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CMS Issues New Rules Governing Medicare Appeals

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.

Nursing Home Residents in Jeopardy if Medicaid Becomes a Block Grant

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.

Study: Uninsured Rates for Older Adults will Increase if ACA is Repealed or Medicare Eligibility Age is Raised

Repealing ACA and raising the Medicare eligibility age is not a "Better Way" as Paul Ryan would have you believe.

Opening Salvo on ACA Replacement Falls Short

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.”

CMS Bulletin Moves to Improve Access to Durable Medical Equipment for Dually Eligible Beneficiaries

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.

What’s at Stake In the Fight to Sustain Medicare, Medicaid and the Affordable Care Act (ACA)

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.

January 2017 – The Fight to Protect the ACA, Medicare and Medicaid & Other Issues

National Medicare Advocates Alliance Issue Brief - The Fight to Protect the ACA, Medicare and Medicaid & Other Issues

The Promise and Failure of Medicare Home Health Coverage

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,

Hospitals Must Give Patients Notice of Their Observation Status, Beginning March 8, 2017

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

Reports Highlight Devastating Effects of Repealing the Affordable Care Act and Turning Medicaid into Block Grants

Protect Our Health Care: It’s All Connected – ACA, Medicaid and Medicare are All Under Threat

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. 

Plenty of Sensible Changes to Help and Preserve Medicare

Minus the overspending and complexity of private plans and non-negotiable drug prices, Medicare could once again be a model for affordable health insurance.

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