Each year the Centers for Medicare & Medicaid Services publishes Medicare & You a handbook for those with Medicare and those who will become Medicare beneficiaries. The handbook offers information on what is important in 2017, as … [Read more...] about Medicare & You 2017 Now Available
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Lodge v. Burwell
No. 3:15-cv-00390-JBA (D.Conn.), filed March 17, 2015Issue: Whether extraordinary dental care should be covered because the exclusion for coverage of dental care should be limited to routine dental care.Relief Sought: Reversal of the Secretary’s … [Read more...] about Lodge v. Burwell
Medicare May Be Helpful in the Event of a Disaster or Emergency
In light of Hurricane Matthew’s disruptions to beneficiary services, equipment and supplies, we are reissuing these reminders.When a Medicare beneficiary lives in an area that has been declared an emergency or disaster by the President, a … [Read more...] about Medicare May Be Helpful in the Event of a Disaster or Emergency
Don’t be Fooled by the Federal Nursing Home Five-Star Quality Rating System
In 2014, The New York Times reported that nursing facilities were gaming the Five-Star Quality Rating System on Nursing Home Compare and that “even nursing homes with a history of poor care rate highly in the areas that rely on self-reported … [Read more...] about Don’t be Fooled by the Federal Nursing Home Five-Star Quality Rating System
New Nursing Home Requirements of Participation: A Missed Opportunity
Public coverage of the new nursing home Requirements of Participation (RoPs)[1] – the standards of care that nursing facilities must meet in order to be eligible for reimbursement by the Medicare and Medicaid programs – has focused … [Read more...] about New Nursing Home Requirements of Participation: A Missed Opportunity
An Open Letter to CMS About Fraud
Can we talk about fraud? It exists. It’s not good for Medicare. Efforts to eliminate its damage to the program are necessary. But CMS’ war on fraud seems to be indiscriminate, full of tactical errors and collateral damage. Rather … [Read more...] about An Open Letter to CMS About Fraud
Stop Calling Inpatients Outpatients: Medicare Created Observation Status – Ask Them to Change It!
This summer, the New York Times article “New Medicare Law to Notify Patients of Loophole in Nursing Home Coverage”* told the story of one of many people who contact the Center for Medicare Advocacy for help with hospital … [Read more...] about Stop Calling Inpatients Outpatients: Medicare Created Observation Status – Ask Them to Change It!
Medicare Affordability and Enrollment Act: Important Protection Introduced for Beneficiaries
Senate Finance Committee Ranking Member Ron Wyden, D-Ore, introduced the Medicare Affordability and Enrollment Act on Wednesday, September 21, 2016. The Bill would improve low-income protections for beneficiaries, eliminate the two-year waiting … [Read more...] about Medicare Affordability and Enrollment Act: Important Protection Introduced for Beneficiaries
Transition of Coverage: The Affordable Care Act and Medicare
The Affordable Care Act (ACA), signed into law in 2010, was enacted to increase the quality and affordability of health care and lower the rate of uninsured by expanding private and public health insurance. One mechanism the ACA established to … [Read more...] about Transition of Coverage: The Affordable Care Act and Medicare
Preview – 2017 Part D Standard Benefit & Other Threshold Amounts
Note: The amounts in this table do not apply to beneficiaries who have the Part D Low Income Subsidy (“Extra Help”) Annual Deductible Maximum $400 Initial Coverage … [Read more...] about Preview – 2017 Part D Standard Benefit & Other Threshold Amounts