Category

Medicaid

Systemic Denti-Cal Problems Increase Financial Hardship for Older Adults

By | BLOG, Health Care, HOMEPAGE, Medicaid, Medicare, Oral Health | No Comments
Linda—a low-income older adult living in Los Angeles County—applied for a dental credit card after being advised to do so by her dentist. Her dentist’s office explained that, while she has dental coverage through Denti-Cal, it often takes a long time to get authorizations approved and it would be in her best interest to pay right now with the card and get reimbursed later. When Linda received her statement, it showed she owed over $2,000. Not only did she receive services that were not covered by her insurance, she also was charged for services that should have been covered by Denti-Cal but that were denied because her dentist’s office did not properly submit the claim to Denti-Cal. Unable to pay the $2,000 within the no-interest six month promotional period, Linda was hit with the balance plus six months of interest that accrued at 26.9%. Distraught, Linda contacted a legal advocate who is now working to dispute the charges and to rescind the credit card contract. Read More

WEBINAR: Medicaid Non-Emergency Medical Transportation: An Overlooked Lifeline for Older Adults

By | Medicaid, Uncategorized, WEBINAR | No Comments
When: Thursday, November 3, 2016 11:00 a.m. PT

Non-emergency medical transportation is a critical benefit ensuring that Medicaid beneficiaries have transportation to medical services. This webinar reviewed this increasingly important component of health care for low-income older adults and people with disabilities; explored challenges to accessing the benefit; shared examples of state strategies to overcome those challenges.

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WEBINAR: Sec. 1557 Civil Rights Protections – What Aging Advocates Need to Know

By | Affordable Care Act, Medicaid, Medicare, WEBINAR | No Comments
When: Tuesday, October 25 at 11:00 a.m. PT/ 2:00 p.m. ET

One important yet sometimes overlooked protection of the Affordable Care Act is its non-discrimination mandate Section 1557. This critical provision incorporates existing civil rights laws that protect against discrimination on the basis of race, ethnicity, sex, age, and disability, and applies them directly to the provision and delivery of health care. Earlier this year, the U.S. Department of Health and Human Services (HHS) released final regulatory guidance on Section 1557 with an effective date of July 18, 2016 for most covered entities.

Join Justice in Aging as we explored how the protections of Section 1557 affect the obligations of Medicare and Medicaid programs and providers serving older adults.

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Cal MediConnect: A Long Way to Go

By | Affordable Care Act, BLOG, DUAL DEMONSTRATIONS, DUAL ELIGIBLES, Health Care, HOMEPAGE, Medicaid, Medicare | No Comments
Evaluation and enrollment data on the Cal MediConnect program reveals that the program has a long way to go to deliver on the promise of integrated person-centered care. While the data contains some promising trends, it also reveals serious deficiencies that demand focused attention from the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Care Services (DHCS).

The Cal MediConnect (CMC) program, which created new health plans integrating Medicare and Medi-Cal benefits for dually eligible beneficiaries, has been in effect for over two years in seven California counties. Enrollment data released by DHCS and a recent series of evaluations, including surveys, focus groups, and polling, paint a picture of how the program is performing and how enrollees are faring so far. Read More

New Medicare Fact Sheets for LGBTQ People

By | BLOG, Health Care, Health Disparities, HOMEPAGE, LGBT, Medicaid, Medicare | No Comments
Ever since the Supreme Court first overturned the federal Defense of Marriage Act in 2013 and then, in 2015, making same-sex marriage legal in every state, there has been a flood of changes in how government programs address the needs of LGBT individuals. For people who qualify for Medicare, there are many important changes:

  • Married same sex couples now have coverage for Medicare and Medicaid under the same rules as opposite-sex married couples.
  • Transgender individuals have protection from discriminatory treatment in health care.

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Doctors Are Improperly Billing Some on Medicare, U.S. Says

By | Health Care, IN THE NEWS, Medicaid, Medicare | No Comments

The New York Times: Doctors Are Improperly Billing Some on Medicare, U.S. Says (7/31/2016) Healthcare providers are illegally billing qualified Medicare beneficiaries, also enrolled in Medicaid, for deductibles, co-payments and other costs. The practice, known as “balance billing,” is illegal. Federal law requires doctors to accept the amount paid by Medicare and Medicaid as payment in full for qualified Medicare beneficiaries. Many beneficiaries do not know the practice is illegal and pay the fees. Part of the problem is due to low state Medicaid reimbursement rates. Justice in Aging’s Denny Chan is quoted saying in the piece, “Because of this gap in payment, many doctors and other health care providers try to bill the beneficiaries or refuse to provide services to them.”

July 5: Immediate Changes to Medicaid Managed Care

By | BLOG, Health Care, HOMEPAGE, Language Access, LGBT, Long Term Care, Medicaid | No Comments
On July 5, the first wave of new Medicaid managed care regulation requirements go into effect. The Centers for Medicare and Medicaid Services (CMS) published the final Medicaid managed care rule this spring, introducing sweeping changes to how the federal government will regulate the entities that manage long-term services and supports (LTSS). While many of regulation’s big ticket items will be implemented over the course of the year, a few important pieces go live this summer. Justice in Aging will discuss these changes in a free webinar on June 30. Here’s a short list of some of the items we’ll be discussing. Read More

WEBINAR: What You Need to Know About Medicaid Managed Care Changes

By | Medicaid, Uncategorized, WEBINAR | No Comments
When: Thursday, June 30 at 11:00 a.m. PT/2:00 p.m. ET

Coming to a State Near You: Medicaid Managed Care Changes…You may have heard that the Centers for Medicare and Medicaid Services (CMS) recently finalized the regulations for Medicaid Managed Care. These new rules become effective in stages with the first round of changes taking effect on July 5. Over 70 regulations will become effective on that date, including the regulations governing important issues such as enrollment, disenrollment, requirements for long-term services and supports, enrollee rights, and grievance and appeal systems.

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Voices of Medicare Summit Highlights Needs of Poor Seniors

By | BLOG, DUAL ELIGIBLES, Health Care, Health Disparities, HOMEPAGE, Medicaid, Medicare | No Comments
At the third annual Center for Medicare Advocacy (CMA) Voices of Medicare Summit earlier this month, I was particularly struck by how many presenters focused on the key role of Medicare for low-income older Americans. In fact, CMS Deputy Administrator and Medicare Director Sean Cavanaugh started off the day by emphasizing CMS’s commitment to make Medicare work for all beneficiaries, including those who are dually eligible for Medicare and Medicaid.

I shouldn’t have been surprised. After all, half of all people on Medicare live on $24,000 or less a year, with 25% living on less than $14,000 a year. Read More

WEBINAR: Dual Eligible Demonstrations and Initiatives: A Spring Update Webinar

By | DUAL ELIGIBLES, Health Care, Medicaid, Medicare, WEBINAR | No Comments
When: Tuesday, April 5, 2016 11:00 A.M. PT/2:00 P.M. ET

This spring marks the 6th anniversary of the passage of the Affordable Care Act, which created the Medicare-Medicaid Coordination Office (MMCO). In the past few years, MMCO, states, and advocates committed incredible resources and time to improving care and services for dual eligible individuals. This webinar provided an update on dual eligible demonstrations and dual eligible initiatives and highlighted areas for future improvement. Read More