Today’s Hot Topics in Medicare News

Medicare card in mouse trap

Medicare scams center around issuance of new cards

BY COLIN VAN WESTEN: “(Scammers) are calling, asking for their card numbers and to verify their personal information and threatening to cancel their health insurance plans,” said Nancy Ketcham, elder rights specialist of Elderbridge. “They are also saying that their Medicare will be canceled if they don’t get your number now. Don’t ever share your Medicare number or your personal information with people because Medicare won’t ever call people and tell you that anyway.” (read more)

Most Americans oppose cuts to Medicare and Medicaid

BY JACOB McDONALD: Some in Congress may be considering cuts to programs that help older adults and people with disabilities meet basic needs—including Medicare and Medicaid—in an effort to fill the expected $1.5 trillion budget shortfall created by recent tax legislation. According to a new Kaiser Health Tracking Poll, this goes against the will of most Americans. In fact, the poll finds that just 7% want cuts to Medicare and 12% want cuts to Medicaid.

In addition, the poll highlights how much word choice affects public opinion. Using “entitlement” or “welfare” instead of the name of the program had a substantial effect on people’s responses. When “Medicare” was changed to “entitlement programs,” the percentage of Americans in favor of cuts increased to 27%. Similarly, when “Medicaid” was changed to “welfare programs,” 32% reported being in favor of cuts. (read more)


Congress can’t afford to wait to make a simple fix to Medicare Part D

BY CHRISTINE SIMMON: Congress has an opportunity to make a meaningful impact on rising health care costs for millions of Medicare patients in the coming weeks as it determines the best way to reach an agreement on a long-term spending bill.

In fact, only a simple fix to the Medicare Part D program – also known as the prescription drug benefit program – could both reduce patient out-of-pocket costs and save taxpayer money. It’s common sense and good public policy. (read more)

CMS proposes Medicare Advantage and Part D updates, including 1.84% payment increase

BY KIMBERLY MARSELAS: The Centers for Medicare & Medicaid Services has issued Medicare Advantage and Part D updates that include an average payment increase of 1.84% and policy changes that include new supplemental benefits for services that improve health and quality of life.

According to a call letter for plan sponsors published Thursday in anticipation of 2019 bidding, coverage would expand for non-skilled in-home supports like portable wheelchair ramps and other assistive devices and modifications when needed.

“CMS has previously not allowed an item or service to be eligible as a supplemental benefit if the primary purpose included daily maintenance,” the letter explained. “Under the new policy … CMS would allow supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.” (read more)

Therapy caps force providers to adjust operations

BY TIM MULLANEY: Now, a permanent repeal of the caps appears to be imminent, in the form of a bill with bipartisan, bicameral support. However, that legislation stalled at the tail end of 2017, as Congress tackled tax reform and other matters. It also was not attached to the temporary spending bill that re-opened the government after a temporary shutdown last month. Meanwhile, the exceptions process expired as of Jan. 1, meaning the 2018 therapy caps are in effect. The cap is $2,010 for occupational therapy and $2,010 for physical therapy and speech-language pathology services combined.

“If each [therapy] visit is roughly $100 worth of billing … that’s roughly 20 visits or so, so we do have cases that are approaching this cap,” Travis King, vice president of quality assurance and professional development at Fox Rehabilitation, told Home Health Care News. New Jersey-based Fox specializes in providing PT, OT and speech therapy in people’s homes under what it terms a Geriatric House Calls model; its practice spans 16 states, and the company works with home health providers. (read more)

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