Close
📢 URGENT: Protect Medicaid for Millions of People with Medicare

Casey Schwarz

Senior Counsel, Education & Federal Policy

MedPAC Makes Part D Recommendations to Congress

In its June report to Congress, the Medicare Payment Advisory Commission (MedPAC) includes several suggestions to improve and reduce costs in the Part D prescription drug program. MedPAC, observing that Part D spending has increased more than 50 percent since 2007 as a result of rising drug costs and other factors, recommends proposals that it estimates could save $10 billion over five years.

U.S. House Members Ask CMS to Withdraw Proposal for Prior Authorization in Home Health Care

Over 100 members of the U.S. House of Representatives wrote to the Centers for Medicare & Medicaid Services (CMS) asking the agency to withdraw a proposal for a demonstration project to test prior authorization requirements in home health care. Home health care services include home-based skilled nursing and therapy care for people with Medicare who are homebound, meaning they are unable to leave their home without difficulty.

Medicare Rights Supports Proposal to Close Loophole in Physician Self-Referral Policies

Last week, Joe Baker, president of the Medicare Rights Center, sent a letter to the leaders of the U.S. Senate Finance Committee, Chairman Orrin Hatch and Ranking Member Ron Wyden expressing support for a proposal to close a loophole in physician self-referral policies. The Ethics in Patient Referrals Act (the Act) prohibits certain types of referrals, specifically ones where the referring doctor owns or has an interest in the provider who administers the referred service. The Act includes exceptions for certain services, including those that could be provided by a physician while the patient is present for the initial visit to aid in diagnosis and minimize delays.

President Obama Proclaims May 2016 as Older Americans Month

Last week, the President proclaimed May 2016 as Older Americans Month. Celebrating the achievements, unique knowledge, and contributions of older Americans, the proclamation shows appreciation for the many kinds of work that older adults do for our country.

AARP Survey Highlights Prescription Drug Use Among Older Adults

This week, AARP released the results of a survey that examined consumers’ prescription drug use and opinions regarding cost. The survey captured common struggles consumers face with the cost of prescription drugs and consumer views on legal strategies to reduce prescription drug costs.

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.

a roll of bills from which spill out pills of many colors

CMS Proposes New Ways to Pay for Part B Covered Medications

Recently, the Centers for Medicare & Medicaid Services (CMS) Innovation Center proposed a demonstration to test new strategies to pay for medications that are covered under Part B. Most prescription medications are covered under Medicare Part D, but some (mostly those administered by a doctor) are paid for under the outpatient Part B benefit.

Common Part B prescription drugs treat cancer, macular degeneration, anemia, and arthritis. Part B medications tend to be very expensive—in 2013, Medicare and its beneficiaries spent $19 billion on Part B prescriptions.

Medicare Rights Responds to MedPAC Recommendations on Part D

Last week, Medicare Rights wrote to the Medicare Payment Advisory Commission (MedPAC) responding to three proposals under consideration by MedPAC to alter the Part D prescription drug program. Established in 1997, MedPAC is an independent federal body made up of 17 members with diverse expertise in the financing and delivery of health care services. MedPAC regularly makes recommendations to Congress regarding the administration of the Medicare program.