We are deeply concerned by ongoing improper payments to MA plans and CMS’ lack of progress in recouping previous payments and deterring future misconduct.
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While we recognize CMS’ stated intention to maintain benefit flexibility and efficiency throughout the MA and Part D programs, we stress that CMS’ focus should not be on rolling back regulations, reducing oversight or minimizing plan sponsor burdens.
Last month in Connecticut, United Healthcare (UHC) set off a panic among its Medicare Advantage (MA) enrollees by sending out letters indicating that they would no longer be affiliated with Hartford HealthCare HHC), one of Connecticut’s largest provider networks.
Today the Center for Medicare Advocacy launches a Ten-Part Series to examine and continue work to resolve the growing crisis in access to Medicare home health coverage and necessary care.
While the Call Letter addresses a range of issues, this Alert touches only on Medicare Advantage payment rates, certain issues that were not addressed in either the draft or final Call Letter, and an additional request for information issued by CMS.
Have regulatory changes at the federal level, while not specifically directed at the goal of increasing nurse staffing, actually led, or may potentially lead, to improved staffing levels at nursing facilities?
The House of Representatives is scheduled to vote on a bill that would gut the ACA, dramatically cut Medicaid payments to states, and undermine Medicare. If passed in the House, the Senate could vote on the bill as early as next week.
On October 4, 2016, the Centers for Medicare & Medicaid Services (CMS) published revised Requirements of Participation (RoP) for skilled nursing facilities (Medicare) and nursing facilities (Medicaid).
The proposed Affordable Care Act (ACA) repeal legislation, the American Health Care Act, would cause 24 million people to lose coverage and cut Medicaid by $880 billion.
Mandating specific levels of direct care nursing staff would seem to be a straightforward method to improve staffing in nursing facilities. If more nursing staff are needed, why not simply require facilities to employ more nurses? The strategy is far more complex, however, than it at first appears. This paper reviews which states have tried this approach, what they have done, how they did it, and whether it worked. It also considers unintended consequences of mandating staffing levels and co
Recent report details details the crucial role Medicaid plays for the 10 million Medicare beneficiaries who also receive Medicaid.
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