Comments to Medicare Marketing Guidelines (MMG) Submitted by Center for Medicare Advocacy April 4, 2019 The following comments were submitted to CMS online via 2020 MCMG feedback tool: https://cmsgov.wufoo.com/forms/cy2020-mcmg-feedback-tool/.  Submitted by David Lipschutz, Senior Policy Attorney, Center for Medicare Advocacy – dlipschutz@medicareadvocacy.org ——————————————————————————– Section: Miscellaneous Communicating About New MA Benefit Flexibilities.  We are disappointed that … Read more

Observation Status Deprives Medicare Beneficiaries of their Skilled Nursing Facility Benefit. Period. Nursing Home Requirements of Participation: Will the Administration Overturn 2016 Rules for Infection Control? New Fact Sheet Available – Medicare Inpatient Rehabilitation Hospital/Facility Coverage In Light of Jimmo v. Sebelius Join Us! 6th Annual National Voices of Medicare Summit & Sen. Jay Rockefeller … Read more

Nursing Home Roundup: What's Causing Nursing Home Closures; Joint Letter; Free Webinar on Phase 3 Nursing Home Regulations Health Care Sabotage News: Court Strikes Blow for Health Care; Advocacy Groups File Amicus Brief in Texas ACA Case Oral Health in Medicare: Kaiser Family Foundation Releases Issue Brief Webinar – April 10, 3:00 PM – Medicare … Read more

Trump Administration Works to Undermine the Affordable Care Act – Yet Again Court Denies All Government Motions in Class Action Seeking Appeal Right for Medicare Beneficiaries on “Observation Status” Observation Status: Physicians Challenge the Inspector General Study Finds Home Health Lowers Costs and Readmission Rates Compared to Hospital Care Medicare Advocates: Trump Budget Would Impede … Read more

Average Nursing Home Fine Drops Significantly After Administration Rolls Back Civil Money Penalties Nursing Home Resident Advocates, Not Invited to Testify, Submit Statement for the Record LTCCC Publishes Report on Nursing Home Resident Abuse, Neglect, and Crime Oral Health Highlight Join Us! 6th Annual National Voices of Medicare Summit & Sen. Jay Rockefeller Lecture Rep. … Read more

NOT FORGOTTEN: PROTECTING AMERICANS FROM ABUSE AND NEGLECT IN NURSING HOMES Hearing held March 6, 2019 Statement for the record submitted by:  Tony Chicotel, Staff Attorney; Michael Connors, Long Term Care Advocate; Janet Wells, Public Policy Consultant California Advocates for Nursing Home Reform 650 Harrison Street, #2 San Francisco, CA  94107 www.canhr.org Toby Edelman, Senior … Read more

Medicare Education & Outreach (David Lipschutz) Information from the February 8, 2019 meeting of CMS’ National Medicare Education Program (NMEP) Medicare Advantage Steering Redesign of Medicare Plan Finder Senate Finance Committee Hearing on Nursing Facilities (Toby Edelman and Dara Valanejad) “Not Forgotten: Protecting Americans From Abuse and Neglect in Nursing Homes” March 6, 2019: https://www.finance.senate.gov/hearings/not-forgotten-protecting-americans-from-abuse-and-neglect-in-nursing-homes … Read more

1. MEDICARE EDUCATION & OUTREACH At a February 8, 2019 meeting of the Center for Medicare & Medicaid Services’ (CMS) National Medicare Education Program (NMEP), the agency released information about the 2018 Annual Coordinated Election Period (ACEP), sometimes referred to as “Open Enrollment” or “OP.” (Note: this is a downloadable “zip” file containing several items. … Read more

Joint Statement by Center for Medicare Advocacy and Medicare Rights Center: President’s Budget Targets Key Health Care Programs Members of Congress Reintroduce Legislation to Fix Outpatient Observation Status Medicare Advantage Case Spotlight Spanish Language Home Health Outreach Materials Available Join Us! 6th Annual National Voices of Medicare Summit & Sen. Jay Rockefeller Lecture Early-Bird Registration … Read more

United States Senate Committee on Finance “Not Forgotten: Protecting Americans From Abuse and Neglect in Nursing Homes” March 6, 2019 Statement submitted by: Long Term Care Community Coalition, Center for Medicare Advocacy, National Consumer Voice for Quality Long-Term Care, Justice in Aging, California Advocates for Nursing Home Reform, and National Academy of Elder Law Attorneys … Read more

March 1, 2019 Via Electronic Submission to www.regulations.gov (CMS-2018-0154)   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) 2020 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies, … Read more

Improve and Expand Medicare: End the Use of Outpatient Observation Status – A Billing Issue that Restricts Needed Care Jimmo Implementation Update: Where is CMS? 2019 National Aging and Law Conference Speaker Proposals Still Accepted through Tomorrow Improve and Expand Medicare: End the Use of Outpatient Observation Status – A Billing Issue that Restricts Needed … Read more

6th Annual National Voices of Medicare Summit Welcomes Congressman John Lewis as the 2019 Sen. Jay Rockefeller Lecturer – Register Now Home Health Aide Coverage Continues to Shrink: Attention Must Be Paid Case Spotlight: A Medicare Beneficiary in Need of Home Health Aides  Cathy Hurwit Joins Center for Medicare Advocacy Advisory Board The Administration for Community Living … Read more

6th Annual National Voices of Medicare Summit Welcomes Congressman John Lewis as the 2019 Sen. Jay Rockefeller Lecturer – Register Now Improve and Expand Medicare: CMS Should Provide Objective Information About Medicare Options Practice Tip: Office of Medicare Hearings and Appeals Manual Can Be a Useful Tool  There’s Nothing Special About How CMS Treats Special Focus Nursing … Read more

Improve and Expand Medicare: Create Parity Between Medicare Advantage and Traditional Medicare 2019 Federal Poverty Levels Released: New Income Limits for Medicare Savings Programs State of the Union: Want More Affordable Prescription Drugs? Start with Medicare.  Home Health Outreach Materials Available Improve and Expand Medicare: Create Parity Between Medicare Advantage and Traditional Medicare Recently, the … Read more

#MedicarePlatform – Improve and Expand Medicare: Long-Term Services and Supports (LTSS) Center Submits Comments on Proposed Medicare Prescription Drug Rule Congressional Hearings Explore Rising Prescription Drug Costs Medicare’s New “What’s Covered” App Adds to Outreach but More Work Is Needed #MedicarePlatform – Improve and Expand Medicare: Long-Term Services and Supports (LTSS) Recently, the Center for … Read more

January 25, 2018 Submitted via www.regulations.gov Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-4180-P Re: CMS-4180-P: Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses The Center for Medicare Advocacy (Center) submits the following comments in response to the Centers for Medicare & Medicaid … Read more

Disclaimer: the views expressed in this Issue Brief and during the Alliance call are solely those of the Center for Medicare Advocacy. ACCESS TO CARE    Home Health Between April 2017 and October 2018, the Center completed the “CMA Issue Brief Series: Medicare Home Health Crisis” – a ten-part series examining the growing crisis in … Read more

Access to Care ​​Home Health (Kathy Holt) Durable Medical Equipment (DME) (Kathy Holt) Observation Status (Judy Stein) Nursing Home Issues (Dara Valanejad)   Leveling the Playing Field – Traditional Medicare and Medicare Advantage (David Lipschutz) Policy Changes and CMS Efforts Favoring MA Law, regulations and policy CMS materials Medicare Fully Informed Project  Promoting Free Choice … Read more

September 2019 – Upcoming Annual Coordinated Election Period (ACEP) & Other Issues May 2019 – Medicare Oral Health Coverage & Other Issues March 2019 – Medicare Education & Outreach, and Other Issues January 2019 – Medicare Advocacy: Highlights from 2018 and Looking Forward in 2019 November 2018 – Special Presentation – Better Advance Care Legal Counseling – Presented … Read more

Improve and Expand Medicare: Add an Out-of-Pocket Cap There's Still Time to Go Back to Traditional Medicare or Change MA Plans Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Updates Healthcare Sabotage Continues Improve and Expand Medicare: Add an Out-of-Pocket Cap Recently, the Center for Medicare Advocacy laid out our Medicare Platform for the New … Read more

Improve and Expand Medicare: Oral Health Center for Medicare Advocacy is Honored to Welcome Judith Feder, Ph.D as President of our Board of Directors Registered Nurses Are the Key to Reducing Hospital Readmissions of Nursing Home Residents Hot off the Press: 2019 Medicare Handbook Nursing Home Residents at Risk: Advocates Submit Briefing to Congress Improve … Read more

Improve and Expand Medicare: Ensure Medigap Access Objective Medicare Appeals Jeopardized By New ALJ Selection Process CMA Report: Nurse Staffing Deficiencies In Nursing Facilities Health Affairs Study Calls for Medicare Coverage of Hearing Care Services Senator Cardin Introduces Bill to Add Oral Health Coverage to Medicare Improve and Expand Medicare: Ensure Medigap Access Recently, the … Read more

Improve Medicare: Correct Medicare Hospital Observation Status Legal Memorandum: Statutory Authority Exists for Medicare to Cover Medically Necessary Oral Health Care Joint Statement on Turmoil in the Nursing Home Industry Improve Medicare: Correct Medicare Hospital Observation Status Recently, the Center for Medicare Advocacy laid out our Medicare Platform for the New Congress. One of the core … Read more

Note: The memo below is the slightly edited version used by the coaltion of by a coalition of organizations seeking to expand Medicare coverage for medically necessary dental therapies. Medicare coverage for medically necessary oral health care is supported by the Medicare statute, its legislative history, Centers for Medicare and Medicaid Services (CMS) policy, and … Read more

Core Considerations for Medicare for Today & Tomorrow – A Medicare Platform for the New Congress Texas Lawsuit Sabotage of the Affordable Health Care Act Core Considerations for Medicare for Today & Tomorrow – A Medicare Platform for the New Congress The Center for Medicare Advocacy works for a comprehensive Medicare program and quality health … Read more

Health Care Sabotage Continues as ACA Open Enrollment Comes to an End Center Submits Comments Opposing Proposed “Public Charge” Rule CURE High Drug Prices Act Introduced Elder Justice "No Harm" Newsletter – Issue 10 Checklist for Medicare Outpatient Therapy “Improvement Standard” Denials Health Care Sabotage Continues as ACA Open Enrollment Comes to an End There … Read more

December 10, 2018 Submitted via www.regulations.gov Samantha Deshommes, Chief Regulatory Coordination Division, Office of Policy and Strategy U.S. Citizenship and Immigration Services Department of Homeland Security 20 Massachusetts Avenue NW Washington, DC 20529-2140 Re: DHS Docket No. USCIS-2010-0012, RIN 1615-AA22, Comments in Response to Proposed Rulemaking: Inadmissibility on Public Charge Grounds The Center for Medicare … Read more

The Center for Medicare Advocacy has launched its Year-end Campaign and we need your support! It has been another long year in the fight to save access to quality health care, Medicare, the Affordable Care Act (ACA), and Medicaid. While we did not see the same level of Congressional zeal to repeal the ACA and … Read more

Important Health Policy Article Published In New England Journal of Medicine: “Medicare Advantage Checkup" ACA Open Enrollment Ends December 15th State Attorneys General Successfully Take on Nursing Home Issues Important Health Policy Article Published In New England Journal of Medicine: “Medicare Advantage Checkup” The November 2018 New England Journal of Medicine features a article by … Read more

Disclaimer: the views expressed in this Issue Brief and during the Alliance call are solely those of the Center for Medicare Advocacy. BETTER ADVANCE CARE LEGAL COUNSELING   Presented by American Bar Association Commission on Law and Aging Director Charles Sabatino See separate PowerPoint slide presentation and ABA Commission on Law and Aging publication “Advance … Read more

Special Presentation – Better Advance Care Legal Counseling – Presented by ABA Commission on Law and Aging Director Charles Sabatino This presentation will discuss the importance of advance care planning, advocates' roles in such planning, and offer a conceptual framework and guidelines to align the practice of advance care planning in legal offices with the realities … Read more

CMS to Clarify Medigap Section of the Medicare.gov Plan Finder Tool CMS Proposes Rollback of Emergency Preparedness Requirements to Reduce “Burdens” for Nursing Home Providers CMS to Clarify Medigap Section of the Medicare.gov Plan Finder Tool Concerned that Medicare beneficiaries could reject proper consideration of Medigap supplement plans because of undefined and significantly high costs … Read more

November 16, 2018 Administrator Seema Verma Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-3346-P P.O. Box 8010 Baltimore, MD 21244-1810 Re: CMS-3346-P; Federal Register, Vol. 83, No. 183 (September 20, 2018). Submitted electronically: www.regulations.gov. Dear Administrator Verma, The Long Term Care Community Coalition (LTCCC) is a non-profit organization dedicated … Read more

Home for the Holidays: Leaving the Nursing Home During a Medicare-Covered Stay Home Health Issue Brief Checklist for Medicare Home Health “Improvement Standard” Denials Home Health Aide Coverage Continues to Shrink in Traditional Medicare While CMS Enhances it in Medicare Advantage Successful Advocacy for Home Health Beneficiary in Need of Maintenance Physical Therapy Home Health … Read more

Health Care Prominent in Mid-Term Elections – How will the New, Divided Congress React? Center for Medicare Advocacy Comments on Proposed Nursing Home Legislation and Rule Jimmo Implementation: Beneficiary Successfully Appeals Denial of Maintenance Therapy Health Care Prominent in Mid-Term Elections – How will the New, Divided Congress React? As results from this week’s mid-term … Read more

ACA Open Enrollment Begins Choosing Between Traditional Medicare and Medicare Advantage Final Medicare Home Health Payment Rule Threatens Access to Care HHS Publishes Final Rules Providing Annual Inflation-Related Increases for Civil Money Penalties in Its Programs. Better Late than Never? ACA Open Enrollment Begins #SaveMedicareNow The #SaveMedicareNow initiative seeks to educate and raise awareness about … Read more

Campaign Codewords from the National Committee to Preserve Social Security and Medicare Health Care Sabotage: Administration Issues New Guidance Making it Easier to Ignore ACA Rules Medicare Enrollment Reminder: Be Fully Informed Checklist for Medicare Nursing Home “Improvement Standard” Denials Campaign Codewords from the National Committee to Preserve Social Security and Medicare Earlier this week … Read more

2019 Medicare Cost-Sharing Announced Government Watchdog Agency Raises Concerns About Medicare Advantage Denials Home Health Issue Brief #10 – Plans to Address and Resolve the Medicare Home Care Crisis New Checklist for Medicare Home Health Care “Improvement Standard” Denials 2019 Medicare Cost-Sharing Announced #SaveMedicareNow The #SaveMedicareNow initiative seeks to educate and raise awareness about current … Read more

President's Medicare Op-Ed is Untrue Enforcement Weakens as Civil Money Penalties Shift From Per Day to Per Instance Elder Justice: What "No Harm" Really Means for Residents Webinar – Medicare Advantage Education & Enrollment Issues – Register Now President's Medicare Op-Ed Is Untrue #SaveMedicareNow The #SaveMedicareNow initiative seeks to educate and raise awareness about current … Read more

Center for Medicare Advocacy Survey: CMS’ Jimmo v. Sebelius “Improvement Standard” Education Still Not Working Health Care Sabotage: Expanded “Short-Term, Limited-Duration Insurance” is Here Study: Three-Day Hospital Requirement for Post-Hospital Care In a Skilled Nursing Facility Increases Medicare Costs Who Owns Nursing Facilities and Why? Center for Medicare Advocacy Survey: CMS’ Jimmo v. Sebelius “Improvement … Read more

Center Launches SaveMedicareNow Initiative Ahead of Mid-Term Elections Public Charge Proposed Rule – A Strike on the Health Care and Well-Being of Immigrants and American Families Center for Medicare Advocacy Welcomes New Board Members Center Launches SaveMedicareNow Initiative Ahead of Mid-Term Elections How has Medicare, Medicaid or the Affordable Care Act (ACA) helped you or your … Read more

Disclaimer: the views expressed in this Issue Brief and during the Alliance call are solely those of the Center for Medicare Advocacy. RECENT CHANGES IN LAW, REGULATIONS AND GUIDANCE RELATING TO MEDICARE ADVANTAGE AND PART D CMA Special Report (September 2018): http://www.medicareadvocacy.org/special-report-recent-changes-in-law-regulations-and-guidance-relating-to-medicare-advantage-and-the-prescription-drug-benefit-program/ Overview The first half of 2018 has seen a number of changes in … Read more

Welcome and Housekeeping  (David Lipschutz, Moderator)  Recent Changes in Law, Regulations and Guidance Relating to Medicare Advantage and Part D (David Lipschutz) CMA Special Report (to be released Monday, 9/17) Summary of Changes Discussion Tipping the Scales Towards MA Impact of Recent Changes on Consumer Decision-Making   Informed Choice and the Mid-Term Elections (Ben Belton) Informed … Read more

Report: Transfer and Discharge Deficiencies Cited Since 2017: Surveyors Focus On paperwork, Not Residents’ Rights Study Finds Link Between Registered Nurse Hours and Antipsychotic Drug Use Webinar: Skilled Nursing Facilities Update Report: Transfer and Discharge Deficiencies Cited Since 2017: Surveyors Focus On paperwork, Not Residents’ Rights The involuntary transfer and discharge of nursing home residents … Read more

More Health Care Sabotage: Inadequate Funding for Navigators Court Ruling May Lead to Even More Overpayments to Medicare Advantage MedPAC Discusses Requiring a Three-Day Hospital Stay for All Post-Acute Care, Threatening Access to Care House Committee Holds Hearing on Nursing Home Quality Issues Proposed DMEPOS Rules: Clarification and Enforcement Needed More Health Care Sabotage: Inadequate … Read more

September 10, 2018 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1691-P Mail Stop C4-26-05 7500 Security Boulevard Baltimore, Maryland  21244-1850 Submitted electronically to: http://www.regulations.gov Re:  CMS-1691-P; Federal Register, Volume 83, No. 139 (July 19, 2018) The Center for Medicare Advocacy (the Center) provides these comments regarding CMS-1691-P and the … Read more

Health Care Sabotage: Association Health Plans Are Here New Jimmo Resources from the Center for Medicare Advocacy and The John A. Hartford Foundation Health Care Sabotage: Association Health Plans Are Here Thanks to a final rule issued by the Administration, Association Health Plans (AHPs) will be available starting this month. Expanding AHPs will make it … Read more

Center Comments on Harmful Proposed Home Health Rule Health Care Sabotage Continues: New Pre-Existing Conditions Legislation Not What It Seems; GAO Critical of HHS ACA Enrollment Actions Re-Review of Some Home Health Denials Now Available Center Comments on Harmful Proposed Home Health Rule The Center for Medicare Advocacy (the Center) submitted comments to the Centers … Read more

August 27, 2018 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1689-P P.O. Box 8013 Baltimore, Maryland  21244-8013 Submitted electronically to: http://www.regulations.gov Re:  CMS-1689-P; Federal Register, Volume 83, No. 134 (July 12, 2018) The Center for Medicare Advocacy (the Center) provides these comments regarding CMS-1689-P and the impact of the … Read more