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Monthly Archives: April 2016

National Initiative Aims to Spur Health Innovation Through Consumer Engagement

Community Catalyst recently launched an initiative, the Center for Consumer Engagement in Health Innovation (the Center) to “make our health system one that is truly people-centered.” Collaborating with partners across the country, including the Medicare Rights Center, the Center’s approach is one that “works directly with consumer advocates to increase […]

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Attention New Yorkers with Medicare and Medicaid: Would You Like To Share Your Experiences with the New Managed-Care Plans?

Do you or a loved one have Medicare and Medicaid and long term care needs? If so, you may have recently experienced a change to the way you receive your coverage. The Medicare Rights Center’s Coalition to Protect the Rights of New York’s Dually Eligible (CPRNYDE) tracks changes New Yorkers with Medicare and Medicaid and long-term care experience, and we would like to hear your story.

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President Signs Reauthorization of Older Americans Act

This week, President Obama signed into law the reauthorization of the Older Americans Act (OAA), which expired in 2011. The OAA was originally signed into law by President Lyndon Johnson in July 1965, and for more than 50 years, it has provided the nation with programs that allow millions of older Americans to continue living and thriving in the communities of their choice for as long as possible.

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What Can I Do if I Think a Family Member Is Being Discharged from a Skilled Nursing Facility Too Soon?

Dear Marci,

My mother has Original Medicare and is currently receiving care from a skilled nursing facility. Her provider gave her a notice saying that she will be discharged soon, but she does not feel she is ready to go home. Is there any way she can stay in the skilled nursing facility and get Medicare to cover the stay?

– Judy (Rockford, IL)

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Infographic: Which is Primary? Medicare and Employer Coverage

Medicare can either be primary or secondary to your employer coverage. This usually depends on the size of the employer and whether or not someone is currently working.

Primary insurance pays first for health care claims. Secondary insurance pays after the primary insurance for some or all of what the primary insurance did not cover. Knowing which is primary is important because secondary insurance often refuses to pay anything if the primary insurance has not paid first.

Check out this handy infographic explaining when employer coverage is primary and when Medicare is primary.

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CMS Releases Final Medicare Advantage and Part D Plan Changes for 2017

Last week, the Centers for Medicare & Medicaid Services (CMS) published the 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter (2017 Final Notice and Call Letter). In March, Medicare Rights submitted comments on the draft version of the call letter supporting of many of the proposed changes, which seek to improve the accuracy of payment structures and strengthen plan accountability. The 2017 Call Letter finalizes most of the proposals included in the draft letter, with some moderate changes.

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Medicare Rights Center Speaks at Public Forum on Part B Medications

Earlier this week, the Medicare Rights Center participated in a panel discussion at a public forum convened by the Pew Charitable Trusts on a proposal by the Centers for Medicare & Medicaid Services (CMS) to test new ways to pay for Medicare Part B prescription drugs. Other panelists included experts on prescription drugs, pharmaceutical makers, and clinical oncologists. The discussion focused on the panelists’ views of the potential merits and downsides of the CMS proposal.

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Prescription Drug Pricing Expert Presents at Medicare Rights

Peter Bach, MD, MAPP, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, was the guest speaker on “The Future of Drug Pricing” at the Medicare Rights Center’s Policy Breakfast on April 5.

Dr. Bach, a physician, epidemiologist, researcher, and healthcare policy expert whose work focuses on the cost and value of anticancer drugs, is an ardent supporter of value-based pricing for prescription drugs and favors the Centers for Medicare and Medicaid Services’ (CMS) recently announced proposal to test value-based payment strategies for medications covered under Medicare Part B.

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