Full Alert

A Victory for “Off-Label” Prescription Drug Coverage On February 11, 2022, the U.S. Court of Appeals for the 11th Circuit reversed a lower-court decision and found that Medicare must provide coverage for a beneficiary’s off-label use of a … [Read more...] about CMA Alert | February 17, 2022

It’s Time: Repeal the 3-Day Inpatient Hospital Requirement for Medicare Skilled Nursing Facility Coverage Last year, the Center for Medicare Advocacy suggested that it was time to repeal the three-day inpatient hospital requirement that is … [Read more...] about CMA Alert | February 10, 2022

Medicare Announces Coverage of Free Over-the-Counter COVID Tests As discussed in last week’s CMA Alert, on January 10, 2022 the Biden Administration announced that certain private insurance companies and group health plans must cover the cost of … [Read more...] about CMA Alert | February 3, 2022

Court Upholds Right to Appeal for Certain Medicare Beneficiaries on “Observation Status” On January 25, 2022, a federal appeals court decided that Medicare must provide appeal procedures for hospitalized beneficiaries who are reclassified from … [Read more...] about CMA Alert | January 27, 2022

CT Governor Issues Executive Order Requiring Nursing Home Visitors Have Vaccine and Booster or Proof of Negative COVID Test - CT Long Term Care Ombudsman Expresses Support and Offers Assistance if Needed Citing a nearly 700% increase in confirmed … [Read more...] about CMA Alert | January 20, 2022

CMS Releases Proposed 2023 Rule for Medicare Advantage and Part D Plans On January 6, 2022, CMS released CY 2023 Medicare Advantage and Part D Proposed Rule (CMS-4192-P) and an accompanying Press Release describing the overall rule, and a separate … [Read more...] about CMA Alert | January 13, 2022

Study Published in Health Affairs Finds that Medicare Advantage Quality Bonus Program Has Not Improved Quality Health Affairs recently published a research article titled “The Medicare Advantage Quality Bonus Program Has Not Improved Plan Quality” … [Read more...] about CMA Alert | January 6, 2022

CMA Home Health Survey | Medicare Beneficiaries Likely Misinformed and Underserved A survey conducted by the Center for Medicare Advocacy over the past year indicates that home health aide services are not available in an amount even approaching … [Read more...] about CMA Alert | December 16, 2021

GUEST POST: Jimmo Enforced, Preventive & Maintenance Therapy Affirmed By John Marmarou, DPT, MSCS - Executive Director, Total Rehab & Fitness For the last 15 years, all of my professional work and efforts have been devoted to keeping … [Read more...] about CMA Alert | December 9, 2021

Pass Build Back Better — Seize the Moment to Protect Nursing Home ResidentsUpdated Factsheet | CMS Nursing Home Visitation GuidanceMedicare Coverage for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) When a Beneficiary is … [Read more...] about CMA Alert | December 2, 2021