Medicaid Event Medicaid Matters For Low Income Medicare BeneficiariesEmergency legislation passed earlier this year required health insurers, including those participating in Medicare, to cover both the coronavirus test, and associated care for COVID-19 without cost sharing. But it's becoming clear that patients may still be vulnerable to "surprise" medical bills for costs they thought would be covered. We hope that your dad is not another such case..TSCL opposes such plans since evidence shows they would result in higher out-of-pocket costs for most older Americans, and we will advocate against them as the administration attempts to build support. To stay updated on the latest Medicare reform news from Washington, visit the Legislative News section of our website..The concern is well justified. The Office of the Inspector General for the Department of Health and Human Services has reported that Medicare Advantage plans deny care inappropriately at high rates. When the Office of the Inspector General collected data, it found that when beneficiaries and providers appealed pre-authorization and payment denials, Medicare Advantage Organizations over-turned 75% of their own denials over the 2014-2016 period. The OIG noted "This is especially concerning because beneficiaries and providers rarely use the appeals process, which is designed to ensure access to care and payment." Only 1 percent of beneficiaries and providers appealed denials. … Continued
Medicare Report The Latest On Geographic Variation In Medicare Spending A Demographic Divide Persists But Variation Has NarrowedOn Monday, the Trustees of the Social Security and Medicare programs released their annual reports on the current and projected financial status of the two programs. As expected, the Trustees found that both programs currently face significant but manageable financial challenges..During these meetings, the following issues were discussed: Social Security cost-of-living adjustments, Social Security Notch fairness, Social Security Totalization agreement reform, and repeal of both the windfall elimination provision and the government pension offset. Support was expressed for many of these key issues, and TSCL looks forward to working with these offices in the future..Adding to the confusion, the program will affect beneficiaries differently depending on the area of the country in which they live, and how they are getting their supplies and durable medical equipment. Effective July 1, 2013, in most cases if you have "Original" Medicare coverage and get items in the new program areas, Medicare will only help pay for these items if they're provided by contract suppliers. … Continued