As discussed in a previous CMA Alert, the Centers for Medicare & Medicaid Services (CMS) recently issued a Request for Information on a proposal relating to “direct provider contracting” or “DPC” which, according to CMS, … [Read more...] about Center for Medicare Advocacy Submits Comments to CMS about Direct Provider Contracting Proposal
Weekly Alert
Health Care Sabotage: Graham-Cassidy Redux?
Last week, it was reported that the failed Graham-Cassidy repeal and replace bill may be making another appearance in some form. In its original form, the bill was defeated as it sparked a huge public outcry and the mobilization of advocates around … [Read more...] about Health Care Sabotage: Graham-Cassidy Redux?
Buying and Selling Nursing Homes: Who’s Looking Out for the Residents?
In recent months, the buying and selling of nursing facilities and the transfers of licenses to new managers have raised questions about who the new owners/managers/lessees are and whether there are sufficient state and federal laws, regulations, and … [Read more...] about Buying and Selling Nursing Homes: Who’s Looking Out for the Residents?
CMS Tries Again: Another New Skilled Nursing Facility Medicare Reimbursement System Proposed – If Implemented, Would Gut Therapy
Proposed changes to nursing facility payment under consideration by CMS would reduce financial incentives to provide therapy, and would do so with such force – providing higher reimbursement to skilled nursing facilities (SNFs) that provide … [Read more...] about CMS Tries Again: Another New Skilled Nursing Facility Medicare Reimbursement System Proposed – If Implemented, Would Gut Therapy
Health Care Sabotage: More on Short-Term Limited-Duration “Junk” Plans
In a New York Times article this week, Robert Pear reported on a study done by the chief actuary of the Center for Medicare & Medicaid Services, which shows the devastating impact of expanding access to short-term, limited-duration plans, as … [Read more...] about Health Care Sabotage: More on Short-Term Limited-Duration “Junk” Plans
Home Health Highlight: People Can Leave Home and Still Receive Medicare-Covered Home Care
The Center for Medicare Advocacy hears from Medicare beneficiaries throughout the country who are living with serious illnesses and injuries without the home care they need - and that should be covered by Medicare. There are many reasons for these … [Read more...] about Home Health Highlight: People Can Leave Home and Still Receive Medicare-Covered Home Care
CMS Issues Request for Information on “Direct Provider Contracting:” Beneficiary Advocates Take Note
The Affordable Care Act created the Centers for Medicare & Medicaid Innovations (CMMI), which is tasked with testing demonstration programs aimed at delivery system reform. According to a press release describing feedback to a Request for … [Read more...] about CMS Issues Request for Information on “Direct Provider Contracting:” Beneficiary Advocates Take Note
If it Looks Like Health Care Sabotage and it Sounds Like Health Care Sabotage…
In a recent speech to the World Health Care Congress, CMS Administrator Seema Verma reportedly said “I take exception to those out there who have made claims that we have tried to sabotage the health care of the American people, particularly … [Read more...] about If it Looks Like Health Care Sabotage and it Sounds Like Health Care Sabotage…
Corporate Integrity Agreements and Nursing Homes
In their April 2, 2018 letter to CMS Administrator Seema, Republican leaders of the House Energy and Commerce Committee express serious concern about “recent media reports describing horrific instances of abuse, neglect, and patient harm … [Read more...] about Corporate Integrity Agreements and Nursing Homes
Medicare Home Health Coverage is Not a Short Term Benefit ‒ Congress Reiterated This in the Balanced Budget Act of 1997 (BBA ’97)
In 1997 Congress specifically recognized that Medicare home care was not a short term, acute care benefit and addressed payment methodologies under Parts A and B to meet the costs of longer-term home care.The Balanced Budget Act of 1997, signed … [Read more...] about Medicare Home Health Coverage is Not a Short Term Benefit ‒ Congress Reiterated This in the Balanced Budget Act of 1997 (BBA ’97)