The National Medicare Advocates Alliance
The National Medicare Advocates Alliance, with support from the John A. Hartford Foundation, provides Medicare advocates with a collaborative network to share resources, best practices, and developments of import to Medicare beneficiaries.
With the support of the John A. Hartford Foundation, the Center for Medicare Advocacy continues to develop and lead a nationwide alliance of Medicare advocates public interest programs and organizations. Through a series of telephone conference calls and related collaborative support, we hope to enhance advocates’ knowledge of Medicare coverage and increase successful Medicare appeals and efforts at systemic change. Alliance calls will be held on an “every-other-month” basis and more frequently if needed.
The calls provide public interest advocates with the opportunity to pose questions, discuss complex and ongoing advocacy concerns, and use the Center’s expertise and the collective wisdom of Alliance participants to problem-solve. Senior Center for Medicare Advocacy attorneys will host the calls, and on each call will obtain further suggestions from participants about particular Medicare coverage and appeal topics of concern. Based on that input, the Center will prepare a short practice-oriented memorandum and guided discussion for the following month’s call. Such topics might include how to deal with Medicare’s erroneous improvement, chronic and stable standards; how to contest a Part B income-based premium; and tips for appealing denials of Medicare home health coverage.
- Conference calls for advocates every other month and more frequently if needed;
- Expert analysis and memoranda about Medicare coverage and appeals;
- Practice Tip Memoranda on specific topics for use in case evaluation and development;
- Simplified coverage screens for beneficiaries.
- July 2017 – Update on Health Reform & Other Issues
- May 2017 – House Passes AHCA, Updates on Home Health, SGD’s & Other Issues
- March 2017 – Updates on Litigation, Health Reform, Observation Status & Other Issues
- January 2017 – The Fight to Protect the ACA, Medicare and Medicaid & Other Issues
- November 2016 – The Election’s Impact on Medicare, New Nursing Home Requirements of Participation and Other Issues
- September 2016 – Progress In Impact Litigation & Other Issues
- July 2016 – Proposed Medicare Appeals Rules & Other Issues
- May 2016 – Medicare’s Coverage of Oral Health & Other Issues
- March 2016 – Back to Court in Jimmo, Litigation Update & Other Issues
- January 2016 – Senate Finance Request for Comments on Chronic Care & Other Issues
Advocacy Tool - MAC Decision Database
In January 2003, the Medicare Appeals Council (MAC) initiated the posting of certain significant decisions and actions on the web site of the Departmental Appeals Board (of which it is a component). The decisions and actions were selected for posting since they involve the adjudication of issues that may be of interest to various stakeholders in the Medicare appeals process. They are searchable as well as indexed by primary topic area. MAC decisions issued beginning in October 2010 are carried by WESTLAW (in the Federal Health Law database, identifier FHTH-HHS), a commercial legal research service. Cases with an asterisk (*) were later appealed to the federal courts.
The Medicare Advocates Alliance is an initiative to assist public interest advocates throughout the country with Medicare cases and issues, funded by the Retirement Research Foundation.
Some recent Alliance successes Include:
- “Medicare Fraud Effort Leaves Elderly Surprise Hospital Bills” July 12, 2010 Bloomberg News article by Drew Armstrong, based on Center for Medicare Advocacy’s efforts, features Center attorney Toby S. Edelman with one of our clients.
- Pennsylvania Lawsuit Increases Access to Medicare for Low income Beneficiaries – Community Legal Services of Philadelphia and the Center for Medicare Advocacy, Inc. represented two low-income Medicare beneficiaries and two advocacy organizations in a lawsuit filed in April 2009 against the Pennsylvania Department of Public Welfare, the Social Security Administration and the Department of Health and Human Services.
- Advocates in MO have been pressing the Centers for Medicare & Medicaid (CMS) to require MO to remove its homebound requirement from its Medicaid rules. This requirement is not valid under Medicaid law. CMS is now requiring MO to amend its state plan to remove the erroneous homebound requirement.
Center for Medicare Advocacy attorney David Lipschutz leads the Medicare Advocates Alliance calls. For further information about this project or to join the Alliance, please contact Attorney Lipschutz in the Center’s Washington, DC office at 202-293-5760 or Matthew Shepard in the Center’s Connecticut office at 860-456-7790.