August 12, 2019 SUBMITTED ELECTRONICALLY VIA Centers for Medicare and Medicaid Services U.S. Department of Health and Human Services 7500 Security Boulevard Baltimore, MD 21244 Re:       CMS-6082-NC; Request for Information: Reducing Administrative Burden to Put Patients over Paperwork Dear Administrator Verma: The Center for Medicare Advocacy (“Center”) appreciates the opportunity to comment on … Read more

Medicare Savings Programs (MSP) offer assistance with meeting the costs of Medicare premiums and deductibles. The MSPs include the Qualified Medicare Beneficiary program (QMB), Specified Low-Income Medicare Beneficiary program (SLMB), and Qualified Individual program (QI).  All of these help Medicare beneficiaries of modest means pay all or some of Medicare’s cost sharing amounts (ie. premiums, … Read more

The Social Security Administration (SSA) has released revisions to the Program Operations Manual System (POMS) regarding how to process Part A enrollments that are conditional to a state’s determination of a beneficiary as a Qualified Medicare Beneficiary (QMB).  The update is intended to address inconsistencies and confusion in SSA field offices and includes important clarifications, … Read more

The Plan: Pass a Devastating Tax Bill, Balloon the Deficit, then Gut the Social Programs We Rely On Jimmo Update: Court Orders CMS to Modify Special Jimmo Webpage ACA and Medicare Enrollment Periods End Soon Changes to Notice of Qualified Medicare Beneficiary (QMB) Status The Plan: Pass a Devastating Tax Bill, Balloon the Deficit, then … Read more

The 2016 Medicare Part A and B General Enrollment Period runs from January 1 through March 31, 2016. As detailed below, this enrollment period is especially important for many individuals who are not eligible for premium-free Medicare Part A. Most people do not pay a premium for Medicare Part A because they have sufficient work history. … Read more

A recent Centers for Medicare & Medicaid Services (CMS) report, Access to Care Issues Among Qualified Medicare Beneficiaries (QMB), revealed several access to care problems for low-income Medicare beneficiaries enrolled in the QMB program. The report analyzed two studies focused on access to care for low-income beneficiaries. The first study utilized qualitative interviews with beneficiaries … Read more

On Tuesday, April 1st, President Obama signed into law the "Protecting Access to Medicare Act of 2014" (H.R. 4302).[1] This bill is a one year short-term "fix" or "patch" to pending Medicare physician payment cuts under the current physician payment formula called the "sustainable growth rate" or "SGR".  Passed by voice vote in the House … Read more

Programs that help low-income people afford their Medicare, including the Medicare Savings Programs and the Part D Low Income Subsidy (also called LIS or Extra Help) have income and resource eligibility guidelines that change yearly. The Federal poverty level (FPL) guidelines for 2014 were published in the Federal Register on January 22, 2014.[1]  These guidelines … Read more

Five years ago this month, the Medicare Improvements for Patients and Providers Act (MIPPA)[1] became law. Since then, MIPPA has successfully increased enrollment in the Medicare Savings Program and helped ensure that thousands of Medicare beneficiaries are able to afford necessary medical care. Despite MIPPA's success, Medicare low-income programs remain under-enrolled. Federal policy makers should … Read more

Balance Billing is Prohibited.  Period. New Guidance released jointly by the Center for Medicaid and CHIP Services (CMCS) and the Medicare-Medicaid Coordination Office (MMCO) once again highlights and advises about an issue that has created hardships for low-income people using Medicare and challenges for advocates trying to help them. The jointly-issued Guidance includes a link … Read more

On Friday, April 23, 2010, Judge Juan R. Sanchez of the United States District Court for the Eastern District of Pennsylvania approved the settlement of a lawsuit brought by Pennsylvania low-income Medicare beneficiaries.  Narcisa Garcia, et al. v. Kathleen Sebelius, et al.[1] The Garcia settlement will lower the cost of Medicare and increase access to … Read more

The Affordable Care Act creates an office within the Centers for Medicare & Medicaid Services (CMS) whose focus is beneficiaries who are eligible for both Medicare and Medicaid (dual eligibles). [1] Specifically, the Federal Coordinated Health Care Office (CHCO) is created for the purposes of: more effectively integrating benefits under Medicare and Medicaid for those … Read more

Introduction Long-awaited guidance from the Centers for Medicare & Medicaid Services (CMS) concerning implementation of various provisions of the Medicare Improvements for Patients and Protections Act of 2008 (MIPPA), Pub. L. 110-275, was released on February 18, 2010. [1] The guidance, in the form of a State Medicaid Director Letter (SMDL # 10-003), signed by … Read more

In 2006 the Centers for Medicare & Medicaid Services (CMS) created the “Point-of-Sale Facilitated Enrollment” (POS) process, administered by WellPoint.  The purpose of the POS is to assist people who are dually eligible for Medicare and Medicaid (dual eligibles) in filling their prescriptions at the pharmacy if they have not yet been assigned to a … Read more