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CMS Rescinds Restrictive Policy and Will Reconsider Technological Advances CMS announced yesterday that it has begun the process of updating its Medicare coverage policy for Speech Generating Devices (SGDs). A new SGD National Coverage Determination (NCD) is expected to be completed by July 31, 2015.  While CMS considers a new coverage rule for SGDs, it … Read more

Twenty-one months after winning a national class action lawsuit that sought to overturn Medicare's practice of denying skilled maintenance care to patients who did not meet an "improvement standard," plaintiff Glenda Jimmo is finally receiving Medicare coverage for skilled home health maintenance care benefits she was denied in 2007. A federal court case in Vermont … Read more

- New legislation would protect patients from being dropped by doctors without cause – Bill is also co-sponsored by Senator Sherrod Brown – More than 10,000 Americans recently urged Congress to support this legislation October 28, 2014 ­­– The Center for Medicare Advocacy and the Medicare Rights Center held a joint telephone conference today with … Read more

August 26, 2014 – The Center for Medicare Advocacy filed a nationwide class action lawsuit in United States District Court in Connecticut today (Lessler et al. v. Burwell, 3:14-CV-1230, D. Conn.). The five named plaintiffs, from Connecticut, New York and Ohio, have all waited longer than the statutory 90-day limit for a decision on their … Read more

Mansfield, Conn. July 28, 2014 – The Medicare trustees reported good news for Medicare today. The Trustees’ annual report finds the life of the Medicare Trust Fund has been extended another four years since their 2013 report, and an additional 13 years from their last projection before the Affordable Care Act passed. The annual report[1] … Read more

The Center for Medicare Advocacy’s 'Rubber Stamp' suit highlights the fact that 98% of Medicare appeals are denied at the first two levels of review June 5, 2014 – The Center for Medicare Advocacy filed a complaint in United States District Court in Connecticut yesterday against Kathleen Sebelius, Secretary of Health and Human Services, on behalf … Read more

Inspector General's Report Underscores Need for Better Staffing and Better Enforcement of Quality Standards March 5, 2014 – The Health and Human Services Office of Inspector General (OIG) recently reported that 32% of Medicare beneficiaries who went to skilled nursing facilities (SNFs) and spent an average of 15.5 days in the SNF in August 2011 experienced … Read more

February 24, 2014 – The Affordable Care Act (ACA) is reining in overpayments to private Medicare Advantage (MA) plans by bringing MA payments closer to what traditional Medicare spends on a given beneficiary. The insurance industry and some legislators suggest that these overpayment reductions are harmful "cuts" to Medicare. This is not true. "Private Medicare … Read more

January 24, 2014 – Today marks the one-year anniversary of the landmark Jimmo v. Sebelius settlement.  The Jimmo case was brought in 2011 by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of a nationwide class of Medicare beneficiaries who were denied Medicare coverage and access to necessary health care or therapy … Read more

December 9, 2013 – The Center for Medicare Advocacy is pleased to announce that the Medicare Policy Manuals have been revised pursuant to the Jimmo vs. Sebelius Settlement. The Manual revisions, which clarify that improvement is not required to obtain Medicare coverage, were published by the Centers for Medicare & Medicaid Services (CMS) on Friday … Read more