January 24, 2014 - Today marks the one-year anniversary of the landmark Jimmo v. Sebelius settlement. The Jimmo case was brought in 2011 by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of a nationwide class of Medicare … [Read more...] about One-Year Anniversary of Medicare Improvement Standard Settlement Brings Victories, and Ongoing Struggle, for Beneficiaries
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Medicare Therapy Caps: A Call for Repeal
Medicare-covered outpatient physical, speech and occupational therapy services are subject to an annual dollar-amount payment cap. As a result, many Medicare beneficiaries have their therapy terminate prematurely when they reach the cap. … [Read more...] about Medicare Therapy Caps: A Call for Repeal
Replacing the Broken Medicare Physician Payment Formula: At What Cost for People with Medicare?
Overview The current Medicare physician payment formula, known as the "Sustainable Growth Rate" (SGR), was designed to control the growth in aggregate Medicare expenditures for physicians' services.[1] If … [Read more...] about Replacing the Broken Medicare Physician Payment Formula: At What Cost for People with Medicare?
Improvement Standard Update: Re-Review Request Form Now Available
The Jimmo Settlement Agreement provides for the re-review of certain Medicare claims under clarified maintenance coverage standards for the SNF, HH, and OPT benefits, applicable when a patient has no restoration or improvement potential, but … [Read more...] about Improvement Standard Update: Re-Review Request Form Now Available
Improvement Standard Update: CMS Revises Medicare Policy to Ensure Coverage for Skilled Maintenance Care
December 9, 2013 – The Center for Medicare Advocacy is pleased to announce that the Medicare Policy Manuals have been revised pursuant to the Jimmo vs. Sebelius Settlement. The Manual revisions, which clarify that improvement is not required to … [Read more...] about Improvement Standard Update: CMS Revises Medicare Policy to Ensure Coverage for Skilled Maintenance Care
Atlantic Philanthropies Awards Center for Medicare Advocacy Three-Year Matching Grant for New and Increased Contributions
As part of a new three-year grant, Atlantic Philanthropies will match new and increased contributions received by the Center for Medicare Advocacy. Atlantic Philanthropies will match a total of $325,000 in new or increased funding during three … [Read more...] about Atlantic Philanthropies Awards Center for Medicare Advocacy Three-Year Matching Grant for New and Increased Contributions
October, 2013 – Medicare Annual Election Period, and the ACA Marketplace and Other Issues
Call-in Number: 1 (888) 206-2266 Pass Code: 9874704 NOTE: We ask people calling from the same location to gather around one telephone. This frees up lines and holds down costs. Please ensure your line is on MUTE for the duration of … [Read more...] about October, 2013 – Medicare Annual Election Period, and the ACA Marketplace and Other Issues
October, 2013 – Medicare Annual Election period, and the ACA Marketplaces and Other Issues
1. PRESENTATION: MEDICARE ANNUAL ELECTION PERIOD & THE MARKETPLACES Medicare Annual Coordinated Election Period (ACEP) – 10/15/13 – 12/7/13 During the Annual Coordinated Election Period (ACEP) people with … [Read more...] about October, 2013 – Medicare Annual Election period, and the ACA Marketplaces and Other Issues
Caution: Home Health Episode Payment Caps
Legislation was introduced on October 4th that could lead to a cap on the home health services available to a Medicare beneficiary. In the midst of a government shutdown, Representatives Matheson (D-Utah) and Guthrie (R-Kentucky) introduced the … [Read more...] about Caution: Home Health Episode Payment Caps
Comments on Post Acute Care (PAC) Reform Proposals
August 19, 2013 Senate Finance Committee House of Representatives, Committee on Ways and Means United States Congress Submitted electronically to: postacutecarereform@finance.senate.gov and postacutecarereform@mail.house.gov Re: Comments … [Read more...] about Comments on Post Acute Care (PAC) Reform Proposals