On March 24, 2020, a federal court issued a decision in a nationwide class action, Alexander v. Azar, finding that certain Medicare beneficiaries who are switched to “observation status” at hospitals after being admitted as “inpatients,” have the right to appeal to Medicare to challenge that status. Here are some answers to frequently asked questions about … Read more

For Immediate Release March 24, 2020 Contact: Matthew Shepard: 202-293-5760, MShepard@MedicareAdvocacy.org In a decision issued today, Judge Michael P. Shea of the U.S. District Court in Hartford, Connecticut found that certain Medicare beneficiaries who are placed on “observation status” at hospitals, rather than being admitted as “inpatients,” have the right to appeal to Medicare. The … Read more

On January 21, 2020, the Supreme Court declined to grant expedited review of the lawsuit that seeks to strike down the entire Affordable Care Act (ACA). Texas and several other states are pursuing the case (now called California v. Texas) with the support of the Trump administration. Even though an expedited schedule was denied, the … Read more

The Center has joined other organizations that advocate for older adults in filing amicus briefs in several lawsuits challenging the Department of Homeland Security’s “public charge” rule. The regulation, finalized last year, represents a drastic change in how applicants for lawful permanent residency (green cards) will be evaluated, and it will have a particularly negative … Read more

Reminder: Objections to Home Health Appeals Settlement Due February 5, 2018

As previously announced, the Center has reached a tentative agreement with CMS in Sherman v. Hargan. The Sherman case challenged the quality of lower-level Medicare home health appeals.  The settlement was preliminarily approved, and any objections from class members must be received by February 5, 2018.  A fairness hearing on the settlement will be held in New Haven, … Read more

CMA Alert – Tax Cuts will Hurt, Not Help; Sherman Fairness Hearing Set; “Homebound” Settlement Objections Due; More

Words Matter. Tax Cuts Will Hurt, Not Help America Final Week in Health Care Sabotage – 2017 ACA Open Enrollment Over in Most States Social Isolation Among Older Medicare Beneficiaries Reminder: Objections to "Homebound" Settlement Due December 28, 2017 Settlement on Lower-Level Home Health Appeals Preliminarily Approved – Fairness Hearing Set for February 26, 2018 … Read more

CMA Alert – It’s Enrollment Season; CMS Reissues HH Booklet; “Homebound” Case Settlement; More

It's Health Care Enrollment Season NEW! CMS Again Reissues Improved Medicare Home Health Booklet THIS Week In ACA Sabotage… Happy Anniversary SSI Medicare "Homebound" Class Action Settled – Fairness Hearing Set for January 11, 2018 It's Health Care Enrollment Season Free Webinar Series Next Webinar: Social Security Disability Insurance (SSDI) Part 2 – Overview of Benefits for … Read more

Decision in Alexander v. Price Means Medicare Patients Could Gain Right to Appeal Placement on “Observation Status” and Avoid Large Medical Bills Eighty-four-year-old Nancy Niemi of North Carolina was hospitalized for 39 days earlier this year after her doctor sent her to the emergency room. It took weeks to stabilize her blood pressure and she … Read more

For Immediate Release Contact: Matthew Shepard mshepard@medicareadvocacy.org 860-456-7790 Feb. 9, 2017 – In a decision released on February 8, 2017, a federal judge allowed Medicare hospital patients seeking a right to appeal their placement on “outpatient observation status” to proceed with their lawsuit. The Barrows case, now called Alexander v. Cochran, is a proposed nationwide … Read more

On August 8, a federal judge in Connecticut largely denied the government’s motion to dismiss and granted plaintiff’s motion for certification of a nationwide class. Sherman v. Burwell, No. 3:15-cv-1468 (JAM) (D. Conn.). The case challenges the fact that, for the last several years, decisions at the earliest two levels of appeal in the Medicare administrative process … Read more

As previously reported, a court preliminarily approved settlement in the case of Exley v. Burwell, 3:14-cv-1230 (JAM) (D. Conn.), in March of this year. Since then the government requested and the plaintiffs agreed to a revision in the proposed settlement. Because of this revision, the parties are posting notice to the class again and the … Read more

On January 29, 2015, a federal judge ruled that Medicare beneficiaries who filed suit about the lengthy and illegal delays in Administrative Law Judge appeals may proceed with the case. The Center for Medicare Advocacy, which represents the plaintiffs, brought the case (Lessler et al. v. Burwell, 3:14-CV-1230, D. Conn.) to help fix a broken … Read more

On August 26, 2014, the Center for Medicare Advocacy filed a nationwide class action lawsuit in United States District Court (Lessler et al. v. Burwell, 3:14-CV-1230, D. Conn.). The five named plaintiffs, from Connecticut, New York and Ohio, have all waited longer than the statutory 90-day limit for a decision on their Medicare Administrative Law … Read more

On September 23, a federal judge in Connecticut dismissed a lawsuit filed by the Center for Medicare Advocacy and the National Senior Citizens Law Center on behalf of Medicare beneficiaries who have been placed on "observation status."[1]  When hospital patients are placed on observation status they are labeled "outpatients," even though they are often on … Read more

Completion of legal process for beneficiaries with long-term and chronic conditions  January 24, 2013 – Mansfield, Conn. – The Center for Medicare Advocacy, along with its co-counsel Vermont Legal Aid are pleased that the Settlement Agreement in the Medicare Improvement Standard case, Jimmo v. Sebelius, was approved today at the conclusion of a scheduled fairness … Read more

Attorneys from the Center for Medicare Advocacy, Vermont Legal Aid and the Centers for Medicare & Medicaid Services (CMS) have agreed to settle the "Improvement Standard" case, Jimmo v. Sebelius.[1] A proposed settlement agreement[2] was filed in federal District Court on October 16, 2012.  When the judge approves the proposed agreement, a process that may … Read more

Back vs. Sebelius, 9th Circuit 7/5/2012 Although it dismissed the case, the U.S. 9th Circuit Court of Appeals today also confirmed that Medicare hospice patients have the right to appeal denials of services. The defendant, Secretary of Health and Human Services Kathleen Sebelius, acknowledged after this lawsuit was filed, that Medicare hospice beneficiaries have a … Read more

Joining five other national organizations that represent the interests of elderly and disabled people, the Center for Medicare Advocacy filed an amicus brief on January 30 in the United States Supreme Court supporting a position of the federal government in the Affordable Care Act (ACA) litigation.[1]  The brief does not address the constitutionality of the … Read more

For Immediate Release                                             Contacts: Judith Stein and Gill Deford November 3, 2011                                                                          (860)456-7790 Center for Medicare Advocacy Seeks … Read more

The Center for Medicare Advocacy has heard increasingly about beneficiaries throughout the country whose entire stays in a hospital, including stays as long as 14 days, are classified by the hospital as outpatient observation.  In some instances, the beneficiaries' physicians order their admission, but the hospital retroactively reverses the decision.  As a consequence of the classification of … Read more

Plaintiffs in a lawsuit filed by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of Medicare beneficiaries with long-term and chronic conditions have overcome a major hurdle.  In a comprehensive 35-page decision, a federal judge in Vermont refused the federal government's request to throw out a lawsuit that seeks to end use … Read more

The Medicare Secondary Payer (MSP) program authorizes the Centers for Medicare & Medicaid Services (CMS) to recover compensation payments from beneficiaries who have private insurance that should be primarily responsible for their medical expenses.[1] In a class action lawsuit brought by Medicare beneficiaries and their attorney to challenge certain harsh MSP collection practices, a federal … Read more

The Center is concerned about the use of MSNs that do not reveal to beneficiaries that their service was denied based on a National Coverage Determination.  Such an MSN will instead provide a misleading explanation, such as "Medicare does not cover this service," or "information provided does not support the need for this service." If … Read more

  March 3, 2011 For Immediate Release Contact:  Gill Deford, (860) 456-7790 gdeford@medicareadvocacy.org Judith Stein, (860) 456-7790 jstein@medicareadvocacy.org Today, the Alzheimer's Association and United Cerebral Palsy joined five other national organizations and several Medicare beneficiaries in a class action lawsuit challenging the Medicare program's Improvement Standard.  Under that Standard, Medicare patients suffering from chronic conditions … Read more

For Immediate Release January 18, 2011 Contact: Patricia Haubner 914-833-7093; 914-275-2984 LAWSUIT FILED TO BLOCK ILLEGAL DENIALS OF SERVICES TO MEDICARE PATIENTS WITH CHRONIC ILLNESS Center for Medicare Advocacy Lead Counsel in National Class-Action Suit Burlington, VT − Today, The Center for Medicare Advocacy and co-counsel from Vermont Legal Aid filed a class action lawsuit … Read more