There are a number of significant changes to the Medicare Part D prescription drug benefit (which includes Medicare Advantage plans that offer Part D coverage) that are taking effect in 2025. The Center for Medicare Advocacy and the PAN Foundation … [Read more...] about Part D Updates for 2025 – Webinar and Other Resources
Weekly Alert
CMA Alum Nominated for Key State Position
Center for Medicare Advocacy alum Kathleen Holt has been nominated by Gov. Ned Lamont to be Connecticut’s new Healthcare Advocate. As noted in a press release, the position “is responsible for serving as the head of the Office of the Healthcare … [Read more...] about CMA Alum Nominated for Key State Position
Know Jimmo | Provider Education is Key
"I am a private nurse care manager who has advocated for my clients regarding the application of Jimmo decision for the last several years... without success. The therapists and nurses in the room continue to repeat 'Must discharge because of lack of … [Read more...] about Know Jimmo | Provider Education is Key
Center Comments on 2025 Physician Fee Schedule, Outpatient Prospective Payment System
Center for Medicare Advocacy Submits Comments on Proposed Physician Fee Schedule RuleOn July 31, 2024, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule titled “Medicare and Medicaid Programs; CY 2025 Payment … [Read more...] about Center Comments on 2025 Physician Fee Schedule, Outpatient Prospective Payment System
In a Medicare Advantage Plan?
Double-Check that Your Providers Are, and Will Be, In-Network for 2025A recent HealthLeaders article titled “Providers Are Fed Up With Medicare Advantage” by Marie Defreitas (Sept. 9, 2024) begins: “[a]cross the country, more providers are opting … [Read more...] about In a Medicare Advantage Plan?
Medicare Advantage Needs More Oversight, Less Overpayment
Last week’s CMA Alert (Aug. 29, 2024) discussed the insurance industry’s launch of a campaign to convince policymakers that Medicare Advantage (MA) plans need more money and less regulation. While the industry is trying to convince lawmakers and … [Read more...] about Medicare Advantage Needs More Oversight, Less Overpayment
Report Urges Closing Medicaid Coverage Gap to Reduce Health Inequities
A recent report from the Center on Budget and Policy Priorities highlights the Medicaid coverage gap and how it exacerbates health inequities. The report, “Closing Medicaid Coverage Gap Would Help Diverse Groups and Reduce Inequities,” … [Read more...] about Report Urges Closing Medicaid Coverage Gap to Reduce Health Inequities
Nursing Homes Make Changes to Increase Staffing
Although nursing home owners, operators, and trade associations (see AHCA’s “Report: Access to Nursing Home Care is Worsening” (Aug. 22, 2024)) continue to complain about the final rule mandating minimum nurse staffing levels in nursing facilities, … [Read more...] about Nursing Homes Make Changes to Increase Staffing
Know Jimmo | Jimmo Applies to Medicare Advantage Plans
As far back as 2013, The Center for Medicare & Medicaid Services made it clear that the Jimmo Settlement applied to private Medicare Advantage plans. In a memo from April that year, announcing a new Jimmo Fact Sheet they stated:The goal of … [Read more...] about Know Jimmo | Jimmo Applies to Medicare Advantage Plans
Medicare Advantage Industry Launches Campaign to Protect Profits and Avoid Oversight
With Medicare’s Annual Enrollment Period fast approaching, the time during which beneficiaries can make changes to their Medicare Advantage (MA) and Part D coverage for the following calendar year, the public will soon learn about plan changes for … [Read more...] about Medicare Advantage Industry Launches Campaign to Protect Profits and Avoid Oversight