CMA Alert – November 27, 2019

Time for Medicare Enrollment – Time to Talk Turkey! Reminder – You CAN Leave the Nursing Home for the Holidays Jimmo Implementation Council Meets to Discuss the State of Skilled Maintenance Care Thank You! Time for Medicare Enrollment – Time to Talk Turkey! Medicare Fall Open Enrollment continues through December 7 — so you still … Read more

Medicare is Being Privatized. Where is the Outcry? Medicare Advantage Plans Impede Access to Care: Case Study #1 Support for Medicare Oral Health Benefits 2020 Medicare Cost-Sharing Rates Released Medicare is Being Privatized. Where is the Outcry? For years, the Center for Medicare Advocacy has warned of wasteful overspending on private Medicare Advantage (MA) plans, … Read more

The Center for Medicare Advocacy is pleased that oral health in Medicare is gaining attention and focus, as evidenced by the number of Congressional bills introduced this year that would add dental benefits to the Medicare program. Among them are the Medicare Dental Benefit Act of 2019 (S.22/H.R. 2951), the Medicare and Medicaid Dental, Vision, … Read more

Medicare Enrollment Problems Persist Medicare’s New Skilled Nursing Facility Payment System Alters Access to Care Poorly Performing Skilled Nursing Facilities: What Happens to Them? Latest Edition – Elder Justice: What “No Harm” Really Means for Residents  Medicare Enrollment Problems Persist Problems with Medicare Plan Finder Persist As reported by SHIPs across the country and some … Read more

Potential Impacts of New Medicare Payment Models On Skilled Nursing Facility and Home Health Care  CMS Extends “Equitable Relief” from Part B Late Enrollment Penalties for People Moving from ACA Marketplace Plans to Medicare Free Webinar: Coordination of Benefits – What Pays When? Potential Impacts of New Medicare Payment Models On Skilled Nursing Facility and … Read more

Medicare Enrollment and Medicare Advantage Updates CMS Administrator Seema Verma Testifies on Health Care Sabotage Before House Subcommittee Center Attorneys Participate in Oral Health Convening and Advocacy Day Nursing Home Compare’s Abuse Icon is Now Live Center for Medicare Advocacy Submits Comments Supporting Modification to ABN Instructions FREE WEBINAR: Register now for Coordination of Benefits … Read more

Center for Medicare Advocacy Board President Judith Feder Testifies at Drug Pricing Hearing  Administration’s “Public Charge” Rule [Temporarily?] Blocked Drug Company Sued Over Kickbacks for Off-Label Marketing of Psychotropic Drug for Nursing Home Residents to Pay Over $115 Million Joint Issue Alert on Medicare Payment and Skilled Therapy Services in Nursing Homes Free Webinar: Medicare … Read more

Center for Medicare Advocacy Analysis of President’s Medicare Advantage Executive Order: Among Vague Language and Proposals, Real Harm to Medicare Beneficiaries  Nursing Home Residents and Therapy Under The New Medicare Reimbursement System Important Update to Nursing Home Compare Will Enable Public to Identify Facilities with a History of Abuse Medicare’s Annual Election Period Starts Next Week … Read more

Connecticut Congressional Delegation Concerned about Medicare Advantage Network Provider Terminations in the State House Companion to Part D Extra Help Bill Introduced The Patient Driven Payment Model is Here – What Does It Mean for Residents? Connecticut Congressional Delegation Concerned about Medicare Advantage Network Provider Terminations in the State As noted in a press release … Read more

Medicare Plan Finder Pending Additional Updates; Concerns Remain Speaker Pelosi Unveils Bill Authorizing Negotiation of Drug Prices and Capping Out-of-Pocket Costs California Attorney General Calls on CMS to Withdraw Proposed Revisions to Nursing Home Requirements of Participation House of Representatives Passes Bill Prohibiting Pre-Dispute Arbitration Agreements Center for Medicare Advocacy Senior Policy Attorney Toby S. … Read more

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

Medicare & You 2020 – Better Than Draft, But Room for Improvement More People Went Without Health Insurance in United States in 2018 Administrator Verma’s Tweet Sparks Support for Addressing Observation Status Proposed Home Health Rules – Payment Shouldn’t Impede Access Register Now – Free Webinar, September 18 – Skilled Nursing Facility Updates Medicare & … Read more

Medicare Platform: Objective Information and Consumer Protections Face Challenges As Home Care Needs Increase, Access Issues Must Be Addressed Nursing Home Deregulation Continues, Despite Substantial Risk to Residents Medicare Platform: Objective Information and Consumer Protections Face Challenges At the beginning of the current session of Congress, the Center for Medicare Advocacy laid out a Medicare … Read more

Advocates Issue Joint Letter Raising Alarms about New Medicare Plan Finder and Revisions to MA and Part D Marketing Guidelines CMS Proposed Medicare Home Health Rules Raise Concerns for Access to Care – Comments due September 9, 2019 Stop Drugging Nursing Home Residents Without their Written Consent Advocates Issue Joint Letter Raising Alarms about New … Read more

Alexander v. Azar Trial Update – Seeking an Appeal of Outpatient Observation Status CMS Could Truly Put “Patients over Paperwork” By Fully Implementing the Jimmo Settlement Comparing Spending on Medicare Advantage vs. Accountable Care Organizations (ACOs) Recorded Webinar: Proposed Changes to Nursing Home Standards Alexander v. Azar Trial Update – Seeking an Appeal of Outpatient Observation Status … Read more

Support Traditional Medicare by Leveling the Playing Field with Medicare Advantage Administration’s “Public Charge” Rule Would Result in Millions Losing Access to Health Care and Other Necessary Services Center Submits Comments Opposing Proposed Changes to Nondiscrimination Rule Center Submits Comments on the “Patients over Paperwork” Initiative CMA Webinar Schedule for 2019-2020 Support Traditional Medicare by … Read more

CMS Administrator Acknowledges that Prior Inpatient Hospital Rules Do Not Make Sense Government Watchdog Report Outlines Problems with Current Medicare Plan Finder As New Version Awaits Debut Short-term Health Plans: Goldmines for Insurance Companies, Junk for Enrollees Annual Surveys at Nursing Facilities Are Essential To Protect Residents CMA Webinar Schedule for 2019-2020 CMS Administrator Acknowledges … Read more

CMS’s Proposed Changes to Nursing Home Requirements of Participation, Survey and Enforcement: Nothing Good for Residents Federal Reports Find Incidents of Nursing Home Resident Abuse Are on the Rise but also Underreported Self-Help Resources for Improvement Standard Denials – August, 2019 CMS’s Proposed Changes to Nursing Home Requirements of Participation, Survey and Enforcement: Nothing Good … Read more

Part D Legislation Markup Today: Improve Beneficiary Appeals CMS Releases Special Focus Facility Candidate List But Transparency Issues Remain Senate Finance Committee Holds Hearing on Nursing Home Issues Private Medicare Advantage Plans Overbill Medicare Part D Legislation Markup Today: Improve Beneficiary Appeals On Tuesday, July 23, the Senate Finance Committee released draft drug pricing legislation, … Read more

More Doors to Medicare Home Health Closing, More Harm for Observation Status Patients CMS finalizes Rollback of Pre-Dispute Arbitration Protections Study Finds Home and Community-Based Services Access Disparities More Doors to Medicare Home Health Closing, More Harm for Observation Status Patients Many Medicare hospital patients classified as observation status “outpatients” currently forego necessary skilled nursing … Read more

Observation Status and Surprise Medical Bills Government Watchdog Agency Issues Report Highlighting “Significant Vulnerabilities” in Medicare’s Hospice Benefit Observation Status and Surprise Medical Bills The Center for Medicare Advocacy frequently hears from Medicare beneficiaries and their families about patients who receive treatment, tests, and services for multiple days while they are in a hospital bed … Read more

Court Hearing Next Week in Case that Threatens the Affordable Care Act – Act Now Nursing Home “Quality Measures” Do Not Reflect Quality of Nursing Home Care New Oral Health Advocacy Collaborative Begins Court Hearing Next Week in Case that Threatens the Affordable Care Act – Act Now Oral argument in Texas v United States, the lawsuit … Read more

Center for Medicare Advocacy Urges No Changes to Federal Poverty Measures without Knowing the Impact Ways & Means Committee Marks Up BENES Act and Other Medicare-Related Provisions Latest Issue – Elder Justice Newsletter In Case You Missed It – New Jimmo Improvement Standard Issue Brief Center for Medicare Advocacy Urges No Changes to Federal Poverty … Read more

New Medicare Home Health Fact Sheet Special Report – “Graduates” From the Special Focus Facility Program Provide Poor Care Center for Medicare Advocacy Submits Joint Comments on Proposed Revisions to the Definition Of Group Therapy In Skilled Nursing Facilities New Medicare Home Health Fact Sheet One of the core considerations of the Center for Medicare … Read more

The National Association of Insurance Commissioners Recognizes Maintenance Therapy, Bolstering the Jimmo Settlement Agreement Inadequate Personal Care at Home Increases Overall Medicare Costs The New York Times Reports On HUD-Backed Nursing Homes Center for Medicare Advocacy Submits Comments to House Ways & Means and Energy & Commerce Committees on Draft Part D Legislation The National … Read more

More Health Care Sabotage: “Censorship” of the Affordable Care Act Nursing Home Study Finds Discharges Linked to Medicare Copayments Senators Release Secret List of Poor Quality Nursing Homes Center for Medicare Advocacy Submits Comments to CMS about Direct Contracting, Geographic-Based Model Center Comments on Proposed Rule Regarding Medicare/Medicaid Interoperability More Health Care Sabotage: “Censorship” of … Read more

Trump Administration Proposes to Gut Health Care Rights, Particularly Targeting LGBTQ People Nursing Home Compare Inaccurately Reports Civil Money Penalties Imposed Against Nursing Facilities Nursing Homes, Medicaid Rates, and Campaign Contributions Trump Administration Proposes to Gut Health Care Rights, Particularly Targeting LGBTQ People The landmark Affordable Care Act (ACA) included an anti-discrimination provision – the … Read more

Congressional Hearing on Surprise Medical Bills; Center for Medicare Advocacy Submits Statement on Observation Status Report Highlights Overpayments to Medicare Advantage Plans and Raises Important Policy Considerations Webinar: Where Does the Money Go? Insights and Consumer Perspectives on Nursing Home Profits and Losses Elder Justice Newsletter – New Issue Available Now Congressional Hearing on Surprise Medical … Read more

Special Update Issue Brief: Medicare Coverage of Dental Services One of the core considerations of the Center for Medicare Advocacy’s Medicare Platform is to expand Medicare coverage to include oral health and dental care for all beneficiaries. We have also long advocated for coverage of medically necessary oral health care, which we think is currently supported … Read more

A First Step in an Important National Discussion: Congressional Committee Holds Hearing on “Medicare for All” Medicare Coverage for Genetic Tests: Know the Facts A First Step in an Important National Discussion: Congressional Committee Holds Hearing on “Medicare for All” Repeated efforts to repeal and undermine the Affordable Care Act (ACA) have led to growing … Read more

Medicare Trustees Issue 2019 Report: Medicare is Not Going Broke Article Raises Concerns about Medicare Advantage and Calls Attention to Limited Medigap Access CMS Proposed Rule to Redefine Group Therapy in Skilled Nursing Facilities: Concern for Resident Care CMS Expands List of DMEPOS Subject to Prior Authorization as a Condition of Payment Only a few … Read more

The Growing Disparity Between Medicare Advantage and Traditional Medicare: CMS Publishes Final MA Telehealth Benefit Rule How to Prevent Re-Hospitalization Of Nursing Home Residents: More Physicians and Nurses In Nursing Homes Joint Statement: Federal Report Finds That CMS Failed to Properly Oversee State’s Nursing Home Investigations Latest Issue: Elder Justice: What “No Harm” Really Means … 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

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

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

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

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

Amidst Medicare Open Enrollment, CMS Reports High Rates of Inaccuracy in Medicare Advantage Provider Directories In Her Own Words: A Beneficiary's Take On Medicare Advantage Steering Health Care Sabotage: Administration Doubles Down on States’ Ability to Undermine ACA Amidst Medicare Open Enrollment, CMS Reports High Rates of Inaccuracy in Medicare Advantage Provider Directories The Medicare … 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