Alliance Issue Brief

PROPOSED RULE TO REVISE MEDICARE ADMINISTRATIVE APPEALS PROCESSAs discussed during previous Alliance calls, there is a significant backlog of cases at the third and fourth levels of the Medicare administrative appeals process, the administrative … [Read more...] about July 2016 – Proposed Medicare Appeals Rules & Other Issues

MEDICARE’S COVERAGE OF ORAL HEALTH  Current Centers for Medicare & Medicaid Services (CMS) policy[1] broadly bars Medicare coverage for practically all dental services.  The Center for Medicare Advocacy firmly believes that … [Read more...] about May 2016 – Medicare’s Coverage of Oral Health & Other Issues

LITIGATION UPDATEBarrows v. Burwell (formerly 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 Justice in Aging filed a class action lawsuit on … [Read more...] about March 2016 – Back to Court in Jimmo, Litigation Update & Other Issues

LEGISLATIVE UPDATESenate Finance Committee Releases Document for Comment  In December 2015, the Senate Finance Committee’s Bipartisan Chronic Care Working Group released a Policy Options Document.  The following is an excerpt … [Read more...] about January 2016 – Senate Finance Request for Comments on Chronic Care & Other Issues

LEGISLATIVE UPDATE: CONGRESS MITIGATES INCREASES IN 2016 PART B PREMIUM AND DEDUCTIBLEBipartisan Budget Act of 2015 – OverviewOn Monday November 2, 2015, President Obama signed into law the Bipartisan Budget Act of 2015.  This … [Read more...] about November 2015 – Budget Act of 2015 Mitigates Increased Part B Premiums And Deductibles; Other Issues

ADMINISTRATIVE UPDATE1. Proposed Requirements of Participation for Nursing FacilitiesOn July 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published proposed rules to revise the nursing home Requirements of Participation … [Read more...] about September 2015 – Proposed Rules for Nursing Facilities are Inadequate & Other Issues

LEGISLATIVE UPDATE1.Senate Finance Committee Addresses Medicare Appeals SystemOn previous Alliance calls, we have discussed that through the Center’s extensive experience with the Medicare administrative appeals process, we continue to … [Read more...] about June 2015 – Reforming Medicare’s Appeals System & Other Issues

LEGISLATIVE/BUDGET UPDATE1.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

LITIGATION UPDATERecent Litigation VictoriesBagnall 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

LEGISLATIVE UPDATEThe Year Ahead1. Legislative & Budget Landscape in a New CongressIn 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