In Alexander v. Becerra, a federal court found that certain beneficiaries must be allowed to appeal to Medicare when their hospitalizations are reclassified from “inpatient” to “outpatient receiving observation services.” The Center for Medicare … [Read more...] about Reminder: Questions or Comments on Proposed Clarification in Hospital “Observation Status” Case Due November 25
Archives for November 2022
Disputes with Medicare Advantage Plans: Know the Difference Between Appeals and Grievances
Under Medicare law, Medicare Advantage plans and stand-alone Part D plans (“Plans”) must follow certain rules when enrollees disagree with Plan health care coverage determinations. Under the law, there are two distinct methods for raising issues with … [Read more...] about Disputes with Medicare Advantage Plans: Know the Difference Between Appeals and Grievances
Sale of “Ancillary Products” to Fill Gaps in Medicare Advantage Highlight Both Coverage Shortfalls and Need for Stronger Regulation of the MA Marketplace
Introduction As discussed in recent CMA publications, including our “Special Report | Recent Articles and Reports Shed Light on Medicare Advantage Issues” (Oct. 31, 2022), and “Senate Report Highlights Widespread Medicare Advantage Marketing … [Read more...] about Sale of “Ancillary Products” to Fill Gaps in Medicare Advantage Highlight Both Coverage Shortfalls and Need for Stronger Regulation of the MA Marketplace
Senate Report Highlights Widespread Medicare Advantage Marketing Misconduct – But the Driving Forces of Misconduct Are Broader
After the Centers for Medicare & Medicaid Services (CMS) reported earlier this year that Medicare beneficiary complaints about Medicare Advantage (MA) marketing more than doubled between 2020 and 2021, the Senate Finance Committee launched an … [Read more...] about Senate Report Highlights Widespread Medicare Advantage Marketing Misconduct – But the Driving Forces of Misconduct Are Broader
CMA Is Hiring an Attorney in Our CT Office
Join a Nationally-Known, Non-Profit Law Organization and Help People Access Medicare and Health Care The Center for Medicare Advocacy (the Center) seeks an attorney with a commitment to health equity and social justice to practice in Connecticut. … [Read more...] about CMA Is Hiring an Attorney in Our CT Office
Wilson Sonsini Firm Honored for its Pro Bono Work on Center’s “Observation Status” Case
The Center for Medicare Advocacy celebrates Wilson Sonsini Goodrich & Rosati’s well-deserved honor as a “Pro Bono Innovator.” This week Bloomberg Law highlighted the firm’s work with the Center and co-counsel Justice in Aging on the nationwide … [Read more...] about Wilson Sonsini Firm Honored for its Pro Bono Work on Center’s “Observation Status” Case
Meet One of the Named Plaintiffs in the Center’s Home Health Aide Lawsuit
This week, Katherine Vaczi, one of the named plaintiffs in Johnson v. Becerra, was featured in an article in the Philadelphia Inquirer. Ms. Vaczi, 81, has used a wheelchair since she sustained a spinal cord injury at age 23. She requires the services … [Read more...] about Meet One of the Named Plaintiffs in the Center’s Home Health Aide Lawsuit
CMS Issues Final Rules That Address Significant Medicare Enrollment Pitfalls for Parts A and B
On November 3, 2022, CMS issued a final rule implementing certain provisions of the Consolidated Appropriations Act of 2021 (CAA), including: Key provisions of the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act … [Read more...] about CMS Issues Final Rules That Address Significant Medicare Enrollment Pitfalls for Parts A and B
In Major Milestone, Medicare to Cover Additional Dental Treatments
The Centers for Medicare & Medicaid Services (CMS) just announced that Medicare will begin making payment in 2023 for dental services necessary to identify and eliminate oral and dental infections prior to, and contemporaneously with, organ … [Read more...] about In Major Milestone, Medicare to Cover Additional Dental Treatments