Medicare Watch articles are featured in a weekly newsletter that helps readers stay up-to-date on Medicare policy and advocacy developments, and learn about changes in Medicare benefits and rules.
Knowing when and how to enroll in Part B, the part of Medicare that covers outpatient services like doctor visits, can be a confusing endeavor. This was true for Sandra Durant—and, regrettably, for the Social Security employee who misinformed her about when to sign up.
This week, Medicare Rights joined health care leaders from across the country for the annual summit of the Health Care Payment Learning & Action Network (LAN). As a committed partner of the LAN, Medicare Rights is one of over 130 national and state organizations working to change how health care is paid for—moving away from paying on the basis of volume (meaning paying a fee for each discrete service) to paying for value (meaning paying for better quality care at a lower cost). Medicare Rights was proud to be an invited member of the LAN’s Primary Care Payment Model (PCPM) Work Group. As part of the Work Group, we added the consumer and patient perspective to a draft white paper on optimal ways to pay for and deliver primary care services.
The Centers for Medicare & Medicaid Services (CMS) recently suspended a policy known as seamless conversion, a practice that allows select insurers to auto-enroll newly eligible Medicare beneficiaries in an issuer’s commercial or Medicaid managed care product into one of the same company’s Medicare Advantage (MA) plans. In light of recent inquiries, including from the Medicare Rights Center, CMS decided to temporarily halt the acceptance of all new seamless conversion proposals from plans.
This week, the Medicare Rights Center signed onto a letter from the Leadership Council of Aging Organizations calling for a Congressional task force to improve Medicare and other health programs for residents of Puerto Rico. These suggested reforms would increase fairness and provide essential access to benefits. The suggestions include improving low income support programs, enhancing Medicaid funding, and providing for automatic enrollment for certain people eligible for Medicare as takes place for residents of the states.
The Kaiser Family Foundation (KFF) recently released an issue brief analyzing the 2017 prescription drug (Part D) plan offerings based on recently released data from the Center for Medicare and Medicaid Services (CMS). The key findings in KFF’s analysis come at an important time as millions of people with Medicare are weighing their plan choices during Fall Open Enrollment, which lasts from October 15 to December 7.
The Affordable Care Act (ACA) requires Marketplace plans to keep people unless they ask to disenroll or stop paying their premiums under a consumer protection called “guaranteed renewability.” This means that people have a right to keep a plan that they are in and their plan cannot drop them because they become older or sicker.
In a recently proposed rule, the Centers for Medicare & Medicaid Services (CMS) asks whether this protection conflicts with a longstanding Medicare law that prohibits a health plan from selling a policy to a person who already has Medicare. Medicare Rights responded that guaranteed renewability should be maintained, based on both the simple reading of the law and on fundamental fairness.
This week, the Medicare Rights Center released a new brief on the complexities of knowing when to enroll in Medicare Part D and the consequences of making mistakes. The brief, Medicare Snapshot: Stories from the Helpline, Part D Enrollment: Penalty Pitfalls, reports on a recurring issue heard on the Medicare Rights national helpline.
Last week, the Medicare Rights Center and partner organizations, including Justice in Aging, the Center for Medicare Advocacy, and the National Council on Aging, wrote to the Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), to urge the agency to revisit the policy that allows certain private insurance companies to automatically enroll certain people into Medicare Advantage plans.
The Centers for Medicare and Medicaid Services (CMS) recently announced Part D plan participants for a new demonstration, the Enhanced Medication Therapy Management Model, that seeks to strengthen Medication Therapy Management (MTM) services in Part D. In 2003, the Medicare Modernization Act was enacted, creating the Part D program and requiring every Part D plan to offer an MTM program. MTM programs are meant to improve quality of care by ensuring people are taking their medications safely and as prescribed, addressing any barriers to their doing so, and bringing any medication issues to the attention of the treating physician. CMS claims that these activities can also create cost savings.
A new bill, the Fair Drug Pricing Act, was introduced in both the Senate and the House this month promising to bring greater transparency to increases in drug prices.
Knowing when and how to enroll in Part B, the part of Medicare that covers outpatient services like doctor visits, can be a confusing endeavor. This was true for Sandra Durant—and, regrettably, for the Social Security employee who misinformed her about when to sign up.
This week, Medicare Rights joined health care leaders from across the country for the annual summit of the Health Care Payment Learning & Action Network (LAN). As a committed partner of the LAN, Medicare Rights is one of over 130 national and state organizations working to change how health care is paid for—moving away from paying on the basis of volume (meaning paying a fee for each discrete service) to paying for value (meaning paying for better quality care at a lower cost). Medicare Rights was proud to be an invited member of the LAN’s Primary Care Payment Model (PCPM) Work Group. As part of the Work Group, we added the consumer and patient perspective to a draft white paper on optimal ways to pay for and deliver primary care services.
The Centers for Medicare & Medicaid Services (CMS) recently suspended a policy known as seamless conversion, a practice that allows select insurers to auto-enroll newly eligible Medicare beneficiaries in an issuer’s commercial or Medicaid managed care product into one of the same company’s Medicare Advantage (MA) plans. In light of recent inquiries, including from the Medicare Rights Center, CMS decided to temporarily halt the acceptance of all new seamless conversion proposals from plans.
This week, the Medicare Rights Center signed onto a letter from the Leadership Council of Aging Organizations calling for a Congressional task force to improve Medicare and other health programs for residents of Puerto Rico. These suggested reforms would increase fairness and provide essential access to benefits. The suggestions include improving low income support programs, enhancing Medicaid funding, and providing for automatic enrollment for certain people eligible for Medicare as takes place for residents of the states.
The Kaiser Family Foundation (KFF) recently released an issue brief analyzing the 2017 prescription drug (Part D) plan offerings based on recently released data from the Center for Medicare and Medicaid Services (CMS). The key findings in KFF’s analysis come at an important time as millions of people with Medicare are weighing their plan choices during Fall Open Enrollment, which lasts from October 15 to December 7.
The Affordable Care Act (ACA) requires Marketplace plans to keep people unless they ask to disenroll or stop paying their premiums under a consumer protection called “guaranteed renewability.” This means that people have a right to keep a plan that they are in and their plan cannot drop them because they become older or sicker.
In a recently proposed rule, the Centers for Medicare & Medicaid Services (CMS) asks whether this protection conflicts with a longstanding Medicare law that prohibits a health plan from selling a policy to a person who already has Medicare. Medicare Rights responded that guaranteed renewability should be maintained, based on both the simple reading of the law and on fundamental fairness.
This week, the Medicare Rights Center released a new brief on the complexities of knowing when to enroll in Medicare Part D and the consequences of making mistakes. The brief, Medicare Snapshot: Stories from the Helpline, Part D Enrollment: Penalty Pitfalls, reports on a recurring issue heard on the Medicare Rights national helpline.
Last week, the Medicare Rights Center and partner organizations, including Justice in Aging, the Center for Medicare Advocacy, and the National Council on Aging, wrote to the Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), to urge the agency to revisit the policy that allows certain private insurance companies to automatically enroll certain people into Medicare Advantage plans.
The Centers for Medicare and Medicaid Services (CMS) recently announced Part D plan participants for a new demonstration, the Enhanced Medication Therapy Management Model, that seeks to strengthen Medication Therapy Management (MTM) services in Part D. In 2003, the Medicare Modernization Act was enacted, creating the Part D program and requiring every Part D plan to offer an MTM program. MTM programs are meant to improve quality of care by ensuring people are taking their medications safely and as prescribed, addressing any barriers to their doing so, and bringing any medication issues to the attention of the treating physician. CMS claims that these activities can also create cost savings.
A new bill, the Fair Drug Pricing Act, was introduced in both the Senate and the House this month promising to bring greater transparency to increases in drug prices.
