Government contractors administering Medicare benefits are routinely denying coverage to cancer patients for claims involving the surgical removal of decayed and infected teeth caused by an aggressive course of radiation treatment to the head and … [Read more...] about The Medicare Dental Exclusion: Is it Being Used to Deny Vulnerable Beneficiaries Needed Care?
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20. Medicare is There When People Need it Most
By A Medicare BeneficiaryHaving Medicare saved my life, and I will be forever grateful. But I never thought of it before I was in the hospital, because I’d never really been sick. You have to fight for Medicare like your life depends … [Read more...] about 20. Medicare is There When People Need it Most
Saga of an Inpatient Hospital Appeal: Notice and Use of Lifetime Reserve Days and Comments on Observation Status
This CMA Alert highlights a recent individual ALJ decision that sets out an important but often unrecognized beneficiary right to a written notice when he or she is about to use hospital “Lifetime Reserve Days.” A hospital’s … [Read more...] about Saga of an Inpatient Hospital Appeal: Notice and Use of Lifetime Reserve Days and Comments on Observation Status
19. Medicare Has Options: Know What You Need… and What You Want
By Matt ShepardMy father worked his entire career for a private insurance company. When he retired before he was 65, he and my Mom were able to remain in the HMO that his company had used. The company was located in the next … [Read more...] about 19. Medicare Has Options: Know What You Need… and What You Want
Bundling Payments for Post-Acute Care
The traditional Medicare program pays individual health care providers for the specific services and care they provide to beneficiaries and guarantees that patients have “freedom of choice”[1] to select their Medicare providers. A … [Read more...] about Bundling Payments for Post-Acute Care
Documenting Skilled Nursing Care for Medicare Coverage
June 10, 2015, 2:00pm - 3:00 PM ESTCost: $99.00 per siteThis webinar will examine proper documentation of skilled care for the purposes of obtaining Medicare coverage. The presentation will examine how to:Identify skilled care and … [Read more...] about Documenting Skilled Nursing Care for Medicare Coverage
18. Medicare Doesn’t Cover Long-Term Nursing Home Care
Medicare is a wonderful program. It provides important health insurance for millions of older and disabled people. But, contrary to common belief, Medicare does not cover long-term care in skilled nursing facilities (often referred to as … [Read more...] about 18. Medicare Doesn’t Cover Long-Term Nursing Home Care
Center Attorneys Meet with Senate Finance Committee Staff Members About Changes to Medicare Appeals Process
The Medicare appeals system is not working. The success rate at the first two levels of appeal is staggeringly low for beneficiaries. It can take years to get an ALJ hearing decision – the third level of appeal, and the first real opportunity … [Read more...] about Center Attorneys Meet with Senate Finance Committee Staff Members About Changes to Medicare Appeals Process
17. Medicare Must Help People Communicate
By Steve GleasonI was diagnosed with ALS four years ago. Now I am unable to move my body, except for my eyes. I communicate through technology called a Speech Generating Device (SGD). The SGD allows me to maintain contact with … [Read more...] about 17. Medicare Must Help People Communicate
Senate Finance Committee Holds Hearing on Medicare Appeals Backlog – Proposed Solutions Are of Great Concern
On April 28, 2015, the Senate Finance Committee held a hearing entitled “Creating a More Efficient and Level Playing Field: Audit and Appeals Issues in Medicare.”[1] As noted by Chairman Hatch in his opening statement, … [Read more...] about Senate Finance Committee Holds Hearing on Medicare Appeals Backlog – Proposed Solutions Are of Great Concern