Mr. G, a retired professional, is a Medicare beneficiary in his 80s with advanced Parkinson’s disease who experienced a bad fall at home. He was hospitalized and then went to a skilled nursing facility for rehabilitation. Mr. G has always had … [Read more...] about Medicare Advantage Marketing Matters: Case Study
Medicare Advantage
Government Watchdog Agency Once Again Finds Wasteful Medicare Advantage Overpayment
The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) recently released a report entitled “Billions in Estimated Medicare Advantage Payments From Chart Reviews Raise Concerns”.The report highlights that in the … [Read more...] about Government Watchdog Agency Once Again Finds Wasteful Medicare Advantage Overpayment
Wasting Time Waiting for Prior Authorization – At What Physical and Emotional Cost?
Mr. Sullivan had been experiencing involuntary hand tremors, muscle weakness and cramping, tripping and balance problems, and occasional slurring of his speech. He thought these symptoms were the result of overwork and fatigue. But rather than … [Read more...] about Wasting Time Waiting for Prior Authorization – At What Physical and Emotional Cost?
Family History of Colon Cancer Should Increase the Frequency of Colonoscopies, but Ultimately the MA Plan, Not the Treating Doctor, May Determine When Procedures Will Occur
Ms. McNeil has a family history of colon cancer that is well known to her doctors. Her mother’s father died of colon cancer at age 52, her father died of colon cancer at 76. Ms. McNeil and all of her siblings have had pre-cancerous polyps removed … [Read more...] about Family History of Colon Cancer Should Increase the Frequency of Colonoscopies, but Ultimately the MA Plan, Not the Treating Doctor, May Determine When Procedures Will Occur
MA Plan Prior Authorization Requirements Cause Problems in a Skilled Nursing Facility (SNF) Leading to Patient Re-Hospitalizations
The SNF referenced here is a highly rated, privately owned, non-profit facility with almost 100 beds. The SNF serves traditional Medicare patients for an average of 14 to 21 days per admission. Typically, as long as the SNF documents that a patient … [Read more...] about MA Plan Prior Authorization Requirements Cause Problems in a Skilled Nursing Facility (SNF) Leading to Patient Re-Hospitalizations
Medicare is Being Privatized. Where is the Outcry?
For years, the Center for Medicare Advocacy has warned of wasteful overspending on private Medicare Advantage (MA) plans, the limitations on access to physicians and health care provided by MA, and the difficulties in obtaining the same coverage from … [Read more...] about Medicare is Being Privatized. Where is the Outcry?
Medicare Enrollment Problems Persist
Problems with Medicare Plan Finder PersistAs reported by SHIPs across the country and some of our partner organizations, problems with the new Medicare Plan Finder (MPF) persist during the current Medicare Annual Election Period, which lasts … [Read more...] about Medicare Enrollment Problems Persist
Medicare Enrollment and Medicare Advantage Updates
On October 22, the Center for Medicare Advocacy and the National Committee to Preserve Social Security and Medicare launched the second annual Medicare Fully Informed Project, with a variety of unbiased, accurate, up-to-date, and comprehensive … [Read more...] about Medicare Enrollment and Medicare Advantage Updates
Medicare Fully Informed Project
Providing Medicare Beneficiaries with Complete, Objective Information to Help Them Make the Best Enrollment DecisionThe Center for Medicare Advocacy and the National Committee to Preserve Social Security and Medicare partnered on an education … [Read more...] about Medicare Fully Informed Project
Center for Medicare Advocacy Analysis of President’s Medicare Executive Order:
Among Vague Language and Proposals, Real Harm to Medicare Beneficiaries On October 3, 2019, President Trump issued his “Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors” (EO).[1] Much of the language of the EO is vague, … [Read more...] about Center for Medicare Advocacy Analysis of President’s Medicare Executive Order: