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Inadequate nurse staffing is the most significant predictor of poor care in nursing facilities.  Despite the fact that understaffing is a pervasive and nationwide problem,[1] understaffing is rarely cited by state survey agencies.[2]  One reason for the lack of deficiencies and enforcement actions is that the federal standard for nurse staffing is vague.  Aside from … Read more

2015 marks the 50th anniversary of Medicare. Since 1965, Medicare has opened doors to health care and increased economic security for hundreds of millions of older people, people with disabilities, and their families. 2015 also ushers in a new Congress. Many of its leaders and members will likely champion plans to further privatize Medicare. These … Read more

While the Center for MEdicare Advocacy continues to press for systemic improvements to the Medicare program, both big and small, there has been some good news for beneficiaries in the health care arena.  As calendar year 2014 draws to a close, the Center highlights positive changes in Medicare and health care that occurred this year, … Read more

The Medicare Payment Advisory Commission (MedPAC), the nonpartisan government agency that advises Congress on Medicare policy, indicated at its November 7, 2014 public meeting that, at its next public meeting in December, it would recommend (1) phasing-in site-neutral payments for inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) for 17 conditions, which it has … Read more

Over 9.6 million older people and people with significant disabilities are dually eligible for both Medicare and Medicaid. Dual eligible beneficiaries are among the poorest and sickest beneficiaries covered by either program. The dual eligible demonstration projects, developed pursuant to the Affordable Care Act (ACA), aim to improve coordination of services between Medicare and Medicaid, … Read more

The Centers for Medicare & Medicaid Services (CMS) announced plans to expand its focused surveys on resident assessments and nurse staffing for nursing facilities nationwide (but not in all facilities), beginning in early fiscal year 2015.  Expanded surveys should lead to more accurate reporting of quality measures and staffing data on the federal website Nursing … Read more

The open enrollment period for health insurance coverage for 2015 under the Affordable Care Act (ACA) begins November 15, 2014, and ends on February 15, 2015. More information on the ACA health insurance Marketplace is available at: https://www.healthcare.gov/ Plans With Automatic Enrollment Some individuals who are currently enrolled in a health plan through the Marketplace … Read more

November 13, 2014 Late November begins a time for gatherings with family and friends – Thanksgiving and Chanukah, soon followed by Christmas and New Years. Nursing home residents often want to participate in these gatherings but may worry they will lose Medicare coverage if they leave the facility to do so. Residents and their families … Read more

Medical Equipment Suppliers' Ongoing Opposition to the Competitive Bidding Program and Consequences for Beneficiaries Report prepared by Mario Ramsey, Center for Medicare Advocacy Summer Health Policy Fellow Summary Under Medicare Part B, Medicare will pay for wheelchairs, hospital beds, some walkers; Certain customized items; prosthetic and orthotic devices; capped rental items; oxygen and oxygen equipment. … Read more

Twenty-one months after winning a national class action lawsuit that sought to overturn Medicare's practice of denying skilled maintenance care to patients who did not meet an "improvement standard," plaintiff Glenda Jimmo is finally receiving Medicare coverage for skilled home health maintenance care benefits she was denied in 2007. A federal court case in Vermont … Read more