One of the major challenges today preventing the effective oversight of nursing facilities is the dramatic change in ownership and management practices since the Nursing Home Reform Law was enacted in 1987. Thirty-five years ago, most facilities were … [Read more...] about Nursing Homes: Addressing the Worst Operator Behaviors under Existing Law
Weekly Alert
Medicare Advantage Round-Up
On December 7, the Medicare Annual Coordinated Election Period (AEP) ended. This is the period during which individuals with Medicare can make coverage choices for the coming year. One thing that sets this AEP apart from prior years’ is that we … [Read more...] about Medicare Advantage Round-Up
CMS Issues Proposed Rules Impacting Medicare Advantage – Part C & D Rule for 2024, and Separate Prior Authorization Rule
As the Center for Medicare Advocacy has long noted, the Medicare Advantage (MA) program is in significant need of heighted regulation and oversight, not just for the sake of the Medicare program’s financial footing, but for the sake of the … [Read more...] about CMS Issues Proposed Rules Impacting Medicare Advantage – Part C & D Rule for 2024, and Separate Prior Authorization Rule
Information Regarding Data Breach at CMS Contractor
The Centers for Medicare & Medicaid Services (CMS) announced on December 14 that they are responding to a data breach at Healthcare Management Solutions, LLC (HMS), a CMS subcontractor. HMS handles CMS data as part of processing Medicare … [Read more...] about Information Regarding Data Breach at CMS Contractor
Study Shows Increased Willingness to Use Telehealth Amongst Previously Resistant Populations
Before the COVID-19 pandemic, use of telehealth in the U.S. was relatively minimal.[1] The Centers for Medicare and Medicaid (CMS) issued waivers to expand access to telehealth services for Medicare beneficiaries in March 2020. In addition to access … [Read more...] about Study Shows Increased Willingness to Use Telehealth Amongst Previously Resistant Populations
Increased Use of Observation Stays Undermined Hospital Readmissions Reduction Program
The Hospital Readmissions Reduction Program (HRRP), enacted as part of the Affordable Care Act, imposes penalties against hospitals that have higher-than-expected rates of readmissions of patients with certain conditions. However, HRRP defined … [Read more...] about Increased Use of Observation Stays Undermined Hospital Readmissions Reduction Program
HHS Inspector General: Too Many Nursing Home Residents Still Inappropriately Receive Psychotropic Medications
The HHS Office of Inspector General (OIG) reports that, from 2011 through 2019, about 80% of long-stay nursing home residents were prescribed a psychotropic drug (defined as “any drug that affects brain activities associated with mental processes and … [Read more...] about HHS Inspector General: Too Many Nursing Home Residents Still Inappropriately Receive Psychotropic Medications
Center for Medicare Advocacy Weighs in on IRA Implementation
The Center for Medicare Advocacy was honored to participate in a recent meeting with leadership of the Department of Health & Human Services (HHS) and a group of Medicare advocacy organizations to discuss implementation of the Inflation Reduction … [Read more...] about Center for Medicare Advocacy Weighs in on IRA Implementation
Provisions of Recently Passed Medicare Drug Bill in Effect Next Month – January 2023
As discussed in a recent CMA Alert (Aug. 18, 2022), President Biden signed into law the Inflation Reduction Act (IRA) of 2022 on August 16, 2022. This bill includes historic prescription drug provisions that will soon be of significant benefit to … [Read more...] about Provisions of Recently Passed Medicare Drug Bill in Effect Next Month – January 2023
Nursing Home Reform: Where Are We Now? Where Do We Need to Go?
Last month, the White House announced additional steps to implement President Biden’s comprehensive nursing home reform agenda, which he originally announced in February. The White House described why nursing home reform is so needed … [Read more...] about Nursing Home Reform: Where Are We Now? Where Do We Need to Go?