CMS Highlights Savings from Fraud Prevention

Mitchell ClarkMedicare Watch0 Comments

The Centers for Medicare & Medicaid Services (CMS) recently reported $1.5 billion in savings due to “big data” initiatives with the Fraud Prevention System (FPS), which started in June 2011. Over the past five years, CMS used data and predictive analytics to quickly identify and take action on cases of fraud, waste, and abuse in the Medicare program. Working closely with public and private predictive analytics experts, data scientists, and law enforcement, the FPS “has had a profound impact on fraudulent providers and illegitimate payments,” according to CMS. Read More...

U.S. House Members Ask CMS to Withdraw Proposal for Prior Authorization in Home Health Care

Casey SchwarzMedicare Watch0 Comments

Over 100 members of the U.S. House of Representatives wrote to the Centers for Medicare & Medicaid Services (CMS) asking the agency to withdraw a proposal for a demonstration project to test prior authorization requirements in home health care. Home health care services include home-based skilled nursing and therapy care for people with Medicare who are homebound, meaning they are unable to leave their home without difficulty. Read More...

Medicare Rights in Strong Partnership with National State Health Insurance Program Technical Assistance Center

Rachel BennettInside Medicare Rights0 Comments

The Medicare Rights Center is in its second year of providing a range of Medicare resources to the 54 State Health Insurance Assistance Programs (SHIPs) across the country. Working with the Northeast Iowa Area Agency on Aging (NEI3A), which was awarded a grant from the Administration for Community Living (ACL) in 2014, Medicare Rights today offers Medicare training and certification to SHIP counselors through the National SHIP Technical Assistance Center (SHIP TA Center). Read More...

Can I Appeal a Part D Late Enrollment Penalty (Lep)?

Emily WhicheloeDear Marci0 Comments

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Dear Marci, I enrolled in Medicare Parts A and B a few years ago when I turned 65, but I only recently signed up for a Part D plan. Then I received a notice from the plan telling me that my monthly Part D premium payment will go up because I have a late enrollment penalty on top of my regular premium. Is there any way I can get this penalty to go away? Carter (Tupelo, MS) Read More...

Medicare Rights Applauds Proposal to Enhance Educational Materials for People Newly Enrolled in Medicare

Mitchell ClarkInside Medicare Rights, Medicare Watch0 Comments

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This week, Medicare Rights expressed support for a formal process to update the “Welcome to Medicare” package and enhance education and understanding among newly eligible beneficiaries about enrollment considerations and rules. In a letter to Chairman Pat Tiberi (R-OH) and Ranking Member Jim McDermott (D-WA), leaders of the Health Subcommittee of the U.S. House Committee on Ways and Means, we applauded this provision in the Helping Hospitals Improve Patient Care Act of 2016 (H.R. 5273), a bipartisan bill advanced by the Committee on Ways and Means. Read More...