Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

Medicare Advantage

Disputes with Medicare Advantage Plans: Know the Difference Between Appeals and Grievances

Under Medicare law, Medicare Advantage plans and stand-alone Part D plans (“Plans”) must follow certain rules when enrollees disagree with Plan health care coverage determinations. Under the law, there are two distinct methods for raising issues with … [Read more...] about Disputes with Medicare Advantage Plans: Know the Difference Between Appeals and Grievances

Sale of “Ancillary Products” to Fill Gaps in Medicare Advantage Highlight Both Coverage Shortfalls and Need for Stronger Regulation of the MA Marketplace

Introduction As discussed in recent CMA publications, including our “Special Report | Recent Articles and Reports Shed Light on Medicare Advantage Issues” (Oct. 31, 2022), and “Senate Report Highlights Widespread Medicare Advantage Marketing … [Read more...] about Sale of “Ancillary Products” to Fill Gaps in Medicare Advantage Highlight Both Coverage Shortfalls and Need for Stronger Regulation of the MA Marketplace

Senate Report Highlights Widespread Medicare Advantage Marketing Misconduct – But the Driving Forces of Misconduct Are Broader

After the Centers for Medicare & Medicaid Services (CMS) reported earlier this year that Medicare beneficiary complaints about Medicare Advantage (MA) marketing more than doubled between 2020 and 2021, the Senate Finance Committee launched an … [Read more...] about Senate Report Highlights Widespread Medicare Advantage Marketing Misconduct – But the Driving Forces of Misconduct Are Broader

Special Report | Recent Articles and Reports Shed Light on Medicare Advantage Issues

News You Won’t Hear from Private Plans During Enrollment Season Introduction/Overview The Medicare Annual Election Period (AEP) is a time during which people can change the way they receive their Medicare coverage – through traditional Medicare … [Read more...] about Special Report | Recent Articles and Reports Shed Light on Medicare Advantage Issues

Recent Articles Address Medicare Advantage Overpayments and Inappropriate Denials

Medicare Advantage Denials As discussed in a recent CMA Alert (August 25, 2022), the Center for Medicare Advocacy has seen an alarming increase in complaints from Medicare Advantage enrollees who, despite requiring skilled nursing facility (“SNF”) … [Read more...] about Recent Articles Address Medicare Advantage Overpayments and Inappropriate Denials

“Medicare & You” Continues to Reverse Bias Towards, and More Accurately Describe, Medicare Advantage

The Medicare & You Handbook is widely read by beneficiaries who often use it as their sole or primary source of information about Medicare. In contrast to advertising and other promotion by companies and their agents seeking to sell products in … [Read more...] about “Medicare & You” Continues to Reverse Bias Towards, and More Accurately Describe, Medicare Advantage

Kaiser Family Foundation Releases Report Regarding Differences Between Traditional Medicare and Medicare Advantage

On September 16, 2022, the Kaiser Family Foundation (KFF) released a report titled Beneficiary Experience, Affordability, Utilization, and Quality in Medicare Advantage and Traditional Medicare: A Review of the Literature.  The report reviewed … [Read more...] about Kaiser Family Foundation Releases Report Regarding Differences Between Traditional Medicare and Medicare Advantage

New from the Center: Form to Contest Multiple Medicare Denials Issued by Medicare Advantage Plans

During the past year, the Center for Medicare Advocacy has received an alarming increase in complaints from Medicare Advantage enrollees who, despite requiring skilled nursing facility (“SNF”) care, receive Notices of Medicare Non-Coverage (“NOMNCs”) … [Read more...] about New from the Center: Form to Contest Multiple Medicare Denials Issued by Medicare Advantage Plans

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