Regulatory Conflicts in CMS’s Proposed Medicaid Rule May Strip Same-Sex Spouses of Federal Financial Protections
CMS’s proposed Medicaid rule on patient protections for beneficiaries in nursing homes (if finalized as drafted) would create a conflict for Long-Term Care facility (nursing home) operators. The conflict would be between CMS’s proposed new regulatory requirements for LTC facilities and the exercise by some state Medicaid programs of their CMS-granted authority that permits the programs to not recognize same-sex marriages.
At issue is whether or not CMS is requiring LTC facility operators in states that do not recognize same-sex marriages to provide Medicaid’s federal “spousal impoverishment” (42 U.S.C. 1396r–5) financial protections to the same-sex spouses of beneficiaries irrespective of where they reside.
CMS has substantial discretion in how it implements the Supreme Court’s Windsor decision. The agency’s discretion is not, however, unlimited. Thus, even though Windsor doesn’t obligate CMS to force state Medicaid programs to recognize the out-of-state marriage licenses of gay couples, neither does it grant CMS the authority to nullify federal fair housing protections for Medicaid beneficiaries by accommodating the preference of states that refuse to honor the marriage licenses of gay couples.
From: A Sweet Life
Medicare and the FDA (Food and Drug Administration) are choosing to lower costs at the expense of your health. They are allowing cheap and faulty diabetes test strips into the marketplace. Test strips that have been proven — the FDA admits – to give inaccurate glucose readings.
This is dangerous for anyone who has diabetes, no matter what your age. We cannot allow this to continue and, together, we can stop it — and we must.
Plunging revenue from its blood-glucose monitors has forced Roche Diagnostics Corp. to cut its staff, the company informed its workers last week.
Roche, which operates its North American headquarters in Indianapolis, suffered a 14-percent decline in revenue in its diabetes care unit during the first six months of
the year. Roche has reportedly put that unit up for sale, according to a May report by the Reuters news agency.
By Bryan Thompson
Medicare patients who have diabetic testing supplies delivered to them experienced some changes this week.
It’s all part of an effort by the Medicare program to save money and cut down on fraud. But some people are worried about unintended consequences.
A public services announcement issued by Medicare attempts to lay out the changes for diabetic Medicare recipients:
“If you are covered by Original Medicare, and have diabetic testing supplies delivered to your home,” the narrator says. “You should know about a new mail-order program for diabetic testing supplies. It will allow you to continue getting quality supplies, while saving money.”
CMS: Temporary Moratoria on Enrollment of Ambulances Suppliers and Providers and Home Health Agencies in South Florida
Editor’s Note: An advance copy of CMS’ Federal Register notice announcing the temporary moratoria is attached here. The Summary is below.
SUMMARY: This notice announces the imposition of a temporary moratorium on the enrollment of home health agencies in Miami-Dade and Cook counties as well as selected surrounding areas, and on the enrollment of new ambulance suppliers and providers in Harris County and surrounding counties to prevent and combat fraud, waste, and abuse.
EFFECTIVE DATE: July 30, 2013.
From: The Hill’s Congress Blog
By Dr. Gary Puckrein
On July 1, the new Medicare competitive bidding program for durable medical products will go into effect nationwide, unless a new move by Congress to delay implementation is passed this week. While the program was created to reduce health care costs, that vision appears to be short-sighted. The policy may actually increase costs longer term by providing our senior citizens with low-quality products, placing more lives at risk of serious health events.
Editor’s Note: CRE has long warned of CMS’ intent to massive expand competitive bidding.
From: The Seattle Times
Editorial: Feds make a hash of state’s mental-health system
An obscure federal auditing issue may require the state to quickly tear up its outpatient mental-health system.
Seattle Times Editorial
THE U.S. Centers for Medicaid and Medicare Services informed the state of Washington that the state’s outpatient mental-health system violated federal procurement laws, as articulated in OMB Circular A-87.
Hope that didn’t lose you. That accountant-speak is bone-dry.
But the consequences of the July 5 letter are huge, and will require immediate, focused attention by state officials and lawmakers.
by Jim Kenyon
When the directional control on Chad Norton’s power wheelchair broke last month. He says he was told by Medicare that the only place he could get it repaired was a medical equipment supplier in Albany which is 150 miles away.
“I think it’s truly a disgrace because they don’t realize the limitations of the disabled,” Norton told CNY Central’s Jim Kenyon.
On July 1st, Medicare instituted new rules for this region. Medical suppliers for wheelchairs, hospital beds, walkers and other accessories had to submit competitive bids to be certified in order to do business with Medicare.
From: Rochester Times
By Conor Makem
ROCHESTER — It came as a shock to much of the Rochester community that Bill and Jan Keefe were closing their store this week. The owners of Carney Medical Supply on North Main Street for more than 46 years, they’ve become as much a part of the city as anyone ever has.
In a letter to the editor, the couple, both in their early 70s, cited health reasons as well the introduction of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program.