CMA In the News

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December 2007

Click here to read “Care For Aging: Jarring Realities” an article that appeared in the Hartford Courant on December 29. The piece describes how agencies that provide home care for older people are inundated with calls during the holidays from adult children who believe that their parents might need help caring for themselves. The Center for Medicare Advocacy is cited as a resource for caregivers.
Click here to read “Medicare drug program faces many changes” an article that appeared in the Hammonton News (a local weekly newspaper for residents of Hammonton, NJ and surrounding areas) on December 26. The piece cites a recent AP article quoting Patricia Nemore, who advises Medicare recipients to shop around every year. The Hammonton News piece also suggests Congress needs to fortify Social Security, Medicare and Medicaid.
Click here to read “Medicare drug plan deadline nears; Seniors have until midnight New Year's Eve to change options” an article that appeared in the Dallas Morning News on December 24. According to the piece, “The Center for Medicare Advocacy says most insurers are making changes in their lists of covered drugs and the co-payments they charge. Plans also are reclassifying some of their drugs from ‘preferred’ to ‘nonpreferred,’ which means consumers will pay more out of pocket for those prescriptions.” The article cautions beneficiaries to review their plans and change them if necessary since the current enrollment period is nearing an end.
Click here to read “Thousands of Floridians miss out on drug savings” an article that appeared in the Sun Sentinel on December 26. The article says, “As many as 31,000 low-income South Floridians are missing out on huge savings on prescription medicine from Medicare because they don't know about it, don't think they qualify or may not want to apply.” The piece cites Vicki Gottlich who urges people to apply for “Extra Help” – a Florida program for low-income seniors to help them pay for their medication. She says even skeptical people should apply. She says, "If you are close, it's definitely worth applying for it."
The Center for Medicare Advocacy also appeared in Inside CMS, The article focuses on how Congress passed a “skinny, $5.3 billion Medicare package that provides physicians with a six-month payment update of 0.5 percent in lieu of a 10.1 percent cut slated for Jan. 1, extends the therapy cap exceptions process for six months and extends a popular children's health program until after next year's elections.” According to the piece, “Patient advocates are disappointed that lawmakers decided not to touch MA plans. Judith Stein, executive director of the Center for Medicare Advocacy, issued a statement condemning lawmakers' failure to use MA cuts to fund other Medicare reforms -- a move championed by many Democrats and anticipated by many health policy observers. ‘The next session of Congress must end the lavish private Medicare subsidies and the unethical tactics private plans use to recruit people,’ Stein said.”
Click here to read “Some see conflict in dual role; AARP is drug plan advocate, marketer,” an article that appeared in the Philadelphia Inquirer on December 20. The piece describes how AARP-branded Medicare drug plans are generally expensive, but attract loyalty from seniors, many of whom may be overwhelmed by the sheer number of plans to choose from. Judith Stein, executive director of the Center for Medicare Advocacy, says in the article, "The privatization of Medicare in general is a very bad thing and a good thing for the companies that are making a huge profit… When one of those companies is benefited by the AARP brand, I think it's a conflict."

Click here to read a New York Times letter to the editor from Ted J. Bliman, staff attorney at the Center for Medicare Advocacy. The letter appeared on December 17 in reaction to a December 10 front-page story entitled “Disability Cases Last Far Longer as Backlog Rises.” Bliman points out that another devastating problem for the disabled is that there is a two-year waiting period for people on Social Security disability to become eligible for federal Medicare. He contends that Medicare works and should be available to people with disabilities without a waiting period and should be expanded to cover the uninsured.
Click here to read “Many Inland nursing homes among those paying fractions of fines owed,” an article that appeared in the Press Enterprise on December 12. The piece focuses on how state and federal law has allowed nursing homes in California to pay fractions of the fines they owe. Furthermore, the GAO has reported that nursing home penalties have not improved regulation compliance. Toby Edelman is quoted as saying, “There’s not much of a consequence of not being in compliance with the law… compliance is almost voluntary.”
Click here to read "Brand names sinking in Medicare drug plans; Insurers say that coverage isn't worth it, so patients are winding up in 'doughnut hole.'" This article appeared in the San Francisco Chronicle on December 9, and said in 2008, no drug plans will cover brand-name prescriptions in the donut hole (a financial gap built into the benefit). The piece quoted Vicki Gottlich as saying that insurers are backing out because it’s too expensive to offer brand-name coverage. She said, "The people with more expensive drugs see that they need more coverage, so they go into these plans that include brand names."
Click here to read "List of Poor Nursing Homes Hit," an article that appeared in the Press Enterprise on December 4 and quoted Toby Edelman. The article focused on how a recently released list of poor performing nursing homes is incomplete and misleading. Toby Edelman says, "It’s not a great tool for people to use." She says that advocacy groups want facility inspectors to better enforce regulations and penalties to mandate compliance.
Click here to read "Potential Medicare reimbursement cuts worry doctors," an article that appeared in the Naples Daily News on December 2. The article says Medicare reimbursement cuts to doctors are slated to take effect on January 1, and doctors are speculating whether Congress will freeze cuts. The American Medical Association is in favor of legislation in favor of "balanced billing" - allowing doctors to bill patients for the difference of what it costs to treat them against what Medicare or other insurers pay for treating them. Vicki Gottlich says that balanced billing is, "not a policy issue under consideration by Congress as a way to reduce costs." She said another option is eliminating overpayments to private Medicare Advantage plans to better compensate doctors.

November 2007

Click here to read "Medicare formula puts hospices in a tight spot," an opinion piece by Saul Friedman that appeared in Newsday on November 24. The piece says that Medicare hospice programs are being penalized because patients are living longer than six months. The Center for Medicare Advocacy says some hospices are closing while others may be forced to turn patients away. The piece quotes Terri Berthelot as saying, "Hospices will limit their services to patients who have predictable dying processes, which generally means those with cancer."
Click here to read "Changes in ’08 Medicare program," an article that appeared in the Asheville Citizen-Times on November 22. The article says 2 million Medicare participants were recently sent letters informing them that they will be moved to a different insurance plan for their drug coverage next year. The reassignments and higher premiums are two reasons why beneficiaries should shop around for their Medicare drug benefit. The piece quotes Patricia Nemore as saying, "Everybody needs to shop around every year. Just because you like your plan this year doesn’t mean that plan will work the same next year."
Click here to read "Advantage: picking the right plan," an article that appeared in the Sarasota Herald-Tribune on November 19. The article says companies are running seminars to give a sales pitch to Medicare beneficiaries on their plans. According to the article, with so many plans to choose from, Medicare beneficiaries can be overwhelmed by their options. The article offers tips on how to choose a plan, and the Center for Medicare Advocacy is listed as a useful web site with Medicare information.
Click here to read "Recommended Reading," an article that appeared in the Wall Street Journal on November 17. The article lists Judith Stein’s recommended resources for Medicare including the Center for Medicare Advocacy’s free newsletter (available at www.medicareadvocacy.org), resources from the Kaiser Family Foundation, and books on Medicare.
Click here to read a piece from The Hill from November 16 "Medicare pamphlet now includes caveats on private plan benefits." Vicki Gottlich is quoted in the article saying that despite changes to the government’s latest "Medicare & You" handbook, it still has a bias towards private plans. "Calling traditional Medicare a ‘health plan’ alongside Medicare Advantage and other private plan options is misleading. Traditional Medicare is not a health plan in the same way and should not be described as such," according to Gottlich.
Click here to read a November 14 article from SeniorJournal.com - "There are no bargains in Part D Plans". The piece describes the price increases the private Medicare Part D plans have in store for beneficiaries this coming year.
Click here to read a November 13 review of Michael Moore's "Sicko" by Judith Stein for the "Screengrab" section of Nerve.com.
Click here to read a November 11 article from the Naples Daily News - "More changes to come for Medicare beneficiaries". The piece describes plan changes face by Medicare Part D beneficiaries as the Part D open enrollment period begins. The Piece features frequent comments from Vicki Gottlich, who concludes with "We’re seeing a variety of changes in 2008... It looks like more cost-sharing is being passed on to beneficiaries."
Click here to read a November 3 article from the Associated Press - "Changes Ahead for Medicare Drug Program". The piece describes the issues beneficiaries will face due to changes in the myriad Part D plans going into this open enrollment season. The Piece features Patricia Nemore warning beneficiaries to take nothing for granted. "Everybody needs to shop around every year... Just because you like your plan this year doesn't mean that plan will work the same next year,"she says. The article also refers readers to the Center's website for more information.
Click here to read a November 2 article from The Hill - "Agency Vows More Oversight of Medicare-plan Marketing". The piece describes problems with Medicare part D oversight, and the stated goal of CMS of improving that oversight. The piece features Vicki Gottlich citing the effect of the lack of limits on plans. "There [are] too many plans to analyze, making it almost impossible to advise beneficiaries," she says.

October 2007

Click here to read an article from the October 31 Tampa Tribune - "Wellcare Faces Lawsuits, Calls to end Enrollment". The piece describes a lawsuit brought against Wellcare which has resulted in a halt to their expansion efforts in Florida. The piece features Judith Stein commenting on the need for CMS to stop automatically assigning dual-eligible beneficiaries to Wellcare plans. "'This is something that's pressing for both beneficiaries and taxpayers,'" says Ms. Stein, who goes on to say that "it doesn't make sense for CMS to add more money to the hundreds of millions of dollars it sends the company each month while its own inspector general and others are investigating how the money is used."
Click here to read an article from the October 28 South Florida Sun Sentinel - "Find the right Medicare plan for you; Even if you expect to keep your current Medicare drug plan, make sure you shop around for best coverage". The piece quotes Judith Stein as saying, "You can't be sure it [your plan] will stay the same. [Plans] know people look first and foremost at the premium. If the premium stays at $25 or goes down to $24.50, it looks good. But if you look carefully … there's going to be a higher co-pay. Those kind of changes make a big difference and add up in the end."
Click here to read an article from MedIll Reports, Chicago from October 24. The piece ("Illinois lawmakers want to increase seniors' drug options") describes efforts by Illinois lawmakers Sen. Dick Durbin and Rep. Jan Schakowsky to establish a prescription drug benefit within the traditional Medicare program that is not reliant on private Medicare Advantage plans. The piece quotes Judith Stein as saying "The choice, complexity, and variations of the private plans are confounding Medicare beneficiaries... Offering an option for people to stay in the traditional Medicare program and get their prescription drug benefit there is exactly what [they] need."
Click here to read an article from The Dallas Morning News from October 22. The piece ("Medicare choices are changing next year, so shop around") urges readers to look for the best Medicare prescription plan for them. Jocelyne Watrous, a beneficiary consultant for the Center for Medicare Advocacy, says that seniors should pay close attention to how a plan classifies the specific drugs they're taking, since that will affect how much their co-payments will be. For example, a "preferred" drug, will have a lower co-payment than a "nonpreferred" drug.

September 2007

Click here to read an article from the September 29 Sun Sentinel about how Medicare recipients will have even more plans to choose from for 2008. The piece (“Seniors Face More Medicare Confusion; Request to Simplify is Ignored”) cites Judith Stein saying that plans often try to attract members with low monthly premiums, but make up for it by raising co-payments and deductibles, or covering less. She also said that Medicare officials had urged insurers to simplify things by reducing the number of drug and health plans, because some were offering multiple plans with virtually identical benefits. But the plans were not forced to do so and did not.

Click here to read an article (“State Insurance Department Forms New Consumer Panel”) from The Hartford Courant from September 27 on Connecticut’s new consumer council, of which Judith Stein, is a member. The council of eight people, which includes health care advocates and insurance agents, will advise Commissioner Thomas R. Sullivan on consumer concerns.
Click here to read Charles Duhigg’s Sep. 23, 2007, article “More Profit and Less Nursing at Many Homes.” The piece quotes Toby S. Edelman, Senior Policy Attorney with the Center for Medicare Advocacy and describes how major for-profit nursing home corporations are dividing themselves into many separate corporations in order to avoid being held accountable to both the public regulatory system and residents whom they harm and kill. In addition, private equity firms are swallowing up large and increasing portions of the nursing home industry because of the enormous profits to be made from the care of sick and frail old people, especially from the Medicare program. Judy and Matt, you could even link to the press release here too – click here to read CMA’s press release responding to the NYT article [in this case, here would link to the press release, not to a news outlet].
Click here to read a September 22 column by Newsday’s Saul Friedman. Friedman argues in favor of the Children’s Health and Medicare Protection (CHAMP) Act, which would expand coverage for children and “repair the damage done to traditional Medicare by the Bush administration's privatization efforts in the last Congress.” Friedman also says, “According to the Center for Medicare Advocacy, the CHAMP legislation would make it easier for low-income beneficiaries who also have modest savings to qualify for the low-income subsidies in Medicare and the Part D drug benefit. And it would eliminate late Part D enrollment penalties for low-income beneficiaries.”