NORC Study Reveals Significant Coverage Loss among Dual Eligibles

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On November 19, 2024, the NORC research center at the University of Chicago released a study examining the impact of Medicaid unwinding on individuals dually eligible for Medicare. Dual eligibles generally represent individuals with the highest level of need given that they qualify for Medicare on the basis of age and/or disability & qualify for […]

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Revised Medicare Non-Coverage Notices Issued

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The Office of Management and Budget (OMB) has renewed the Notice of Medicare Non-Coverage (NOMNC, CMS-10123), and the Detailed Explanation of Non-Coverage (DENC, CMS-10124). The NOMNC and DENC renewed notices contain updates which are applicable only to Medicare Advantage (MA) enrollees. Providers must use the current notices until December 31, 2024, and are required to […]

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2025 Medicare Parts A & B Premiums and Deductibles

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On November 8, 2024, the Centers for Medicare & Medicaid Services (CMS) released the 2025 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2025 Medicare Part D income-related monthly adjustment amounts.  Medicare Part B Premium and Deductible Medicare Part B covers physicians’ services, outpatient hospital services, certain […]

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Medicare Open Enrollment Period Outreach Materials

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The Alliance wants you to know that Medicare open enrollment outreach materials from the Centers for Medicare & Medicaid Services (CMS) exist and if you believe it would help your patients and families to share them. There are outreach materials for English-speaking, Spanish-speaking, and other audiences that can help you to help others with Medicare Open Enrollment.  General market […]

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VP Harris Proposes Medicare Pay for Home Care

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Vice President Kamala Harris released a plan on Tuesday proposing to extend Medicare coverage to home care for the first time. According to the Harris campaign, the proposed coverage would include: The campaign asserts the proposal is intended to help the “sandwich generation” of adults caring for aging parents while raising their children at the […]

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2023 Medicare Current Beneficiary Survey Now Available

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The Centers for Medicare & Medicaid Services (CMS) is making the new LDS product, the 2023 Medicare Current Beneficiary Survey (MCBS) Survey File – Early Release LDS. The MCBS Survey File – Early Release LDS provides select microdata from the MCBS Survey File LDS on an expedited schedule for beneficiaries living in the community only. […]

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Hospice Medicare FY2025 Pricer & Medicaid Rates Now Available

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Beginning October 1, 2024, hospice base payment rates will increase by 2.9 percent, as published in the final FY 2025 Hospice Payment Rule.  As is customary, the Medicaid program waits until Medicare rates are finalized to issue guidance on the applicable corresponding hospice payment rates. The Centers for Medicare & Medicaid Services (CMS) Medicaid Financial Management […]

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MedPAC Recommends 7% Reduction in Home Health Payments

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The Medicare Payment Advisory Commission (MedPAC) last week released their March,2024 Medicare Payment Policy Report to Congress. Based on the Commission’s review of the payment and cost indicators, the MedPAC recommends that the Congress should reduce the 2024 Medicare base payment rates for home health agencies by seven percent. MedPAC, once again, has concluded that […]

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New Legislation Would Expand Access to Occ Therapy

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In a promising bipartisan effort, the Medicare Home Health Accessibility Act, H.R. 7148, has been introduced by a coalition of legislators including Reps. Lloyd Smucker (R-PA-11), Dr. John Joyce (R-PA-13), Paul Tonko (D-NY-20), and Lloyd Doggett (D-TX-37). This crucial bill aims to revolutionize home health care by allowing occupational therapy (OT) to be ordered as […]

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