In an alarmist State of the Nursing Home Sector, the American Health Care Association (AHCA) reports, yet again, dire news about nursing facilities. It claims that historic labor shortages have led to the lowest nursing home staffing levels since … [Read more...] about A Message to Nursing Home Trade Associations: Stop Scaring Residents and Staff About Nursing Home Staffing, Spend Public Reimbursement on Resident Care
Archives for June 2023
ACA No-Cost Preventive Services Will Continue Pending Appeal
An agreement was reached this week in a lawsuit regarding preventive benefits, allowing cost-free coverage of services such as annual wellness visits and many cancer screenings to continue essentially unchanged for the time being.The agreement … [Read more...] about ACA No-Cost Preventive Services Will Continue Pending Appeal
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
Lawsuit Settlement Allows Medicare Coverage for “Off-Label” Medication
Medicare has agreed to cover an essential medication for a retired public school teacher in New Jersey who needs the drug to control debilitating symptoms of a digestive system disorder.Cheryl Hough experiences extreme nausea, vomiting, and … [Read more...] about Lawsuit Settlement Allows Medicare Coverage for “Off-Label” Medication
Center Appeals Dismissal of Home Health Aide Lawsuit
The Center for Medicare Advocacy has appealed the dismissal of a lawsuit filed on behalf of beneficiaries with chronic, disabling conditions who cannot access the home health aide services they require. The proposed class action, filed in October … [Read more...] about Center Appeals Dismissal of Home Health Aide Lawsuit
Drug Company Sues Medicare to Reverse Gains Being Made in Reining in Drug Costs
June 6, 2023WASHINGTON, D.C. - Today, pharmaceutical company Merck filed a lawsuit against the Medicare program in an effort to stop progress being made on drug pricing in Medicare through the Inflation Reduction Act (IRA), signed into law by … [Read more...] about Drug Company Sues Medicare to Reverse Gains Being Made in Reining in Drug Costs
Bipartisan Group of Senators and Representatives Support CMS’s Proposed Rule on Nursing Home Ownership Transparency and Urges CMS to Strengthen Rule in Seven Specific Ways
In a May 17, 2023 letter to CMS Administrator Chiquita Brooks-LaSure, Senators Charles E. Grassley (R, IA), Elizabeth Warren (D, MA), and Robert P. Casey, Jr. (D, PA), and Representatives Katie Porter (D, CA) and Lloyd Doggett (D, TX) express support … [Read more...] about Bipartisan Group of Senators and Representatives Support CMS’s Proposed Rule on Nursing Home Ownership Transparency and Urges CMS to Strengthen Rule in Seven Specific Ways
Submit Comments on Part A Medicare Reimbursement For Skilled Nursing Facilities – Due June 5
The Centers for Medicare & Medicaid Services’ proposed annual update to Medicare Part A reimbursement for skilled nursing facilities, published in the Federal Register on April 10, 2023, includes policy issues of concern to advocates for … [Read more...] about Submit Comments on Part A Medicare Reimbursement For Skilled Nursing Facilities – Due June 5
Center Comments on Skilled Nursing Facilities Payments and Oversight, 2023
Centers for Medicare & Medicaid ServicesDepartment of Health and Human ServicesJune 5, 2023Re: Medicare and Medicaid Programs; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality … [Read more...] about Center Comments on Skilled Nursing Facilities Payments and Oversight, 2023
Updated Factsheet: Medicare Skilled Nursing Facility Coverage Does Not Require Improvement
In 2013, a federal district court approved a settlement agreement in the case of Jimmo v. Sebelius that confirmed Medicare coverage should be determined by a beneficiary’s need for skilled care, not the individual’s potential for improvement.The … [Read more...] about Updated Factsheet: Medicare Skilled Nursing Facility Coverage Does Not Require Improvement