Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

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Issue Brief – January 2020 – Medicare Payment and Coverage – Barriers to Medicare-Covered Care & Other Issues

Payment V. Coverage – Access To Care Threats During the last several months, the Center for Medicare Advocacy has been drawing attention to changes in two new Medicare payment systems that pose significant threats to beneficiaries’ access to … [Read more...] about Issue Brief – January 2020 – Medicare Payment and Coverage – Barriers to Medicare-Covered Care & Other Issues

Final Rule for Medicare Parts C and D Includes Weakened Standards for Medicare Advantage Networks

On May 22, 2020, the Centers for Medicare & Medicaid Services (CMS) published a final rule regarding Medicare Advantage (Medicare Part C) and Part D prescription drug plans (“C & D Rule”). The rule is entitled “Medicare Program; Contract Year … [Read more...] about Final Rule for Medicare Parts C and D Includes Weakened Standards for Medicare Advantage Networks

Medicare Coverage of Home Health Care Has Not Changed Under the New Payment System (PDGM)

Background.  On January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) began implementing a new Medicare payment system—“Patient Driven Groupings Model” (PDGM)—for home health services. Under PDGM, home health agencies have a new set … [Read more...] about Medicare Coverage of Home Health Care Has Not Changed Under the New Payment System (PDGM)

Incorrect Implementation of the Jimmo V. Sebelius Settlement in a Skilled Nursing Facility: A Case Study

January 2020Download this Case Study I. Background - The Jimmo Settlement In 2013, a U.S. District Court approved the settlement agreement in Jimmo v. Sebelius,[1] requiring the Centers for Medicare & Medicaid Services (CMS) to confirm … [Read more...] about Incorrect Implementation of the Jimmo V. Sebelius Settlement in a Skilled Nursing Facility: A Case Study

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