Medicare Fraud Prevention Week focuses on the actions everyone can take to prevent Medicare fraud, errors, and abuse. June 2022

A draft handbook on Medicare enrollment has drawn criticism from senior’s advocates – and rightly so. The Centers for Medicare and Medicaid Services (CMS) released the draft for review in advance of mailing a final version to 43 million households this September. What bothers advocates is the handbook’s apparent bias toward private Medicare Advantage plans over traditional Medicare – using inaccurate and misleading information.

The Center for Medicare Advocacy, Justice in Aging, and the Medicare Rights Center have sent a letter to CMS Administrator Seema Verma, calling out “serious inaccuracies” in the draft handbook, entitled Medicare & You.

If you’re among the 7 million Americans enrolled in the Qualified Medicare Beneficiary (QMB) Program , doctors, suppliers, and other providers aren’t allowed to bill you for Medicare costs when you receive covered medical services, equipment, and supplies. Your Medicare premiums, as well as costs like deductibles, coinsurance, and copayments, are all covered by Medicaid.

Anyone living with a form of dementia such as Alzheimer’s is at risk of wandering. “It’s predicted that six of

Medicaid is a complicated program. Determining whether or not you are eligible is complicated. Qualifying for benefits is complicated. Making the program work with Medicare can be complicated. And often, even knowing what services you qualify for as a Medicaid recipient can be complicated.
One service in New York that many people are unfamiliar with is a community-based long term care service called Consumer Directed Personal Assistance, or CDPA. This program, which is becoming increasingly popular, is for people who need home care or nursing services at home; but, who do not want to work through an agency to have people they do not know sent to assist them.

In 1972, Medicare benefits were extended to cover the high cost of medical care for most individuals suffering from permanent kidney failure also known as end-stage renal disease (ESRD). People whose kidneys have failed need dialysis or a kidney transplant to live. To this day, kidney failure is one of only two medical conditions that gives people the option to enroll in Medicare without a two-year waiting period, regardless of age. Because Medicare for people with ESRD was established separately and later, there are some specific rules around eligibility and coverage of Medicare for dialysis and transplant patients.

Central to any good job is the opportunity to learn, grow, and develop one’s skill set. Unfortunately, in America’s nursing homes, too many jobs aren’t good jobs; they offer poverty-level wages, inadequate benefits, and little opportunity for advancement. Attracting and retaining quality workers to nursing homes requires improving entry-level positions, but also providing meaningful opportunities to graduate to advanced roles, with enhanced responsibility and higher wages. Unfortunately, in the vast majority of nursing homes, those opportunities simply aren’t there.