On June 13, 2023, the USC Schaeffer Center for Health Policy & Economics published a white paper titled “Medicare Advantage Enrolls Lower-Spending People, Leading to Large Overpayments” by Steven M. Lieberman, Samuel Valdez, PhD and Paul … [Read more...] about New Research Outlines Extent of Medicare Advantage Overpayments: It’s Much Worse Than We Thought
Weekly Alert
CMS Report Highlights Quality of Care Concerns in MA
A recent report released by the Centers for Medicare & Medicaid Services (CMS) Office of Minority Health, Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability, … [Read more...] about CMS Report Highlights Quality of Care Concerns in MA
Honoring the Anniversary of Olmstead and Lois Curtis
On June 22, 1999, the Supreme Court decided in Olmstead v. L.C. that people with disabilities cannot be unnecessarily segregated and that they have a right to receive services in the most integrated setting possible. The case was brought by Lois … [Read more...] about Honoring the Anniversary of Olmstead and Lois Curtis
Understaffing at State Survey Agencies Places Nursing Home Residents at Risk
In May 1986, the Senate Special Committee on Aging held a hearing titled “Nursing Home Care: The Unfinished Agenda” and released a report finding “disturbing shortfalls in nursing home oversight” that place residents at risk. The average surveyor … [Read more...] about Understaffing at State Survey Agencies Places Nursing Home Residents at Risk
A Message to Nursing Home Trade Associations: Stop Scaring Residents and Staff About Nursing Home Staffing, Spend Public Reimbursement on Resident Care
In an alarmist State of the Nursing Home Sector, the American Health Care Association (AHCA) reports, yet again, dire news about nursing facilities. It claims that historic labor shortages have led to the lowest nursing home staffing levels since … [Read more...] about A Message to Nursing Home Trade Associations: Stop Scaring Residents and Staff About Nursing Home Staffing, Spend Public Reimbursement on Resident Care
ACA No-Cost Preventive Services Will Continue Pending Appeal
An agreement was reached this week in a lawsuit regarding preventive benefits, allowing cost-free coverage of services such as annual wellness visits and many cancer screenings to continue essentially unchanged for the time being. The agreement … [Read more...] about ACA No-Cost Preventive Services Will Continue Pending Appeal
Inflation Reduction Act (Medicare Drug Law) Updates – Including Part D Low Income Subsidy
HHS Actions to Increase LIS Enrollment Among other changes aimed at reducing drug costs for both Medicare beneficiaries and the Medicare program at large, a provision of the Inflation Reduction Act of 2022 (IRA) expands access to the Part D Low … [Read more...] about Inflation Reduction Act (Medicare Drug Law) Updates – Including Part D Low Income Subsidy
Lawsuit Settlement Allows Medicare Coverage for “Off-Label” Medication
Medicare has agreed to cover an essential medication for a retired public school teacher in New Jersey who needs the drug to control debilitating symptoms of a digestive system disorder. Cheryl Hough experiences extreme nausea, vomiting, and … [Read more...] about Lawsuit Settlement Allows Medicare Coverage for “Off-Label” Medication
Center Appeals Dismissal of Home Health Aide Lawsuit
The Center for Medicare Advocacy has appealed the dismissal of a lawsuit filed on behalf of beneficiaries with chronic, disabling conditions who cannot access the home health aide services they require. The proposed class action, filed in October … [Read more...] about Center Appeals Dismissal of Home Health Aide Lawsuit
Bipartisan Group of Senators and Representatives Support CMS’s Proposed Rule on Nursing Home Ownership Transparency and Urges CMS to Strengthen Rule in Seven Specific Ways
In a May 17, 2023 letter to CMS Administrator Chiquita Brooks-LaSure, Senators Charles E. Grassley (R, IA), Elizabeth Warren (D, MA), and Robert P. Casey, Jr. (D, PA), and Representatives Katie Porter (D, CA) and Lloyd Doggett (D, TX) express support … [Read more...] about Bipartisan Group of Senators and Representatives Support CMS’s Proposed Rule on Nursing Home Ownership Transparency and Urges CMS to Strengthen Rule in Seven Specific Ways