Right here’s what we’re watching in Washington:
CMS Points Ultimate Rule Establishing Medicare Hospital Commentary Standing Appeals
On Tuesday, the Facilities for Medicare & Medicaid Providers (CMS) printed a long-awaited closing rule to ascertain appeals processes for sure Medicare enrollees who had been initially admitted as hospital inpatients however later reclassified as outpatients receiving statement companies. The rule implements the District Courtroom of Connecticut’s 2020 order in Alexander v. Azar, a nationwide class motion lawsuit introduced by the Heart for Medicare Advocacy, Justice in Getting old, and professional bono legislation agency Wilson Sonsini Goodrich & Rosati in search of enchantment rights for individuals on hospital statement.
Sufferers categorised as statement standing can not entry Medicare protection of nursing facility companies. As a substitute, they need to both pay out-of-pocket or forgo medically obligatory nursing facility companies altogether. With the brand new appeals, Medicare enrollees may have the chance to problem their statement standing designation.
Be taught extra in our feedback on the proposed rule and the Heart for Medicare Advocacy’s announcement on the ultimate rule. We shall be offering extra evaluation and sources for advocates earlier than the appeals processes are operationalized early subsequent 12 months and look ahead to working with CMS and advocates to make sure that Medicare enrollees perceive and might simply entry their new enchantment rights.
GAO Releases Report with Actions to Handle Housing & Well being Wants of Older Adults Experiencing Homelessness
The Authorities Accountability Workplace has issued a report on the causes, experiences of homelessness amongst older adults, and potential options. Nationwide, there are about 138,000 older adults (age 55+) who had been counted within the January 2023 Level in Time depend. The chance of coming into homelessness is larger for Black, Latino/Latina, and Indigenous adults.
Older adults typically have particular well being circumstances, mobility limitations, and practical impairments that the homeless service system is just not geared up to fulfill. The report incorporates particular suggestions about how one can handle the actual wants of older adults, together with integrating dwelling and community-based companies and bodily accessible areas.
The complete report could be discovered right here: Homelessness: Actions to Assist Higher Handle Older Adults’ Housing and Well being Wants.
Medicare Open Enrollment Began October 15
Medicare Open Enrollment started October 15 and can shut on December 7. This is a crucial alternative for Medicare enrollees to evaluate and alter their protection. There are a selection of modifications taking place in 2025 that advocates working with low-income older adults ought to find out about when counseling their shoppers this 12 months.
Beginning in January 2025, there shall be two new Particular Enrollment Durations (SEPs) out there to low-income enrollees. These new SEPs will have an effect on when people can modify their Medicare Benefit protection. Additionally efficient in January 2025, the Inflation Discount Act will restrict Medicare Half D out-of-pocket prescription prices to $2,000 yearly.
Lastly, many low-income enrollees misplaced Medicaid over the past two years because of the public well being emergency. These people might must reapply for the Low-Revenue Subsidy (“Further Assist”) with the Social Safety Administration with a purpose to keep away from having to pay for prescription drug out-of-pocket prices or select a special Medicare Benefit or Half D plan to keep away from increased prices. Learn extra in our weblog.
New Justice in Getting old Sources
Upcoming Justice in Getting old Webinars
Justice in Getting old Webinar Recordings
New from the Nationwide Heart on Regulation & Elder Rights (NCLER)
On October 23rd, NCLER will current a coaching on Authorized Fundamentals: Medicaid Lengthy-Time period Providers and Helps (LTSS). This webinar will cowl the fundamentals of Medicaid LTSS eligibility for nursing dwelling residents and residential and community-based companies (HCBS) enrollees. Attendees will higher perceive the other ways during which states cowl HCBS and protections out there to all LTSS beneficiaries. Be taught extra and register for the webinar.
Learn NCLER’s latest Guardianship Consciousness Useful resource Information, created in partnership with the Nationwide Heart on Elder Abuse. The information has hyperlinks to useful guardianship trainings, podcasts, publications, and tips about alternate options to guardianship.
New & Up to date Federal Sources
Different New Sources
