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A Message from the Executive Director

Welcome to the first issue of the CMA Community News and to the Center for Medicare Advocacy community.  We are grateful for your interest in the Center and for your active support of fair access to Medicare and health care. We hope to keep connected by bringing you news of current events, spotting issues in which we think you will be interested, and hearing your concerns.

Despite all the noise in the media and in Washington, there are very few who speak for the people who rely on Medicare or for those who can’t get necessary health care.  The Center's mission is to work for people who would otherwise not be heard.

I established the Center for Medicare Advocacy in 1986. We have grown from my kitchen, to a one-room office, to an organization with offices around the country and a national impact.  We know how to advocate for people – not for profits or political gain.

Together we can make our voices heard!

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News You Can Use

  • "Improvement" is NOT needed to get Medicare coverage for skilled services

The Center won a settlement with the Medicare agency (the Centers for Medicare & Medicaid Services, or CMS) clarifying that skilled nursing and therapy services can be covered whether a patient is improving or not.  The Case, Jimmo v. Sebelius, was settled last January, and CMS has begun to educate providers and Medicare decision makers on the issue.   Want to learn more?  You can view our Timeline of the Improvement Standard or read more here.

  • Nursing Home Residents CAN Leave for the Holidays

At this busy time of year, you don’t need to be worrying about whether your relatives will lose their nursing facility coverage if they come home for a celebration.  According to Medicare law, nursing home residents may leave the facility occasionally without losing their Medicare coverage.  Residents may be charged a "bed hold" fee, but cannot legally lose Medicare coverage for this reason.  Read more here.

  • 2014 Medicare Co-payments and Deductibles

Compare them to 2013 at: http://cma.benfredaconsulting.com/medicare-info/medicare-basics-2/#2013d

For a more detailed weekly look at Medicare and healthcare issues, sign up for the Center's weekly Alert.

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Legislative Watch

  • Medicare Physician Payment

Without Congressional action, physicians faced a cut in payment of over 20% starting in January 2014. Almost every year, Congress has temporarily prevented these cuts from going into effect by passing short-term "fixes."  Recently, though, lower cost-projections have led to momentum for permanent legislative action.  Last week, in the first step of a longer legislative process, both the Senate Finance Committee (SFC) and the House Ways and Means (W&M) Committee approved legislation to replace the formula used to calculate payments to physicians in the Medicare program, known as the sustainable growth rate (SGR).  Neither Committee has tackled the issue of how to pay for the repeal and replacement of SGR. The Center supports efforts to replace the flawed SGR formula, but opposes any effort to pay for it by cutting benefits or increasing costs for beneficiaries and their families who rely on the Medicare program.

  • Budget Update

Last week, the House passed a budget deal that would fund the government through September 2015 (the debt limit will still need to be addressed in early 2014). The budget was subsequently approved in the Senate.

The budget deal offsets a portion of the Sequester (automatic cuts to certain federal spending that resulted from the “fiscal cliff” negotiations and subsequent legislation in 2011), but keeps the originally-included 2% Medicare provider cuts in place through 2023. However, threats to beneficiaries and the Medicare program will likely remain as Congress looks to address another debt-ceiling extension early in 2014.

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At the NAELA conference, CMA staff led a highly informative and fun Medicare version of Wait, Wait, Don’t Tell Me!

CMA In the Community

  • CMA had a total of twelve staff and board members present  at six different educational sessions during the 2014 National Academy of Elder Law Attorneys Conference.
  • CMA will hold its 1st Annual Voices of Medicare Summit and Senator Jay Rockefeller Lecture to be held on March 21st, 2014 with national leaders and advocates for older people and people with disabilities.

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