CMA’s David Lipschutz was quoted in a Rolling Stone article by Andrew Perez titled, "Republicans’ Health Care Plan: Dr. AI Will See You Now."“The track record of using AI or algorithms in Medicare Advantage prior authorization and coverage … [Read more...] about CMA in Rolling Stone – Dr. AI Will See You Now
Archives for May 2025
Proposed Annual Update to Reimbursement Rates for Skilled Nursing Facilities
The annual update to Medicare Part A reimbursement rates for skilled nursing facilities proposes to increase Medicare rates by 2.8%. Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the … [Read more...] about Proposed Annual Update to Reimbursement Rates for Skilled Nursing Facilities
Center for Medicare Advocacy Statement on Proposed Massive Medicaid Cuts
Attack on MedicaidThe Center for Medicare Advocacy strongly opposes the recent tax legislation that proposes devastating cuts to the Medicaid program and harms millions of Medicaid and Medicare beneficiaries. The latest estimates from the … [Read more...] about Center for Medicare Advocacy Statement on Proposed Massive Medicaid Cuts
Know Jimmo | A Summary
“This is long-standing criteria, consistent with regulation.” - See the CMS Important Message About Jimmo … [Read more...] about Know Jimmo | A Summary
Know Jimmo | Jimmo Applies to Medicare Advantage Plans
As far back as 2013, The Center for Medicare & Medicaid Services made it clear that the Jimmo Settlement applied to private Medicare Advantage plans. In a memo from April that year, announcing a new Jimmo Fact Sheet they stated:The goal of … [Read more...] about Know Jimmo | Jimmo Applies to Medicare Advantage Plans
Court Rejects Pharma’s Challenge to Medicare Drug Price Negotiation
In a significant victory for beneficiaries, the first appeals court to consider substantive legal claims against the Medicare drug price negotiation program has rejected arguments put forward by drug manufacturer AstraZeneca. In a decision announced … [Read more...] about Court Rejects Pharma’s Challenge to Medicare Drug Price Negotiation
Medicaid Proposals Will Lead to Benefit Cuts and Loss of Health Coverage
As Congress continues to negotiate potential drastic cuts and changes to the Medicaid program, an important development occurred this week. On May 7, 2025 the Congressional Budget Office (CBO) provided estimates for five policy options concerning … [Read more...] about Medicaid Proposals Will Lead to Benefit Cuts and Loss of Health Coverage
As Medicaid Faces Potential Deep Cuts, Some Lawmakers Draw Attention to Wasteful Medicare Advantage Payments
As discussed in another CMA Alert article today Medicaid is under grave threat by a reconciliation process in Congress aimed at cutting spending in order to pay for tax cuts and other administration priorities. As discussed below, some lawmakers are … [Read more...] about As Medicaid Faces Potential Deep Cuts, Some Lawmakers Draw Attention to Wasteful Medicare Advantage Payments
Medicare Home Health and DME Updates
__________Medicare Home Health and DME UpdatesWith gratitude, this program is presented in partnership with the Christopher & Dana Reeve Foundation.This webinar reviews the services that the Medicare home health benefit should … [Read more...] about Medicare Home Health and DME Updates