Under the Affordable Care Act, states will be eligible for greatly increased federal-match payments beginning in 2014 if they expand their Medicaid programs to cover adults with incomes up to 133% of the Federal Poverty Level (FPL). In a letter … [Read more...] about States Can’t Get Full Federal Funding for Partial Medicaid Expansion
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2013 Medicare Cost-Sharing
Hospital Deductible: $1,184 per spell of illness Hospital Coinsurance:Days 0-60: $0 Days 61-90: $296 / day Days 91-150: $592 / daySkilled Nursing Facility CoinsuranceDays 0-20: $0 Days 21-100: $148 / dayPart A Premium (for … [Read more...] about 2013 Medicare Cost-Sharing
Putting a Donut Hole Back in Medicare: Proposals to Increase Medigap Costs Put Vulnerable Beneficiaries at Risk
Among proposals aimed at reducing federal spending for Medicare, some are suggesting that Medigap insurance be restructured to increase the cost-sharing burden on beneficiaries and/or add a surcharge for those that choose plans offering … [Read more...] about Putting a Donut Hole Back in Medicare: Proposals to Increase Medigap Costs Put Vulnerable Beneficiaries at Risk
Warning: Medicare Payment Limits Are Bad for Health!
One of the deficit reduction proposals being discussed to achieve savings from Medicare is to introduce new cost-sharing for home health care. As a means to ward off such potential home health co-payments, some instead suggest capping Medicare … [Read more...] about Warning: Medicare Payment Limits Are Bad for Health!
Special Report – Independence of Medicare Administrative Law Judges Threatened by Office of Inspector General’s Recommendations
In November, the Office of Inspector General (OIG) issued a report entitled, "Improvements are Needed at the Administrative Law Judge Level of Medicare Appeals." The report can be found at … [Read more...] about Special Report – Independence of Medicare Administrative Law Judges Threatened by Office of Inspector General’s Recommendations
Annual Medicare Payment Limits for Home Health – Even Worse Than Co-Pays for Beneficiaries
The Center for Medicare Advocacy has represented Medicare beneficiaries since 1986. As one of the few advocacy organizations in the nation solely serving Medicare beneficiaries, we strongly oppose home health episodic payment caps or any other such … [Read more...] about Annual Medicare Payment Limits for Home Health – Even Worse Than Co-Pays for Beneficiaries
Raising the Medicare Eligibility Age: A Costly and Dangerous Proposal
Despite Medicare's remarkable success as a health and economic lifeline for American families, proposals to dramatically alter the program have resurfaced in the context of deficit reduction. While not a new idea, proponents of increasing … [Read more...] about Raising the Medicare Eligibility Age: A Costly and Dangerous Proposal
The Improvement Standard: Real Stories
In October 2012, the Center for Medicare Advocacy announced the settlement of the “Improvement Standard” class action lawsuit, Jimmo vs. Sebelius. For more than thirty years, the wrongful interpretation of the Medicare statue led to the … [Read more...] about The Improvement Standard: Real Stories
Déjà Vu All Over Again: CMS Decides (Again) Not to Decide About Observation Status
On July 30, 2012, as part of proposed rulemaking on the outpatient prospective payment system, the Centers for Medicare & Medicaid Services (CMS) asked for public comment on potential policy options related to "observation … [Read more...] about Déjà Vu All Over Again: CMS Decides (Again) Not to Decide About Observation Status
Deficit Reduction and Medicare: Save Money Without Harming Beneficiaries
Although passage of the Affordable Care Act (ACA) has achieved considerable savings for the Medicare program, Medicare is still being targeted by policymakers looking to negotiate a large "grand bargain" deficit-reduction package. Many of … [Read more...] about Deficit Reduction and Medicare: Save Money Without Harming Beneficiaries