Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

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Increased Use of Observation Stays Undermined Hospital Readmissions Reduction Program

The Hospital Readmissions Reduction Program (HRRP), enacted as part of the Affordable Care Act, imposes penalties against hospitals that have higher-than-expected rates of readmissions of patients with certain conditions. However, HRRP defined … [Read more...] about Increased Use of Observation Stays Undermined Hospital Readmissions Reduction Program

HHS Inspector General: Too Many Nursing Home Residents Still Inappropriately Receive Psychotropic Medications

The HHS Office of Inspector General (OIG) reports that, from 2011 through 2019, about 80% of long-stay nursing home residents were prescribed a psychotropic drug (defined as “any drug that affects brain activities associated with mental processes and … [Read more...] about HHS Inspector General: Too Many Nursing Home Residents Still Inappropriately Receive Psychotropic Medications

Provisions of Recently Passed Medicare Drug Bill in Effect Next Month – January 2023

As discussed in a recent CMA Alert (Aug. 18, 2022), President Biden signed into law the Inflation Reduction Act (IRA) of 2022 on August 16, 2022. This bill includes historic prescription drug provisions that will soon be of significant benefit to … [Read more...] about Provisions of Recently Passed Medicare Drug Bill in Effect Next Month – January 2023

Center for Medicare Advocacy Sues, Again, for Coverage of “Off-label” Prescription Drug

On November 18, 2022, the Center for Medicare Advocacy and Murphy Orlando LLC filed suit on behalf of a retired public-school teacher in New Jersey who seeks coverage of her “off-label” (non-FDA-approved) use of a critically needed medication. … [Read more...] about Center for Medicare Advocacy Sues, Again, for Coverage of “Off-label” Prescription Drug

Report | Trained Workers in Nursing Homes, a Requirement Since 1990, Threatened

When the Nursing Home Reform Law was enacted in 1987, half of the states did not require that nurse aides receive any training in how to do their jobs. One of the major changes mandated by the Reform Law was the requirement that every nurse aide be … [Read more...] about Report | Trained Workers in Nursing Homes, a Requirement Since 1990, Threatened

Reminder: Questions or Comments on Proposed Clarification in Hospital “Observation Status” Case Due November 25

In Alexander v. Becerra, a federal court found that certain beneficiaries must be allowed to appeal to Medicare when their hospitalizations are reclassified from “inpatient” to “outpatient receiving observation services.” The Center for Medicare … [Read more...] about Reminder: Questions or Comments on Proposed Clarification in Hospital “Observation Status” Case Due November 25

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