The Department of Homeland Security recently released a proposed “public charge” rule that could greatly harm families and prevent people with Medicare from accessing the services and supports they need. The proposal would dramatically expand the government’s “public charge” test, which considers whether immigrants are likely to use public benefits when deciding whether or not to grant entry to the United States or permanent resident status.

This week, Congress passed two bipartisan bills aimed at removing barriers that may prevent people from paying the lowest possible price for their prescription drugs. The legislation will prohibit contractual limitations that can stop pharmacists from volunteering information about how consumers may be able to save money on their needed medications.

The Patient Right to Know Drug Prices Act (S.2554) bars insurers and Pharmacy Benefit Managers (PBMs) from restricting a pharmacy’s ability to tell consumers when here is a difference between how much they would pay for a drug using their insurance and how much they would pay without it. This bill applies to plans offered through the Affordable Care Act’s exchanges and by private employers. The Know the Lowest Price Act (S. 2553) provides this same protection for individuals who are covered by Medicare Advantage and Medicare Part D plans.

This week, the Center for Medicare Advocacy (CMA) released an issue brief that examines the details and legal underpinnings of several proposed and upcoming changes to the Medicare Advantage (MA) program. Designed to be a resource for advocates and attorneys, CMA’s analysis combines several disparate sources of MA changes, including recently signed legislation, regulatory rulemaking, and sub-regulatory guidance. It also predicts some of the consequences of these changes on, among other things, beneficiary decision-making and informed choice. The brief outlines the changes to MA made in the Balanced Budget Act of 2018 (BBA), in the Part C and D final rule issued earlier this year, and in the Final Call Letter for 2019.

Today, the Medicare Rights Center and a diverse coalition of 80 state and national organizations representing health plans, consumers, and advocates urged the Centers for Medicare & Medicaid Services (CMS) to retain a policy that helps some Medicare beneficiaries correct problems with their Part B enrollment resulting from confusion or misinformation with Medicare and the Affordable Care Act Marketplaces. Under this relief, Medicare-eligible individuals with Marketplace coverage can apply to enroll in Part B without penalty, and those who have already transitioned to Medicare can request that any Part B late enrollment penalties be reduced or eliminated.

Efforts are underway right now to roll back critical reforms to the Medicare Part D donut hole, or coverage gap, that help reduce out-of-pocket costs for people with Medicare, especially those who face the highest prescription drug costs. We need your help! Ask your Members of Congress to maintain the Part D donut hole changes that will improve the health and economic security of people with Medicare and their families.

This week, the Medicare Rights Center submitted comments in response to a proposal from the Centers for Medicare & Medicaid Services (CMS) that would, in part, make major changes to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.

Through the DMEPOS bidding program, medical equipment suppliers compete for Medicare’s business based on quality and price, by submitting bids to serve beneficiaries in a specified geographical region. In the proposed rule, CMS is seeking to effectively suspend this program when current contracts expire at the end of 2018, and until new contracts are awarded under the outlined new payment methodology. CMS does not provide a time frame for when new contracts would begin.

A federal court is considering a challenge to the Affordable Care Act’s (ACA) protections for people with pre-existing conditions that a number of state attorneys general have filed and the Trump Administration has chosen not to defend. But the public—including most Republicans—want those protections preserved. A recent Kaiser Family Foundation tracking poll finds that 72-75% of Americans say that it is “very important” to keep provisions that stop insurance companies from denying coverage or charging more based on medical history. Over 55% of Republicans said it was very important to do so. It is also the 90th time that the foundation has asked about the public’s opinion of the ACA generally, and this month 50% view the law favorably, while 40% view it unfavorably.

The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, is seeking comments on a proposed rule that would completely restructure how Medicare providers are paid. This new proposal could have significant, negative implications for people with Medicare. We encourage those who are interested in Medicare policy to let CMS know about your concerns before the comment period closes on Monday, September 10. Learn what’s in the proposal and what you can do to respond before the deadline!

This week, the Centers for Medicare and Medicaid Services (CMS) announced that, starting in 2020, Part D Plans and Medicare Advantage Plans with Part D will be able to include medications on their formulary for some FDA-approved uses, but not others. Currently, a plan can favor one drug over another by: including a medication on its formulary or not; placing it on a lower cost sharing tier; or putting coverage restrictions, like prior authorization, quantity limits, or step therapy on the less preferred medication. These rules apply uniformly to each drug, for all FDA- and compendia-approved purposes—the new rules do not.

This week, Kaiser Health News (KHN) and National Public Radio (NPR) published and broadcast the story of 44 year-old Drew Calver, a high school teacher in Austin, Texas who faced an outrageous hospital bill.

In the wake of a life-threatening heart attack, Mr. Calver was rushed to a nearby emergency room, where he was admitted to the hospital and underwent surgery. The heart attack was a shock for Calver, an avid swimmer and triathlete. Adding to his surprise was the bill he faced afterwards: the hospital charged $164,941 for the surgery and four days in the hospital. His insurer paid the hospital $55,840. The hospital then billed Mr. Calver for the unpaid balance of $108,951.31.