In the Elder Justice Newsletter, we highlight citations, including deficiencies related to abuse, neglect, and substandard care, that have been identified as not causing any resident harm. The goal of this brief newsletter is to shed light on the … [Read more...] about Elder Justice “No Harm” Newsletter Volume 6, Issue 1 Now Available
Archives for October 2024
Ongoing Medicare Advantage Overpayments and Barriers to Care Prompt More Congressional Interest in Oversight
As Medicare Open Enrollment proceeds, more MA issues are coming to light, and Congress is starting to pay attention.As the Medicare annual enrollment period continues through December 7, and beneficiaries are tasked with comparing their coverage … [Read more...] about Ongoing Medicare Advantage Overpayments and Barriers to Care Prompt More Congressional Interest in Oversight
When Private Equity Takes Over Nursing Facilities, Residents Beware!
Private equity firms and other private owners are buying increasing numbers of nursing facilities. The consequences for residents are significant and troubling.In “Private-equity firm buys 29 Iowa nursing homes in massive $85 million deal,” Clark … [Read more...] about When Private Equity Takes Over Nursing Facilities, Residents Beware!
Medicare or Social Security? New Fact Sheet Shows Who to Contact
Social Security offers retirement, disability, and survivors benefits. Medicare provides health insurance.But because these services are often related, you may not know which agency to contact for help. The Social Security Administration has recently … [Read more...] about Medicare or Social Security? New Fact Sheet Shows Who to Contact
Opinion: Medicare or Medicare Advantage? One of them doesn’t give you what you pay for.
Medicare open enrollment is here. It’s time for Congress to level the playing field.By Andrea Ducas and David LipschutzLast Updated: Oct. 26, 2024 at 9:38 a.m. ET. First Published: Oct. 25, 2024 at 7:35 a.m. ETSMedicare’s … [Read more...] about Opinion: Medicare or Medicare Advantage? One of them doesn’t give you what you pay for.
Study Finds “Opportunistic” Nursing Home Systems Provide Poorer Quality Care and Overbill Medicare
In “Overbilling and Killing? An Examination of the Skilled Nursing Industry” (Oct. 2024), (Abstract includes a link to the full paper), John M. Griffiin (University of Texas) and Alex Priest (University of Rochester) document the increasing … [Read more...] about Study Finds “Opportunistic” Nursing Home Systems Provide Poorer Quality Care and Overbill Medicare
Risk-Based Surveys for Nursing Facilities: CMS Responds to Advocates’ Concerns
In April 2024, the Centers for Medicare & Medicaid Services (CMS) described in a single paragraph a shorter “more focused survey” for up to 10% of a state’s nursing facilities that provide “consistently higher quality” care. The sole … [Read more...] about Risk-Based Surveys for Nursing Facilities: CMS Responds to Advocates’ Concerns
Medicare Advantage “Flex Card” Issues Getting Attention
Last week CMA issued a press release detailing issues some beneficiaries are having with "Flex Cards" issued by Medicare Advantage plans. These cards, similar to pre-loaded debit cards, have become an increasing popular enticement from MA plans. … [Read more...] about Medicare Advantage “Flex Card” Issues Getting Attention
Know Jimmo | Jimmo Applies to Home Health Care
Skilled Maintenance Care is CoveredThe Jimmo Court rulings and related policy changes specifically apply to Medicare coverage for home health care. The Medicare Home Health Benefit Policy Manual makes that very clear. It states: “Coverage of … [Read more...] about Know Jimmo | Jimmo Applies to Home Health Care
Senate Subcommittee Report Details Medicare Advantage Coverage Denials
On October 17, 2024, U.S. Senator Richard Blumenthal (D-CT), Chair of the U.S. Senate Permanent Subcommittee on Investigations, released a 54-page report regarding its ongoing investigation of Medicare Advantage plans’ Prior Authorization and … [Read more...] about Senate Subcommittee Report Details Medicare Advantage Coverage Denials