• Getting the Runaround: Problems with Obtaining Accurate Information from Part D Plans

    By on October 1, 2006

    Fixing the Part D Plan Call Centers Before the Next Enrollment Period Starts on November 15, 2006 Download PDF Issue Brief October 2006 By California Health Advocates and Medicare Rights Center Principal Authors: David Lipschutz, Staff Attorney, California Health Advocates Paul Precht, Deputy Policy Director, Medicare Rights Center Bonnie Burns, Training & Policy Specialist,...

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  • Doubt Cast on ‘Safety Argument’ Regarding Canadian Drugs

    By on October 1, 2006

    The tide seems to be turning on the battle of whether or not to permit U.S. residents to order prescription drugs from Canada. In early October, the Department of Homeland Security, which operates the Customs and Border Protection agency, disclosed that it would halt confiscation of Canadian drugs and instead conduct random sampling to...

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  • Have CMS and OIG Clarifications Had Any Effect on PAP Availability?

    By on October 1, 2006

    In a policy clarification the Centers for Medicare & Medicaid Services recently announced that pharmaceutical companies’ Patient Assistance Programs (PAPs) can provide Part D-covered drugs to Medicare drug benefit enrollees but the value of the donated drugs will not count towards the total beneficiary drug costs. In the past CMS said that drug payments...

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  • Misleading Information on Medicare Tip Sheet for Part D Coverage Gap May Confuse Beneficiaries

    By on August 15, 2006

    Advocates statewide are receiving more calls as more beneficiaries reach their coverage gap in their Part D plans. Although the Centers for Medicare and Medicaid Services (CMS) recently released tip sheets on navigating this coverage gap (also known as the ‘donut hole’), some of the information and tips are misleading and inaccurate (see links...

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  • Los Angeles County Home Health Agency Identifies Potential Fraud Scam

    By on August 8, 2006

    The administrator of a Los Angeles County home health agency recently called the Cahaba Safeguard Administrators (one of Medicare’s program safeguard contractors) to report a potential fraud incident. A patient informed the administrator that a man wearing a suit had shown up at her doorstep claiming to be a “Physical Therapy Inspector for Medicare.”...

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  • Pharmacies Play Important Role in Beneficiaries’ Access to Part D Appeals

    By on August 3, 2006

    Despite advocates’ efforts to educate beneficiaries and providers on the Part D appeals process, many people are still either unaware of these important appeal rights, or do not know how to access them. A main reason for this lack of knowledge is the absence of notification given to beneficiaries when they find out that...

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  • Cancer Patients Take the Brunt of HMO Cost Increases

    By on August 1, 2006

    A 60 year old man living with a disability and working part-time had enjoyed good health and regular exercise in his life. Yet, in a bout of illness, he visited his primary care physician in his Medicare HMO only to discover he had advanced lung cancer. He was immediately referred to an oncologist and...

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  • Are Your Services Available to Beneficiaries with Disabilities?

    By on August 1, 2006

    As of 2004 about 13 percent, or 550,000, of California’s Medicare beneficiaries were on Medicare with a disability. This number is increasing and has increased 18 percent between 1999 and 2004 (see California HealthCare Foundation publication, Medicare Facts and Figures: a California Perspective). Because different rules and programs often apply to beneficiaries living with...

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