The Center for Medicare Advocacy has co-authored an amicus brief with the National Health Law Program (NHeLP) in support of West Virginia Medicaid beneficiaries seeking coverage of medically necessary gender affirming care. In Fain v. Crouch, 2022 WL … [Read more...] about Center Supports Coverage of Gender Affirming Care in Amicus Brief
litigation update
Center for Medicare Advocacy Sues, Again, for Coverage of “Off-label” Prescription Drug
On November 18, 2022, the Center for Medicare Advocacy and Murphy Orlando LLC filed suit on behalf of a retired public-school teacher in New Jersey who seeks coverage of her “off-label” (non-FDA-approved) use of a critically needed medication. … [Read more...] about Center for Medicare Advocacy Sues, Again, for Coverage of “Off-label” Prescription Drug
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
Wilson Sonsini Firm Honored for its Pro Bono Work on Center’s “Observation Status” Case
The Center for Medicare Advocacy celebrates Wilson Sonsini Goodrich & Rosati’s well-deserved honor as a “Pro Bono Innovator.” This week Bloomberg Law highlighted the firm’s work with the Center and co-counsel Justice in Aging on the nationwide … [Read more...] about Wilson Sonsini Firm Honored for its Pro Bono Work on Center’s “Observation Status” Case
Notice to the Class of a Proposed Clarification in Hospital “Observation Status” Case
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 Notice to the Class of a Proposed Clarification in Hospital “Observation Status” Case
Supreme Court to Hear Nursing Home Case with Broad Implications for Litigation to Enforce Federal Laws
On November 8, the U.S. Supreme Court will hear oral argument in Health and Hospital Corporation of Marion County v. Talevski,[1] a nursing home case that has troubling implications for whether beneficiaries of federal programs can continue, as they … [Read more...] about Supreme Court to Hear Nursing Home Case with Broad Implications for Litigation to Enforce Federal Laws
Center for Medicare Advocacy Sues on Behalf of Medicare Beneficiaries Seeking Fair Access to Home Health Care
Washington, DC: After years of fruitless efforts to ensure Medicare beneficiaries can receive Medicare-covered home health care in general, and aide services in particular, the Center for Medicare Advocacy (the Center) filed a lawsuit today … [Read more...] about Center for Medicare Advocacy Sues on Behalf of Medicare Beneficiaries Seeking Fair Access to Home Health Care
Proposed Civil Rights Rule Marks Important Step in Restoring Health Care Protections
This week the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services issued a proposed rule that seeks to restore critical nondiscrimination protections the previous administration rolled back. Section 1557 of the … [Read more...] about Proposed Civil Rights Rule Marks Important Step in Restoring Health Care Protections
Medicare Announces Development of Appeal Process for Certain Hospital “Observation Status” Patients
As the result of a court case, the Medicare.gov website now alerts a nationwide class of Medicare beneficiaries that they “have appeal rights” when a hospital changes their status from inpatient to outpatient observation, and that the appeal process … [Read more...] about Medicare Announces Development of Appeal Process for Certain Hospital “Observation Status” Patients
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 medication in Dobson v. Secretary of Health & Human … [Read more...] about A Victory for “Off-Label” Prescription Drug Coverage