Center for Medicare Advocacy Co-Director, David Lipschutz, Litigation Director, Ali Bers and Managing Policy Attorney, Kata Kertesz recently published an analysis for the Commonwealth Fund of a 2024 Medicare rule that disallows tactics that … [Read more...] about Analysis | New Rule to Protect Medicare Beneficiaries Is Stuck in the Courts
Archives for January 2025
New Research Confirms Medicare Advantage Beneficiaries Do Not Experience Greater Access to Dental, Vision, or Hearing Care
Inflation Reduction Act Continues to Reduce High Medicare Drug Prices as New Administration Rolls Back Other Efforts to Reduce Drug Costs
On one of the last days of the Biden Administration, the Department of Health and Human Services (HHS) announced the second set of drugs selected for Medicare price negotiation pursuant to provisions of the Inflation Reduction Act (IRA), signed into … [Read more...] about Inflation Reduction Act Continues to Reduce High Medicare Drug Prices as New Administration Rolls Back Other Efforts to Reduce Drug Costs
New Medicare Advantage Flex Card Guidance Will Assist Enrollees Who Rely on Housing Benefits
The Department of Housing and Urban Development (HUD) has released important new guidance clarifying when Medicare Advantage (MA) “Flex Cards” (similar to pre-loaded debit cards) can be counted toward calculations of income for purposes of rental … [Read more...] about New Medicare Advantage Flex Card Guidance Will Assist Enrollees Who Rely on Housing Benefits
Court Denies Preliminary Injunction in Challenge to Nursing Home Staffing Rule
The federal district court in Iowa has denied a motion for preliminary injunction in a challenge by 20 states and 21 non-profit nursing home industry groups to the final nurse staffing rule for nursing facilities. State of Kansas v. Becerra, … [Read more...] about Court Denies Preliminary Injunction in Challenge to Nursing Home Staffing Rule
Medicare Enrollment – Certain People Can Make Changes through March 31
Medicare Advantage Open Enrollment Period (MA-OEP)People who are currently enrolled in a Medicare Advantage (MA) plan have an additional opportunity to switch MA plans or disenroll from an MA plan and enroll in traditional Medicare with a Part D … [Read more...] about Medicare Enrollment – Certain People Can Make Changes through March 31
Know Jimmo | No Matter Who’s In Charge – Jimmo is the Law
Medicare IS available for skilled care to maintain or slow decline of an individual’s condition.“Restoration potential is not the deciding factor in determining whether skilled care is required. Even if full recovery or medical improvement is not … [Read more...] about Know Jimmo | No Matter Who’s In Charge – Jimmo is the Law
CMA Special Report | Hidden Profits that Detract from Nursing Facility Care Are Unregulated and Ignored
Medicare cost reports submitted by nursing facilities are not audited to determine compliance with related party requirements.Nursing home owners and operators hide their profits by making inflated payments to companies they own and control, … [Read more...] about CMA Special Report | Hidden Profits that Detract from Nursing Facility Care Are Unregulated and Ignored
CMS Clarifies Treatment of Medicare Advantage “Flex Cards” For Public Benefit Purposes
On January 8, 2025 the Centers for Medicare & Medicaid Services (CMS) released a letter in response to Rep. Lloyd Doggett’s request for clarification that Medicare Advantage (MA) “flex cards” should be excluded from the calculation of income when … [Read more...] about CMS Clarifies Treatment of Medicare Advantage “Flex Cards” For Public Benefit Purposes
New CMS Rule Helps MA Plan Enrollees Against Repeated SNF Denials in the Same Episode of Care
The Center for Medicare Advocacy would like to highlight a recent legal development that may help enrollees and their families advocate for themselves when Medicare Advantage Plans prematurely deny Skilled Nursing Facility (“SNF”) care.In a … [Read more...] about New CMS Rule Helps MA Plan Enrollees Against Repeated SNF Denials in the Same Episode of Care