Concerted, broad-based advocacy over the past several years has achieved results in advancing policies and initiatives to improve equity and access in oral health care for older adults and persons with disabilities. One recent example is Medicare’s … [Read more...] about Medicare & Oral Health Care – Webinar Recording
Weekly Alert
Medicare Program Cannot Afford Medicare Advantage “Stability” – Especially as New Study Shows Inferior Home Health Care Provided by MA Plans
MA OverpaymentAs discussed in a recent CMA Alert (Feb. 22, 2024), the Centers for Medicare & Medicaid Services (CMS) has issued proposed MA payment rates for 2025 (“Rate Notice”), which will be finalized by April 1, 2024. As described … [Read more...] about Medicare Program Cannot Afford Medicare Advantage “Stability” – Especially as New Study Shows Inferior Home Health Care Provided by MA Plans
New From the House Ways & Means Committee: No Nursing Home Staffing Standards Ever
On March 6, 2024, the House Ways and Means Committee passed a bill, H.R. 7513, “Protecting America’s Seniors’ Access to Care Act,” that prohibits the Secretary of Health and Human Services from promulgating any nursing home staffing standards, now or … [Read more...] about New From the House Ways & Means Committee: No Nursing Home Staffing Standards Ever
Know Jimmo | It’s Not About Care Setting
The Jimmo Settlement Agreement is consistent with the Medicare program’s regulations governing maintenance nursing and therapy in skilled nursing facilities, home health services, and outpatient therapy (physical, occupational, and speech) and … [Read more...] about Know Jimmo | It’s Not About Care Setting
Two Courts Reject Nursing Home Industry Challenges to New York Law Requiring Minimum Spending on Care and Caps on Profit
In 2021, New York enacted a state law requiring facilities to spend 70% of their revenue on resident care, including 40% of resident-facing care, and limiting profits to 5%. The law has not been implemented.The nursing home industry filed two … [Read more...] about Two Courts Reject Nursing Home Industry Challenges to New York Law Requiring Minimum Spending on Care and Caps on Profit
Greetings & Goodbyes for the Center for Medicare Advocacy Board
The Center for Medicare Advocacy is thrilled to announce the addition of three new members to its Board of Directors. We wholeheartedly welcome:As we welcome these three incredible women and honor their commitment to advocacy and social justice … [Read more...] about Greetings & Goodbyes for the Center for Medicare Advocacy Board
Medicare Advantage Plans Under Scrutiny by Department of Justice and Office of Inspector General
As discussed in a recent CMA Alert (Feb. 22, 2024), the Centers for Medicare & Medicaid Services (CMS) has issued proposed Medicare Advantage (MA) and Part D payment rates for 2025, comments to which are due March 1, 2024. MA plans are … [Read more...] about Medicare Advantage Plans Under Scrutiny by Department of Justice and Office of Inspector General
Know Jimmo | CMS Reminder to MA Plans
In a February 2024 memo, the Centers for Medicare & Medicaid Services reminded Medicare Advantage organizations that the Jimmo Settlement...clarified that the Medicare program covers skilled nursing care and skilled therapy services under … [Read more...] about Know Jimmo | CMS Reminder to MA Plans
Know Jimmo | Skilled Nursing Facility Policy
Medicare Benefit Policy Manual, Chapter 8 – Skilled Nursing Facility ServicesSection 30Coverage of nursing care and/or therapy to perform a maintenance program does not turn on the presence or absence of a patient’s potential for improvement … [Read more...] about Know Jimmo | Skilled Nursing Facility Policy
Medicare Advantage Proposed Payment for 2025 and Other Updates
The Centers for Medicare & Medicaid Services (CMS) has issued proposed Medicare Advantage (MA) and Part D payment rates for 2025. As discussed below, the insurance industry is already trying to pressure the agency to increase their payment in … [Read more...] about Medicare Advantage Proposed Payment for 2025 and Other Updates