The Social Security Administration (SSA) has released revisions to the Program Operations Manual System (POMS) regarding how to process Part A enrollments that are conditional to a state’s determination of a beneficiary as a Qualified Medicare … [Read more...] about Helpful News for Some Lower Income Medicare Beneficiaries
Weekly Alert
Proposed Home Health Rule Affirms Medicare Coverage and Payment for Patients Who Will Not Improve and May Need More Care than the Norm
In the proposed rule, published in the Federal Register on July 12, 2018[1], CMS confirms that a patient’s condition does not need to improve for home health care to be covered by Medicare. CMS also acknowledges the following:There have … [Read more...] about Proposed Home Health Rule Affirms Medicare Coverage and Payment for Patients Who Will Not Improve and May Need More Care than the Norm
Administrative Law Judges and Objective Medicare Appeals Jeopardized By Recent Executive Order
On July 10, 2018, the President signed an Executive Order undermining the impartial hiring of Administrative law Judges (ALJs). The order states that “conditions of good administration make necessary an exception to the competitive hiring rules … [Read more...] about Administrative Law Judges and Objective Medicare Appeals Jeopardized By Recent Executive Order
Studies Differ Regarding Traditional Medicare and Medicare Advantage
Researchers studying patients with hip fractures found that patients with Medicare Advantage (MA) plans have shorter stays in skilled nursing facilities (SNFs) and receive less rehabilitation than patients in traditional Medicare, but are, … [Read more...] about Studies Differ Regarding Traditional Medicare and Medicare Advantage
Health Care Sabotage – Navigators Face another Round of Cuts
Last year, we highlighted how the Administration cut funding for Affordable Care Act (ACA) outreach and enrollment assistance. They are at it again. This week it was reported that the Administration is slashing even more funding for organizations … [Read more...] about Health Care Sabotage – Navigators Face another Round of Cuts
CMS Releases Issue Brief on Access Challenges of DME for Duals
The Medicare-Medicaid Coordination Office’s Integrated Resource Center (ICRC) of the Center for Medicare & Medicaid Services recently released an issue brief addressing the challenges of access to durable medical equipment (DME) for dually … [Read more...] about CMS Releases Issue Brief on Access Challenges of DME for Duals
Medicare Home Health Rules Proposed by CMS to “Improve Access to Solutions” Will Further Reduce Patient Access to Care
The announcement on July 2, 2018, that CMS seeks to “modernize” Medicare home health care is filled with patient-oriented rhetoric, but will actually further gut the Medicare home health benefit – which is already being implemented … [Read more...] about Medicare Home Health Rules Proposed by CMS to “Improve Access to Solutions” Will Further Reduce Patient Access to Care
Health Care Sabotage: Impact of Sabotage on the Exchanges
This week, the Centers for Medicare and Medicaid Services (CMS) released their reports on the performance of the exchanges and individual health insurance market. These reports include the Early 2018 Effectuated Enrollment Snapshot, Exchange Trends … [Read more...] about Health Care Sabotage: Impact of Sabotage on the Exchanges
Did CMS’s Partnership to Improve Dementia Care Reduce the Inappropriate Prescribing of Antipsychotic Drugs for Nursing Home Residents as Much as CMS Claims? Two Recent Studies Say No
The Centers for Medicare & Medicaid Services (CMS) has ended its campaign to reduce the inappropriate use of antipsychotic drugs for long-stay residents in nursing facilities (formally called the National Partnership to Improve Dementia Care in … [Read more...] about Did CMS’s Partnership to Improve Dementia Care Reduce the Inappropriate Prescribing of Antipsychotic Drugs for Nursing Home Residents as Much as CMS Claims? Two Recent Studies Say No
Center for Medicare Advocacy Discusses Nursing Home Resident Protections with CMS Administrator Seema Verma
Seema Verma, the Administrator of the Centers for Medicare & Medicaid Services (CMS), invited the Center for Medicare Advocacy and other advocacy organizations to meet with her on June 25, 2018. The Administrator asked our organizations to … [Read more...] about Center for Medicare Advocacy Discusses Nursing Home Resident Protections with CMS Administrator Seema Verma