A Step in the Right Direction, But Not Enough to Stem Wasteful Overpayments As documented in various CMA Alerts, there is consistent and growing evidence that Medicare Advantage (MA) plans are paid more on average than traditional Medicare spends … [Read more...] about Center for Medicare Advocacy Statement on Recent Medicare Advantage Payment Policies and Proposals
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Report | Too Much Secrecy in The Nursing Home Enforcement System
In “How Nursing Homes’ Worst Offenses Are Hidden From the Public,” The New York Times reported on December 10, 2021 that the nursing home survey and enforcement systems keep hidden from the public important information about some of the … [Read more...] about Report | Too Much Secrecy in The Nursing Home Enforcement System
Medicare Advantage Round-Up
On December 7, the Medicare Annual Coordinated Election Period (AEP) ended. This is the period during which individuals with Medicare can make coverage choices for the coming year. One thing that sets this AEP apart from prior years’ is that we … [Read more...] about Medicare Advantage Round-Up
Study Shows Increased Willingness to Use Telehealth Amongst Previously Resistant Populations
Before the COVID-19 pandemic, use of telehealth in the U.S. was relatively minimal.[1] The Centers for Medicare and Medicaid (CMS) issued waivers to expand access to telehealth services for Medicare beneficiaries in March 2020. In addition to access … [Read more...] about Study Shows Increased Willingness to Use Telehealth Amongst Previously Resistant Populations
Reminder: Questions or Comments on Proposed Clarification in Hospital “Observation Status” Case Due November 25
In Alexander v. Becerra, a federal court found that certain beneficiaries must be allowed to appeal to Medicare when their hospitalizations are reclassified from “inpatient” to “outpatient receiving observation services.” The Center for Medicare … [Read more...] about Reminder: Questions or Comments on Proposed Clarification in Hospital “Observation Status” Case Due November 25
Sale of “Ancillary Products” to Fill Gaps in Medicare Advantage Highlight Both Coverage Shortfalls and Need for Stronger Regulation of the MA Marketplace
Introduction As discussed in recent CMA publications, including our “Special Report | Recent Articles and Reports Shed Light on Medicare Advantage Issues” (Oct. 31, 2022), and “Senate Report Highlights Widespread Medicare Advantage Marketing … [Read more...] about Sale of “Ancillary Products” to Fill Gaps in Medicare Advantage Highlight Both Coverage Shortfalls and Need for Stronger Regulation of the MA Marketplace
Recent Articles Address Medicare Advantage Overpayments and Inappropriate Denials
Medicare Advantage Denials As discussed in a recent CMA Alert (August 25, 2022), the Center for Medicare Advocacy has seen an alarming increase in complaints from Medicare Advantage enrollees who, despite requiring skilled nursing facility (“SNF”) … [Read more...] about Recent Articles Address Medicare Advantage Overpayments and Inappropriate Denials
White House Releases Blueprint for Basic Protections Against Artificial Intelligence Threats
For over seventy years, mathematicians and scientists have been exploring and expanding the possibilities of artificial intelligence (AI). Now, in an era of “big data,” AI has seeped into almost every sector of society, including healthcare.[1] The … [Read more...] about White House Releases Blueprint for Basic Protections Against Artificial Intelligence Threats
Issue Brief 77, October 2022 | Home Health Updates & Other Issues
HOME HEALTH UPDATE Center for Medicare Advocacy Sues on Behalf of Medicare Beneficiaries Seeking Fair Access to Home Health Care After years of fruitless efforts to ensure Medicare beneficiaries can receive Medicare-covered home health care … [Read more...] about Issue Brief 77, October 2022 | Home Health Updates & Other Issues
Issue Brief #76 – August 2022 – Medicare Provisions in the Inflation Reduction Act & Other Issues
1. MEDICARE PROVISIONS in the INFLATION REDUCTION ACT of 2022 (IRA) On Tuesday, August 16, 2022, President Biden signed into law the Inflation Reduction Act (IRA) of 2022 (Pub Law 117-169), which includes expansive health and climate … [Read more...] about Issue Brief #76 – August 2022 – Medicare Provisions in the Inflation Reduction Act & Other Issues