In its March 2024 policy report, the Medicare Payment Advisory Commission (MedPAC), the independent government agency that advises Congress on Medicare policy, recommends a reduction of 3% in payments to skilled nursing facilities in the traditional … [Read more...] about MedPAC Report Undermines Nursing Home Industry Claims
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Advocates Join Center in Comments on Observation Status Appeals
A broad coalition of 75 national, state, and local advocacy organizations joined the Center for Medicare Advocacy (the Center) in submitting comments on a rule to establish appeals for beneficiaries who have been placed in “observation status.” As a … [Read more...] about Advocates Join Center in Comments on Observation Status Appeals
Medicare Drug Pricing Updates from HHS
This week the Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced the list of 41 drugs available through Medicare Part B that will have a lowered Part B coinsurance rate from April … [Read more...] about Medicare Drug Pricing Updates from HHS
Know Jimmo | You Do Not Have to Decline
You do not have to decline in order to receive Medicare coverage for care to maintain or slow declineToo often Medicare beneficiaries are told the care they are receiving to maintain their condition has to end and, if they decline, then they can … [Read more...] about Know Jimmo | You Do Not Have to Decline
Reports: Nursing Facilities’ “Financial Shenanigans” Divert Reimbursement to Private Gain, Jeopardizing Resident Care
In March 2024, two lengthy investigative pieces exposed the complex and often hidden ownership practices that increasingly dominate nursing facilities, evade meaningful public scrutiny and enforcement, and result in grossly poor care for … [Read more...] about Reports: Nursing Facilities’ “Financial Shenanigans” Divert Reimbursement to Private Gain, Jeopardizing Resident Care
A Model for Nursing Home Enforcement
Acting New Jersey Comptroller Kevin Walsh issued three reports identifying the worst-performing nursing facilities in the state and the millions of dollars these facilities receive in Medicaid funding, despite the poor care they provide to residents … [Read more...] about A Model for Nursing Home Enforcement
Good Progress in Litigation Against Medicare Drug Price Negotiations
In nine lawsuits filed across the country, the pharmaceutical industry is challenging the Medicare drug price negotiation program established by the Inflation Reduction Act (IRA). So far, the drug companies have not scored any victories, which means … [Read more...] about Good Progress in Litigation Against Medicare Drug Price Negotiations
KFF Report on Dual-Eligible Special Needs Plans (D-SNPs)
In 2021 almost 13 million people had health care through Medicare and Medicaid. These dual eligible individuals have the option of receiving care through Medicare Advantage plans for dual-eligible individuals, known as Dual-Eligible Special Needs … [Read more...] about KFF Report on Dual-Eligible Special Needs Plans (D-SNPs)
Know Jimmo | Why Skilled Maintenance Care Matters, In a Daughter’s Words
“These changes [from the Jimmo Settlement] are extremely meaningful, as my mother has repeatedly been denied the ability to continue the physical therapy she needs in order to prevent further deterioration of her condition. It has been … [Read more...] about Know Jimmo | Why Skilled Maintenance Care Matters, In a Daughter’s Words
Thanks to All Who Made the 2023 National Voices of Medicare Summit a Success
Thank You for Joining Us!10th Annual National Voices of Medicare Summit& Senator Jay Rockefeller Lecture– Advancing Equitable Access to Care –Thank you for joining CMA for the 10th Anniversary National Voices of Medicare Summit. … [Read more...] about Thanks to All Who Made the 2023 National Voices of Medicare Summit a Success