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We are a non-profit organization dedicated to Medicare advocacy and education for Californians. Our website provides accurate and unbiased information about Medicare benefits and long-term care for people who live in California.

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Learn About Medicare! Summer 2015 Medicare Webinar Series
June 23, 2015 WEBINAR » Join our Medicare webinar series this summer and learn the in's and out's of Medicare. Whether you’re a beneficiary, family member, or provider, these webinars will help you understand Medicare's benefits, health care options, beneficiary rights and resources to answer questions. Dates are June 30, July 2, July 7, July 9 from 10 a.m. to 12 noon. Call or email Jasmine Suo to register at 916-231-5110 or jsuo@cahealthadvocates.org.
Long-Term Care and the Graying of America
June 23, 2015 LONG-TERM CARE Many people today are familiar with the term “long-term care” because they or someone they know is caring for an elderly relative. As more people live into their 80s and 90s, the need for long-term care (LTC) services has been increasing. This article provides an overview of LTC, its cost, and long-term care as a growing national issue.
Medicare Celebrates Its 50th!
June 23, 2015 BASICS This year marks half a century of health care coverage for our country’s seniors. Learn just what it took, including key players, debates and strategies, to create a successful program that helps prolong lives, increases well-being and peace of mind, and gives access to both acute and preventive care to over 55 million beneficiaries nationwide.
What Happens When a Beneficiary is Marked as Dead but is Still Very Much Alive? ~ Importance of Advocacy
June 12, 2015 BILLING Medicare mistakenly marked a woman as deceased while she was still very much alive. When she had a stroke less than a month later, health care coverage chaos ensued. This article highlights the importance of advocacy, particularly the work of the Health Insurance Counseling and Advocacy Program and the ways they help beneficiaries correct problems, navigate the health care system and receive their entitled care.
Join our Free Webinar on Balance Billing & Concierge Medicine
June 25, 2015 WEBINAR » What is balance billing? What is "concierge medicine", "retainer medicine" or "boutique doctors"? Can a doctor bill a Medicare beneficiary for what Medicare does not pay? Join us on June 25 from 10 - 11:30 a.m. to find out. Register today!
Meet the National Center on Elder Abuse
May 28, 2015 WEBINAR » Julie Schoen, Deputy Director of the National Center on Elder Abuse presents on the role of the National Center on Elder Abuse (NCEA) and World Elder Abuse Awareness Day, (WEAAD) which occurs June 15, 2015. She covers the many layers, types and complexities of elder abuse and how this issue is evolving into a global social justice movement.
Doc Fix and H.R. 2 ~ It Could Have Been Worse
May 14, 2015 BASICS After 17 “doc fix” patches in the past 11 years, Congress finally passed a bill to replace a broken payment system and reform the way Medicare pays its doctors. The new law includes many changes, including making the Qualified Individual program permanent, ending the use of Social Security numbers on Medicare cards and adding increased costs for beneficiaries.
SMP Superheroes in Action! Humorous Skits Educate Public on Medicare Fraud
May 5, 2015 BLOG Be entertained by our Senior Medicare Patrol superheros in action! As there is a lot of scary news and doom and gloom reports regarding scams, we thought is was time to turn up the fun factor and spread our message with some humor and a dose of silliness. Enclosed are two funny SMP superhero skits on back brace scams and genetic testing scams.
Are You Aware of the Issues LGBT Elders Face? Let’s Be Inclusive
May 1, 2015 DISPARITIES Many of the over 4 million lesbian, gay, bisexual and/or transgender elders (LGBT) in the U.S. remain invisible to most service providers and to the LGBT community at large. Becoming aware of the challenges these elders face and implementing easy, subtle yet powerful ways of being inclusive make a big difference in their access to care, services and a better quality of life.
Spreading Awareness & Empowering Seniors Through Laughter!
Apr 9, 2015 BLOG One way to make a change is to get people laughing! This is what an acting troupe of seniors do…traveling and performing comedy as a way to educate their peers on senior scams.
CHA Calls for Task Force to Create a Statewide Program to Provide Long Term Care
Apr 6, 2015 ADVOCACY CHA submitted this letter of support for AB 332 which would establish a task force to begin exploring the feasibility of a statewide program to provide and pay for long term care, and subsequently to recommend options to the Governor and the legislature.
CHA Supports AB 763 to Raise the Aged & Disabled Program Income Level to 138% of the FPL
Apr 6, 2015 ADVOCACY California Health Advocates submitted this letter of support for AB 763, which would raise Medi-Cal's Aged and Disabled program income level of to 138% of the federal poverty level, the same as the income ceiling for MAGI Medi-Cal, California’s adoption of expanded Medicaid provided by the Affordable Care Act.
What's New with the DMEPOS Competitive Bidding Program?
Mar 26, 2015 WEBINAR » Malisa Rogan of Palmetto presents updates on the Durable Medical Equipment Competitive Bid program that has expanded in both scope of items covered and the areas in the country affected since it began in 2011. It's estimated to save the Medicare Trust funds over $25 billion dollars by 2022. Learn how the program began, where we are now and what to expect in the future.
CHA Supports SB 426 Requiring Deferred Annuity Death Benefits to be Equal to Annuity Value
Mar 25, 2015 ADVOCACY CHA submitted this letter of support for SB 426 which would require the death benefit of a deferred annuity sold to an individual 65 years of age or older to be at least equal to the annuity value at the time death occurs.
CHA Calls for Annual Notification to Beneficiaries with "Banked" Long Term Care Benefits
Mar 25, 2015 ADVOCACY CHA submitted this letter of support for SB 575 which would require annual notification of long term care insurance benefits that were "banked" as a result of increased or unaffordable premiums.
SGR Legislation is a Bad Deal for Beneficiaries
Mar 25, 2015 BLOG California Health Advocates supports a long-term solution to the physician payment formula known as the Sustainable Growth Rate (SGR) that is good for beneficiaries and doctors and does not add extra costs to our elders and people with disabilities.
Fraud Prevention Efforts Recoup Over $3.3 Billion for Medicare
Mar 20, 2015 BLOG The Obama Administration announced the recovery of over $3.3 billion in fraudulent health care payments for fiscal year 2014. This amounts to a return of $7.70 for every $1 invested in fraud prevention, detection and investigation efforts in the last 3 years.
CHA Calls for Limit on Medi-Cal's Estate Recovery
Mar 19, 2015 ADVOCACY California Health Advocates wrote this letter in support of SB 33 to limit Medi-Cal estate recovery to what is federally required. This would help protect the homes and health of some of our state's most vulnerable families.
CHA Says No to Shifting Doc Fix Cost onto Beneficiaries’ Shoulders
Mar 13, 2015 BASICS House Speaker John Boehner and Minority Leader Nancy Pelosi are looking for ways to pay for the cost of fixing the way that Medicare pays doctors known as the “doc fix,” yet several proposals put much of the cost on beneficiaries' shoulders. Without Congressional action, doctors who treat Medicare beneficiaries are facing a 21% cut in their Medicare payments beginning on April 1st.
Medicare Covers Lung Cancer Screening for Qualified Beneficiaries
Mar 10, 2015 BASICS Did you know lung cancer is the leading cause of cancer deaths for both men and women in the U.S.? Only 15% of cases are detected in an early stage, and if the cancer has already spread, the 5-year survival rate is only 4%. Because of its affect on a growing number of beneficiaries and the benefit of early detection, Medicare now covers lung cancer screening for qualified beneficiaries.
CHA Advocates for Making the Part D Exceptions and Appeals Processes More Accessible for Beneficiaries
Mar 6, 2015 ADVOCACY CHA and other advocates submitted this letter to the Centers for Medicare and Medicaid Services in support of making the Part D appeals process more accessible for beneficiaries, including improving the clarity of denial notices and streamlining the appeals process.
Seniors Pay Skyrocketing Price for "Free" Ice Cream
Mar 2, 2015 FRAUD Have you or groups of elders you know been offered a free ice cream social AND a “free” Medicare-covered cheek swab genetic test? If so, it's a scam that is happening around the country.
The Importance of Inclusivity for LGBT Older Adults
Feb 26, 2015 FRAUD Learn more about SMP's LGBT Integration Project; the unique issues lesbian, gay, bisexual and transgender (LGBT) older adults face; why inclusion is important; trends and changes in aging services; how language, forms, and communication make a difference; ways SMP has become more inclusive; and links to a powerful short film by Project Visibility.
Beware of Genetic Testing for Beneficiaries in Group Settings
Feb 17, 2015 FRAUD This alert warns of genetic testing scams where beneficiaries are offered a presentation or an ice cream social along with a "free cheek swab" test to help their doctors prevent adverse medication affects. Available in English, Spanish, Chinese, Vietnamese, Korean and Russian.
Anthem Insurance Data Breach Effects Millions ~ Tips on Best Response
Feb 11, 2015 FRAUD Tens of millions of Americans may be affected by the latest corporate data breach at Anthem Insurance. Learn some tips from the Better Business Bureau on how best to respond and protect yourself and/or loved ones.
Medicare & Covered California
Feb 4, 2015 WEBINAR » Learn about Medicare and Covered California. In the webinar we discuss: who can have a qualified health plan and Medicare and who cannot; what you should do if you have a qualified health plan and then become eligible for Medicare; and what the tax consequences are if you receive premium tax credits and then become Medicare eligible.
Pressure in Poverty: How One HiCAP Saved $1.4 Million for Seniors
Feb 2, 2015 BASICS Medicare’s open enrollment is the busiest time of year for our partners, the Health Insurance Counseling and Advocacy Program. Learn of some of the successful strategies of one of the HICAP programs that conducted 36 enrollment clinics this fall and helped their clients save over $1.4 million in health care costs for 2015. This story inspires and shows how each HICAP’s team efforts contribute much in service and wellbeing for the entire community.
Overview of Medicare Part A Payment Systems with Diane Caradeuc
Jan 29, 2015 WEBINAR » Review the Part A program and how its benefits are paid. In this webinar, Diane discusses both how program payments historically started and the current Part A benefits payment methods. She also reviews some of the controls established to protect the financial solvency of the Medicare program and some commonly used Medicare terms like DRG, HAC, RACs, and consolidated billing.
Updated! ~ Do You Have an Aetna Medicare or First Health Part D Plan?
Jan 20, 2015 ADVANTAGE The Medicare's Plan Finder tool had incorrect information on Aetna and First Health Part D plan network pharmacies during the AEP which has left some members thinking their pharmacy is in-network when it is not. Aetna is putting in place a temporary solution so that members pay the network price. Medicare is also giving affected beneficiaries the right to an Special Election Period to change plans.
Large Newspaper Ad Falsely Promises FREE Medicare-Covered Back Brace
Jan 15, 2015 PRESS RELEASE Watch out for large newspaper ads that lure Medicare beneficiaries to call to get a free, “Medicare-covered” back brace in exchange for their Medicare number. This is one of many scams to designed to collect beneficiaries' Medicare numbers.
NAIC Appoints Bonnie Burns as Consumer Representative for 23rd Term
Jan 13, 2015 PRESS RELEASE Bonnie Burns, our Training and Policy Specialist, begins her 23rd term as one of the 20 appointed and funded consumer liaison representatives by the National Association of Insurance Commissioners (NAIC). Ms. Burns spearheaded the standardization of Medicare supplemental insurance, known as Medigap and has provided numerous Congressional testimonies guiding the standardization of long-term care insurance and the policies for financing long-term care.
Medicare’s Open Enrollment is Over, Can I Still Switch Plans?
Dec 15, 2014 ADVANTAGE Medicare’s Open Enrollment period is over, yet some people may have some options for changing coverage. This article provides a Q&A to review these options, including for people whose Medicare Advantage and/or Part D plan is terminating December 31, 2014.
CHA Calls for Government Notifications to Inform People Nearing 65 of Their Medicare Rights and Obligations
Dec 11, 2014 ADVOCACY CHA and other advocates submitted this letter to several government agencies requesting them to inform people nearing 65 of their rights and obligations surrounding Medicare enrollment, including their options to enroll, when they can delay enrollment and consequences of not enrolling (such as life time late enrollment penalties).
Medicare Marketing Misconduct with Julie Lowry of DMHC
Nov 20, 2014 WEBINAR Learn about the current types of marketing misconduct as seen from the perspective of the California Knox-Keene Act. In the archived webinar, Ms. Lowrie reviews the do's and don'ts of Medicare Marketing, and provides examples of activities considered to be misleading, deceptive, and potentially fraudulent in the sale of Medicare Advantage products. She also reviews how to report marketing fraud.
Medicare Marketing Do’s & Don’ts for 2015
Nov 17, 2014 FRAUD Learn what agents and plan sponsors can and cannot do as they market Medicare Advantage and Part D plans to beneficiaries. Also, Medicare recently expanded the scope of what plan sponsors and agents can call their enrollees about to include other Medicare plan products as well their current plan.
CHA Responds to Proposed Health Plan Innovation Initiatives for Supplemental Insurance
Nov 3, 2014 ADVOCACY A pilot program proposed by the Centers for Medicaid and Medicare Innovation to help Medicare beneficiaries better manage their daily chronic care needs and utilize existing community services and supports could be very beneficial for certain beneficiaries. Yet, this is not an appropriate task for Medigap carriers, as discussed in the submitted comments.
Are You Spending More On Drugs?
Nov 1, 2014 DRUGS Are you spending too much on your medications but unsure how to navigate other plan options? Learn clear navigating tips during Medicare's Open Enrollment, and where to go for help.
Quality Improvement Organization Update for California
Oct 23, 2014 WEBINAR Two Quality Improvement Organizations (Livanta and Health Services Advisory Group) now cover California. This webinar reviews the their current scope of work and the separation of the care reviews and discharge appeals work with the quality of care improvement work with providers.
Open Enrollment is Here! Do You Know Your Plan Changes for 2015?
Oct 16, 2014 BASICS Open Enrollment is upon us. This enrollment period runs from October 15 through December 7, and is one of the few times you can change, enroll into or disenroll from a Medicare Advantage or Part D plan. Learn your options and review changes for 2015.
Windsor, DOMA and Medicare Benefits
Oct 16, 2014 BASICS Windsor, a 2013 Supreme Court decision, was a victory for lesbian, gay, bisexual and transgender populations and has opened the door for same-sex spouses to apply for more than 1,000 federal spousal benefits, which previously had been denied to them.
Medicare Changes in 2015
Oct 14, 2014 WEBINAR Learn what's new for Medicare in 2015. We discuss: 2015 Medicare Part D cost-sharing; stand-alone Medicare Part D plans available in California; benchmark plans in 2015; Medicare Advantage- landscape of 2015 plans; and Special Election Periods.
CHA Testifies on Behalf of Beneficiaries "Trapped in the Gap" at White House Conference on Aging
Sep 29, 2014 ADVOCACY Elaine Wong Eakin of California Health Advocates provided oral and written testimony at the White House Conference on Aging. She illuminates the challenges many low and middle income beneficiaries “trapped in the gap” face, explains why proposals to increase Medicare cost-sharing on beneficiaries could be harmful, and advocates for innovative and affordable solutions for long-term care services. See written testimony (PDF).
(updated) Medicare & Covered California ~ Get Your Questions Answered
Sep 9, 2014 REFORM Get answers to some of the most common questions about Medicare and Covered California, our state's new health insurance marketplace.
Concierge Medicine
Aug 28, 2014 WEBINAR A relatively new business model in healthcare is concierge medicine. While some people embrace this type of healthcare service, others wonder if it violates Medicare rules and regulations. Find out how concierge medicine does or doesn't work for a Medicare beneficiary. Learn some of the questions a Medicare beneficiary needs to ask their doctor who is now offering them concierge medicine.
New Pilot Program Allows Some Beneficiaries Access to Both Hospice & Life-Prolonging Care
Aug 12, 2014 BLOG This program would allow some beneficiaries covered under the Medicare hospice benefit with certain health conditions to receive both hospice care and life-prolonging treatments.
Can I Choose Health Coverage through Covered California Instead of Medicare?
Aug 8, 2014 REFORM The Centers for Medicare and Medicaid Services released FAQs Regarding Medicare and the Marketplace (PDF) in response to questions from us and other advocacy organizations. The 5-section document answers questions about prescription drug coverage, premium tax credits and penalties that may apply to Medicare beneficiaries.
Getting HIP at Walgreens! SMP/HICAP Expands Community Outreach in CA Pharmacies
Jul 16, 2014 FRAUD SMP/HICAP are creating partnerships with pharmacies across the state as a way to reach more Medicare beneficiaries and spread the word on fraud prevention. This partnership program is known as HIP – Health In Pharmacies.
Beware of Providers and Suppliers Who Advertise Free Services
Jul 8, 2014 BLOG We’re getting several reports of fraudulent providers and durable medical equipment (DME) suppliers who are offering beneficiaries “free” services or equipment in exchange for their Medicare numbers. “Free” is the red flag.
Is It Fishy? How to Identify Scams as They Morph and Multiply
Jun 25, 2014 BLOG The traditional phone scam keeps morphing and now shows up as email scams, post office scams, delivery scams, bank scams. But all of these scams do have something in common. They are fishy. Learn from these few examples and what to watch out for.
Why Can’t Medicare Negotiate Lower Drug Prices for Part D?
May 29, 2014 BLOG Both Medicaid and the Department of Veteran Affairs negotiate for lower drug prices, but Medicare Part D, from it’s inception in 2006, is barred from doing this.
New Medicare Card Scam – Skit by SMP Thespian Society!
May 15, 2014 BLOG This video, featuring SMP Liaisons Pat Macholl and Doug Shaw, demonstrates a common Medicare Part D fraud scam involving mail-order medications and provides a fun example of creative outreach.
Are You Eligible for a Re-Review of Past Denied Medicare Claims?
May 12, 2014 BILLING Certain beneficiaries who were wrongly denied maintenance coverage for skilled nursing or therapy services now have an opportunity to have their claims re-reviewed. Learn the background on the Jimmo settlement, who is eligible for a re-review process, and a timeline to apply.
Are You Affected by Cal MediConnect?
Apr 22, 2014 LOW-INCOME Starting April 1, 2014, beneficiaries dually eligible for Medicare and Medi-Cal in a few counties have received notices about or experienced changes in how they receive benefits. These changes are brought about by “Cal MediConnect,” a demonstration to integrate Medicare and Medi-Cal that affects 8 counties statewide.
California SMP’s Efforts Result in Over $7 Million in Recoverable Funds to Medicare
Apr 1, 2014 BLOG The amount of funds recovered to Medicare for fraudulent claims that is attributed to cases our California Senior Medicare Patrol closed in 2013 totals over $7 million. This success mirrors success on the national level as reported in the 2013 OIG report where government teams have recovered a record $4.3 billion for FY 2013, and $19.2 billion over the past 5 years.
Support AB 2025 ~ Legislation Raises Income Level for Aged & Disabled Medi-Cal Program
Mar 31, 2014 LOW-INCOME Assemblymember Roger Dickinson recently introduced AB 2025 to raise the income level of the Aged and Disabled Medi-Cal program to 138% of the federal poverty level. This change would create consistent income eligibility for different Medi-Cal programs and parity for seniors and people with disabilities.
Will the Therapy You Need be Covered?
Mar 13, 2014 BILLING Currently Medicare limits payment for outpatient therapy services at an annual dollar amount, commonly called “therapy caps.” If a beneficiary needs services above the capped amount, the therapist can help a beneficiary request an exception through an “exceptions process.” Yet, the exceptions process is about to expire on 3/31/14, and we urge Congress to extend the exceptions process or, better yet, repeal the therapy caps.
Tips to Prevent Medicare Part D Prescription Drug Fraud
Mar 10, 2014 FRAUD Are you getting the most out of your Part D benefit? Does your doctor prescribe less expensive generics when they're available? Do you receive the correct number of pills in your prescription bottles? Learn several simple tips to make sure: you are making the best use of your drug benefits; you know how to prevent fraud and abuse, and you know how to detect fraud if it occurs.
SMP Forms Fruitful Community Outreach Partnership with Local Pharmacy
Feb 24, 2014 FRAUD Chico Rite Aid's "Wellness Ambassador" reached out to HICAP and our Senior Medicare Patrol program to see if we'd come to the pharmacy on a regular basis to offer an information table on Medicare fraud to help educate their customers on fraud. This is turning out to be a win/win partnership and can easily be modeled in pharmacies statewide.
California Bill AB 1553 Says No to Gender-Based Pricing
Feb 13, 2014 BLOG Without legal intervention, women could end up paying 40% more for long-term care insurance coverage than men. And this could happen as early as January 2015. AB 1553 introduced by Assembly member Mariko Yamada seeks to prohibit such gender-based pricing products in California.

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