The 2024 Medicare Physician Fee Schedule (PFS) proposed rule released last week includes a proposal to clarify reimbursement for dental services necessary to the clinical success of certain cancer treatments. In last year’s PFS final rule, CMS … [Read more...] about Proposed Medicare Rule Clarifies Specific Dental Service Coverage
Weekly Alert
CMS Posts Nursing Home Ownership Information on Care Compare and CMS Data Website
On June 28, 2023, the Centers for Medicare & Medicaid Services (CMS) began posting more detailed nursing home ownership information on the federal website Care Compare and on its data website, data.cms.gov, as promised by President Biden as part … [Read more...] about CMS Posts Nursing Home Ownership Information on Care Compare and CMS Data Website
CMS Publishes Guidance on Medicare Dental Coverage
CMS recently published information on its website about the dental services that Medicare will and will not cover. Although dental services are generally excluded from coverage under the Medicare statute, the agency clarifies in this guidance that … [Read more...] about CMS Publishes Guidance on Medicare Dental Coverage
Ongoing Scrutiny of Medicare Advantage Plans
At a time when Medicare Advantage (MA) enrollment has surpassed 50% of the Medicare population, overpayments to MA plans now exceed $75 billion annually (see, e.g., CMA Alert, June 22, 2023) and access to care problems, including inappropriate use of … [Read more...] about Ongoing Scrutiny of Medicare Advantage Plans
Join! July 13 Virtual Rally for Nurse Staffing Standards in Nursing Facilities
The National Consumer Voice for Quality Long-Term Care, the AFL-CIO, and SEIU will host a virtual rally on July 13, at 2:00 pm ET, to call for strong federal nurse staffing standards in nursing facilities. Speakers at Safe Staffing in Nursing Homes … [Read more...] about Join! July 13 Virtual Rally for Nurse Staffing Standards in Nursing Facilities
CMS to Review Five Medicare Claims from Each Skilled Nursing Facility
The Comprehensive Error Rate Testing (CERT) program projects an improper Medicare Part A payment rate to skilled nursing facilities (SNF) of 15.1% in 2022, nearly double the 7.79% improper payment rate in 2021, and the highest improper payment rate … [Read more...] about CMS to Review Five Medicare Claims from Each Skilled Nursing Facility
Newly Revised CMS Home Health Benefit Brochure
The Center for Medicare Advocacy (the Center) is grateful to the Center for Medicare & Medicaid Services (CMS) for revising a CMS Medicare home health brochure issued earlier this year. The Center identified some concerns about the brochure’s … [Read more...] about Newly Revised CMS Home Health Benefit Brochure
Supreme Court Victory for Court Access and Nursing Home Residents
Court Upholds Right of Residents in Publicly-Owned Nursing Facilities to Sue for Violations of the Nursing Home Reform LawThe U.S. Supreme Court upholds the right of nursing home residents in publicly-owned nursing facilities to file lawsuits … [Read more...] about Supreme Court Victory for Court Access and Nursing Home Residents
Medicare Enrollment Numbers
The Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare on January 5th. As of March 2023, 65,748,297 people are enrolled in Medicare, an increase of almost 100,000 since the last report in September. … [Read more...] about Medicare Enrollment Numbers
Home for the Holidays | Leaving the Nursing Home During a Medicare-Covered Stay
Summer brings various holidays and family vacations. Nursing home residents often want to participate in these gatherings but may worry that they will lose Medicare coverage if they leave the facility to do so. Over the years, the Center for Medicare … [Read more...] about Home for the Holidays | Leaving the Nursing Home During a Medicare-Covered Stay