Common ACA & Medicare transition of coverage situations and their associated technicalities and consequences.
Archives: Publications : Page 7
Note: The amounts in this table do not apply to beneficiaries who have the Part D Low Income Subsidy (“Extra Help”)
While the Medicare prescription drug benefit provides assistance for many people with their drug costs, the requirements for coverage of the off-label use of a drug are onerous and often result in beneficiaries not being able to get the drug coverage they need.
The Center is building a coalition to support a Home Health Access Initiative. The Initiative will oppose inappropriate restrictions on Medicare to open doors to Medicare-covered, necessary home care.
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, or the appropriate amount of care. In particular, people living with long-term and debilitating conditions find themselves facing significant access problems.
Medicare Advocate's Alliance Issue Brief - Progress In Impact Litigation & Other Issues
Prescription Drug Pricing and Medicare Advantage Overpayments
NIH Establishes New Research Program to Address Health Disparities of Chronic Diseases
On Friday August 19, 2016, the Center for Medicare Advocacy submitted comments in response to a June 30 request from the Centers for Medicare & Medicaid Services (CMS) for information regarding Durable Medical Equipment (DME) access issues faced by individuals who are dually eligible for Medicare and Medicaid.
The Center will be expressing our concerns that the proposed changes will result in drastically reduced access to Medicare home health care coverage, particularly for people who are clinically complex or who have poorly controlled chronic conditions.
For the first time in more than 20 years – since the federal enforcement regulations were published in 1994 – CMS has increased the numbers and types of situations when CMPs must be imposed against facilities, without first giving the facilities an opportunity to correct their noncompliance.
Justice in Aging, one of the Center's longtime partners, recently released an issue brief, Oral Health in California: What About Older Adults? The Issue Brief includes a summary of the state of oral health for older adults in California. It cites disparities in oral health based on income level, education and race.