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CMA Community News – December, 2014

December 31, 2014

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  • A Message from the Executive Director
  • News You Can Use
  • Legislative & Policy Update
  • CMA In the Community

A Message from the Executive Director

2015 Marks the 50th Anniversary of Medicare – Help Ensure its Future

Since 1965, Medicare has opened doors to health care and increased economic security for hundreds of millions of older people, people with disabilities, and their families.

2015 will also usher in a new Congress.  Many of its leaders and members will likely champion plans to further privatize Medicare.  These proposals will likely surface despite increasing reports that Medicare costs and the federal deficit are declining, and that traditional Medicare costs less than private Medicare.  Once again we will likely hear about plans to transform Medicare to “Premium Support” (a voucher towards the purchase of private insurance). We will probably read about proposals to increase the age of Medicare eligibility, decrease the value of Supplemental Medicare Insurance (Medigap), redesign Medicare to make it “simpler” (but less useful for most beneficiaries). We urge you to listen carefully for these and other such plans. And respond!

Since 1986, the Center for Medicare Advocacy has been on the front lines, advocating for people who depend on Medicare and for a comprehensive Medicare program for future generations.  That’s why you joined the CMA Community.  As we mark Medicare’s 50th anniversary, help us ensure its promise to advance access to healthcare. Help us explain what’s true and what’s not, where real savings exist, and when the true interests of beneficiaries are at stake. Help us ensure a real Medicare program lasts for another 50 years.

Be part of the CMA Community Truth Squad.  Ask us if you have questions.  Spread the word – on Twitter, Facebook – in conversations!  The future of a comprehensive Medicare program may depend on it.

Judith Stein

Executive Director


News You Can Use

  • "Site Neutral" Payment for Inpatient Rehabilitation Facilities and Skilled Nursing Facilities is a Bad Idea

Site Neutral Payment is the concept of paying the same amount for rehabilitation regardless of whether the patient is treated in an inpatient rehabilitation facility (IRF) or nursing home (skilled nursing facility, or SNF). The Medicare Payment Advisory Commission (MedPAC), the nonpartisan government agency that advises Congress on Medicare policy, has recommended adopting Site Neutral Payment for over 20 diagnoses. The Center opposes this idea. Research consistently shows that care in these two settings is absolutely not the same. IRFs offer better care outcomes, fewer hospital readmissions, and lower risk of other injury or death. Further, decisions regarding the appropriate level of care should not be based on any "rule of thumb."  Each person's needs should be individually assessed. Read more. 

  • Medicare Advantage Provider Network Terminations – New Special Enrollment Period for 2015

Starting in 2015 CMS has instituted a limited Special Enrollment Period (SEP) possibility for certain MA enrollees following certain provider network terminations. This SEP will be available on a case-by-case basis when CMS "determines that changes to an MA plan's provider network that occur outside the course of routine contract initiation and renewal cycles are considered significant based on the affect or potential to affect [sic], current plan enrollees." See the Medicare Managed Care Manual for more details. And click the link at right to see USA Today's related article quoting the Center's own David Lipschutz.

– Back –


For a more in-depth weekly look at Medicare and healthcare issues,
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Legislative & Policy Update

  • Medicare Agency Rescinds Restrictive Policy and Will Reconsider Technological Advances

The Centers for Medicare & Medicaid Services (CMS) announced in November that it has begun the process of updating its Medicare coverage policy for Speech Generating Devices (SGDs). A new SGD National Coverage Determination (NCD) is expected to be completed by July 31, 2015.  While CMS considers a new coverage rule for SGDs, it announced that beneficiaries will "continue to have access to this critical technology."  This is a reversal of a proposed "Coverage Reminder" and coding review that was to have taken effect this month and would have limited Medicare coverage only to devices that were dedicated to speech, but were not capable of any other form of communication, such as text or email. The Center for Medicare Advocacy and other groups met with CMS to urge reconsideration of this harmful policy.  Read more.

  • As You May Have Heard…

2015 marks the 50th anniversary of Medicare and Medicaid. Each of these programs has become an invaluable safety net for our older and vulnerable citizens, and should be protected and enhanced. Be sure to follow us in 2015 as we bring you Medicare Matters: 50 Insights for Medicare’s 50th Anniversary in the weeks leading up to Medicare's anniversary on July 30, 2015.

– Back –


Take Action

Get unprecedented access to some of the greatest Medicare advocates in the country and help ensure a strong Medicare program for the next 50 years. Become a Member of the CMA Community today. 

  • I’m ready to join the CMA Community now!
  • I'd like to read more about CMA Community Membership.

Donate

Today is the last day to make your donation online or to mail your check before the end of the tax year. There's still time — make your donation before midnight tonight!

Your support of the Center's Medicare Advocacy Fund is critical to our efforts to continue educating, advocating, and litigating on behalf of older people and people with disabilities.

Help us ensure fair access to health care for all Medicare beneficiaries.

Thank you!

And remember, all new and increased donations will be matched by Atlantic Philanthropies.

– Back –


CMA In the Community

  •   Center for Medicare Advocacy Executive Director Judith Stein was recently invited to a private reception at the White House, and had an opportunity to talk Medicare with President Barack Obama. The President, pictured here with Ms. Stein, agreed that "Medicare is always a priority."
  • Center to Host 2nd Annual National Voices of Medicare Summit and Jay Rockefeller Lecture. Our own experts will be joined in lectures and panel discussions by luminaries including Representative Rosa DeLauro (D.CT); Patricia Neuman, Senior Vice President, Kaiser Family Foundation; Bruce Vladeck, former Health Care Finance Administration (now CMS) Administrator; and Julie Rovner of NPR and Kaiser Health News. Early-Bird Registration is open now.
  • The Center signed on in support of legislation to protect the rights of those who rely on Durable Medical Equipment.  The Medicare DMEPOS Competitive Bidding Improvement Act of 2014/HR 4920 will add badly needed provisions to improve the poorly designed bidding program by requiring that participating durable medical equipment suppliers comply with state licensure requirements and binding bids to ensure that access to quality equipment and services is protected.
  • Finally, congratulations to frequent Center collaborator Eric Carlson.  The esteemed NSCLC Attorney has been awarded the Toby S. Edelman Legal Justice Award by Consumer Voice. The award, named for the Center for Medicare Advocacy's remarkable Senior Attorney, Toby Edelman, recognizes individuals who go to extraordinary lengths to achieve justice for long-term care customers.

– Back –

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Jimmo v. Sebelius

Medicare covers skilled care to maintain or slow decline as well as to improve.

Improvement Isn’t Required. It’s the law!

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National Voices of Medicare Summit

With the many threats currently facing the Medicare program, now is the time to come together as allies and explore ways to advocate for comprehensive Medicare coverage, health equity, and quality health care. Drawing inspiration from real-life experiences and stories of beneficiaries and caregivers, we hope to share impactful discussions with you.

Learn more.

Center for Medicare Advocacy Follow 10,583 5,345

A national nonpartisan, nonprofit law organization working to advance access to comprehensive #Medicare coverage and quality #healthcare.

CMAorg
CMAorg avatar Center for Medicare Advocacy @CMAorg ·
17h 2065518738338664903

A recent @statnews article revealed a federal review showing the major Medicare Advantage insurers denied long-term care hospital prior auths 71–80% of the time, while industry peers averaged 42%.

Some denials were later overturned 92–99.7% of the time. A denial is not always

Reply on Twitter 2065518738338664903 Retweet on Twitter 2065518738338664903 0 Like on Twitter 2065518738338664903 0 X 2065518738338664903
CMAorg avatar Center for Medicare Advocacy @CMAorg ·
10 Jun 2064819351409041776

💙It's Wellness Wednesday!💙 ⠀

One crucial component of being well is being able to afford healthcare. Join us June 16 at 2p ET for a free webinar covering Medicare Savings Programs and how they may be able to help you receive and afford the care you need and deserve.

Reply on Twitter 2064819351409041776 Retweet on Twitter 2064819351409041776 1 Like on Twitter 2064819351409041776 0 X 2064819351409041776
CMAorg avatar Center for Medicare Advocacy @CMAorg ·
9 Jun 2064372659832360965

Medicare Savings Programs (MSPs) can be a gamechanger.

Read more about how MSPs can change your life from our friends at @NCOAging in the link below.
https://www.ncoa.org/.../what-are-medicare-savings.../

And please join us for our free webinar on MSPs Tues, June 16th at 2pm ET
https://medicareadvocacy.org/free-webinar-medicare-savings-programs/?utm_source=twitter&utm_medium=social&utm_campaign=webinar&utm_content=msp_ncoa_article

Reply on Twitter 2064372659832360965 Retweet on Twitter 2064372659832360965 0 Like on Twitter 2064372659832360965 0 X 2064372659832360965
CMAorg avatar Center for Medicare Advocacy @CMAorg ·
9 Jun 2064365389975261311

There are certainly some upsides to AI. A study found 55% of healthcare workers intended to switch jobs in 2026, largely in part to burnout. But there are clearly risks that need further scrutiny, particularly around biases.

How do you feel about AI in healthcare?

There are certainly some upsides to AI. A study found 55% of healthcare workers intended to switch jobs in 2026, largely in part to burnout. But there are clearly risks that need further scrutiny, particularly around biases.How do you feel about AI in healthcare?
JAMA @JAMA_current

Ambient #AI scribes now #automate documentation and #clinical assessments, offering time savings and reduced burnout, but raise important questions about oversight, automation bias, and accountability.

In the latest episode of the #HealthyDialogue podcast, JAMA Senior Editor

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