LEGISLATIVE/BUDGET UPDATE 1.Medicare Physician Payment (SGR) In an effort to address the perennial issue of payment for Medicare physicians -- the fundamentally flawed reimbursement system known as the sustainable growth rate or SGR – the … [Read more...] about April 2015 – The Potential Impact of the “Doc Fix” & Other Issues
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Center for Medicare Advocacy Submits Comments to Draft 2016 Call Letter for Medicare Parts C and D
Every year, the Centers for Medicare and Medicaid Services (CMS) releases a draft of payment, performance and other rules that apply to Medicare Advantage (MA) and Part D plans that choose to participate in the Medicare program in the following … [Read more...] about Center for Medicare Advocacy Submits Comments to Draft 2016 Call Letter for Medicare Parts C and D
Center Comments on Proposed 2016 Medicare Part C and Part D Changes
March 6, 2015 VIA ELECTRONIC SUBMISSION AdvanceNotice2016@cms.hhs.gov Centers for Medicare & Medicaid Services Department of Health and Human Services P.O. Box 8016 Baltimore, MD 21244-8016 Re: Advance Notice of … [Read more...] about Center Comments on Proposed 2016 Medicare Part C and Part D Changes
2016 Medicare Advantage (Part C) and Part D Final Rule Issued
On February 12, 2015, the Centers for Medicare and Medicaid Services (CMS) published final rules entitled “Medicare Program; Contract Year 2016 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit … [Read more...] about 2016 Medicare Advantage (Part C) and Part D Final Rule Issued
Center Comments on Proposed Rules for SNFs & ACOs
Centers for Medicare & Medicaid Services Submitted electronically, http://www.regulations.gov Re: CMS-1461-P Dear CMS Colleagues: The Center for Medicare Advocacy (Center) is pleased to provide the Centers for Medicare & Medicaid … [Read more...] about Center Comments on Proposed Rules for SNFs & ACOs
February 2015 – Live to Fight Another Day: Bagnall, Lessler & Other Issues
LITIGATION UPDATE Recent Litigation Victories Bagnall v. Sebelius (Observation Status) No. 3:11-cv-01703 (D. Conn., filed 11/3/2011). In November 2011, the Center for Medicare Advocacy and the National Senior Citizens Law Center filed … [Read more...] about February 2015 – Live to Fight Another Day: Bagnall, Lessler & Other Issues
50 Insights for Medicare’s 50th Anniversary
As part of our recognition of Medicare’s first 50 years, this week begins our Medicare Matters: 50 Insights for Medicare’s 50th Anniversary. Help us spread the word – on Twitter, Facebook – in … [Read more...] about 50 Insights for Medicare’s 50th Anniversary
Appeal Steps
Standard Appeals Process for Part A and Part B: 1. Redetermination No minimum claim amount Must be filed within 120 days of receipt of "Initial Determination" Filed with Medicare Contractor Reviewed and decided by … [Read more...] about Appeal Steps
Medicaid-Medicare Dual Eligible Updates
Over 9.6 million older people and people with significant disabilities are dually eligible for both Medicare and Medicaid. Dual eligible beneficiaries are among the poorest and sickest beneficiaries covered by either program. The dual eligible … [Read more...] about Medicaid-Medicare Dual Eligible Updates
December 2014 – The Year Ahead & Other Issues
LEGISLATIVE UPDATE The Year Ahead 1. Legislative & Budget Landscape in a New Congress In the 114th Congress staring in January 2015, Republicans will control both the House of Representatives and the Senate. What will this … [Read more...] about December 2014 – The Year Ahead & Other Issues