In “Private Equity and Nursing Home Care: What Policies Can Be Adopted to Address the Growing Problems,” published in The Gerontological Society of America’s Public Policy & Aging Report, Charlene Harrington and Center for Medicare Advocacy … [Read more...] about New Article: Private Equity and Nursing Homes
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CMS Issues Final Medicare Advantage Payment Rates for 2024 and Final Rule Addressing Prior Authorization, Marketing, and Other Issues
The Center for Medicare Advocacy has long-highlighted concerns relating to Medicare Advantage (MA) overpayments, as well as access to care issues, including MA plans’ widespread and inappropriate use of prior authorization and on-going denials. … [Read more...] about CMS Issues Final Medicare Advantage Payment Rates for 2024 and Final Rule Addressing Prior Authorization, Marketing, and Other Issues
Federal Court Dismisses Home Health Aide Lawsuit
On April 5, 2023, a federal court in D.C. dismissed a lawsuit filed by the Center for Medicare Advocacy on behalf of beneficiaries with chronic, disabling conditions who cannot access the home health aide services they require. By law, Medicare’s … [Read more...] about Federal Court Dismisses Home Health Aide Lawsuit
Medicaid and Nursing Homes: Don’t Believe Owners and Operators That All Medicaid Rates Are Too Low
Owners and operators of nursing homes, and their trade associations, invariably argue that Medicaid rates are too low. They claim that Medicaid rates must be increased if the Centers for Medicare & Medicaid Services (CMS) imposes mandatory nurse … [Read more...] about Medicaid and Nursing Homes: Don’t Believe Owners and Operators That All Medicaid Rates Are Too Low
Elder Justice “No Harm” Newsletter | Volume 5, Issue 1 Now Available
In the Elder Justice Newsletter, we highlight citations, including deficiencies related to abuse, neglect, and substandard care, that have been identified as not causing any resident harm. The goal of this brief newsletter is to shed light on … [Read more...] about Elder Justice “No Harm” Newsletter | Volume 5, Issue 1 Now Available
Report: Limited Federal Oversight of Cost Reports, Inflated Prices Paid in Nursing Home “Related Party Transactions”
In “Where Do the Billions of Dollars Go? A Look at Nursing Home Related Party Transactions,” the National Consumer Voice for Quality Long-Term Care (the national advocacy organization representing residents) reports on the limited federal scrutiny of … [Read more...] about Report: Limited Federal Oversight of Cost Reports, Inflated Prices Paid in Nursing Home “Related Party Transactions”
Medicare Advantage: It’s Not “Over-reach” – It’s Fraud
A Message from the Executive DirectorThe New York Times recently published an article by Reed Abelson and Magot Sanger-Katz discussing the frenzied reaction of private Medicare Advantage plans to the Administration’s proposed changes to … [Read more...] about Medicare Advantage: It’s Not “Over-reach” – It’s Fraud
GAO Issues Report on Improving Infection Prevention And Control Practices In Nursing Facilities
In Nursing Homes: Experts Identified Actions Aimed at Improving Infection Prevention and Control, the Government Accountability Office (GAO) sets out actions that the Department of Health and Human Services could “continue, enhance, or discontinue to … [Read more...] about GAO Issues Report on Improving Infection Prevention And Control Practices In Nursing Facilities
Nursing Homes Operate Managed Care Programs for Their Residents – A Conflict of Interest
Although skilled nursing facility owners and operators complain about Medicare Advantage (MA) plans because they pay lower daily Medicare rates for shorter period of time than the traditional Medicare program,[1] they increasingly see a financial … [Read more...] about Nursing Homes Operate Managed Care Programs for Their Residents – A Conflict of Interest
Medicare Advantage Under Increased Scrutiny Pending Final Payment and Oversight Rules
As documented in a recent series of CMA Alerts, the Centers for Medicare & Medicaid Services (CMS) has proposed long overdue steps to address Medicare Advantage (MA) overpayments and oversight, including restrictive prior authorization and … [Read more...] about Medicare Advantage Under Increased Scrutiny Pending Final Payment and Oversight Rules