CMS recently finalized significant changes affecting Medicare appeals, particularly at the Administrative Law Judge (ALJ) level of review. These changes apply to appeals of payment and coverage determinations for items and services furnished to Medicare beneficiaries, enrollees in Medicare Advantage (MA) and other Medicare competitive health plans, and enrollees in Medicare prescription drug plans, as well as to appeals of enrollment and entitlement determinations, and certain premium appeals.
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If Medicaid becomes a block grant program, nearly one million nursing home residents who rely on Medicaid could immediately lose coverage for their nursing home care. In addition, all of the federal standards that govern nursing home care today could be in jeopardy.
Repealing ACA and raising the Medicare eligibility age is not a "Better Way" as Paul Ryan would have you believe.
Senators Susan Collins (R- ME) and Bill Cassidy (R- LA) introduced the Patient Freedom Act of 2017 (S. 191) billed as a “comprehensive replacement plan for Obamacare.”
he Bulletin addresses a serious and persistent obstacle to obtaining DME faced by people dually eligible for Medicare and Medicaid in many states because of the mismatch of processing rules in the two programs.
A vote to repeal the Affordable Care Act would impact access and coverage for health care in Medicare and Medicaid, as well as for people directly covered through ACA.
National Medicare Advocates Alliance Issue Brief - The Fight to Protect the ACA, Medicare and Medicaid & Other Issues
The Center for Medicare Advocacy has been hearing from people who meet Medicare coverage criteria but are unable to access Medicare-covered home health care,
Effective August 6, 2016, the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act) requires acute care hospitals to provide oral and written notification to patients who are classified as outpatients or observation status patients for more than 24 hours.
Reports Highlight Devastating Effects of Repealing the Affordable Care Act and Turning Medicaid into Block Grants
The President-Elect and Republican leaders in Congress have promised to repeal, and at some point, “replace” the Affordable Care Act. They also plan to gut the Medicaid program by imposing block granting or per-capita caps. Speaker Ryan, Trump’s nominee for HHS Secretary Rep. Price, and many others in Congress also want to further privatize Medicare by turning it into a voucher program.
Minus the overspending and complexity of private plans and non-negotiable drug prices, Medicare could once again be a model for affordable health insurance.