Dual Eligibles Archives - JUSTICE IN AGING

New Legislation in Congress Seeks to Bolster Access to Medicare for Low-Income Seniors and Persons with Disabilities

By | BLOG, HOMEPAGE | No Comments
By Directing Attorney of Health Jennifer Goldberg and Borchard Fellow Catherine Bourque

Sandy had a good job as a registered nurse, and a middle class standard of living. She lost her husband and her ability to work her physically demanding job around the same time, leaving her with no income. Because of her job as a nurse, she receives just enough Social Security to be disqualified from means-based assistance like Medicaid and subsidized housing. As a result she spends a large percentage of her monthly income on rent, leaving little money to cover food or her Medicare copayments and premiums. Read More

The Duals Demonstration: A First Glimpse at Lessons Learned

By | DUAL DEMONSTRATIONS, ISSUE BRIEF, Medicaid, Medicare | No Comments

In January 2016, the Centers for Medicare and Medicaid Services (CMS) released the first ever evaluation of the Financial Alignment Initiative (FAI) known as the dual eligible demonstration.

Since the first dual eligible demonstrations rolled out in August 2013, Justice in Aging has followed the process both through the advocates on the ground who counsel clients directly, through the plans we’ve worked closely with, and through our work directly with the state agencies that administer the demonstrations. As national experts on the issues facing dual eligibles we’ve been both an information hub for advocates and feedback loop for policymakers. As such, we’ve been awaiting the release of the first formal evaluations of the demonstrations to see if they match the information we’ve been receiving. They have been released and we’ve analyzed them and published an issue brief on the findings.

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Advocate’s Guide on California’s Coordinated Care Initiative

By | Alerts, CA Health Network Alert, DUAL ELIGIBLES, REPORTS | No Comments

July 2013 — The Advocate’s Guide to California’s Coordinated Care Initiative helps advocates understand the Coordinated Care Initiative (CCI), a new state program changing the way dual eligible beneficiaries and other seniors and persons with disabilities get their health care in eight California counties.

The guide includes a description of the CCI, information on whom the CCI impacts, how individual beneficiaries are impacted, why it is being implemented and when and where the program is taking place.

The guide, which will be updated as program rules develop and change, includes a pull-out table that an advocate can use to determine who the CCI impacts and how it affects beneficiaries.

The National Senior Citizens Law Center and the Disability Rights Education and Defense Fund (DREDF) coauthored the guide.

QMB Program Needs Fixes to Operate Effectively


(11/16/11) A new issue brief from NSCLC says that dual eligibles who qualify for the Qualified Medicare Beneficiary (QMB) program often go without needed care because they can’t find physician specialists, mental health professionals or other providers who are willing to serve them and may end up facing demands from providers for co-payments that they should not have to pay.

To read a press release about the brief, click here.

Appeals Processes Need to be Integrated for Dual Eligibles


(10/4/11) An issue brief from the National Senior Citizens Law Center entitled “Building an Integrated Appeals System for Dual Eligibles,” recommends that as the Centers for Medicare and Medicaid Services (CMS) works with states to create new models that better integrate the delivery of Medicare and Medicaid benefits, efforts should be made to integrate the appeals processes as well. Medicare and Medicaid each have their own appeals processes with distinct rules and protections related to when someone needs to file an appeal, how many levels of appeal there are, who does the review, who makes the decisions and more.

To read a press release about the brief, click here.

To listen to and see the power point from the webinar, click here.