“Diane Archer on the Medicare Advantage Racket,” by Editor, Corporate Crime Reporter “In September 2018, a government report was released and was largely ignored by the mainstream press. The report from the Inspector General at the Department of Health and Human Services (HHS) seductively titled – Medicare Advantage Appeal Outcomes and Audit Findings Raise Concerns About Service and Payment Denials – found that Medicare Advantage regularly denies claims and that when patients appeal those denials, the Medicare Advantage plan reversed three-quarters of their own denials. The numbers were troubling because of the infrequency with which patients and providers used the appeals process
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“The Nursing Home Vulnerabilities That Led to Disaster,” by Emily Gurnon, Next Avenue “The pandemic has exacerbated and raised awareness about the poor conditions in many nursing homes nationwide. But those conditions existed before COVID-19 hit the U.S., and they are likely to continue unless changes are made, experts say. … What set nursing homes up to fail so dramatically during the pandemic? Experts point to five main factors.”   LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform: All five of those factors play a role, but note this. Nothing in this article, nor in most of the
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“Reverse Mortgages: 10 Things You Must Know,” by Jackie Stewart, Rachel L. Sheedy, the Editors of Kiplinger’s Retirement Report, March 26, 2021, Kiplinger   “Get a large wad of cash! Never make a mortgage payment again! Stay in your home as long as you want! Sounds like a great deal, right? Well, for some older homeowners, a reverse mortgage can be. For others, it’s more perilous than promising. If you’re considering a reverse mortgage, there’s a lot you need to know before signing on the dotted line. … If the person suggests investing the funds in certain financial products, such as long-term care
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“Cutting Medicaid and SNAP Red Tape During the Pandemic,” by Suzanne Wikle, CLASP   “Under the Families First Coronavirus Response Act (FFCRA) passed in March 2020, states were given additional federal dollars for Medicaid. But in exchange, they had to commit to not cutting people off Medicaid (with few exceptions for voluntary disenrollment, a move out of state, and death) for the duration of the Covid-19  public health emergency. March 18 marked the one-year anniversary of this provision, known as the Medicaid maintenance of effort (MOE) requirement. States were also provided several administrative flexibilities, such as increasing the use of presumptive eligibility and self-attestation.” LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform: This pro-MOE
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“How To Walk the Medicare Advantage Communications Tightrope,” by John Krahnert III, ThinkAdvisor “If you’ve worked in the Medicare Advantage space, you probably know that finding the right balance between compelling and compliant marketing content is like walking a tightrope. If you lean too far in the direction of ‘compelling,’ you could fall off into the abyss of the CMS’ Medicare Communications & Marketing Guidelines (MCMG) and find yourself in some hot water. If you lean too far in the direction of ‘compliant,’ you could find yourself in the black hole of painfully boring copy that makes your customers’ dishwasher
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“The Nation’s Fiscal Health: After Pandemic Recovery, Focus Needed on Achieving Long-Term Fiscal Sustainability,” Government Accountability Office “Congress and the administration have responded in an unprecedented manner to address the COVID-19 pandemic and the resulting severe economic repercussions. Since March 2020, pandemic response has cost trillions of federal dollars. Until the country better contains the virus, the pandemic will likely remain a significant obstacle to more robust economic activity. After the pandemic recedes and the economy substantially recovers, Congress and the administration should quickly pivot to developing an approach to place the government on a sustainable long-term fiscal path. In fiscal
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“The Boom in Out-of-State Telehealth Threatens In-State Providers,” by Matt Volz, Kaiser Health News “A year into the pandemic, telehealth has become widely accepted. Some states are now looking to make permanent the measures that have fueled its growth. But with it have come some unintended consequences, such as a rise in fraud, potential access problems for vulnerable groups and conflicts between out-of-state and in-state health providers. … Before covid, remote doctor visits by computer or phone were rare: Just 2.4% of enrollees in large-employer health plans used a telehealth service in 2018, according to KFF. That was due in part
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“2021 Poverty Projections: Assessing Four American Rescue Plan Policies,” by Laura Wheaton, Sarah Minton, Linda Giannarelli, and Kelly Dwyer, Urban Institute “Four key elements of the American Rescue Plan Act would reduce the projected poverty rate for 2021 by more than one-third. In an earlier analysis, we projected that without this legislation, the 2021 annual poverty rate would be 13.7 percent.  We project that key elements of the American Rescue Plan would reduce that annual poverty rate to 8.7 percent. The policies would reduce poverty by more than half for children and for people in households experiencing job loss. Poverty would
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“Amazon Care reportedly to launch telehealth offering in all 50 states,” by Joe Jancsurak, McKnight’s Senior Living “Amazon’s app-based healthcare service for employees, Amazon Care, soon will launch throughout the country, according to a Healthcare IT report.” LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform: What’s next? Amazon LTC? What’ll that look like?        
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“Long-Term Care Insurers Reveal Early COVID-19 Effects,” by Allison Bell, ThinkAdvisor “The first two U.S. waves of the COVID-19 pandemic may have hit some U.S. long-term care insurance issuers’ customers hard and missed the customers of other issuers. A team from Milliman Inc. has described the early effects of the pandemic on U.S. LTCI issuers in a new report prepared for the Society of Actuaries, with funding from the Senior Health Care Oversight Trust.”   LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform: All in all, not exactly devastating, but wait until D.        
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