CMS rolls back beneficiary protection in the name of reducing “MA plan burden” and making things “easy to read” for eligible beneficiaries The most urgent and frequent type of call we receive at the Center for Medicare Advocacy is from a Medicare … [Read more...] about MA Plans Allowed to Report Less Data about Appeals Outcomes
Coverage & Appeals
Issue Brief: Medicare Payment vs. Coverage for Home Health & Skilled Nursing Facility Care
New Issue Brief: Medicare Payment vs. Coverage for Home Health & Skilled Nursing Facility Care The Centers for Medicare & Medicaid Services (CMS) — the federal agency responsible for administering the Medicare program — has begun … [Read more...] about Issue Brief: Medicare Payment vs. Coverage for Home Health & Skilled Nursing Facility Care
2020 Medicare Cost-Sharing Rates Released
On November 8, 2019, the Centers for Medicare & Medicaid Services (CMS) released the 2020 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs. Each year, Medicare premiums, deductibles, and copayment … [Read more...] about 2020 Medicare Cost-Sharing Rates Released
Center Comments on Use of written Advance Beneficiary Notice of Noncoverage (ABN)
October 21, 2019 VIA ELECTRONIC SUBMISSION Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-9115-P, Mail Stop C4-26-05 7500 Security Boulevard Baltimore, MD 21244-1850 RE: … [Read more...] about Center Comments on Use of written Advance Beneficiary Notice of Noncoverage (ABN)
CMA Comments on “Patients Over Paperwork”
August 12, 2019 SUBMITTED ELECTRONICALLY VIA www.regulations.gov Centers for Medicare and Medicaid Services U.S. Department of Health and Human Services 7500 Security Boulevard Baltimore, MD 21244 Re: CMS-6082-NC; Request for … [Read more...] about CMA Comments on “Patients Over Paperwork”
Beneficiary ALJ Appeals Continue to Get Priority at Office of Medicare Hearings and Appeals (OMHA)
Recent OMHA statistics show that beneficiaries[1] currently wait an average of 60 days[2] to obtain an Administrative Law Judge (ALJ) hearing and receive a decision. In contrast, non-beneficiaries (providers, suppliers, state Medicaid agencies, and … [Read more...] about Beneficiary ALJ Appeals Continue to Get Priority at Office of Medicare Hearings and Appeals (OMHA)
Practice Tip: Office of Medicare Hearings and Appeals Manual Can Be a Useful Tool
The Office of Medicare Hearings and Appeals (OMHA) is the agency that administers the Administrative Law Judge (ALJ) hearing program for Medicare Parts A, B, C and D appeals. OMHA has a Case Processing Manual that sets out day-to-day procedures for … [Read more...] about Practice Tip: Office of Medicare Hearings and Appeals Manual Can Be a Useful Tool
Objective Medicare Appeals Jeopardized By New ALJ Selection Process
On July 10, 2018, the President signed an Executive Order undermining the impartial hiring of Medicare Administrative law Judges (ALJs). The Order states that “conditions of good administration make necessary an exception to the competitive … [Read more...] about Objective Medicare Appeals Jeopardized By New ALJ Selection Process
2019 Medicare Cost-Sharing Announced
Last week the Centers for Medicare & Medicaid Services released the Medicare premium, deductible and co-pay amounts for 2019. Below are the 2019 cost-sharing amounts. Part A Premium (For those not automatically enrolled) 0-29 … [Read more...] about 2019 Medicare Cost-Sharing Announced
Re-Review of Some Home Health Denials Now Available
In January, Vermont Legal Aid and the Center for Medicare Advocacy settled a case on behalf of Medicare beneficiaries in the six New England states and New York who had had been denied coverage of home health services for not being … [Read more...] about Re-Review of Some Home Health Denials Now Available