Yesterday, the Medicare Rights Center submitted comments in response to a Centers for Medicare & Medicaid Services (CMS) Request for Information (RFI) on enhancing their Medicare Advantage (MA) data collection. According to CMS, the solicited information is intended to “support efforts for MA plans to best meet the needs of […]
Prior authorization is one of the processes Medicare Advantage and other private insurance companies use to manage health care utilization and provide pre-service coverage information. While this can help plans control costs and allow patients and providers to make informed decisions, plans can over- or misuse it in ways that […]
During the COVID-19 pandemic, states had the option to get increased federal funding for Medicaid if they agreed to place a hold on redeterminations until March 31, 2023. These continuous enrollment provisions meant that states did not assess enrollees’ eligibility to receive Medicaid, so people were not required to prove […]
Last month KFF released a report and fact sheet explaining Medicare’s coverage rules and restrictions for coverage of sexual and reproductive health services. Because of the common understanding of Medicare as insurance for older adults, discourse about the program can often overlook the needs of people with Medicare who […]
People who are eligible for both Medicare and Medicaid have diverse needs and circumstances. However, nearly all face challenges navigating their coverage because being enrolled in both programs means working with two sets of benefits, rules, processes, and providers. There is federal and state interest in improving care integration for […]
Earlier this month, the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE) released new numbers showing how Inflation Reduction Act (IRA) provisions have increased uptake of Part D-covered vaccines and saved beneficiaries over $400 million in 2023. Starting in January of […]
While most older adults are automatically enrolled in Medicare Part B because they are receiving Social Security benefits at age 65, a growing number are not. In 2016, only 60% of Medicare-eligible 65-year-olds were taking Social Security, compared to 92% in 2002. Several factors are responsible for this shift, including […]
On Monday, the Medicare Trustees released their mandatory annual report on the financial status of Medicare’s trust funds. Last year, the Trustees extended the Hospital Insurance (HI) Part A trust fund by three years. This year’s projection goes even further, extending it by five additional years. The fund is now […]
On Friday, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a final rule under Section 1557 of the Affordable Care Act (ACA), also known as the Health Care Rights Law. The Medicare Rights Center welcomes these new and restored anti-discrimination protections. Key provisions: […]
During the past several weeks, the Biden-Harris administration has finalized two rules that curtail the sale of “junk insurance” and other health plans that skirt Affordable Care Act (ACA) rules. The Medicare Rights Center welcomes these changes. We previously urged the administration to take these actions to better protect consumers. […]
