Medicare: Just the Facts! Misinformation about Medicare and the Affordable Care Act is widespread and increasing as the election nears. Below, we try to dispel misinformation and base discussions on a factual foundation. Spread the word. … [Read more...] about Medicare and ACA Facts and Updates; Jimmo Update
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Settlement Reached to End Medicare’s “Improvement Standard”
Attorneys from the Center for Medicare Advocacy, Vermont Legal Aid and the Centers for Medicare & Medicaid Services (CMS) have agreed to settle the "Improvement Standard" case, Jimmo v. Sebelius.[1] A proposed settlement agreement[2] … [Read more...] about Settlement Reached to End Medicare’s “Improvement Standard”
October 2012 – Updates on Medicare Appeals and Complaints
National Medicare Advocates Alliance Issue brief #18 1. PRESENTATIONS ADMINISTRATIVE REVIEW PROCESS: LITTLE SUCCESS, LONG DELAYS Based upon the Center’s extensive experience with the Medicare administrative appeals … [Read more...] about October 2012 – Updates on Medicare Appeals and Complaints
New Procedures for Review of Quality of Care Complaints
On April 6, 2012, the Centers for Medicare & Medicaid Services (CMS) issued Transmittal 17, which revises and creates new procedures for the review of quality of care concerns[1] by Quality Improvement Organizations (QIOs).[2] Effective May 7, … [Read more...] about New Procedures for Review of Quality of Care Complaints
Making Sense of Medicare’s Preventive Service Benefits
September 20, 2012 With the Balanced Budget Act of 1997 (BBA1997), Congress began an expansion of preventive benefits and services available through Medicare.[1] The Medicare Modernization Act of 2003 (MMA) added additional preventive … [Read more...] about Making Sense of Medicare’s Preventive Service Benefits
Medicare Cost-Sharing for Qualified Medicare Beneficiaries
Balance Billing is Prohibited. Period. New Guidance released jointly by the Center for Medicaid and CHIP Services (CMCS) and the Medicare-Medicaid Coordination Office (MMCO) once again highlights and advises about an issue that has created … [Read more...] about Medicare Cost-Sharing for Qualified Medicare Beneficiaries
Federal Judge Refuses to Dismiss Medicare Beneficiaries’ Challenge to the Medicare “Improvement Standard”
Plaintiffs in a lawsuit filed by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of Medicare beneficiaries with long-term and chronic conditions have overcome a major hurdle. In a comprehensive 35-page decision, a federal judge … [Read more...] about Federal Judge Refuses to Dismiss Medicare Beneficiaries’ Challenge to the Medicare “Improvement Standard”
Why Medicaid Matters to Medicare Beneficiaries and Their Families
Medicare and Medicaid, which together serve over 95 million Americans,[1] are our two major national public programs offering secure and stable access to health care for beneficiaries, and peace of mind to the their families. Medicaid is under … [Read more...] about Why Medicaid Matters to Medicare Beneficiaries and Their Families
Help CMA Protect Medicare and Health Care
Donations from individuals like you help the Center for Medicare Advocacy fight on behalf of individuals across the country. We want to share a story with you about just one of those people. Mrs. B. has lived with multiple sclerosis for decades. She … [Read more...] about Help CMA Protect Medicare and Health Care
Concern over Skilled Nursing Facilities’ Upcoding Medicare Reimbursement Should Not Be Allowed to Deprive Residents of Necessary Care
Between 2006 and 2008, skilled nursing facilities (SNFs) increasingly billed for residents' care at higher-paying reimbursement categories (upcoding) under Medicare's prospective payment system. Medicare uses Resource Utilization Groups … [Read more...] about Concern over Skilled Nursing Facilities’ Upcoding Medicare Reimbursement Should Not Be Allowed to Deprive Residents of Necessary Care