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Celebrating 35 years of making Medicare more accessible, affordable, and equitable!

Julie Carter

Senior Federal Policy Associate

CMS Announces New Model to Reduce Unnecessary Emergency Department Use

Today, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced a new model within traditional Medicare that could help people with Medicare avoid unnecessary trips to the Emergency Department. This new model would allow emergency transportation services to take individuals to their primary care doctor or urgent care, or to deliver treatment in place, when the person does not need to be seen in an emergency room.

Cardiovascular Preventive Medicine Saving Lives and Saving Medicare Money

Though it’s well known that preventive care can improve health and save lives, establishing that preventive care can also save money has been more difficult. Until now, researchers have consistently found that preventive services do not end up saving money in the long term, but a new study shows that cardiovascular treatment seems to be the exception.

CMS Completes Rollout of New Medicare Cards Ahead of Schedule

Last week, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced that they finished the rollout of new Medicare cards to 61 million people with Medicare ahead of the original deadline of April, 2019. This means that all people with Medicare should now have Medicare cards that include a random Medicare Beneficiary Identifier (MBI) instead of a number based on their Social Security number.

Medicaid Changes Likely in 2019

As 2019 gets underway, the Medicaid program continues to be in the spotlight. This week, the Kaiser Family Foundation (KFF) released an issue brief that highlights some of the major program changes that states, the Administration, and Congress may pursue in 2019.

Over 66 million people receive their health coverage through Medicaid, including older adults, people with disabilities, children, low-income parents, and other adults. Any changes to the program, therefore, have the potential to affect millions of families.

Administrative Proposal to Lower Medicare Drug Prices Shows Promise but Risks Remain

In November, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced new proposals that could potentially lower prices for some of the drugs covered by Medicare Part B but could threaten access to medications for people with Medicare. CMS invited comment on their proposals and, last month, Medicare Rights responded.

Health care affordability is a top issue on our national helpline each year, and the high cost of prescription drug coverage is one major component of this. Most of the medications people with Medicare take are covered under Part D. Part B only accounts for a small percentage of Medicare-covered drugs, but they are some of the most expensive. It is clear that Part B medications can drive significant out-of-pocket costs for people with Medicare with life-altering conditions like cancer, end-stage renal disease, or rheumatoid arthritis.

Leveling the Medigap Playing Field

At the Medicare Rights Center, we encourage states to provide equal protections for people with Medicare, regardless of age. Last week, we joined the American Kidney Fund to explain the importance of Medigap access for people under 65 to the National Conference of State Legislatures.

Most people with Medicare have two major options when choosing how to receive their Medicare coverage: Original Medicare or Medicare Advantage. While this decision is complicated, those who choose Original Medicare may have another decision to make as well—whether to add Medigap coverage.

Medicare Advantage Directories Remain Full of Errors Due to CMS Inaction

It is important that Medicare Advantage organizations (MAOs) supply complete, accurate, and easily accessed provider directories to ensure those who enroll in Medicare Advantage (MA) plans know which providers are in a given plan’s network. Unfortunately, as we have highlighted before, MAO provider directories are not complete and accurate. Instead, for the third year running, the Centers for Medicare & Medicaid Services (CMS), the agency that runs the Medicare program, has revealed directory audit results showing widespread errors and inaccuracies.

Help Us Help Congress Protect and Strengthen Medicare

As we recently discussed, there are two big ways Congress can help protect and strengthen Medicare in the current lame duck session—by passing the BENES Act and protecting important Part D reforms. But we need your help! Follow the steps below to ask your lawmakers to prioritize people with Medicare.

Call your Members of Congress by dialing the Capitol Switchboard at 202-224-3121. Ask to be connected with your Representative and Senators.

Advocacy Success: Improvements to Proposed Physician Payment Rules

Earlier this year, the Centers for Medicare & Medicaid Advocacy (CMS)—the federal agency that oversees the Medicare program—proposed changing the way Medicare pays physicians, in part by creating a flat fee per office visit. As Medicare Rights and other commenters noted, doing so could have devastating consequences for people with Medicare.

Guidance for Advocates to Help People Move from Expansion Medicaid to Medicare

Last week, the Medicare Rights Center and the National Council on Aging (NCOA) released a new resource on the expansion Medicaid-to-Medicare transition process. Our Expansion Medicaid Transitions Guide is designed, in part, to help advocates learn about their state’s transition process and better assist clients when they need to switch from expansion Medicaid to Medicare. The guide includes terminology, an overview of select state processes, and some troubleshooting steps advocates can consider when encountering problems.