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  1. House Passes Bill Jeopardizing Civil Rights of Individuals with Disabilities
  2. Medicare Home Health Highlight
  3. Latest Nursing Home Rights Issue Alert
  4. 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 activism, civic engagement, and efforts to preserve (and enhance) the Affordable Care Act, Medicare, and Medicaid. Senators Chris Murphy and Jay Rockefeller will be present to help participants think about building a healthy future for all Americans.

On February 15, 2018, the U.S. House of Representatives passed the ADA Education and Reform Act (HR 620), which would undermine the Americans with Disabilities Act (ADA) by shifting the burden of compliance with the ADA away from businesses and onto individuals with disabilities.  As described by Senator Tammy Duckworth, in a Washington Post op-ed opposing the bill, HR 620  “would reward businesses that fail to comply with the law […. by allowing them] to wait until they are notified of their failure to meet legal obligations before they even have to start removing barriers that prevent Americans with disabilities from leading independent lives.”

The bill now moves on to the Senate. For more information about the bill and ways to respond, see American Association of People with Disabilities (AAPD) and ADAPT



Medicare Home Health Highlight

Home health access problems have ebbed and flowed over the years, depending on the reigning payment mechanisms, systemic pressures, and misinformation about Medicare home health coverage.  Regrettably, as we’ve been reporting, it seems access issue are on the upswing.  Here is the first of several Practice Tips to help maximize Medicare-covered home care under the law.

Medicare Home Health Coverage Can be Available for Daily Skilled Nursing

Medicare home health coverage can sometimes be available for daily skilled nursing. Medicare law authorizes coverage for daily skilled nursing under the home health benefit for less than 8 hours each day, for periods of 21 days or less.  Extensions of the 21-day period can occur in exceptional circumstance when the need for additional daily nursing care is finite and predictable.  (See, 42 U.S.C. § 1395x(m)(7)(B); Medicare Claims Processing Manual, Ch. 7 Section 40.1.3)

Additional Information

It is important for beneficiaries and advocates to know what home health care should be covered under the law, especially for those with long term, chronic, and debilitating conditions. Download our quick-reference Medicare Home Health Coverage Infographic, and, if you or someone you know has experienced home health care access issues, submit the story today.


Latest Nursing Home Rights Issue Alert

The Long Term Care Community Coalition (LTCCC), in partnership with the Center for Medicare Advocacy, publishes monthly Issue Alerts on the rights of nursing home residents. These Issue Alerts focus on specific standards of care that nursing homes must follow as a requirement of participating in Medicare and Medicaid. The goal of this project is to provide residents, families, and advocates with information on why a standard of care is important to residents, what the nursing home requirements for that standard are, how prevalent deficiencies in meeting that standard are, what resident harm looks like when nursing homes fail to meet that minimum standard of care, and where readers can go for additional information.

To date, LTCCC and the Center have published Issue Alerts on standards of care relating to pressure ulcers, antipsychotic drugs, staffing, and infection control and prevention. In the latest Alert, readers will learn about the enormous impact that infection control and prevention requirements have on the lives of residents and how deficient practices lead to resident harm.


This Week in Healthcare Sabotage

Earlier this week the Trump Administration issued proposed rules to allow the sale of junk health insurance plans that won’t have to comply with Affordable Care Act (ACA) coverage rules or protections. Under the Administration rule, insurers could sell temporary “skinny” plans that could lure younger, healthier consumers away from ACA-compliant plans.

Unfortunately, consumers who choose these junk plans won’t have critical comprehensive coverage when they need care and coverage the most. Other consumers remaining in the individual market, including those with pre-existing conditions or more significant health needs, would be left with higher costs.  The Center for Budget and Policy Priorities notes that “The proposal itself acknowledges that it “may further reduce choices for individuals remaining in the individual market risk pool” by weakening states’ individual markets, and that “consumers who purchase short-term, limited-duration insurance policies and then develop chronic conditions could face financial hardship as a result.” (emphasis added)

The ACA requires insurers to cover essential health benefits such as emergency services, hospitalization, rehabilitative services, laboratory services, preventive and wellness services and more. Any attempt to weaken these essential benefits or other consumer protections and deny people comprehensive care is unacceptable and must be rejected.  

Comments on the rule are due on April 23rd and we encourage everyone to submit comments.


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