The Center for Medicare Advocacy (the Center) has developed information, materials, and educational webinars to promote informed choice by beneficiaries. As the Center has written, information about Medicare coverage options produced by the Medicare agency is no longer neutral; instead it now actively promotes private Medicare Advantage (MA) enrollment, and paints MA plans in the … Read more

Medicare’s annual open enrollment period (October 15 – December 7), is time for beneficiaries to take stock of their Medicare options for the upcoming calendar year – whether to choose traditional (real) Medicare or a private insurance Medicare Advantage (MA) plan. The Center for Medicare Advocacy (the Center) has developed information, materials, and educational webinars … Read more

Medicare’s annual open enrollment period (October 15 – December 7), is time for beneficiaries to take stock of their Medicare options for the upcoming calendar year – whether to choose  traditional (real) Medicare or a private insurance Medicare Advantage (MA) plan. The Center for Medicare Advocacy (the Center) has developed information, materials, and educational webinars … Read more

For years, the Center for Medicare Advocacy has warned of wasteful overspending on private Medicare Advantage (MA) plans, the limitations on access to physicians and health care provided by MA, and the difficulties in obtaining the same coverage from the plans as is available in real Medicare. (See Case Study below.) Despite these efforts, Medicare … Read more

Problems with Medicare Plan Finder Persist As reported by SHIPs across the country and some of our partner organizations, problems with the new Medicare Plan Finder (MPF) persist during the current Medicare Annual Election Period, which lasts through December 7, 2019. These problems include: inaccurate information about covered drugs and costs, non-formulary drugs, dosage options, … Read more

On October 22, the Center for Medicare Advocacy and the National Committee to Preserve Social Security and Medicare launched the second annual Medicare Fully Informed Project, with a variety of unbiased, accurate, up-to-date, and comprehensive information about the full range of Medicare coverage options. The Medicare Fully Informed Project includes an array of tools to … Read more

Among Vague Language and Proposals, Real Harm to Medicare Beneficiaries On October 3, 2019, President Trump issued his “Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors” (EO).[1] Much of the language of the EO is vague, and much is unknown about what polices might emerge from it. Some of the proposals are … Read more

Among Vague Language and Proposals, Real Harm to Medicare Beneficiaries On October 3, 2019, President Trump issued his “Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors” (EO).[1] Much of the language of the EO is vague, and much is unknown about what polices might emerge from it. Some of the proposals are … Read more

FOR IMMEDIATE RELEASE October 3, 2019 Contact: Matthew Shepard: 202-293-5760, MShepard@MedicareAdvocacy.org Today the Trump Administration issued an Executive Order (EO) entitled “Protecting and Improving Medicare for Our Nation’s Seniors.” Since the President’s speech announcing the EO lacked policy specifics, we looked to the administration’s telephone press conference to discern the intentions behind the EO. As … Read more

As noted in a press release issued by Rep. Rosa DeLauro’s office, on September 30, 2019, members of Connecticut’s congressional delegation sent a letter to the President of Anthem Blue Cross Blue Shield to “express our concern regarding the recently announced provider terminations from Anthem Blue Cross and Blue Shield’s (Anthem) Medicare Advantage (MA) network … Read more

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” … Read more

At the beginning of the current session of Congress, the Center for Medicare Advocacy laid out a Medicare Platform for the New Congress to guide improvements to Medicare and possible expansion of the Medicare-covered population. One of the core considerations to improve Medicare for all beneficiaries, now and in the future, is the need to preserve … Read more

On August 27, 2019, the same day that the Centers for Medicare and Medicaid Services (CMS) debuted the updated Medicare Plan Finder (MPF) tool, four beneficiary advocacy organizations – the Center for Medicare Advocacy, Justice in Aging, Medicare Rights Center, and the National Council on Aging – sent a joint letter to CMS raising concerns … Read more

FOR IMMEDIATE RELEASE August 27, 2019 Contact: Justice in Aging – Vanessa Barrington: 510-256-1200, vbarrington@justiceinaging.org Medicare Rights Center – Mitchell Clark: 212-204-6286, mclark@medicarerights.org Center for Medicare Advocacy – Matt Shepard: 860-456-7790, mshepard@MedicareAdvocacy.org National Council on Aging – Armando Trull: 202-709-2474, armando.trull@ncoa.org Beneficiary Advocates Raise Alarms Concerning Roll-Out of New Medicare Plan Finder and Revision of Medicare Marketing Rules Washington, DC ─ … Read more

The Center has previously written about how legislative and regulatory policy changes are tipping the scales in favor of Medicare Advantage (MA) over traditional Medicare. For example, coverage expansions such as the ability to provide new supplemental benefits have been advanced in MA but not in traditional Medicare. In recent years, this has been exacerbated … Read more

This week the CT Mirror published a Kaiser Health News article about overpayments to private Medicare plans. The article, originally titled “Insurers Running Medicare Advantage Plans Overbill Taxpayers By Billions As Feds Struggle To Stop It” underscores the need for improved oversight and enforcement of Medicare Advantage plans. According to the Kaiser Health News article, … Read more

The Kaiser Family Foundation (KFF) recently released a report entitled “Do People Who Sign Up for Medicare Advantage Plans Have Lower Medicare Spending?” (May 2019). As summarized in the report, “Even after risk adjustment, the results indicate that beneficiaries who choose Medicare Advantage have lower Medicare spending – before they enroll in Medicare Advantage plans … Read more

A recent Bloomberg News article highlighted an important issue for Medicare beneficiaries: limited access to Medigap plans. The Center for Medicare Advocacy has long advocated for improved access to Medigap plans for all Medicare beneficiaries. Medigap plans are private plans that provide supplemental health insurance for beneficiaries in Traditional Medicare to assist with out-of-pocket medical … Read more

The Centers for Medicare & Medicaid Services (CMS) published a Final Rule this week implementing provisions of the Bipartisan Budget Act of 2018.[1] As detailed in this Rule, Medicare Advantage (MA) plans will be allowed to offer telehealth services as a basic benefit starting in 2020. The Rule limits this telehealth benefit to services available … Read more

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

The son of a hospitalized patient recently called the Center for Medicare Advocacy. His father was ready for discharge. Physicians at both the hospital and the inpatient rehabilitation hospital (IRH) agreed that the patient would benefit from IRH services. However, the patient’s Medicare Advantage (MA) plan refused to authorize IRH care.  The plan instead said … Read more

On January 30, 2019, the Centers for Medicare & Medicaid Services (CMS) issued Part II of its draft 2020 Call Letter, an annual set of proposed rules, guidelines and clarifications for Part C Medicare Advantage (MA) and Part D plans that want to participate in Medicare in the following calendar year. In collaboration with several … Read more

Recently, the Center for Medicare Advocacy laid out our Medicare Platform for the New Congress. One of the core considerations to improve Medicare for all beneficiaries, now and in the future, is the need to preserve and expand consumer protections and quality coverage for all Medicare Beneficiaries – including parity between traditional Medicare and private Medicare … Read more

Recently, the Center for Medicare Advocacy laid out our Medicare Platform for the New Congress. One of the core considerations to improve Medicare for all beneficiaries, now and in the future, is the need to preserve and expand consumer protections and quality coverage for all Medicare Beneficiaries – including parity between traditional Medicare and private Medicare … Read more

The Center for Medicare Advocacy recently submitted comments to a Notice of Proposed Rulemaking issued by the Centers for Medicare & Medicaid Services (CMS) entitled “Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses” (CMS-4180-P).  The Center’s comments are available at: https://www.medicareadvocacy.org/center-comments-on-modernizing-part-d-and-medicare-advantage/.   Currently, Part D prescription drug plans (PDPs) … Read more

As reported widely, including in The New York Times,[1] the Trump Administration spent this Medicare Annual Enrollment Period steering beneficiaries towards private Medicare Advantage (MA) plans. While CMS contests this conclusion, Administrator Verma stated they are “unleashing and strengthening” Medicare Advantage[2] and HHS Secretary Azar says he sees Medicare Advantage as the future of Medicare: … Read more

Dear CMA, I am a retiree and my health plan is Medicare. I am retired 13 years and never have had any problem with my Medicare coverage. Most of my doctors accept Medicare and I have been very pleased with their services. I have become increasingly troubled by the targeted ads to seniors on TV … Read more

The Medicare Annual Coordinated Election Period (ACEP) is the most crucial time of year for Medicare beneficiaries to make decisions about how they wish to receive their Medicare coverage.  This year the Administration seems to be actively promoting Medicare Advantage plans. However, at the same time that this steering toward private plans is occurring, the … Read more

As we approach the final week of the Medicare Annual Coordinated Election Period (ACEP), individuals continue to make decisions about how they want to access their Medicare benefits in 2019.  Consumer advocates are concerned, however, that the information put out by the Medicare program about coverage options is incomplete and continues to promote one option … Read more

The November 2018 New England Journal of Medicine features a article by KFF’s Tricia Neuman and Gretchen Jacobson of the Kaiser Family Foundation (KFF) that “examine[s] the extent to which Medicare Advantage plans are achieving goals with respect to benefits, out-of-pocket costs, plan choice, federal spending and quality. They also highlight areas where more evidence … Read more

The Department of Health and Human Services (DHHS) Office of Inspector General (OIG) recently issued a report entitled “Medicare Advantage Appeal Outcomes and Audit Findings Raise Concerns About Service and Payment Denials” (OEI-09-16-00410) (see summary and full report). Among the report’s findings are that when beneficiaries and providers appealed preauthorization and payment denials, MA plans … Read more

Providing Medicare Beneficiaries with Complete, Objective Information to Help Them Make the Best Enrollment Decision Updated for 2019 The Center for Medicare Advocacy and the National Committee to Preserve Social Security and Medicare have partnered once again on an education and outreach project to support Medicare beneficiaries and those who assist them enroll and re-enroll … Read more

September 2018 Numerous changes were made to Medicare law, regulations and guidance during the first half of 2018.The changes are particularly noteworthy regarding Part C, governing private Medicare plans, known as Medicare Advantage (MA), and Part D, the prescription drug benefit.This report focuses on the impact to Medicare beneficiaries from changes to Parts C and … Read more

As reported in FierceHealthcare, “Medicare Advantage insurers scored a significant legal victory” when a U.S. District Court judge recently “struck down a 2014 rule requiring [plans] to report and return overpayments.”  Further, according to Modern Healthcare, this ruling “leaves the federal government with fewer tools to combat upcoding practices that cost the taxpayer-funded Medicare program … Read more

Researchers studying patients with hip fractures found that patients with Medicare Advantage (MA) plans have shorter stays in skilled nursing facilities (SNFs) and receive less rehabilitation than patients in traditional Medicare, but are, nevertheless, less likely to be readmitted to an acute care hospital within 30 days or to become long-term care residents.[1]  These findings … Read more

Ranking Committee Members Echo Advocates’ Complaints to CMS about Draft 2019 Medicare & You As discussed in a previous CMA Alert, the Center for Medicare Advocacy, Justice in Aging and the Medicare Rights Center recently sent a letter to the Centers for Medicare & Medicaid Services (CMS) raising “strong objections to serious inaccuracies” in the … Read more

The Center for Medicare Advocacy, Justice in Aging and the Medicare Rights Center recently sent a letter to the Centers for Medicare & Medicaid Services (CMS) raising “strong objections to serious inaccuracies” in the draft 2019 Medicare & You Handbook, and urged CMS to rectify the errors prior to dissemination.  As stated in a joint … Read more

On April 26, 2018, the Center for Medicare Advocacy provided comments to the Centers for Medicare & Medicaid Services (CMS) in response to an April 12, 2018  Request for Input on the 2019 Medicare Communications and Marketing Guidelines (MMG).  Unlike previous opportunities to provide comment, CMS did not offer draft language for revisions to the … Read more

Part C of the Medicare program, also known as Medicare Advantage (MA), is an option available to Medicare beneficiaries who wish to receive their benefits through private insurance companies, primarily HMOs.  In 2017, more than 19 million Medicare beneficiaries (33%) were enrolled in MA plans.  MA enrollment is projected to continue to grow, rising to … Read more

On February 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued its draft 2019 Call Letter, an annual set of proposed rules, guidelines and clarifications for Part C Medicare Advantage (MA) and Part D plans that wish to participate in Medicare in the following calendar year.  In collaboration with several other advocacy organizations, … Read more

The Journal of the American Medical Association (JAMA), recently published a Viewpoint article entitled “Time to Release Medicare Advantage Claims Data” by Niall Brennan, Charles Ornstein, and Austin B. Frakt (February 19, 2018).  After pointing out that almost 33% of the Medicare population is enrolled in Medicare Advantage (MA) plans at a cost of over $200 billion a year, … Read more

“Medicare Advantage Enrollees More Likely to Enter Lower-Quality Nursing Homes Compared to Fee-For-Service Enrollees,” a report recently published by Health Affairs, examines the quality of skilled nursing facilities (SNFs) used by Medicare Advantage (MA) enrollees and traditional Medicare beneficiaries. As the title indicates, the authors of the report found that traditional Medicare beneficiaries “tended to … Read more

Tax Cut Bill Just Got Worse. Health Care at Risk. This Week in Sabotage CMS Steering to Medicare Advantage Administration And Nursing Home Industry: Lockstep in Deregulating Nursing Facilities & Reducing Resident Protections Tax Cut Bill Just Got Worse.  Health Care at Risk. Free Webinar Series Next Webinar: Hospital Observation Status Update January 24, 2018 … Read more

CMA Alert – Remember You CAN Choose Original Medicare; Equitable Relief; This Week’s Sabotage News

You Can Choose Original Medicare: CMS Over-Emphasizes Private Medicare Advantage Plans in Open Enrollment Roll-Out CMS Extends Equitable Relief  CMA Joins 30 Organizations in Amicus Brief in Support of Court Challenge to Trump ACA Sabotage And THIS Week in ACA Sabotage… Auto-Enrollment… And No Time to Switch More Repeal Disguised as Reform You Can Choose Original … Read more

CMA Alert – Critical Issue Roundup: MA Overpayment; HH Payment; Observation; More

Former CMS Administrator Comments on Medicare Advantage Overpayments Proposed Home Health Rules – Payments Drive Delivery of Care, Harming Beneficiaries Observation Status Harms Low-Income Medicare Beneficiaries Poll: Americans Favor Making the ACA Work Former CMS Administrator Comments on Medicare Advantage Overpayments In Austin Frakt’s August 7, 2017 The Upshot blog in the New York Times … Read more

As noted in a previous Alert, the Center for Medicare & Medicaid Services (CMS) recently finalized their 2018 Call Letter.  In the same document, CMS issued a Request for Information regarding ideas for “regulatory, sub-regulatory, policy, practice and procedural changes to better accomplish” the goals of “using transparency, flexibility, program simplification and innovation to transform … Read more

April 24, 2017 VIA ELECTRONIC SUBMISSION PartCDcomments@cms.hhs.gov Seema Verma, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Baltimore, MD 21244 Re:                  2017 Transformation Ideas – Response to Request for Information re: Medicare Advantage and Part D Dear Administrator Verma: The Center for Medicare Advocacy (Center) is pleased to provide … Read more

Last month in Connecticut, United Healthcare (UHC) set off a panic among its Medicare Advantage (MA) enrollees by sending out letters indicating that they would no longer be affiliated with Hartford HealthCare HHC), one of Connecticut’s largest provider networks. These MA enrollees often received multiple letters – one for each of their HHC providers. One … Read more

On February 1, 2017, the Centers for Medicare & Medicaid Services (CMS) issued its draft 2018 Call Letter, an annual set of proposed rules, guidelines and clarifications for Part C Medicare Advantage (MA) and Part D plans that wish to participate in Medicare in the following calendar year.  In collaboration with several other advocacy organizations, … Read more

In last week’s Alert, we posed 10 questions to ask before deciding between traditional Medicare and a Medicare Advantage Plan. This week we discuss what your answers may mean. Do you qualify for payment assistance or have access to other coverage through any of the following… Medicare Savings Program? Part D Low Income Subsidy? Employer/Military/Other … Read more