On January 27, 2025 the Center for Medicare Advocacy submitted comments to CMS on the proposed rule for Medicare Advantage and Part D for 2026.The comments are available here.If finalized, the provisions in the proposed rule will … [Read more...] about CMA Comments on Proposed Part C & D Rule
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Know Jimmo | What It Means
Coverage does not turn on the presence or absence of potential for improvement but rather on the need for skilled care. Skilled maintenance therapies and nursing are covered by Medicare. Claims should never be denied because patient cannot achieve … [Read more...] about Know Jimmo | What It Means
Webinar | The Federal Nursing Home Reform Law: A History and Lessons for Today
DescriptionHow did we get from January 1, 1981, when the Reagan Administration repealed nursing home residents’ rights proposed by the Carter Administration, to enactment of the Nursing Home Reform Law in December 1987? This webinar tells the … [Read more...] about Webinar | The Federal Nursing Home Reform Law: A History and Lessons for Today
Analysis | New Rule to Protect Medicare Beneficiaries Is Stuck in the Courts
Center for Medicare Advocacy Co-Director, David Lipschutz, Litigation Director, Ali Bers and Managing Policy Attorney, Kata Kertesz recently published an analysis for the Commonwealth Fund of a 2024 Medicare rule that disallows tactics that … [Read more...] about Analysis | New Rule to Protect Medicare Beneficiaries Is Stuck in the Courts
New Research Confirms Medicare Advantage Beneficiaries Do Not Experience Greater Access to Dental, Vision, or Hearing Care
Inflation Reduction Act Continues to Reduce High Medicare Drug Prices as New Administration Rolls Back Other Efforts to Reduce Drug Costs
On one of the last days of the Biden Administration, the Department of Health and Human Services (HHS) announced the second set of drugs selected for Medicare price negotiation pursuant to provisions of the Inflation Reduction Act (IRA), signed into … [Read more...] about Inflation Reduction Act Continues to Reduce High Medicare Drug Prices as New Administration Rolls Back Other Efforts to Reduce Drug Costs
New Medicare Advantage Flex Card Guidance Will Assist Enrollees Who Rely on Housing Benefits
The Department of Housing and Urban Development (HUD) has released important new guidance clarifying when Medicare Advantage (MA) “Flex Cards” (similar to pre-loaded debit cards) can be counted toward calculations of income for purposes of rental … [Read more...] about New Medicare Advantage Flex Card Guidance Will Assist Enrollees Who Rely on Housing Benefits
Court Denies Preliminary Injunction in Challenge to Nursing Home Staffing Rule
The federal district court in Iowa has denied a motion for preliminary injunction in a challenge by 20 states and 21 non-profit nursing home industry groups to the final nurse staffing rule for nursing facilities. State of Kansas v. Becerra, … [Read more...] about Court Denies Preliminary Injunction in Challenge to Nursing Home Staffing Rule
Medicare Enrollment – Certain People Can Make Changes through March 31
Medicare Advantage Open Enrollment Period (MA-OEP)People who are currently enrolled in a Medicare Advantage (MA) plan have an additional opportunity to switch MA plans or disenroll from an MA plan and enroll in traditional Medicare with a Part D … [Read more...] about Medicare Enrollment – Certain People Can Make Changes through March 31
Know Jimmo | No Matter Who’s In Charge – Jimmo is the Law
Medicare IS available for skilled care to maintain or slow decline of an individual’s condition.“Restoration potential is not the deciding factor in determining whether skilled care is required. Even if full recovery or medical improvement is not … [Read more...] about Know Jimmo | No Matter Who’s In Charge – Jimmo is the Law