Tag Archives for Centers for Medicare and Medicaid Services

HHS Shake-Up Sends Shockwaves Through Aging Network

Published on April 31, 2025

Taking a page from President Donald J. Trump’s to “Make America Great Again,” last week the U.S. Department of Health and Human Services (HHS) announced a major restructuring of the federal agency to “Make America Healthy Again.” The dramatic restructuring in accordance with Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”

The U.S. Department of Health and Human Services (HHS), under management of HHS Secretary Robert F. Kennedy, Jr., last week announced a major restructuring and renaming of the federal agency under the initiative “Make America Healthy Again.” This dramatic reorganization follows Trump’s Executive Order, Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” said HHS Secretary Robert F. Kennedy, Jr. in a statement announcing the massive overhaul. “This Department will do more—much more—at a lower cost to taxpayers.”

“Over time, bureaucracies like HHS become wasteful and inefficient, even when most of their staff are dedicated and competent civil servants,” Kennedy added. “This overhaul will be a win-win for taxpayers and those HHS serves. That’s the entire American public, because our goal is to Make America Healthy Again.”

During the Biden administration, HHS’s budget increased by 38%, and its staffing grew by 17%, prompting the new HHS chief to place the federal agency on the budgetary chopping block.

According to HHS, this restructuring will not impact critical services while saving taxpayers $1.8 billion per year through a reduction of approximately 10,000 full-time employees. When combined with other cost-cutting initiatives, including early retirement, and the Fork in the Road program, the total downsizing will reduce HHS’s workforce from 82,000 to 62,000 employees.

HHS also plans to streamline departmental functions. Currently, the agency’s 28 divisions contain redundant units. Under the restructuring plan announced on March 27, 2025, these units will be consolidated into 15 new divisions, including a newly created Administration for a Healthy America (AHA). Additionally, core organizational functions—such as Human Resources, Information Technology, Procurement, External Affairs, and Policy—will be centralized. The number of regional offices will be cut from 10 to five.

As part of the restructuring, several agencies will see workforce reductions. The U.S. Food and Drug Administration (FDA) will cut approximately 3,500 full-time employees, focusing on streamlining operations and centralizing administrative functions, though HHS asserts these reductions will not affect drug, medical device, or food reviewers, nor inspectors.

Similarly, the U.S. Centers for Disease Control and Prevention (CDC) will downsize by approximately 2,400 employees, refocusing its efforts on epidemic and outbreak response. The National Institutes of Health (NIH) will eliminate 1,200 positions by centralizing procurement, human resources, and communications across its 27 institutes and centers. Meanwhile, the Centers for Medicare and Medicaid Services (CMS) will cut around 300 positions, targeting minor duplication within the agency. HHS insists these changes will not impact Medicare or Medicaid services, but improve them.

Restructuring HHS to Focus on Chronic Illness Prevention

HHS’s overhaul aligns with the agency’s new priority of ending America’s chronic illness epidemic by focusing resources on ensuring safe, wholesome food, clean water, and the elimination of environmental toxins.

The Administration for a Healthy America (AHA) will consolidate five agencies—the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health—into a single entity. This unification aims to enhance health resource coordination for low-income Americans, emphasizing primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development.

Additionally, the Administration for Strategic Preparedness and Response, responsible for national disaster and public health emergency response, will be transferred to the CDC to strengthen its core mission of protecting Americans from health threats.

To combat waste, fraud, and abuse, HHS will create a new Assistant Secretary for Enforcement, overseeing the Departmental Appeals Board, the Office of Medicare Hearings and Appeals, and the Office for Civil Rights.

Furthermore, HHS will merge the Assistant Secretary for Planning and Evaluation with the Agency for Healthcare Research and Quality to form the Office of Strategy, enhancing research to inform policy decisions.
Critical programs under the Administration for Community Living (ACL), which supports older adults and people with disabilities, will be integrated into other HHS agencies, including the Administration for Children and Families, the Office of the Assistant Secretary for Planning and Evaluation, and the Centers for Medicare and Medicaid Services (CMS). HHS assures that these changes will not impact Medicare or Medicaid services.

Sounding the Alarm

Following the announcement of HHS’s restructuring plans, which would broad without a lot of detail, aging advocacy groups quickly released statements to voice strong concerns.

“For decades, the federal health programs that retirees and people with disabilities depend on have been ably administered under both Democratic and Republican administrations. However, the radical cutbacks proposed by the Trump administration place the delivery of these programs in jeopardy,” warned Dan Adcock, Director of Government Relations & Policy at the National Committee to Preserve Social Security and Medicare (NCPSSM).

Adcock also noted that HHS plans to eliminate the ALC and divide its responsibilities between two offices with no prior experience in this area. “This administration has already demonstrated a reckless disregard for public interests in favor of slashing operations and staff under the guise of ‘efficiency,’” he added. “So far, all they have done is create chaos and confusion, disrupting essential programs for seniors and the disabled. We view Secretary Kennedy’s plans with alarm.”

Nancy LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer at AARP, also urged HHS to prioritize older Americans’ health needs. “HHS must ensure access to senior centers, community health centers, nutritious meals, Medicare assistance, and other vital services that countless older Americans rely on. Health is central to the lives, well-being, and financial security of AARP’s members and the more than 100 million Americans over age 50,” she emphasized.

Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation, echoed these concerns. “The announcement of workforce cuts at HHS comes at a time of unprecedented growth in America’s aging population. The proposed reorganization of ACL and its integration into other agencies requires careful consideration.”

Fulmer stressed that ACL administers programs essential to older adults’ daily lives, such as meal delivery, transportation to medical appointments, and chronic disease management. Absorbing these functions with far fewer staff demands careful planning. The government’s commitment to older adults requires a cautious approach, she said.

The Center for Medicare Advocacy also expressed deep concerns, particularly regarding plans to restructure ACL and consolidate oversight of Medicare appeals. “Given what we have seen with Social Security Administration cuts and restructuring, HHS’s claim that these changes won’t impact critical services rings hollow,” said Co-Director David Lipschutz.

LeadingAge, a national association representing nonprofit aging services providers, called for HHS to ensure older adults and their caregivers are not overlooked. “Cutting staff responsible for critical agency functions raises serious concerns. How will the work our members rely on get done? How will this impact quality care for older adults?” asked President and CEO Katie Smith Sloan.

Sloan also cautioned that reducing HHS’s field offices from 10 to five could impact CMS’s ability to oversee nursing home surveys and provider compliance. “A 25% workforce reduction must be undertaken with extreme care—especially given the millions of older adults who depend on these services,” she emphasized.

For a fact sheet on the HHS restructuring, visit https://www.hhs.gov/about/news/hhs-restructuring-doge-fact-sheet.html

Chair Casey leaves mark on national aging policy. Leadership changes in DC and RI 

Published in RINewsToday on December 16, 2024

Last week, U.S. Sen. Bob Casey (D-PA), Chairman of the U.S. Senate Special Committee on Aging, held his last hearing, entitled “Empowering People with Disabilities to Live, Work, Learn, and Thrive, in SD 106.  This hearing was his swan song as Chairman of the Senate Aging Committee. 

The 3-term Democratic Senator, first elected in 2006, lost his reelection bid for a fourth term to Republican Dave McCormick, a West Point graduate, combat veteran and Bronze star recipient, and a national security expert, and former hedge fund manager.  A recount of votes confirmed that Casey lost by 16,000 votes (3,398,628 to 3,382,423) and he conceded the race on Nov. 21st.

With the dust settling after the Nov. 5th presidential election, Republicans will take control of the legislative agenda of the upper chamber, with a 53-47 majority, and control the house.

According to a Senate Aging Committee, during the upcoming 119th Congress Sen. Tim Scott (R-SC), a former Ranking Member, is expected to replace Casey as chairman on Jan. 3rd, 2025. Former Ranking Member Mike Braun (R-Ind) will leave the Senate after becoming Governor-elect of Indiana. 

An advocate for America’s seniors

During the 118th, the Senate Aging Committee under the helm of Casey held 18 full hearings, five field hearings, and one joint full hearing.  His final hearing, lasting one hour and 46 minutes, highlighted his long record as a champion for people with disabilities, and laid out his vision for how Congress must continue to work to empower them. 

“From the beginning of my time in the Senate, I heard a constant refrain from disability advocates that their needs were not being met—they faced barriers to save for their future, they were being paid well below a living wage, and they could not afford or access the care they needed,” says Casey in his opening statement. “Those refrains, including from some of the people we heard from at today’s hearing, are what inspired me to make people with disabilities a focus of my Senate career and time as Aging Committee Chairman,” he said.

During his 18 years in the Senate, Casey has been one of the foremost champions in Washington for people with disabilities. He created the Stephen Beck Jr. Achieving a Better Life Experience Act (ABLE) program, which has helped hundreds of thousands of families save for long-term care for their disabled loved ones with a tax-advantage savings account. The Associated Press hailed this legislation as “the most important new law for [those with disabilities] in 25 years.  He also made federal websites more accessible for people with disabilities, and propelled the fight for access to home care to the forefront of the national conversation. 

In addition, the Pennsylvania Senator led efforts to improve care in nursing homes by expanding and strengthening oversight over poor-performing facilities while ensuring that nursing homes and long-term care facilities have the resources they need to provide high-quality care to residents. His work has led the Centers for Medicare and Medicaid Services (CMS) to publicly release information about nursing facilities with a documented pattern of poor care, ensuring older adults and their families have the information they 

At the Dec. 12th hearing, Chairman Casey also released a series of issue briefs documenting his record chairing the Aging Committee on making government technology accessible, expanding access to home care, improving nursing homes, lowering prescription drug costs, and ensuring economic security for older adults:

“We have made a lot of progress, from creating the ABLE program to making government technology more accessible,” Casey continued. “But as we heard today, there is still a lot more to do—from expanding access to home care to finally phasing out the subminimum wage,” he added.

Kudos to Casey’s advocacy for America’s disabled Seniors

At the hearing, witnesses from Pennsylvania and national organizations testified about the impact of Casey’s work impacting the disability community in the Commonwealth and around the country.

I want to thank Senator Casey for your leadership. None of the successes I outlined would have been possible without your steadfast championship, advocacy and partnership. It is daunting to think about facing the challenges ahead, particularly the threats to Medicaid, without you at the helm, but we have been emboldened to reimagine what is possible because of your leadership,” says Witness Ai-Jen Poo, President of the National Domestic Workers Alliance and Executive Director of Caring Across Generations.

Witness Neil McDevitt, Mayor of North Wales, Pennsylvania, noted: “Senator Casey, you have been a steadfast ally of North Wales Borough, the Commonwealth of Pennsylvania, and millions of disabled and Deaf Americans. We owe you a debt that can never be repaid.”

“Things are actually changing. We are not yet where we need to be when it comes to disability access and acceptance, but we are getting there. It brings me great joy when I hear of disabled people in my community getting good paying jobs and not being relegated to sheltered workshops for less than minimum wage,” adds Erin Willman, CEO of White Cane Coffee in Warren, Pennsylvania. 

Witness Lydia Brown, Director of Policy, National Disability Institute, told the attending Senators:“Ten years ago, Sen. Casey’s leadership in introducing and passing The ABLE Act changed the game. People whose disabilities began before age 26 can now access a savings vehicle that can conserve up to $100,000 total without their savings counting against them in determining eligibility for SSI and Medicaid. Money in an ABLE account can be used for a wide range of qualified disability expenses, including otherwise unaffordable assistive technology and health care, as well as educational and employment related costs. For many disabled people on Medicaid, an ABLE account is also their only available means to save for retirement.”

A fond farewell 

“Bob Casey served honorably as the chair of the Senate Special Committee on Aging.  He held a wide range of hearings intended to develop a record that could be used to help shape future legislation,” says Max Richtman, President & CEO, National Committee to Preserve Social Security and Medicare who also is a  former staff director of the Senate Special Committee on Aging. Casey had held numerous hearings on issues facing older adults that helped build support for components of the Older Americans Act reauthorization – which just passed the Senate and may be included in the end-of-year package, noted Richtman. 

“Senator Casey also held hearings on disabled older adults, including one with former Social Security Commissioner Martin O’Malley to discuss what the Social Security Administration (SSA) is doing to make the application process easier,” added Richtman, noting that other hearings were held on scammers preying on the elderly – designed to help older adults and their families know what to look for — and protect against.  

“We can only hope that when Republicans assume control of the Senate in January, this committee will continue the serious work of looking after the interests of seniors, who have contributed so much to our society and yet are among our most vulnerable citizens,” says Richtman.

“Leadership Council of Aging Organizations (LCAO) thanks Senator Bob Casey for his leadership and dedication to improving the lives of older Americans through his work on the Senate Aging Committee,” said Debra Whitman, LCAO Chair. “We look forward to collaborating with incoming Chairman Rick Scott to continue addressing the needs and enhancing the well-being of our nation’s growing aging population,” she says.

“As Chairman of the Senate Special Committee on Aging, Senator Bob Casey was a critical champion for seniors. He fought to strengthen Social Security and Medicare, stop elder abuse, and improve conditions in nursing homes. Casey will be greatly missed in the Senate by everyone who cares about senior issues. We urge the next chairman of this invaluable committee to continue his legacy.” Says Nancy Altman, President of Social Security Works.

“It is wonderful to have a Senate Aging Committee and Senator Casey’s terrific advocacy but inexcusable for the House not to restore its counterpart, which Chairman Claude Pepper proved is indispensable,” said Robert Weiner, former Chief of Staff of the House Select Committee on Aging and later a senior White House spokesman.

Announcing job transitions and retirement – in Rhode Island

Two well-known aging advocates have announced their departures.

The Alliance for Better Long-Term Care announces the retirement of Kathleen “Kathy” Heren. She dedicated 26 years to serving Rhode Island’s seniors.  For the past 15 years, Heren has served as the Rhode Island State Long Term Care Ombudsman, tirelessly advocating for the rights and well-being of residents in long-term care facilities across the state. She is known for her “fierce dedication, wisdom, and compassion have made her an unwavering champion for those in need.”

After serving as Executive Director of LeadingAgeRI for over 16 years, James P. Nyberg is leaving the nonprofit to become Senior Advisor at the Boston-based Public Consulting Group.   He will provide his expertise to the company on home and community-based services.

During his tenure, he significantly advanced aging services by advocating for quality, affordable care and fostering partnerships with state and national stakeholders. His leadership has driven innovative initiatives addressing the needs of older Rhode Islanders while supporting workforce development and professional growth among member organizations.

Nyberg ably served as Chair of the state’s Advisory Commission on Aging for over six years.

Spotlight on scams and frauds targeting older Americans 

Published in RINewsToday on September 23, 2024 

Although the U.S. Senate Special Committee on Aging, initially established in 1961 as a temporary committee, later becoming a permanent Senate Committee in 1977, has no legislative authority, it studies an array of issues related to older Americans. Last week, U.S. Senator Bob Casey (D-PA), Chairman of the U.S. Senate Special Committee on Aging, held a full Committee Hearing, taking a look at an important issue impacting older Americans, the rampant increase of scams and frauds.

The hearing entitled “Fighting Fraud: How Scammers are Stealing from Older Adults,” lasting over one hour and thirty minutes, highlighted the psychological and economic impacts that frauds and scams have older adults, who are disproportionately targeted by fraudsters.

During the hearing, held on Sep. 19, Casey unveiled the Aging Committee’s 9th annual Fraud Book, “Fighting Fraud: Scams to Watch Out For.” The 93-page book, hot off the press, provides seniors with an overview of the most prevalent scams to help them identify and avoid being victimized. The Fraud Book also contains valuable resources for scam victims.

At this hearing, Casey also touched on the 2017 Republican tax law, called “Scammed Then Taxed,”which details how the law’s repeal of the theft loss deduction has imposed significant taxes on many scam victims.

The 91-page Majority Staff Report details the results of a months-long investigation examining how the removal of the casualty and theft loss tax deduction—repealed by Republicans in the 2017 tax law has devastated many American fraud victims.

This report details how some older adults—who lose the most to frauds and scams—are now facing huge tax bills on top of losing all their assets, leading them to feel as though they have been victimized twice.

According to the report, for a century, the theft loss deduction allowed taxpayers who experienced theft to receive a tax deduction to offset their losses. The repeal of this provision has meant that fraud victims are now often obligated to pay taxes on money that has been stolen.

Keeping Scammers from Stealing from Older Adults

In his opening statement, Casey stated: “At today’s hearing, we heard tragic stories from scam victims and law enforcement about how fraudsters are getting more sophisticated and aggressive with their scams and throwing the lives of older adults into chaos.” The Pennsylvania Senator stressed the importance of educating older adults about the threats they face from frauds and scams.

Casey rattled off a list of common scams, detailed in the released Fraud Book, including grandparent scams, investment scams, tech support scams, to name just a few.

With the advent of Artificial Intelligence, scammers have now gotten even more sophisticated, especially by cloning the voice, warned Casey, making their phone and online message even more convincing to the older victim.

“That may explain why recent FBI data shows that fraud losses among older adults have gone up in recent years – reaching $3.4 billion in 2023,” says Casey.

Casey also called for more resources to be provided to persons who have been victimized by scams, including those who have been forced to pay taxes on money they’ve lost due to changes in the 2017 Republican tax law.

Like Casey, in his opening statement Ranking Member Mike Braun (R- Indiana) also stressed the need to prioritize education and outreach to older adults help them to recognize red flags that warn of scams.

“Our community banks and credit unions are often the first line of defense intervening on transactions that just don’t add up,” says Braun. “In my home state of Indiana, one community bank has been able to stop over $1.2 million worth of scams this year,” he notes.

According to Braun, last year Medicare lost an estimated $60 billion due to fraud, errors, and abuse. “Every dollar lost to fraud is a dollar that can be spent on vital programs for American seniors,” he says.

The Indiana Senator noted that he has requested the U.S. Government Accountability Office (GAO) to initiate a full audit of Medicare fraud. The GAO has begun its audit in July, says Braun, noting it to be the most comprehensive audit in Medicare’s history.

And Braun expects the GAO investigation to uncover “how much fraudsters are stealing from the American taxpayer” and to revamp the current Medicare Fraud Prevention System to reduce fraud taking place. 

Witnesses testifying before Senate Aging Committee

Casey invited Susan Whittaker, an Administrative Assistant at Lehigh County Aging and Adult Services in Allentown, Pennsylvania, to testify at the hearing about her late husband’s experience as a QuickBooks scam victim.  At the time of the scam, Bill, 75, suffered from dementia along with other chronic conditions.

Susan told Senators that her husband had received an email receipt on Tuesday, that appeared to be from QuickBooks. It claimed that a software upgrade fee of $499 had been charged to the business account that Bill used to manage his son’s company.  He knew that he hadn’t purchased this upgrade.  Calling the company and requesting a refund, he was told to pay $500 upfront, thru a created Venmo account, install an application on his computer and provide personal financial information.  Once done, Bill would get his money back.

On Friday, by the time Susan had learned about the financial transaction, $28,000 had been withdrawn from their accounts. Although the bank ultimately recovered $8,000 the following week, $20,000 was gone — money that her husband was planning to use to buy medications.  And he lost his job, too.

“This scam was devastating and had a devastating effect on Bill—both financially (losing $20,000) and emotionally,” stated Susan, forcing her husband to begin rationing his medications.

“We just couldn’t afford them [medications] anymore… He also lost his sense of self-worth. I was really sad to see this very intelligent and past business owner, become so afraid to read emails and use a phone. It was a huge setback for him, and I think contributed to his worsening health conditions…he stopped living,” said Susan.  

Kathy Stokes, Director of AARP’s Fraud Prevention Program, told Senators that there has been a “meteoric” growth in fraud crimes. When considering fraud that goes unreported, Stokes noted that the Federal Trade Commission estimated the cost of fraud at $137 billion in 2022.  But most fraud experts say that this is far higher than the $ 8.9 billion in losses reported that year, she added.

Beyond educating seniors about fraud prevention thru the sharing of information online at aarp.org/fraudwatchnetwork, AARP covers the issue in AARP the Magazine, AARP Bulletin, biweekly emails or text ‘watchdog alert newsletter,” and on its podcast “A Perfect Story,” notes Stokes.

“Beyond education, AARP is unique in its focus on supporting victims of fraud and their families,” says Stokes, noting that its Fraud Watch Network Helpline receives 500 calls a day.

“Addressing fraud requires more than piecemeal solutions; it demands a whole-of-society approach,” warns Stokes. “But together, educators, policymakers, law enforcement and industry can turn the tide against vicious crime gangs who hold the power right now. Together we can disrupt their business model, protect millions of consumers, and keep billions of dollars in saving and retirement accounts and in our economy,” she says.

“Currently, we are all failing the very people who need us the most: older adults- m any of whom can’t afford to lose anything, let everything. We are failing in our most basic duties to protect those in their golden years who are living off their nest eggs they worked for their entire lives and who are beyond the ability to rejoin the workforce to make the money back,” charged Scott Pirrello, who oversees the San Diego District Attorney’s Office’s Elder Abuse Prosecution. 

“Too many very well intended programs are not implemented in a way to truly impact the tsunami of fraud that we are facing each day,” he said.

Pirrello told the Senators about the success of the Elder Justice Task Force (EJTF), created by his office, working with the San Diego FBI, to combat elder fraud. Oversea scammers depended on organized networks of money launders operating in the United States, he said, noting that EJTF worked to disrupt these networks.

Like the other witness, Pirrello called for investing in education, as well as adequately fund task forces like the EJTF, to fight against scammers.

One of the biggest crimes affecting Medicare beneficiaries and persons with disabilities is Medicare fraud, waste and abuse, says Nancy Gilmer Moore, who works for the Indiana Association of Area Agencies on Aging managing its Senior Medicare Program. “Health care experts estimate improper Medicare payments are approximately $ 60 billion a year,” she says.

Gilmer Moore admitted to the Senate Aging Panel that she was personally the target of the “Intermittent Urinary Catheter fraud scheme.  Medicare paid the fraudsters $1,500 a month (for supplies never ordered) before she noticed it on her statement. Moore ultimately reported the suspicious claims to Centers for Medicare and Medicaid Services and requested a new Medicare number since her number was compromised.

“Be on the lookout for duplicate billing, services or products not rendered or received and services not ordered by their physicians,” urged Gilmer Moore, noting that beneficiaries and caregivers should never give their Medicare number or financial information over the telephone to an unknown called.  Medicare does not make. unsolicited phone calls.

For information on fraud prevention, go to aarp.org/fraudwatchnetwork.

To download a copy of the 2024 Fraud Book, go to https://www.aging.senate.gov/imo/media/doc/2024_fraud_book_english.pdf.

To watch the Senate Aging Panel’s hearing on fighting fraud, go to https://www.aging.senate.gov/hearings/fighting-fraud-how-scammers-are-stealing-from-older-adults.

To see the Majority Staff Report, “Scammed Then Taxed,” go to

https://www.casey.senate.gov/news/releases/scammed-then-taxed-casey-unveils-new-report-showing-how-republican-tax-law-further-devastated-scam-victims