This update expands on our earlier CMA Issue Brief about the “flex cards” offered by many Medicare Advantage (MA) plans. Flex cards, sometimes called Over-the-Counter (OTC) cards, are essentially preloaded debit cards used by MA plans to provide … [Read more...] about Issue Brief | Medicare Advantage “Flex Cards” Update
Archives for July 2025
Podcast on the Nursing Home Reform Act Featuring Center Attorney Toby Edelman
In 1987, after multiple reports, articles, and studies described inadequate conditions in nursing homes, Congress passed the Nursing Home Reform Act. The comprehensive law raised the standard of care for residents of nursing homes across the country … [Read more...] about Podcast on the Nursing Home Reform Act Featuring Center Attorney Toby Edelman
Study Confirms that Nursing Facilities “Staff Up” For Surveys
For many years, advocates for nursing home residents have said that nursing facilities significantly improve their staffing levels when they anticipate that surveyors will soon be on-site to conduct an annual inspection. A new study confirms … [Read more...] about Study Confirms that Nursing Facilities “Staff Up” For Surveys
Helpful Hint | Who to Contact; Social Security or Medicare?
Many people are surprised to learn how intertwined Medicare is with the Social Security Administration (SSA). For that reason, it can be confusing to know which agency to contact for assistance and information. For example, the following actions … [Read more...] about Helpful Hint | Who to Contact; Social Security or Medicare?
Know Jimmo | Jimmo Applies to Medicare Advantage
Skilled Nursing and therapy to maintain an individual's condition are covered by Medicare. Improvement is not required. This applies to Medicare Advantage as well as traditional Medicare.CMS wrote in the 2/13/2024 memo "Reminder: Jimmo Settlement … [Read more...] about Know Jimmo | Jimmo Applies to Medicare Advantage
Medicare Will Not Expand on Dental Payment Examples in 2026
The Centers for Medicare & Medicaid Services (CMS) announced this week that it will not codify additional examples of clinical scenarios in which dental services may be paid by Medicare as part of its CY 2026 Physician Fee Schedule … [Read more...] about Medicare Will Not Expand on Dental Payment Examples in 2026
Study: Delays in Nursing Home Inspections Lead to More Health Deficiencies
Reviewing data involving 81,769 standard nursing home health inspections from 2016 to April 2024, researchers find that delays in two consecutive standard inspections lead to more total deficiencies, but not to lower nurse staffing levels. Wilson … [Read more...] about Study: Delays in Nursing Home Inspections Lead to More Health Deficiencies
CMA Success Story | Premium Reduction
The Center for Medicare Advocacy was recently successful in advocating for a beneficiary’s Part A premium elimination, saving the beneficiary thousands of dollars in reimbursed premiums and a significantly reduced burden in healthcare costs into the … [Read more...] about CMA Success Story | Premium Reduction
Report | Nurse Staffing Standards for Nursing Homes
How to Overcome Current Challenges and Ensure Facilities Are Fully Staffed and All Residents Receive the Care they NeedMeaningful nurse staffing levels in nursing facilities are possible and can be achieved, even under current challenges. … [Read more...] about Report | Nurse Staffing Standards for Nursing Homes
Know Jimmo | Right from the Medicare Agency
The Centers for Medicare & Medicaid Services (CMS) reminds the Medicare community of the Jimmo Settlement Agreement (January 2013), which clarified that the Medicare program covers skilled nursing care and skilled therapy services under … [Read more...] about Know Jimmo | Right from the Medicare Agency