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CMS Suspends New Applications for MA “Seamless Conversion” Enrollment

The Center applauds CMS’ decision to both impose a moratorium on approving plans and issue information concerning what plans have already been approved. Absent rescinding the authority of plans to conduct seamless conversion enrollment altogether, we urge CMS to incorporate much stronger consumer protections.

Minimal Social Security COLA Increase Will Likely Lead to Dramatic Part B Premium Increases for Some, Large Deductible Increase for All, Unless Congress Intervenes

Although Medicare premiums won’t be announced until later this Fall, as a result of this small increase to COLA, Part B premiums are projected to increase significantly.

Don’t be Fooled by the Federal Nursing Home Five-Star Quality Rating System

Providing composite scores is intended to help consumers make sense of the large amounts of material on Nursing Home Compare, but composite scores do a disservice to the public when nursing facilities’ self-reported information boosts facilities’ ratings into higher levels.

New Nursing Home Requirements of Participation: A Missed Opportunity

Residents’ advocates had hoped that the Centers for Medicare & Medicaid Services (CMS) would use the opportunity of comprehensively revising the RoPs, for the first time in more than 25 years, to correct the most serious problem in nursing home standards of care – the absence of a requirement for sufficient numbers of well-trained, well-supervised nursing staff, including the need for registered nurses around the clock. CMS did not.

An Open Letter to CMS About Fraud

CMS’ war on fraud seems to be indiscriminate, full of tactical errors and collateral damage. Rather than carefully targeting the perpetrators of fraud, a wide net is cast, resulting in legitimate claims for necessary care sinking into a sea of denials.

Transition of Coverage: The Affordable Care Act and Medicare

Common ACA & Medicare transition of coverage situations and their associated technicalities and consequences.

Preview – 2017 Part D Standard Benefit & Other Threshold Amounts

Note: The amounts in this table do not apply to beneficiaries who have the Part D Low Income Subsidy (“Extra Help”)

CMA REPORT: MEDICARE COVERAGE FOR OFF-LABEL DRUG USE

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.

Center for Medicare Advocacy Launches Home Health Access Initiative ​To Open Doors to Home Health Care

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 Promise 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, or the appropriate amount of care. In particular, people living with long-term and debilitating conditions find themselves facing significant access problems.

September 2016 – Progress In Impact Litigation & Other Issues

Medicare Advocate's Alliance Issue Brief - Progress In Impact Litigation & Other Issues

The Center’s Long-Time Concerns Gain Attention

Prescription Drug Pricing and Medicare Advantage Overpayments

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