacy (Center) is pleased to provide comments on the proposed rule on short-term limited-duration insurance. The Center, founded in 1986, is … Read more

CMA Alert – Choose Medicare Act Offers a Step Forward; Health Care Sabotage Slides Back; More

Choose Medicare Act Introduced – Improving Medicare, Moving Toward Universal Coverage The Sabotage of Health Care Continues – Important News The Center for Medicare Advocacy and Florida Health Justice Project Sue to Obtain “Off-label” Part D Prescription Drug Coverage for Beneficiary Choose Medicare Act Introduced – Improving Medicare, Moving Toward Universal Coverage On April 18, … Read more

CMA Alert – Congress Poised to Vote on Harmful Amendment; Home Health Highlight; SNF Updates

Congress Poised to Vote for Harmful Balanced Budget Amendment Home Health Highlight: New Fact Sheet – Medicare Home Health Coverage In Light of Jimmo v. Sebelius  Nursing Home Roundup: Nurse Staffing in Nursing Homes: CMS Transitions to Payroll-Based Journal Staffing Data on Nursing Home Compare Elder Justice Alert: Republican Congressmen Question CMS’s Oversight of Nursing Homes … Read more

CMA Alert – Jimmo “Improvement Standard” News; Elder Justice Newsletter & More

Jimmo "Improvement Standard" News: ALJ Rules Medicare Covers Outpatient therapy to Maintain Function, Indefinitely if Needed New Fact Sheet: Skilled Nursing Facility Coverage and Jimmo v. Sebelius  Elder Justice Newsletter, March 2018 You Guessed it… More Health Care Sabotage Jimmo "Improvement Standard" News: ALJ Rules Medicare Covers Outpatient therapy to Maintain Function, Indefinitely if Needed … Read more

Highlights from FY18 “Omnibus” Appropriations Bill: Some Good, Some Not-So-Good News This Week in Healthcare Sabotage: Double Digit Rate Hikes Expected and Proposed “Conscience” Rules Elder Justice Alert: New York Times Publishes Article on Drug Use Among Older Adults Highlights from FY18 “Omnibus” Appropriations Bill: Some Good, Some Not-So-Good News Webinar Rescheduled! Home Health Updates … Read more

March 27, 2018 Via Electronic Submission: Regulations.gov U.S. Department of Health and Human Services Office for Civil Rights Attention: Conscience NPRM, RIN 0945-ZA03 Hubert H. Humphrey Building Room 509F 200 Independence Avenue, S.W. Washington, D.C. 20201 RE: Public Comment in Response to the Proposed Regulation, Protecting Statutory Conscience Rights in Health Care RIN 0945-ZA03 The … Read more

CMA Alert – Proposed Payment Rules Will Worsen Home Care Crisis; CMS Clarifies “3-Hour Rule;” Still Time to Register for Next Week’s Summit

Proposed CMS Payment Rules Will Worsen the Home Care Crisis CMS Clarifies 3-Hour “Rule” Should Not Preclude Medicare-Covered Inpatient Rehabilitation Hospital Care Register Now – One Week Left Until the National Voices of Medicare Summit & Sen. Jay Rockefeller Lecture in Washington, DC Proposed CMS Payment Rules Will Worsen the Home Care Crisis This is … Read more

CMA Alert – Center Comments on MA & Part D; Bill to Reduce Medicare Drug Costs; More

Center for Medicare Advocacy Submits Comments to CMS’ Draft 2019 Call Letter for Medicare Advantage and Part D This Week in Healthcare Sabotage: Administration Wants Older People to Pay More Bill to Control Medicare Prescription Drug Costs Introduced  JAMA Calls for Release of Medicare Advantage Data – A Full Review of MA is Long Overdue … Read more

Via Electronic Submission: Regulations.gov March 6, 2018 U.S. Department of Labor 200 Constitution Avenue, NW Washington, DC 20210 RE: Definition of “Employer” under Section 3(5) of ERISA – Association Health Plans (RIN 1210-AB85) The Center for Medicare Advocacy (Center) is pleased to provide comments in response to the proposed rule, Definition of “Employer” under Section … Read more

March 5, 2018 Via Electronic Submission to www.regulations.gov Seema Verma, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services 7500 Security Blvd. Baltimore, Maryland 21244 Re: Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies, and 2019 … Read more

CMA Alert – Bill Jeopardizes Civil Rights of People with Disabilities; More

House Passes Bill Jeopardizing Civil Rights of Individuals with Disabilities Medicare Home Health Highlight Latest Nursing Home Rights Issue Alert This Week in Healthcare Sabotage House Passes Bill Jeopardizing Civil Rights of Individuals with Disabilities 5th Annual National Voices of Medicare Summit & Sen. Jay Rockefeller Lecture This year's Summit will focus on health care … Read more

CMA Alert – Therapy Caps Repealed; New Toolkit; Gleason Act Passes. More

Congress Repeals Medicare Outpatient Therapy Caps, Strengthening the Jimmo Settlement Agreement New Toolkit! Medicare Home Health Coverage & Jimmo v. Sebelius Congratulations, Team Gleason, on the Passage of the Steve Gleason Enduring Voices Act Health Care Sabotage Continues Congress Repeals Medicare Outpatient Therapy Caps, Strengthening the Jimmo Settlement Agreement 5th Annual National Voices of Medicare Summit & … Read more

Jimmo v. Sebelius, No. 11-cv-17 (D. VT), is a nationwide class-action lawsuit brought on behalf of Medicare beneficiaries who received care in skilled nursing facilities, home health care, and outpatient therapy and who were denied Medicare coverage on the basis that they were not improving or did not demonstrate a potential for improvement (known as … Read more

Khelan is a seasoned political strategist and campaign director with 18 years of experience in elections, voter education, political intelligence, grassroots organizing, advocacy, congressional and legislative relations, external outreach, coalition building, and legislative analysis. For nearly sixteen years, Khelan has been a part of AARP’s advocacy efforts. Most recently, he worked on the Association’s health … Read more

CMA Alert – Home Health Care Barriers; Overuse of Antipsychotic Drugs; More

Barriers to Home Care Created by CMS Payment, Quality Measurement, and Fraud Investigation Systems Elder Justice Alert: Human Rights Watch Publishes In-Depth Report on Antipsychotic Drug Use in U.S. Nursing Homes Consumer Statement on New Federal Landmark Study on “Critical Incidents” in Assisted Living Barriers to Home Care Created by CMS Payment, Quality Measurement, and … Read more

Kate McEvoy is the Director of the Division of Health Services at the Department of Social Services, and is responsible for administration of medical, behavioral health, pharmacy, dental and transportation benefits for over 785,000 Medicaid and CHIP beneficiaries.  Related, she oversees health policy aspects of Connecticut Medicaid's implementation of the Affordable Care Act, Administrative Services … Read more

CMA Alert – SOTU Address; Therapy Caps; More

State of the Union Speech Touches on Health Care Issues Outpatient Therapy Caps: What Now? Observation Status Update Webinar Now Available Nursing Home Resident’s Rights Newsletter – January Edition Kaiser Family Foundation Issues Report on Medicare Beneficiaries’ Out-of-Pocket Spending Center for Medicare Advocacy Comments on HHS Request for Information State of the Union Speech Touches … Read more

January 25, 2018 Via Electronic Submission: CompetitionRFI@hhs,gov U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation 200 Independence Avenue S.W. Washington, DC 20201 Re: Promoting Healthcare Choice and Competition Across the United States The Center for Medicare Advocacy (Center) is pleased to provide the Office of the Assistant … Read more

CMA Alert – Don’t Forget Medicare Beneficiaries In Spending Debates; Skilled Nursing Facility Updates

Remember People with Medicare in Renewed Spending Bill Debates Skilled Nursing Facility Roundup Medicare Advantage Enrollees Have Fewer SNF Options than Traditional Medicare Beneficiaries CMS to Propose Revising the Nursing Home Requirements of Participation Lawsuit Challenging Chronic SNF Understaffing Settled for $72 Million Remember People with Medicare in Renewed Spending Bill Debates  Don't Miss It! … Read more

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

Posted in Uncategorized

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