The traditional Medicare program limits coverage in a skilled nursing facility (SNF) to individuals who were first hospitalized as inpatients for at least three consecutive days. The Centers for Medicare & Medicaid Services waived the 3-day … [Read more...] about 3-Day Inpatient Hospital Requirement Increases Total Medicare Costs
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Millions of Beneficiaries Could Benefit from Dental Payment Clarifications
Findings from a recent analysis by Harvard School of Dental Medicine and Brigham and Women’s Hospital support that approximately 1.31 million beneficiaries in traditional Medicare annually are eligible for payment of dental services that are … [Read more...] about Millions of Beneficiaries Could Benefit from Dental Payment Clarifications
Still No Guidance Regarding Medicare Restriction Applicable to Noncitizens Under H.R. 1
February 12, 2026Washington, DC – The Center for Medicare Advocacy (CMA) and three other national advocacy organizations have taken new legal steps to demand transparency from the Social Security Administration (SSA) and the Centers for Medicare … [Read more...] about Still No Guidance Regarding Medicare Restriction Applicable to Noncitizens Under H.R. 1
Know Jimmo | Skilled Care & Individual Assessments, Not “Improvement”
In 2013, the Center for Medicare Advocacy reached a settlement with the Centers for Medicare & Medicaid Services (CMS) in the national class action case, Jimmo v. Sebelius. The Settlement, reaffirmed in 2017, confirmed that beneficiaries do not … [Read more...] about Know Jimmo | Skilled Care & Individual Assessments, Not “Improvement”
CMS Revises Nursing Home Special Focus Facility Program, Eliminating Focus on Staffing
On January 28, 2026, the Centers for Medicare & Medicaid Services (CMS) revised the Special Focus Facility (SFF) Program for nursing homes, replacing staffing with “prevalence of falls” as the factor that CMS and states should emphasize as they … [Read more...] about CMS Revises Nursing Home Special Focus Facility Program, Eliminating Focus on Staffing
New Jersey Once Again Demonstrates How Nursing Home Enforcement Should Be Done
The New Jersey Office of the State Comptroller (OSC) has engaged in a thoughtful, deliberative process to evaluate nursing home care in the state and to remove from nursing home ownership the owners that provide the poorest quality care to residents. … [Read more...] about New Jersey Once Again Demonstrates How Nursing Home Enforcement Should Be Done
Medicare Telehealth Coverage Extended Through 2027
Finally, some good news! As previously reported, the Covid-era telehealth flexibilities lapsed September 30, 2025 and again on January 30, 2026, wreaking havoc on both beneficiaries and providers alike. After the signing of H.R. 7148 (the … [Read more...] about Medicare Telehealth Coverage Extended Through 2027
Know Jimmo | Home Health Care is Available for Medicare Beneficiaries with Long Term, Chronic, and Terminal Conditions
The key to coverage is whether the individual requires skilled nursing or therapy and whether care would be safe and effective if skilled care was not provided. (And the individual meets other qualifying criteria: is homebound and has proper provider … [Read more...] about Know Jimmo | Home Health Care is Available for Medicare Beneficiaries with Long Term, Chronic, and Terminal Conditions
In Defense of State Health Insurance Assistance Programs (SHIPs)
State Health Insurance Assistance Programs (SHIPs) are federally funded programs in every state and several territories that provide free, unbiased counseling to Medicare beneficiaries about navigating the Medicare program. Sometimes going by … [Read more...] about In Defense of State Health Insurance Assistance Programs (SHIPs)
CMA Comments to Proposed CY 2027 Rule re: Medicare Advantage and Part D
In collaboration with several advocacy partners, CMA submitted comments to a proposed rule issued by the Centers for Medicare & Medicaid Services (CMS) titled “Medicare and Medicaid Programs; Contract Year 2027 Policy and Technical Changes to the … [Read more...] about CMA Comments to Proposed CY 2027 Rule re: Medicare Advantage and Part D