[Date][Attorney’s Name] [Address]Re: [Beneficiary’s Name], Medicare No. [XXXXX]To Whom It May Concern:I am writing on behalf of my client, [Full Name], to request an expedited reconsideration. The skilled nursing facility (SNF) … [Read more...] about Jimmo “Improvement Standard” Appeal Letter Template
Archives for October 2019
Expedited/Fast-Track Medicare Appeals in Skilled Nursing Facilities in Light of the Jimmo v. Sebelius Settlement Agreement *
BackgroundThe United States District Court for the District of Vermont approved a settlement agreement in Jimmo v. Sebelius[1] on January 23, 2013. The Jimmo Settlement required the Centers for Medicare & Medicaid Services (CMS) to confirm … [Read more...] about Expedited/Fast-Track Medicare Appeals in Skilled Nursing Facilities in Light of the Jimmo v. Sebelius Settlement Agreement *
Center Comments on Use of written Advance Beneficiary Notice of Noncoverage (ABN)
October 21, 2019VIA ELECTRONIC SUBMISSIONCenters for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-9115-P, Mail Stop C4-26-05 7500 Security Boulevard Baltimore, MD 21244-1850RE: … [Read more...] about Center Comments on Use of written Advance Beneficiary Notice of Noncoverage (ABN)
Medicare Fully Informed Project
Providing Medicare Beneficiaries with Complete, Objective Information to Help Them Make the Best Enrollment DecisionThe Center for Medicare Advocacy and the National Committee to Preserve Social Security and Medicare partnered on an education … [Read more...] about Medicare Fully Informed Project
CMA Alert – October 17, 2019
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 … [Read more...] about CMA Alert – October 17, 2019
Center for Medicare Advocacy Board President Judith Feder Testifies at Drug Pricing Hearing
On October 17, 2019, the House Ways & Means Committee held a hearing entitled “Investing in the U.S. Health System by Lowering Drug Prices, Reducing Out-of-Pocket Costs, and Improving Medicare Benefits.” The hearing focused on H.R. 3, the Lower … [Read more...] about Center for Medicare Advocacy Board President Judith Feder Testifies at Drug Pricing Hearing
Joint Issue Alert on Medicare Payment and Skilled Therapy Services in Nursing Homes
On October 1, 2019, the Centers for Medicare & Medicaid Services (CMS) implemented a new payment system for Medicare-covered nursing home stays—the “Patient Driven Payment Model” (PDPM). PDPM creates new financial incentives for nursing homes and … [Read more...] about Joint Issue Alert on Medicare Payment and Skilled Therapy Services in Nursing Homes
Drug Company Sued Over Kickbacks for Off-Label Marketing of Psychotropic Drug for Nursing Home Residents to Pay Over $115 Million
BackgroundWhen the Centers for Medicare & Medicaid Services (CMS) launched a national campaign to reduce the off-label prescribing of antipsychotic drugs for nursing home residents in 2012, Avanir Pharmaceuticals directed its sales force to … [Read more...] about Drug Company Sued Over Kickbacks for Off-Label Marketing of Psychotropic Drug for Nursing Home Residents to Pay Over $115 Million
Administration’s “Public Charge” Rule [Temporarily?] Blocked
Last week federal judges in several states issued temporary injunctions against the Trump administration's "public charge" rule, preventing it from taking effect. The rule was set to take effect this week.The “Public Charge” final rule, which was … [Read more...] about Administration’s “Public Charge” Rule [Temporarily?] Blocked
CMA Letter to Energy & Commerce in Support of H.R. 3 and Reinvestment of Savings in Medicare
October 16, 2019Frank Pallone Chairman Energy and Commerce Committee United States House of Representatives Washington, DC 20515 Greg Walden Ranking Member Energy and Commerce Committee United States House of … [Read more...] about CMA Letter to Energy & Commerce in Support of H.R. 3 and Reinvestment of Savings in Medicare