Procedures for Appealing Section 8 Rent Adjustments

The proposed information collection requirement described below has been submitted to the Office of Management and Budget (OMB) for review, as required by the Paperwork Reduction Act. The Department
is soliciting public comments on the subject proposal.

When a rent increase for certain Section 8 subsidized projects is denied, in full or in part, owners may submit to HUD an appeal letter outlining the basis for the appeal. The appeal letter must be submitted to the Contract Administrator or the HUD Director for review. HUD uses the information to determine whether to deny or allow Section 8 rent increases.

Comments Due Date: January 12, 2009.

Board of Veterans' Appeals: Expedited Claims Adjudication Pilot Program

Final Rule

The Department of Veterans Affairs (VA) is launching an initiative for accelerated claims and appeals processing at four VA facilities, based on voluntary participation by eligible claimants. The purpose of this initiative is to determine whether VA can expedite the processing of claims and appeals by obtaining claimants' waivers of certain statutory and regulatory response periods, and by utilizing the Board of Veterans' Appeals' (Board or BVA) statutory authority to pre-screen cases. VA's responsibility to fully develop and decide cases in a fair, accurate, and non-adversarial manner remains unchanged under this initiative. If this initiative is successful at the four trial sites, the data obtained may provide a basis for expanding some, or all, of the program nationwide, and ultimately help accelerate the processing of all claims and appeals. The parameters of the initiative are set forth in these regulations.

Effective Date: The final rule is effective December 5, 2008.

Medicare Part D Appeals Help for Advocates Is Here!

Medicare Rights Center’s new Medicare Part D Appeals: An advocate’s manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources. Register for a FREE copy of this great resource.

Medicare Consumer Advocacy Update

Asclepios Your Weekly Medicare Consumer Advocacy Update Mind the Gap August 28, 2008 • Volume 8, Issue 35 Mind the Gap New research confirms what many people with Medicare, as well as their caregivers and counselors, know already. The sudden shock of paying full price for prescription drugs in the Part D coverage gap causes many older adults and people with disabilities to stop taking the medicines they need to treat serious, chronic conditions. Researchers for the Kaiser Family Foundation estimate that 3.4 million people with Medicare reached the coverage gap in 2007, and had to pay the full cost of their drugs for at least three months. People who hit the gap, or doughnut hole, between April and July spent about half the year paying both premiums and the full cost of their medicine. After July, almost all enrollees could count on spending the remainder of the year in the gap, never accessing the catastrophic coverage that kicks in after enrollees spend $3,850 out of their own pocket. (The out-of-pocket threshold increased to $4,050 this year; it rises to $4,350 in 2009.) Looking at people undergoing treatment for eight conditions, including diabetes, hypertension, Alzheimer’s Disease and depression, the report shows that 15 percent of Part D enrollees who reached the gap stopped taking their medication. Only about one-third of those who qualified for catastrophic coverage later in the year resumed drug therapy. About half of Part D enrollees taking medicine for diabetes hit the coverage gap. Of these, one in 10 stopped taking their medicine, risking potentially serious consequences to their health. The Part D coverage gap is a serious public health problem that is getting worse every year. By 2017, Part D enrollees are expected to face a gap of over $6,000 in their drug coverage. There are two steps the next administration and Congress can take to address this problem:

• Congress should expand eligibility to Extra Help, which provides coverage through the doughnut hole and helps pay premiums and cost sharing. Currently, people with Medicare earning just over $15,612 ($21,012 for a couple) cannot qualify for assistance.
• Congress should work to lower drug prices by providing the option to receive drug coverage directly through Original Medicare, instead of through the private companies that have failed so miserably in lowering drug prices.

Medical Record “I have multiple diseases and I find that I am in the doughnut hole long before the year is up! Why can't the program be run like the VA with no cut-off on medications that are covered? ” (Story submitted to the Part D Monitoring Project from Odessa, FL, March 2008)

“Ten percent of patients taking medication for diabetes stopped taking their medication when they reached the gap, and an additional 5 percent stopped taking one of multiple drugs they were taking in the class. Terminating use of drugs used to manage diabetes could pose serious and immediate health concerns.” (The Medicare Part D Coverage Gap: Costs and Consequences in 2007, Kaiser Family Foundation, August 2008)

“The failure of Part D plans to negotiate price concessions from manufacturers on par with those achieved by government programs results in higher costs to taxpayers and higher premiums and cost-sharing for people with Medicare drug coverage,” (The Best Medicine: A Drug Coverage Option under Original Medicare, Medicare Rights Center, November 2007)

* * * * Medicare Part D Appeals Help for Advocates Is Here!

MRC ’s new Medicare Part D Appeals: An advocate’s manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources.

Download a FREE copy of this great resource. * * * * Medicare Part D Monitoring Project

The Medicare Rights Center (MRC) would like to hear about your experience, or that of someone you know, enrolled in a Medicare private drug plan. With information about what the issues are with Medicare Part D, we will be able to demand that those problems be fixed. Submit your story at http://www.medicarerights.org/partdstories.html.

* * * * The Louder Our Voice, the Stronger Our Message

Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly e-newsletter designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.

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The Medicare Rights Center (MRC) is the largest independent source of Medicare information and assistance in the United States. Founded in 1989, MRC helps older adults and people with disabilities get high-quality, affordable health care.

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