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  1. Senator Brown Leads Charge for Better Oversight of Medicare Advantage Plans
  2. Health Care Sabotage Takes its Toll
  3. Center for Medicare Advocacy Submits Comments Opposing the Administration’s Proposed Roll Back of Nursing Home Standards
  4. Rule Allowing Pre-Dispute Arbitration Agreements in Nursing Homes Takes Effect
  5. FREE WEBINAR: Register Now for Medicare for People with Paralysis 

Senator Brown Leads Call for Better Oversight of Medicare Advantage Plans

Senator Sherrod Brown (D-OH) recently sent a letter to the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, urging the Administration “to be better stewards of taxpayer dollars and conduct sufficient oversight of Medicare Advantage plans, to ensure they are appropriately managing the health care needs of older Americans and people with disabilities” according to a press release issued by Senator Brown’s office dated September 17, 2019. Senator Brown was joined on the letter by Sens. Debbie Stabenow (D-MI), Amy Klobuchar (D-MN), Bernie Sanders (D-VT), Richard Blumenthal (D-CT) and Chris Murphy (D-CT).

The letter calls on the Administration to increase oversight and enforcement over Medicare Advantage (MA) plans on a range of issues, including inappropriate overbilling (estimated to be at least $30 billion over the last 3 years), accuracy of plan provider directories, and performance problems including denial rates. As noted in the letter, “CMS’ own audits have found ‘widespread and persistent [Medicare Advantage] performance problems related to denials of care and payment’ and Medicare Advantage plans that ‘threaten the health and safety of their members.’”

The Center for Medicare Advocacy continues to try to draw policymakers’ attention to the MA program’s growing imbalance with traditional Medicare. The lack of adequate oversight over the MA program exacerbates such imbalance by failing to hold plans accountable to their enrollees and taxpayers. The Center applauds Senator Brown and his co-signers, and join them in urging CMS to improve oversight and enforcement.

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Health Care Sabotage Takes its Toll

Last week the New York Times reported even that while the number of Americans living in poverty has declined, the number of people without insurance has actually gone up. This is the first increase in the ranks of the uninsured since the Affordable Care Act (ACA) was enacted. The New York Times reported that “experts said it was at least partly the result of the Trump Administration’s efforts to undermine the law.”

Over the course of this administration, the Center for Medicare Advocacy has highlighted how the ACA has been weakened by executive action (or inaction). While it is no surprise that these actions have taken their toll, it is shocking so many Americans were uninsured while average income increased. In 2018, the number of people without insurance grew to 27.5 million.

Though it was limited by the political realities of the time when it was created, the ACA transformed American health care for the better. Our health care system is more equitable because the ACA banned discrimination based on age or health status. Quality of care has been improved because the ACA mandated plans cover essential health benefits. And the ACA made health care services more affordable by offering subsidies to help low income people afford coverage. To see these gains reversed should concern everyone that places value on fair access to quality health care.

Even though much damage has been done, it is not too late to reverse course. Access to coverage must be increased not decreased. The ACA must be administered and strengthened, not weakened. We once again call on the administration do no more harm to our health care system and end efforts to undermine the ACA.

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Center for Medicare Advocacy Submits Comments Opposing the Administration’s Proposed Roll Back of Nursing Home Standards

On September 15, 2019, the Center for Medicare Advocacy (the Center) and the Long Term Care Community Coalition (LTCCC) submitted comments opposing the Trump Administration’s proposed rule to revise the nursing home Requirements of Participation. The proposed rule is the latest example of the Administration’s efforts to deregulate the nursing home industry. Among the changes, the Centers for Medicare & Medicaid Services (CMS) is proposing to make it easier for facilities to administer antipsychotic drugs to residents, despite decades of reporting indicating the widespread and inappropriate use of such drugs. The Center and LTCCC believe that the proposed rule, if finalized, will endanger the health, safety, and wellbeing of residents across the country.

The Center and LTCCC submitted comments on behalf of our, and the following, organizations:

  • Alliance of New York Family Councils
  • The American Occupational Therapy Association
  • The American Physical Therapy Association
  • CaringKind
  • Center for Independence of the Disabled, New York
  • Christopher & Dana Reeve Foundation
  • Disabled in Action of Greater Syracuse Inc.
  • Disability Rights Education and Defense Fund
  • Elder Justice Committee of Metro Justice
  • Friends of Residents in Long-Term Care (North Carolina)
  • Gray Panthers NYC
  • Greater Boston Legal Services, Elder, Health and Disability Unit, on Behalf of Our Clients
  • Health Care For All New York
  • Kansas Advocates for Better Care
  • Massachusetts Advocates for Nursing Home Reform
  • Mobilization for Justice, Inc.
  • National Academy of Elder Law Attorneys
  • The National Assn of County Behavioral Health and Developmental Disability Directors
  • New York Lawyers for the Public Interest

To read our joint comments, please visit https://www.medicareadvocacy.org/center-comments-on-proposed-rule-to-revise-nursing-home-requirements-of-participation/. For additional information about Medicare and nursing home care, please visit: https://www.medicareadvocacy.org/medicare-info/skilled-nursing-facility-snf-services/.

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Rule Allowing Pre-Dispute Arbitration Agreements in Nursing Homes Takes Effect

As of September 16, 2019, nursing homes nationwide can begin asking residents (or their representatives) to sign a pre-dispute arbitration agreement. The Trump Administration reversed a previous prohibition on such agreements in a July 2019 final rule. Although there is ongoing legal action to overturn the Administration’s rule, implementation has not been delayed for the majority of nursing homes nationwide.

Residents and their representatives have certain protections under the new rule. Most importantly, facilities cannot require pre-dispute arbitration agreements as a condition of admission or as a requirement for continued care. Furthermore, residents and their representatives may rescind an agreement to arbitrate future claims within 30 calendar days of signing the agreement. (For more information about additional protections under the rule, please visit: https://www.medicareadvocacy.org/cms-finalizes-rollback-of-pre-dispute-arbitration-protections//.)

The Center for Medicare Advocacy believes that pre-dispute arbitration agreements are inherently unfair to consumers, especially those experiencing a health crisis and seeking immediate access to care. Therefore, our organization is encouraging residents and their families not to sign these so-called “voluntary” pre-dispute arbitration agreements.

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FREE WEBINAR: Register Now for Medicare for People with Paralysis

As part of our 2019-2020 webinar series, the Center for Medicare Advocacy is honored to partner with the Christopher and Dana Reeve Foundation to present Medicare for People with Paralysis. 

Understanding Medicare is important to those who currently qualify for health coverage through Medicare, or may qualify in the future. This webinar includes information on eligibility, enrollment, and coverage – with a special emphasis on home health care and durable medical equipment including related laws, regulations, policies and practical tips to assist people living with paralysis to access home and community-based Medicare coverage. We will also discuss important factors in choosing between traditional Medicare and Medicare Advantage.

Register now at https://register.gotowebinar.com/register/2659626668997138188.

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