In order to manage costs, Medicare Advantage (MA) plans are able to restrict their enrollees to a contracted network of health care providers that is “sufficient to provide access to covered services to meet the needs of the population served.”* Some … [Read more...] about Advocacy Tip for Medicare Advantage Enrollees Facing Difficulty Obtaining In-Network Care
Medicare and Health Care Reform
Improving Medicare by Reining in Medicare Advantage Overpayments: Policy Options
Building on several recent studies that have found massive overpayments to Medicare Advantage (MA) plans, the Center for Medicare Advocacy released a report outlining how policymakers can look to utilize cost savings by reining in overpayments to … [Read more...] about Improving Medicare by Reining in Medicare Advantage Overpayments: Policy Options
More Medicare Prescription Drug Help for Beneficiaries in 2024 – Including Out-of-Pocket Cap
The Inflation Reduction Act of 2022 (IRA), signed into law by President Biden on August 16, 2023, is already providing cost-savings for Medicare beneficiaries in 2023, including a monthly cap of $35 for covered insulin and free vaccines for certain … [Read more...] about More Medicare Prescription Drug Help for Beneficiaries in 2024 – Including Out-of-Pocket Cap
Medicare Drug Price Negotiation Program Begins After Encouraging Court Decision
A federal court has rejected a bid by the pharmaceutical industry and its allies to stop the newly established Medicare drug price negotiation program before it starts. On September 29, 2023, Judge Michael J. Newman of the U.S. District Court for … [Read more...] about Medicare Drug Price Negotiation Program Begins After Encouraging Court Decision
Senate Finance Committee Confirms Medicare Home Health Coverage Can Be Long-Term
At a September 19, 2023 hearing, held by the Subcommittee on Health Care of the Senate Finance Committee and entitled “Aging in Place: The Vital Role of Home Health and Access to Care,” Subcommittee Chair Senator Benjamin L. Cardin (D – MD) confirmed … [Read more...] about Senate Finance Committee Confirms Medicare Home Health Coverage Can Be Long-Term
Inflation Reduction Act (Medicare Drug Law) Updates – Including Part D Low Income Subsidy
HHS Actions to Increase LIS EnrollmentAmong other changes aimed at reducing drug costs for both Medicare beneficiaries and the Medicare program at large, a provision of the Inflation Reduction Act of 2022 (IRA) expands access to the Part D Low … [Read more...] about Inflation Reduction Act (Medicare Drug Law) Updates – Including Part D Low Income Subsidy
President Biden’s Prescription for Medicare Solvency
Before rolling out his Administration’s proposed budget today, President Biden authored a New York Times guest essay titled “Joe Biden: My Plan to Extend Medicare for Another Generation” (March 7, 2023). The same day, the White House released a … [Read more...] about President Biden’s Prescription for Medicare Solvency
Implementation of Medicare Drug Bill Proceeds – This Progress Must be Defended
As discussed in a previous CMA Alert (Aug. 18, 2022), President Biden signed into law the Inflation Reduction Act (IRA) of 2022 on August 16, 2022. This bill includes historic prescription drug provisions that are already providing significant … [Read more...] about Implementation of Medicare Drug Bill Proceeds – This Progress Must be Defended
Center for Medicare Advocacy Statement on Recent Medicare Advantage Payment Policies and Proposals
A Step in the Right Direction, But Not Enough to Stem Wasteful OverpaymentsAs documented in various CMA Alerts, there is consistent and growing evidence that Medicare Advantage (MA) plans are paid more on average than traditional Medicare spends … [Read more...] about Center for Medicare Advocacy Statement on Recent Medicare Advantage Payment Policies and Proposals
Critical Provisions of Medicare Drug Bill Already Taking Effect
As discussed in a recent CMA Alert (Dec. 8, 2022), provisions of the Inflation Reduction Act (IRA) have begun to take effect, and other provisions are soon to follow. However, these historic changes are already being threatened by the pharmaceutical … [Read more...] about Critical Provisions of Medicare Drug Bill Already Taking Effect