For Professionals

Latest News for Professionals:

Have You Heard of Social Security’s Representative Payee Program?
MAY 13, 2016 WEBINAR » Join our free webinar on Thursday 5/26 at 10 a.m. as Shana Wynn of Justice in Aging addresses: the basics of the Representative Payee Program; information on its administration; and the problems SSA faces as more seniors need representative payees to help manage their benefits. Register today!
Join Us in Promoting World Elder Abuse Awareness Day on June 15!
MAY 10, 2016 BLOG » Did you know that 1 in 10 Americans is affected by elder abuse? And that elders who have experienced abuse have a 300% higher risk of death when compared to those who had not been abused? These sobering statistics highlight the importance of creating awareness with World Elder Abuse Awareness Day on June 15.
Do You Know How to Access Supplies Through Medicare’s Competitive Bidding Program?
APR 28, 2016 WEBINAR » Tangita Daramola, Competitive Acquisition Ombudsman with the U.S. Department of Health and Human Services, reviews Medicare’s competitive bidding program and how to ensure access to Durable Medical Equipment, Prosthetics/Orthotics Supplies (DMEPOS).
May is Older American’s Month ~ Blaze a Trail!
APR 21, 2016 BLOG » Did you know that our senior population is the fastest growing population group in America? With so many people coming into “elderhood”, celebrating our older adults and empowering them to contribute and live rich, quality lives will benefit all of society. Celebrating Older Americans Month is one way to do this.
Are You Getting an Endless Supply of Supplies?
Beware of Medicare Durable Medical Equipment Scams
APR 6, 2016 FRAUD » Did you see the ad for the free back brace in the newspaper? The one covered 100% by Medicare? If you did, it’s a scam and this article explains new trends to watch out for.
Are You Transitioning from Covered California to Medicare?
MAR 25, 2016 WEBINAR » In this archived webinar, Elaine Wong Eakin, Executive Director with California Health Advocates, discusses transitioning coverage from Covered California to Medicare. Some topics include: who must enroll in Medicare if they have a Covered CA plan; what happens to a person’s tax credits when s/he becomes eligible for Medicare; and how will costs be affected for those on MAGI Medi-Cal when they enroll in Medicare?
What to Do If You Have a Covered CA Plan & Become Eligible for Medicare? (Part 4)
MAR 24, 2016 BASICS » This is the 4th article in a series that addresses various scenarios regarding people who have a Covered CA plan and become eligible for Medicare. This one discusses options for people transitioning from expanded Medi-Cal (or MAGI Medi-Cal) to Medicare.
What to Do If You Have a Covered CA Plan & Become Eligible for Medicare? (Part 3)
MAR 16, 2016 BASICS » This is the 3rd article in a series that addresses various scenarios regarding people who have a Covered CA plan and become eligible for Medicare. This one reviews your options if you aren’t entitled to premium-free Medicare Part A.
What to Do If You Have a Covered California Plan & Become Eligible for Medicare? (Part 2)
MAR 10, 2016 BASICS » This is the 2nd article in a series to address various scenarios as more people who have a Covered California plan become eligible for Medicare. This one reviews your costs and whether they increase or decrease when you transition from a Covered California plan to Medicare.
CHA Advocates for Increased Consumer Protections in MA and Part D Plans for 2017
MAR 10, 2016 ADVOCACY » CHA submitted comments on the Advance Notice and Call Letter for CY 2017. These comments include recommendations for: increased beneficiary access to providers, clarity in provider directory publications, and greater education for plan providers on the balance billing prohibition for dual eligibles.
Are Medical Costs Taking a Toll?
MAR 8, 2016 BLOG » Over 26% of people in a recent poll said that health care costs posed a significant financial burden on them and/or their family. Forty-two percent of the people said they have paid all or nearly all of their savings on medical costs, and 27% said they were unable to pay for basic necessities such as food, heating, or housing.
Looking to Save Money? Start with Rx Costs
MAR 4, 2016 BLOG » Did you know that drug costs rose 12.2% in 2014 alone which is 5 times as fast as the year before? And that the price of the 50 top most-used generic drugs has soared over 373% between 2010-2014? What’s happening? Learn how you can save money and be savvy about our prescriptions.
What to Do If You Have a Covered California Plan and Become Eligible for Medicare? (Part 1)
FEB 28, 2016 BASICS » Learn what steps to take if you have a Covered California plan and become eligible for Medicare. This article is the first in a series and focuses on people who are entitled to premium-free Medicare Part A.
What’s New with the Coordinated Care Initiative?
FEB 25, 2016 WEBINAR » Amber Cutler, Staff Attorney with Justice on Aging will discuss the current status of the Coordinated Care Initiative (CCI), including the federally-approved dual eligible demonstration known as Cal MediConnect, that began implementation in April 2014. Topics include:  the CCI and the 2016/17 budget; enrollment; policy changes; and early evaluation results. The CCI is now underway in 7 counties including Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara.
HICAP Saves Clients Millions of Dollars ~ It Helps to Review Your Coverage
FEB 8, 2016 BASICS » If you want to learn how to reach seniors, make a difference and promote a sense of wellbeing in thousands of Medicare beneficiaries across the state, check out your local Health Insurance Counseling and Advocacy Program (HICAP). During the 7 weeks of Medicare’s 2015 Open Enrollment, they helped save clients millions of dollars.
Did Your Health Plan Terminate in December? You Have Rights to New Coverage Before 2/29/16
FEB 5, 2016 MEDICARE ADVANTAGE » If your MA plan terminated at the end of last year, you have the right — regardless of age or health condition — to join another MA plan, or to return to Original Medicare and join a Part D plan. You have till the end of February to exercise this right.
Want to Leave Your Medicare Advantage Plan & Join a New Part D Plan? You Can Before 2/14!
FEB 5, 2016 MEDICARE ADVANTAGE » If you are enrolled in a Medicare Advantage plan and want to leave your plan, you can use the Medicare Advantage Disenrollment Period which runs from January 1 to February 14.
New Telemarketing Sales Rules Provide Additional Protection for Consumers
JAN 28, 2016 WEBINAR » Tracey Thomas, Attorney with the Federal Trade Commission’s Bureau of Consumer Protection discusses telemarketing health care fraud, including scams involving Medicare, the Affordable Care Act, prescription discount cards, and medical discount plans. She also reviews new rules and restrictions recently added to the Telemarketing Sales Rule that can provide additional protection for consumers.
Are You Being Offered “Hospice Housekeeping” Services? Hospice Fraud Alert!
JAN 11, 2016 FRAUD » Watch out for a hospice company that enrolls beneficiaries into hospice even though they do not have a terminal illness. This company misleads people into enrolling in hospice by offering beneficiaries housekeeping, home health, nurse visits and/or medications for “free”. This is a red flag and is a scam. Please share. Available in English, Spanish, Chinese, Vietnamese, Korean, Russian and Farsi.
New California Law Involves Family Caregivers in Discharge Planning
JAN 12, 2016 BASICS » A new California law requiring hospitals to involve caregivers in discharge planning became effective January 1, 2016. For Medicare patients and their family caregivers, the new law increases the opportunity to participate in the discharge planning process.
NAIC Honors Bonnie Burns as Long-Time Consumer Representative
DEC 7, 2015 PRESS RELEASE Last month the National Association of Insurance Commissioners honored Bonnie Burns, Training and Policy Specialist with California Health Advocates, for her decades of service as a consumer representative. Long recognized as a national expert in her field, Burns has served with the NAIC consumer liaison representative program protecting consumer rights and reforming policy at state and federal levels since the program began over two decades ago in 1992.
Just a Few Days Left! Medicare’s Open Enrollment Ends Dec 7
DEC 3, 2015 BLOG » Have you or someone you know procrastinated on the sometimes-daunting-task of reviewing your health care options for 2016? If so,now is the time to take action.
GivingTuesday! Join the Global Movement of Generosity & Giving Back!
NOV 23, 2015 BLOG » This year, on Tuesday, December 1, 2015, we at California Health Advocates are participating in #GivingTuesday, a global day dedicated to giving. We invite you to join us and the more than 27,000 organizations in 68 countries around the world and consider giving to CHA. Any gift is doubled thanks to the matching grant of up to $1,000.
Can I Keep My Medigap Plan C or F?
OCT 19, 2015 INSURANCE » Rumors have been flying around about Medigap Plans C and F and whether people can keep them or have to give them up. The rumors are a result of Congressional changes in the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The Act prohibits the sale of Medigap Plans C and F beginning in 2020, but only to newly eligible Medicare beneficiaries.
Will Medicare Part B Premium and Deductible Increase in 2016?
OCT 19, 2015 BASICS » Medicare’s Part B premium and deductible have a projected increase of 52% for some beneficiaries. While 70% of beneficiaries would be protected from such an increase of their Part B premium due to a provision in Medicare law, 30% would be stuck with paying $159.30 per month. Most beneficiaries would pay the increased deductible. Learn about 2 new bills aimed to prevent such a sharp increase and what you can do to keep Medicare Part B’s premium and deductible stable for 2016.
Reviewing Your Coverage Options for 2016 Can Save You Money!
OCT 19, 2015 DRUGS » Learn about a client who saved money by reviewing his Part D coverage options and making the good choice for 2016. This article reviews the landscape of Part D plans for 2016, questions to consider when reviewing plans and where to go for help.
Governor Signs Bill that Brings in New Long-Term Care Consumer Protections
OCT 13, 2015 BLOG » Good news!! Governor Brown signed Senate Bill 575, which protects consumers, specifically the elderly and their caregivers by requiring long-term care insurers to provide annual notification of the availability of nonforfeiture benefits and contingent benefits to the insured and the insured’s designated backup contact.
Use Our New Novella Cartoon to Spread the Word on Medicare Marketing Scams ~ Available in English & Spanish
OCT 9, 2015 FRAUD » This novella cartoon shares a simple story to demonstrate some of the common Medicare marketing scams, and to empower beneficiaries to protect their Medicare, their choice of plans/coverage and to know where to report fraud or call for help. Enjoy and please share!
Open Enrollment is Oct 15 – Dec 7: Review Your Medicare Options for 2016
OCT 9, 2015 BASICS » Open Enrollment, also known as the Annual Election Period (AEP), is the period each year during which you may change your Medicare Advantage plan and/or Part D coverage, and/or return to Original Medicare. The AEP is October 15 – December 7. Any plan changes you make during the AEP are effective January 1. Review coverage options for 2016!
Learn About Medicare Changes in 2016
OCT 8, 2015 WEBINAR » View our webinar and get the 2016 info regarding: Medicare Part D cost-sharing; stand-alone Medicare Part D plans available in California; benchmark plans; and the Medicare Advantage landscape of plans.
Medicare Open Enrollment – Making Good Choices
OCT 8, 2015 FRAUD » Open enrollment is the time each year where beneficiaries can review their current coverage and plan changes for the coming year and make a change. While there is a lot of good information out there, there is also bad, misleading info and scams to steer clear from. Learn some helpful tips on reviewing your Medicare coverage and making a good choice for 2016.
Soaring Drug Prices Remind Beneficiaries to Review Their Part D Coverage in Medicare’s Open Enrollment
OCT 2, 2015 BLOG » Medicare Open Enrollment is a once-a-year window where beneficiaries can review and change their Medicare and/or Part D prescription drug plan. While people don’t have to switch plans, it’s important to review any changes in their current plan for the new year. Otherwise people can end up paying hundreds of dollars for a drug that was covered under this year’s formula but not next year’s.
SMP Superheroes Discuss Part D Fraud!
SEP 28, 2015 FRAUD » Our SMP Superhero team meets in Los Angeles, one of our nation’s fraud hotspots, to discuss and devise a plan to address Part D prescription drug fraud. Through good humor, this skit educates people on 4 main types of Part D fraud, what to look for and how to report it.
SMP Superheroes Address Home Health Care Fraud!
SEP 28, 2015 FRAUD » Be entertained! Join Ethel and her friends for a game of cards as she shares about her “new home health benefit” that includes cleaning and cooking services. SMP Superhero comes to the rescue to point out this example of home health fraud and tells Ethel and her friends where to go for help and to report fraud!
Time for CalPERS Members to Review Their Medicare Coverage Options for 2016
SEP 21, 2015 BLOG » While Medicare’s fall open enrollment begins Oct 15, CalPERS fall open enrollment has already begun. Their members have from Sept 14 – Oct 9 to review and change their coverage, which is then effective January 1, 2016. For their members on Medicare, CalPERS is dropping most of their Medicare Advantage HMO plans in 2016 and adding a new PPO plan.
Beware of Agents Pressuring You to Switch Plans
AUG 28, 2015 FRAUD » This alert warns people of aggressive behavior from some insurance agents who are pressuring people to switch plans for the sole purpose of making a commission. Available in English, Spanish, Chinese, Vietnamese, Korean, Russian and Farsi.
CHA Advocates for Long Term Care Insurance Rate Increase Protections for Policy Holders
AUG 27, 2015 ADVOCACY » CHA submitted a letter to the Minnesota Department of Commerce that advocates and provides recommendations for clear and meaningful options for consumers when faced with rate increases they can’t afford.
Medicare Marketing Misconduct with Julie Lowry of DMHC
AUG 27, 2015 WEBINAR » Learn about the current types of marketing misconduct as seen from the perspective of the California Knox-Keene Act. Julie Lowrie, Investigator with the CA Department of Managed Health Care presents the current Do’s and Don’ts of Medicare Marketing, the kinds of activity that can be considered misleading, deceptive, and potentially fraudulent in the sale of Medicare Advantage products and how to report such activities.
CHA Provides Recommendations on Medicaid Managed Care Proposed Rule
AUG 17, 2015 ADVOCACY » CHA submitted comments on the Centers for Medicare and Medicaid’s proposed rule on Medicaid managed Care. Some recommendations include adopting a minimum of 60 choice period for beneficiaries to make a choice in switching from fee-for-service care to managed care, requiring prior testing of notices before sending, and mandating notices include inserts in multiple languages to alert beneficiaries of their right to interpreter services.
Can a Nursing Home Evict You for Being “Difficult”? Know Your Rights
AUG 4, 2015 BLOG Can a nursing home evict you for being “too difficult”, limit the hours your family and friends can come visit, or deny you needed physical therapy services because you’re not improving? The answer to all of these questions is a big NO. Learn about your rights through an updated guide, 20 Common Nursing Home Problems and How to Resolve Them.
OIG Reports Show Part D is Vulnerable to Fraud & Provides Tips for Improvement
JUL 7, 2015 BLOG Last month the Department of Health and Human Services announced the largest national take down charging 243 individuals for $712 billion in fraudulent billing. Forty-four of those individuals were charged with fraud involving the Part D prescription drug benefit. Learn about Part D vulnerabilities and OIG improvement tips.
Are You New to Medicare? Review Your Medicare Enrollment Periods
JUL 1, 2015 BLOG Are you new to Medicare and Medicare’s various enrollment periods? If so, it is important to learn the basics of Medicare requirements and options for enrollment to make the most of your coverage and avoid costly mistakes.
Retirement “Nest Eggs” May Increasingly Go Towards Rising Health Care Costs
JUN 23, 2015 BLOG Many people save up for retirement with visions of traveling and pursuing their dreams. Yet, our country’s elders may need to make a different plan as increasingly more of their retirement nest egg is funneled into rising health care costs.
CHA Supports Task Force to Create a Statewide Long-Term Care Program
JULY 6, 2015 ADVOCACY » CHA submits another letter in support of AB 332 to create task force for developing a statewide long-term care program. In the coming years, almost a quarter of California’s population will be comprised of people 60 and older. Planning, providing and paying for long-term care is critical to the social and economic health of all populations.
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 centuffry 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.
Learn About 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? Listen to our recorded webinar with presenters: Georgia Burke, Justice in Aging; Elaine Wong Eakin, California Health Advocates; Micki Nozaki, California Health Advocates.
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.
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.
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.
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 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.
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.
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.
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.
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 theJimmo settlement, who is eligible for a re-review process, and a timeline to apply.
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.
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.