Let Us Bring Our Customized Medicare Trainings to You!
Workshops are specifically designed for professionals who serve Medicare beneficiaries. CHA’s interactive workshops are presented by Medicare subject matter experts, ensuring high-quality training
customized to meet your needs.
Benefits to your organization:
- Premier up-to-date training for staff and management and customized technical assistance
- Improved personalized assistance, Medicare knowledge and service to clients, patients and staff
- Increased understanding about local community-based services available to Medicare beneficiaries in the community
While some may think Medicare is not a relevant topic within your organization, it’s important and matters! It especially matters to those with Medicare, to staff serving people with Medicare and/or employees aging into Medicare.
That’s why we developed customizable integrated training and marketing modules to bring our 20+ years of expertise to you.
These training programs, serving pharmacy organizations and corporations, hospitals, social workers and other service agencies and companies, provide up-to-date and comprehensive Medicare training while creating a program to reach out to your patients and potential patients in a very personal way.
For more information on our customized Medicare trainings and fees, please contact Jasmine Suo, Operations Manager at email@example.com or 916-231-5112.
Current Workshop Topics
- Medicare: An Overview (3-6 hours)
- An Introduction to Medicare Part C Advantage Plans (3 hours)
- Assistance for People with Low incomes (3-6 hours)
- Medicare Supplemental Insurance & Other Coverage (6 hours)
- Medicare Appeals & Grievances (3 hours) – Thorough background in Medicare recommended.
- Protecting Your Medicare Benefits from Fraud & Abuse (2 hours) – CHA receives federal funding to provide Senior Medicare Patrol workshops free of charge. Also available in Spanish.
- Long-Term Care Planning (Basic and/or Advanced) (6-12 hours)
Our in-depth onsite workshops combine instructor-led presentations, small group exercises, case studies, and question and answer sessions. An additional 10 hours of customized technical assistance is provided following every workshop.
Participants receive a complete packet of reference materials and other useful resources. CHA also offers all workshops as webinars. Webinars include 30-day access to a recording of the workshop. We also offer a-la-carte workshops tailored to meet your educational needs.
For more information about our knowledgeable speakers/trainers, see our staff biographies.
- Bonnie Burns, Training & Policy Specialist
- Micki Nozaki, Project Director, Senior Medicare Patrol (SMP)
- Sandy Morales, Manager of Outreach & Volunteer Coordination, SMP
- Tatiana Fassieux, Training Specialist
- Doug Shaw, Training Specialist
- Paula Holden, Regional Liaison, SMP
- Julie Lowrie, Outreach Specialist, SMP
New Medicare Payment Systems – Obstacles to Accessing Covered Care
March 26, 2020 » 10 -11:30 a.m. » Register Today!
Skilled Nursing Facilities (SNFs) and Home Health Care Agencies (HHAs) are subject to new Medicare reimbursement systems that favor providing care to some types of patients over others by altering the profitability of various services, even though Medicare eligibility and coverage rules have not changed. This webinar will:
- Provide a brief overview of Medicare SNF and HHA Medicare coverage.
- Examine new Medicare payment systems for SNF (Patient Driven Payment Model or PDPM) and for HHA (Patient Driven Groupings Model or PDGM).
- Discuss the impact of PDPM and PDGM on access to Medicare covered services since implementation.
- Review practice tips and tools to access Medicare covered services.
Presented in collaboration with California Health Advocates Senior Medicare Patrol and Center for Medicare Advocacy Associate Director, attorney Kathleen Holt and Center Senior Policy Attorney Toby S. Edelman.
Prescription Drugs for Limited Income Beneficiaries AND Medicare Fraud: What the Investigators Are Investigating
Kell Dixon, with Humana will present on Medicare’s limited Income NET program (LINET). LINET is a nationwide Medicare demonstration program which provides prescription drug coverage for low income Medicare beneficiaries who do not have prescription coverage. California is the largest enrollment state for LINET.Ryan Dorsey, Health Fraud Investigator with Qlarant will present on current fraud cases. Qlarant is Medicare’s Unified Program Integrity Contractor (UPIC) to detect, prevent, and proactively deter fraud, waste, and abuse in Medicare and Medicaid Programs.
Learn How Medicare Fraud Affects Your Health & What the Current Fraud Trends Are
February 26, 2020 » View Webinar » View Materials: TBA
Presenters: Linda Williams, Community Outreach and Training Manager, Consumer Action; and Micki Nozaki, California SMP Director, California Health Advocates
As the debate around “Medicare for All” takes center stage, Medicare and its more than 60 million beneficiaries are under attack from an army of scammers eager to pillage the program, costing the program billions of dollars a year. AARP reports that each year roughly 10 cents of every dollar budgeted for Medicare is stolen or misdirected. Just last year, the Department of Justice indicted 35 people across the country on charges of fraudulently billing Medicare for more than $2.1 billion.
In this webinar, Consumer Action’s Community Outreach and Training Manager, Linda Williams, and guest speaker Micki Nozaki, Director of the California Senior Medicare Patrol Project at California Health Advocates, discuss how to stop Medicare fraud.
Here’s what you’ll learn:
- What changes are coming to Medicare in 2020
- How Medicare fraud jeopardizes the health and welfare of older adults and people with disabilities
- What the current health care fraud trends are across the country
- How Medicare beneficiaries bear the cost of fraud through higher deductibles and copayments
- How senior advocates can protect clients and consumers from Medicare fraud
Preventing Workplace Violence & Active Shooters in a Healthcare Environment
Presenters: Caroline Ramsey-Hamilton, Certified Homeland Security Level III; Sandy Morales, Case and Volunteer Manager, CA Senior Medicare Patrol
Workplace Violence and Active Shooters in a Healthcare Environment is one of SMP’s newest topics of discussion. In this webinar, Caroline Ramsey Hamilton of Risk & Security LLC will cover the kinds of Active Shooter and Workplace Violence incidents that occurred in 2019 and, using the latest data from the FBI, Secret Service, and other sources, will forecast what kind of incidents we can expect in 2020. Ms.Ramsey Hamilton will also cover the cost of these incidents to hospitals and other kinds of healthcare organizations, and why lawsuits after the incidents are increasing.
We’ll also review the new State Laws that require special protections against Workplace Violence from all 50 states.
How to Prevent Hospice Fraud
Presenters: Sheila Clark, CAE, President and CEO of California Hospice and Palliative Care Association; Judy Thomas, JD, President and CEO Coalition for Compassionate Care of California; Sandy Morales, Case and Volunteer Manager, CA Senior Medicare Patrol
Lawmakers have implemented new regulations against fraud, waste, and abuse of hospice patients. This webinar for Medicare advocates will discuss new hospice enrollment disclosure and transparency laws.
Join us to learn about palliative care and hospice and why and how they are different. We discuss how to identify good hospice providers and be vigilant during the period of care. Learn the questions to ask to avoid, detect and report healthcare fraud when seniors enroll in a hospice program.
Medicare Updates 2020
October 7, 2019 » Recording available for purchase » Buy today!
Presenters: Tatiana Fassieux, Training Specialist, California Health Advocates
Join us for a comprehensive webinar on Medicare Updates for 2020. Our presenter, Tatiana Fassieux, will cover the following:
- Stand-alone Medicare Part D plans in 2020
- Landscape of Medicare Advantage (Part C) plans in 2020
- Changes in Medicare Advantage and Medicare Part D
- What’s new for people with Extra Help/LIS
- Information about Medicare’s premiums and cost sharing for 2020
- Beneficiary Options
Webinar Recording Fee:
- $45 per site for CHA Members (Membership will be verified)
- $55 per site for General Public
The Good, Bad & Ugly? Revisions to the CMS Medicare Advantage & Part D Marketing Guidelines
Presenters: Julie Lowrie, SMP Specialist, California Senior Medicare Patrol, and David Lipschutz, Associate Director and Senior Policy Attorney
Learn from the experts about the Centers for Medicare & Medicaid Services’ (CMS) revisions to the Medicare Advantage Communication and Marketing Guidelines, and how they may impact the nature and type of marketing activity this AEP 2020.
Julie Lowrie, SMP, Outreach Specialist will explain the guidelines revisions, compare old and new, focus on what to look for when marketing misconduct occurs, how to report to potential abuse to SMP. David Lipschutz, Associate Director and Senior Policy Attorney, Center for Medicare Advocacy will have an advocate’s perspective on the marketing guidelines.
Genetic Testing/Cancer Screening Medicare Fraud
Presenters: Steve Mahmood, Special Investigator, Health and Human Services Office of Inspector General (OIG) and Maureen Kerrigan, National SMP Liaison for Centers for Medicare and Medicaid Services (CMS).
Genetic Testing / Cancer Screening and other types of Medicare Fraud – they’re all spiking! Are you CONCERNED, CONFUSED or just CONFOUNDED? Well, in this California SMP educational webinar you’ll learn what fraud trends OIG is investigating and how they use the case information received from us.
Updates on Durable Medical Equipment, Prosthetics, Orthotics & Supplies
June 12, 2019 » View Webinar
Presenters: Center for Medicare Advocacy Associate Director, attorney Kathleen Holt, with special guest, Senior Medicare Patrol Project Director Micki Nozaki of California Health Advocates.
This presentation discusses Medicare coverage of DMEPOS, as well as looks at the process for obtaining and maintaining proper access to necessary equipment and supplies, including cautions for beneficiaries.
Center for Medicare Advocacy conducted this webinar in partnership and with California Health Advocates, Senior Medicare Patrol.
Medicare Tips for Low-Income Beneficiaries
- Sandy Morales, Case Manager, Senior Medicare Patrol
- Denny Chan, Senior Staff Attorney, Justice in Aging
Did you know that if a Medicare beneficiary qualifies for just one month of Medi-Cal, they can eliminate their Part D enrollment penalty and start with a clean slate? Or that if a beneficiary receives extra help with paying for Part D prescription drugs, they can ask for a $10/month repayment plan for overpayments that may be assessed by the Social Security Administration?
Low-income Medicare beneficiaries have specific rights and protections under state and federal laws, but these rules are complicated and many beneficiaries and advocates are not aware of them. This webinar focuses on providing advocates and other providers who work with low-income Medicare beneficiaries a summary of these protections and useful tips to help beneficiaries make Medicare work for them.
Justice in Aging conducted this webinar in partnership and with support from California Health Advocates, Senior Medicare Patrol, and begins with an update on recent beneficiary scams and fraud trends.
Working with LBGTQI Individuals
Presenter: Marco Ramirez, LMFT
Enjoy this informative webinar with Marco Ramirez of the Orange County Health Care Agency ACCEPT Program.
Mr. Ramirez helps you recognize and define common terms used within the LGBTQI community, better understand some of the mental health needs of the LGBTQI Community, discusses Cass’s 6 stages of identity development model and identifies ways to be an LGBTQI+ ally.
Here’s the links to the videos played in the webinar:
Aging as LGBT: Two Stories (Very good idea of how Older LBGITQ+ individuals lives are effected as they age) https://www.youtube.com/watch?
Mitu – Coming Out (This one has one or two strong words but aside from that it’s very effective)
Love is Love (closing video)
Durable Medical Equipment, Prosthetics/Orthotics Supplies (DMEPOS) Webinar
February 28, 2019 »View Webinar » View Materials: Noridian DME slides, DME Orthotics Telemarketing slides, What Suppliers Need to Know for DMEPOS Orders slides
- Tangita Daramola, CMS/CAO-Competitive Bidding & the Temporary Gap
- Cindy White, Noridian-MLN Article (Clarification on Documentation Requirements)
- Lawrence Ball, CMS/CPI- DME Orthotic Telemarketing
- CMS and SMP Discussion: Responding to Beneficiary Complaints
In this webinar, you’ll learn about the Durable Medical Equipment, Prosthetics/Orthotics & Supplies (DMEPOS) program, the DMEPOS gap and partake in a a robust discussion with Medicare about helping victims of DME fraud.
Medicare and Dual Eligibles 2019 Update
- Presenter: Georgia Burke, Directing Attorney, Justice in Aging
In this webinar, Georgia Burke, Directing Attorney with Justice in Aging addresses the following topics:
- Changes in Special Enrollment Period for LIS/Duals
- Supplemental Benefit Changes in Medicare Advantage
- Opioid Lock-Ins
- Language Access Improvements
- QMB improvements update
- Default Enrollment and D-SNP’s
Medicare Updates 2019
- Presenter: Tatiana Fassieux, Training Specialist, California Health Advocates
In this webinar, Tatiana Fassieux, Training Specialist of California Health Advocates, provides Medicare Updates for 2019. She:
- Shares the 2019 Medicare Premiums & Deductibles
- Identifies Medicare Enrollment Periods
- Lists options available to beneficiaries in non-renewing plans
- Reviews basic information about 2019 plan landscape
- Identifies situations that allow a SEP and/or guaranteed issue period
- Highlights changes and limitations for Duals/LIS program
- Reviews more fraud prevention tools
- Lists resources for more information.
Veterans Fraud & Long Term Care Ombudsman Program
- Shawna Reeves, MSW, Director of Elder Abuse Prevention, Institute on Aging
- Neil Granger, Consultant, veteran in the life and disability insurance industry
- Libby Anderson, Director, Ombudsman Program at the Council on Aging, Southern California
In this informative webinar, Shawna Reeves of the Elder Abuse Prevention at the Institute on Aging, speaks about the VA’s Aid and Attendance benefit and the scammers who exploit it for their own gain. After viewing it, you will be able to spot an Aid and Attendance scam and know where to refer an older veteran who has fallen victim to one. You will also learn where to send older veterans who would like to explore — for free — whether they might qualify for veterans benefits. Finally, you will learn about the innovative Veterans Benefits Protection Project in San Francisco. Neil Granger, a veteran in the life and disability insurance industry, also joins Ms. Reeves.
In addition, Libby Anderson of the Long Term Care Ombudsman program at the Council on Aging Southern California speaks about the Long-Term Care Ombudsman Program, a state mandated program that provides advocacy for those residents of skilled nursing and residential care facilities.
Avoid Financial Scams: Dept of Business Oversight & Dept of Real Estate
- Katie Carruesco, Northern California Education & Outreach Specialist, Department of Business Oversight
- Antonio Chavez, Special Investigator, California Department of Real Estate
In this informative webinar, Katie Carruesco of the Department of Business Oversight and Antonio Chavez of the Dept. of Real Estate, present on common scams and their consumer assistance efforts.
Medicare Part D: Better Understanding the Nuances of the Prescription Drug Benefit
- Rajul A. Patel, Pharm.D., PhD, Professor of Pharmacy Practice, Pacific School of Pharmacy & Health Sciences
- Sandy Morales, SMP Manager of Outreach and Volunteer Coordination, California Health Advocates
In this informative webinar, Dr. Rajul A. Patel, Pharm.D., Ph.D. of the Thomas J. Long School of Pharmacy & Health Sciences at University of the Pacific covers the following topics:
- Medicare Part B vs. Part D coverage of prescription drugs
- Overview of Pharmacy Networks and how PBMs work
- Tiering, cost-sharing ceilings, specialty tier drugs
- 2019 Standard Part D Benefit
Sandy Morales of California Senior Medicare Patrol (SMP) provides a brief SMP Overview before the main presentation.
Financial Exploitation & Medicare Fraud
- Micki Nozaki, Director, Senior Medicare Patrol, California Health Advocates
- Georgia Burke, Directing Attorney, Justice in Aging
Medicare fraud hurts individuals and is harmful to the Medicare Trust Fund. The Medicare Trust fund loses between $60 and $90 billion dollars every year to fraud, waste and abuse. Individuals can lose access to Medicare services because their identity has been misappropriated by someone else. Law and aging advocates play an important role in helping older adults prevent, detect, and report Medicare fraud and abuse.
In this webcast, Financial Exploitation and Medicare Fraud, California’s Senior Medicare Patrol teaches advocates how to identify potential Medicare scams and report fraud and abuse to the Senior Medicare Patrol. Justice in Aging highlights potential exploitive Medicare practices and outlines strategies to help prevent exploitation.
Scams & Fraud in the US Mail
- Lisa Mayberry, US Postal Inspector, Supervisor for Mail Fraud Teams in Santa Ana and Long Beach, CA
Learn about scams in the mail. Our featured presenter is Lisa Mayberry, a supervisor with the US Postal Inspection Service. Find out what kinds of scams they investigate, how they receive referrals and the challenges and needs they see in working with older and other vulnerable adult victims and families, harmed in scams by financial predators.
We also have an informative update from Jeffrey Rodriguez with the Social Security Administration. Mr. Rodriguez shares some updates about the SSA and discuss the mailing of the new Medicare cards. And as always, Sandy Morales from the Senior Medicare Patrol shares healthcare fraud trends with us.
Criminals Diagnose Dementia Faster than Doctors Do
- Presenter: Elizabeth Landsverk, M.D., Geriatrician and Adjunct Professor of Medicine at Stanford University
Geriatrician Elizabeth Landsverk, MD outlines the importance of identifying dementia early, how it is diagnosed, and what behaviors indicate that there may be a problem. Dr. Landsverk will also discuss the issues of ‘capacity’, along with the common abusers, frauds and scams. How do criminals know whom to choose? She shares case studies from her practice, along with her suggestions as a medical doctor specializing in treating elders with various forms of cognitive decline.
Financial Frauds Targeting Seniors ~ What We Can Do: California Department of Business Oversight
- Presenter: Katie Carruesco, Northern California Education & Outreach Specialist, Department of Business Oversight
This webinar, presented by the California Department of Business Oversight, provides financial education resources to help keep seniors stay informed of smart financial tips, emerging financial trends and how to protect themselves from financial fraud and scams.
Medicare’s 2018 Premium
- Presenter: Diane Caradeuc, Centers for Medicare and Medicaid Services Liaison
SSA gave beneficiaries a 2% Cost of Living increase (COLA) this year. This should mean that all beneficiaries are paying the same standard amount for their Part B premium. But due to various legislative acts, the standard premiums in 2018 could vary greatly.
The presentation covers some of the history of Medicare premiums which result in today’s variation of premiums. It covers the hold harmless provision and how it will be used, even when there is a 2% COLA. The presentation also covers other laws and actions and how they also affect the monthly Medicare premium in 2018. This should provide the tools to explain to a beneficiary why their Part B Medicare premium is different than their friends.
Meet the Medical Board of California
- Presenter: Kimberly Kirchmeyer, Executive Director of the Medical Board of California
Have you seen a listing of sanctioned providers lately? What if you see your doctor listed? How do complaints get referred to the Medical Board? What type of complaints are received?
This informative webinar with Kimberly Kirchmeyer, Executive Director of the Medical Board of California will answer all of your questions.
The presentation provides information about laws regulating medical providers, enforcement and violations.
Medicare Part D and the Details You Need to Know to Assist Beneficiaries
Do you work with Medicare beneficiares? If so, you don’t miss out on this webinar recording on Medicare Part D and the Details You Need to Know to Assist Beneficiaries, presented by Rajul Patel, Pharm D with University of the Pacific. We are offering this for a limited time for $25!
You can access the webinar here.
Everything You Always Wanted to Know About the CA Board of Pharmacy
- Presenter: Virginia Herold, Executive Officer of the California State Board of Pharmacy
In this informative webinar, Virginia Herold, Executive Officer of the California State Board of Pharmacy explains the role of the Board of Pharmacy and who they regulate. She’ll discuss the types of pharmacy fraud they have dealt with including drug diversion, pill mills, doctor shopping, and why prescription review for contraindications is important.
Learn How the FAST Protects Seniors from Elder Abuse
Presenters: Kelli Morris, JD, Director of the Council on Aging’s Southern California’s Senior Protection Program and Financial Abuse Specialist Team (FAST); and Sandy Morales, SMP Manager of Outreach & Volunteer Coordination at California Health Advocates
In this webinar, Kelli Morris, JD, Director of the Senior Protection Program and Financial Abuse Specialist Team (FAST) at the Council on Aging Southern California, covers:
- How to direct a successful FAST program
- Fraud trends – Processes and Protocols
- Tough cases
Afterwards, Sandy Morales, SMP Manager of Outreach & Volunteer Coordination, jumps into SMP Business including SMP healthcare fraud trends.
Ransomware and Western Union Consumer Protection
- Presenters: Michael J. Corby, IT Consultant, and John Skoglund III, Senior Manager, Fraud Risk Management at Western Union
This archived webinar includes 2 informative presentations on how to avoid being a victim of ransomware followed by a presentation on the Western Union Consumer Protection Program.
Ransomeware is rampant across the internet and organizations are paying the criminal hackers who are holding their critical information hostage. Ransomware is a type of malicious software that blocks access to the victim’s data or threatens to publish or delete it until ransom is paid.
Western Union takes consumer protection seriously and has a comprehensive program that deters fraudsters and helps protect consumers from fraud. This session includes an overview of the Western Union Consumer Protection Program.
More Than Just a Band-Aid: Learn About the Better Business Bureau
- Connie Alarcon, Manager, Bakersfield division of the Better Business Bureau (BBB)
This webinar covers information about who and what is the Better Business Bureau (BBB); how we can best utilize the BBB in our everyday tasks, types of complaints we can file with the BBB and information on how to prevent, detect and report healthcare fraud, abuse, and errors. Connie Alarcon also dives into the latest scams that are happening all around us.
Recruiting, Training & Working with Hispanic Volunteers
- Maria Eugenia Hernandez-Lane, Vice President, National Hispanic Council on Aging (NHCOA)
Maria Eugenia Hernandez-Lane, Vice President of National Hispanic Council on Aging, provides an an informative webinar on how to recruit, train and work with Hispanic volunteers.
Providing LGBT Older Adult Resources and Outreach
- Sherrill Wayland, MSW, Manager of National Projects at Services and Advocacy for GLBT Elders (SAGE)
Sherrill Wayland, Manager of National Projects at Services and Advocacy for GLBT Elders (SAGE), provides an overview of findings from the 2014 Out and Visible Survey. She also shares of many resources available in support of LGBT older adults including fact sheets developed for SMP/SHIP programs, best practice guides available through SAGE’s National Resource Center on LGBT Aging, SAGENet Affiliate Programs, the SAGE National LGBT Elder Hotline and LGBT National Housing Initiative and the SAGECare Training Program. This webinar gives valuable resources you can use each day in outreach and service to LGBT older adults.
Sandy Morales, Manager of SMP Outreach & Volunteer Coordination, also starts off the webinar with an overview of current Medicare fraud trends.
This archived webinar provides an overview of tips for working with Medicare beneficiaries under age 65. Note – a portion of this webinar was pre-recorded. The webinar includes:
1. Resources for younger Medicare beneficiaries developed by the Center for Medicare Advocacy and the Center’s partners through the course of the Administration for Community Living grant – Kathy Holt, Associate Director/Attorney, Center for Medicare Advocacy.
2. Insights from the disability community about where younger Medicare beneficiaries look for information and find resources – Michael Murray, Executive Director, American Association of People with Disabilities.
3. Innovative new programs and resources developed by the Social Security Administration to improve access to services and quality of life for younger Medicare beneficiaries – Ben Belton, Senior Advisor to the Commissioner, Social Security Administration & Robert Pfaff, Deputy Associate Commissioner in the Office of Research, Demonstration, and Employment Support.
4. Fraud schemes, where and how to refer any potential Social Security fraud, and Section 1140 – Alex Rzasa and David Rodriguez, Office of the Counsel to the Inspector General (OCIG).
5. Health Care Fraud and Abuse Quiz – 17 Questions to test your knowledge!
Medicare Changes in 2017
October 28, 2016 » Download Materials
This webinar reviews Medicare Changes in 2017. The discussion includes:
- Healthcare fraud update
- 2017 Medicare Part D cost-sharing
- Stand-alone Medicare Part D plans available in California in 2017
- Benchmark plans in 2017
- Medicare Advantage- landscape of 2017 plans
Critical Issues Facing Seniors & Persons with Disabilities
October 27, 2016 » Download Materials
This enlightening, 3-part educational webinar educates on critical issues facing seniors and persons with disabilities, including: Medical Identity Theft and Healthcare Fraud; Marketing Violations involving Medicare Advantage Plans; and the Universal Epidemic of Elder Abuse.
Presenters: Micki Nozaki, Project Director with California Senior Medicare Patrol; Julie Schoen, Deputy Director with National Center on Elder Abuse; and Julie Lowrie, Investigator with the Office of Enforcement at the California Department of Managed Health Care
Updates on DMEPOS Round 2 & National Mail Order Recompete
- Phabian Barrett, Palmetto GBA
Phabian Barrett with Palmetto GBA presents on the the Round 2 Recompete and National Mail Order Recompete for the next phase of the DMEPOS competitive bidding program. As in Round 2, Fee-For-Service Medicare beneficiaries residing in competitive bidding areas (CBA) must use contract suppliers to obtain their DME/diabetic testing supplies if they want Medicare to pay. With the recent release of the new Single Payment Amounts (SPAs) and the unveiling of the contract winners, this is interesting information to learn.
Ambulance Take Down
July 28, 2016 » Download Materials
- Jacob Dugger, Fraud Investigator, SafeGuard Services
Jacob Dugger, Fraud Investigations Team Lead (Zone 1) with SafeGuard Services (SGS) details the ambulance take down on providers that were transporting dialysis patients for dialysis and whether or not the transports met Medicare guidelines for transportation. He shares what qualifies a beneficiary for transportation.
Learn About Common Nursing Home Problems
- Eric Carlson, Staff Attorney, Justice in Aging
Eric Carlson, Directing Attorney with Justice In Aging covers the many common nursing home practices that are illegal. In order to receive the best possible quality of care, a resident or resident’s family member should be familiar with the protections of the federal Nursing Home Reform Law, and understand how to use the law effectively.
Do You Know How to Access Supplies Through Medicare’s Competitive Bidding Program?
- Tangita Daramola, Competitive Acquisition Ombudsman, U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services
Tangita Daramola reviews Medicare’s Competitive Bidding Program and how to ensure access to Durable Medical Equipment, Prosthetics/Orthotics Supplies (DMEPOS).
Are You Transitioning from Covered California to Medicare?
Mar 24, 2016 » Download Materials
- Elaine Wong Eakin, Executive Director, California Health Advocates
Elaine Wong Eakin reviews the series of articles posted on this topic in our Medicare Basics section. (See 1st article, What to Do If You Have a Covered California Plan and Become Eligible for Medicare? (Part 1)).
As people with a Covered California plan turn 65 and become eligible for Medicare, some are asking what they should do. Others are not aware they need to do anything, continue with their Covered California plan, and face penalties later. This webinar discusses the following questions in relation to different groups and their options.
- Must I enroll in Medicare if I have a Covered CA plan?
- What happens to my tax credits when I become eligible for Medicare?
- If I have MAGI Medi-Cal, will my costs go up when I enroll in Medicare?
Coordinated Care Initiative Updates
- Amber Cutler, Staff Attorney, Justice on Aging
Amber Cutler, Staff Attorney with Justice on Aging discusses 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
- Policy changes
- 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.
Telemarketing Healthcare Fraud
- Tracey Thomas, Attorney, Federal Trade Commission’s Bureau of Consumer Protection
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. Tracey also reviews new rules and restrictions recently added to the Telemarketing Sales Rule that can provide additional protection for consumers.
Medicare Marketing Misconduct with Julie Lowry of DMHC
- Julie Lowrie, Investigator, Department of Managed Health Care
Julie Lowrie presents the current types of marketing misconduct as seen from the perspective of the California Knox-Keene Act. You will learn the current Do’s and Don’ts of Medicare Marketing, the kinds of activity considered to be misleading, deceptive, and potentially fraudulent in the sale of Medicare Advantage products and how to report such activities.
Meet the National Center on Elder Abuse
- Julie Schoen, Deputy Director, National Center on Elder Abuse
Fraud has a great impact on the cost and quality of health care. Medicare Fraud can be considered one type of financial elder abuse. But elder abuse as a whole, encompasses many layers and complexities. Julie Schoen, JD, 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. Julie addresses the types of elder abuse and how this issue is evolving into a global social justice movement.
Learn About the DMEPOS Competitive Bidding Program
» Download Handouts
- Malisa Rogan, Competitive Bidding Liaison, Palmetto
Malisa Rogan 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.
The Importance of Inclusivity for LGBT Older Adults
- Karen Fazio, SMP Special Projects Manager, California Health Advocates
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.
Overview of Medicare Part A Payment Systems with Diane Caradeuc
- Diane Caradeuc, CMS Liaison, California Health Advocates
Diane reviews the Part A program and how its benefits are paid. The discussion includes 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.
Medicare Marketing Misconduct with Julie Lowry, DMHC
- Julie Lowrie, Associate Corporations Investigator, CA Department of Managed Health Care
Learn about the current types of marketing misconduct as seen from the perspective of the California Knox-Keene Act. 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.
Quality Improvement Organization (QIO) Update for California
- Diane Caradeuc, CMS Liaison, California Health Advocates
- Kym Roundtree, Communications Lead, Livanta
- Jennifer Wieckowski, California State Program Director, Health Services Advisory Group (HSAG)
- Linda Schoenbeck, Executive Director of Medical Review Utilization Services/Management Activities , HSAG
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. Livanta is the QIO that now reviews individual cases and appeals while HSAG is focused on Quality Improvement Projects. Learn how each organization works with California beneficiaries and providers, how to best submit appeals or complaints about quality of healthcare to the QIO, and what new quality projects may involve our providers.
- Diane Caradeuc, CMS Liaison, California Health Advocates
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.
The Process of Complaint Investigations
- Sharon Won, RN, East Bay State Licensing & Certification Office
Have you ever wondered what happens when you lodge a quality of care complaint about a licensed medical facility? Sharon Won from the East Bay State Licensing and Certification office explains the process. Learn what California’s field offices do to investigate and resolve the complaints that are filed as well as what type of facilities they do investigate. Also, find out how an individual can be involved in the complaint process.
Navigating the Medicare Drug Maze
- Diane Caradeuc, CMS Liaison, California Health Advocates
If you have ever wondered which part of Medicare (A, B, C or D) covers a particular prescribed drug, this webinar will help you understand some of the rules that determine which part of Medicare pays for which drug. While most people know about Part D, the drug benefit, Medicare has and does cover some drugs in all parts of Medicare. And, if you have ever wondered why the flu vaccine is covered by Part B but the shingles vaccine is covered by Part D, this webinar will also answer this question (and more).
LGBT Cultural Competencies
- Karen Fazio, SMP Special Projects Manager, California Health Advocates
- Micki Nozaki, SMP Project Director, California Health Advocates
Learn about our Senior Medicare Patrol’s LGBT (Lesbian Gay Bisexual Transgender) Integration Project. Topics covered include:
- Why the LGBT community is considered under served
- Progress of this important project
- Prevalance of discrimination, fear, and isolation
- Your toolkit for outreach
Home Health & Hospice Potential Fraud
Feb 27, 2014 » Download PowerPoint:
- Carolyn Cahn, RN of Centers for Medicare and Medicaid Services
Learn about Home Health & Hospice and the fraud potential in these programs. Carolyn also discusses a recent court decision regarding maintenance therapy since it applies to the home health benefit.
Senior Medicare Patrol Intro to Medicare Fraud & Abuse
Jan 24, 2014 » Download PowerPoint:
- Micki Nozaki, SMP Project Director, California Health Advocates
- Sandy Morales, Bilingual Case and Outreach Specialist, California Health Advocates
- Paula Holden, SMP Regional Liaison, California Health Advocates
Learn about Medicare fraud and abuse, and common schemes in outpatient, inpatient, home health and hospice care, and in the Part D prescription drug benefit. Also review the work of the Senior Medicare Patrol and how you can participate in sharing the “Protect, Detect, Report” message.
Round 2 of the DME Competitive Bidding Program
Jul 25, 2013 » Download PowerPoint:
- Diane Caradeuc, CMS Liaison, California Health Advocates
Review what the DMEPOS competitive bidding program means and get an update on Round 1. Also, learn about how the national mail-order competition for diabetic supplies that began July 1, 2013 affects our beneficiaries and potential areas of abuse in the program.
Medicare Rx Drug Benefit Part B vs Part D Home Infusion Perspective
Mar. 28, 2013 » Download PowerPoint:
- Lucy Saldaña, Pharm.D., Centers for Medicare and Medicaid Services Region IX Pharmacist Consultant
Social Security Updates
Feb. 28, 2013 » Download PowerPoint:
- Frank Van Nostrand, Public Affairs Specialist, Social Security Administration
California Department of Corporations & Seniors Against Investment Fraud
Jan. 24, 2013 » Download PowerPoint:
- Jackie Wiley-Sistrunk, California Department of Corporations
Potential Fraud in Hospice Agencies & Hospice Payments
Nov 1, 2012 » Download PowerPoint:
- Fraud in Hospice Agencies (Pat Frey, Center for Medicare and Medicaid Services)
- Hospice Payment (Diane Caradeuc, California Health Advocates)