Three residents at Saint Francis Center for Rehabilitation and Healthcare, a Pennsylvania nursing facility, “suffered from conditions that should have been identified and routinely treated by the St. Francis staff.” Instead, all three residents were … [Read more...] about Judge Sustains Mandatory Exclusion of Manager, whose Understaffing Caused Three Deaths, from Participating in Medicare
Archives for November 2023
CMS Issues Final Rule on Nursing Home Transparency
The Centers for Medicare & Medicaid Services (CMS) issued final rules on disclosure of ownership of nursing facilities participating in the Medicare and Medicaid programs, as required by §6101(a) of the Affordable Care Act, 88 Fed. Reg. 80141 … [Read more...] about CMS Issues Final Rule on Nursing Home Transparency
Know Jimmo – CMS Reminded Providers & Contractors in 2021
“Skilled Nursing Care & Skilled Therapy Services to Maintain Function Or Prevent or Slow Decline: Reminder Medicare covers skilled nursing care and skilled therapy services under skilled nursing facility, home health, and outpatient … [Read more...] about Know Jimmo – CMS Reminded Providers & Contractors in 2021
New Substance Use Disorder Coverage in Medicare in 2024
Guest article by Deb Steinberg, Senior Health Policy Attorney, Legal Action Center On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released its Physician Fee Schedule (PFS) and Outpatient Prospective Payment System … [Read more...] about New Substance Use Disorder Coverage in Medicare in 2024
STAT News Report Further Exposes Medicare Advantage Misconduct Concerning Prior Authorization Using Restrictive Algorithmic Tools
The latest in a series of articles, STAT News recently issued a report titled “UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care” by Casey Ross and Bob Herman (Nov. 14, 2023). The report found that ‘[t]he … [Read more...] about STAT News Report Further Exposes Medicare Advantage Misconduct Concerning Prior Authorization Using Restrictive Algorithmic Tools
Know Jimmo | Medicare Law and CMS Policy Spell It Out
The Code of Federal Regulations: “Restoration potential is not the deciding factor in determining whether skilled care is required. Even if full recovery or medical improvement is not possible, a patient may need skilled services to prevent … [Read more...] about Know Jimmo | Medicare Law and CMS Policy Spell It Out
Center Comments on Proposed Rule to Discourage Discrimination in Federal Programs
The Center for Medicare Advocacy submitted comments this week in response on a proposed rule updating Section 504 of the Rehabilitation Act of 1973 in order to protect against discrimination on the basis of disability in HHS-funded programs. The … [Read more...] about Center Comments on Proposed Rule to Discourage Discrimination in Federal Programs
Help the Veterans in Your Life this Veterans Day with our Recorded Webinars on Medicare for Veterans
Watch as we explore Medicare basics; how Medicare and TRICARE For Life work together; considerations to optimize access to health coverage for Veterans living with paralysis; and engage in discussion and Q&A Join us as we dive into potential … [Read more...] about Help the Veterans in Your Life this Veterans Day with our Recorded Webinars on Medicare for Veterans
2024 Cost of Living Adjustment (COLA)
The Social security Administration has announced that More than 71 million Americans will see a 3.2% increase in their Social Security benefits and Supplemental Security Income (SSI) payments in 2024. On average, Social Security retirement benefits … [Read more...] about 2024 Cost of Living Adjustment (COLA)
CMS Final Rule Includes Important Oral Health Clarification
Last week the Centers for Medicare & Medicaid Services (CMS) issued a final rule that announced finalized policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues. The rule included … [Read more...] about CMS Final Rule Includes Important Oral Health Clarification