GeneralQuestion: Are professional therapy services available under Medicare only for patients who are improving or who are expected to improve?Answer: No. The Jimmo Settlement confirms that services by a physical therapist, occupational … [Read more...] about Frequently Asked Questions (FAQs) Regarding the Jimmo v. Sebelius “Improvement Standard” Settlement
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CMS Updates Guidance for Hospital Discharge Planning
On May 17, 2013, the Centers for Medicare & Medicaid Services (CMS) released an update of Appendix A of the State Operations Manual (SOM) revising its interpretive guidelines for hospital Discharge Planning.[1] Medicare discharge planning … [Read more...] about CMS Updates Guidance for Hospital Discharge Planning
Center for Medicare Advocacy Submits Joint Testimony to Congress on Medicare Reform Proposals
This week, the House Ways and Means Subcommittee on Health held a hearing on proposals to reform Medicare at which critical issues facing the Medicare program and current and future beneficiaries were discussed. The Center for Medicare Advocacy, … [Read more...] about Center for Medicare Advocacy Submits Joint Testimony to Congress on Medicare Reform Proposals
CMS Addresses Observation Status Again… And Again, No Help for Beneficiaries
As part of the annual update to inpatient hospital reimbursement under the Medicare program, the Centers for Medicare & Medicaid Services (CMS) is again considering observation status. This time CMS is proposing "a time-based … [Read more...] about CMS Addresses Observation Status Again… And Again, No Help for Beneficiaries
Debunking Medicare Myths: Drug Rebates for Dual Eligibles
In the midst of ongoing budget discussions, policymakers are considering a wide array of approaches for cutting spending and saving federal dollars. The Center for Medicare Advocacy recently wrote of ways to strengthen the Medicare program while … [Read more...] about Debunking Medicare Myths: Drug Rebates for Dual Eligibles
Medicare’s Future: Letting the Affordable Care Act Work, While Learning From the Past
This article is part of a NAELA Journal symposium edition that focuses on "The Future of Elder Law and Special Needs Planning."This article will provide an overview of the policy debate that led to the creation of the Medicare … [Read more...] about Medicare’s Future: Letting the Affordable Care Act Work, While Learning From the Past
End Observation Status!
$30,000 – that’s Mrs. Kauffman’s nursing home bill for care she received following a three-day hospitalization. Although she was in the hospital for three full days, Mrs. Kauffman was never admitted as an inpatient. Instead, she was … [Read more...] about End Observation Status!
Immigration Reform and Access to Health Care
Recently, a bipartisan group of Senators unveiled a plan to overhaul our nation's immigration system, a key portion of which aims to provide a pathway to citizenship for the 11 million undocumented immigrants living in the United States, … [Read more...] about Immigration Reform and Access to Health Care
Privatization: Not Right for Medicaid, Not Right for Medicare
The role of private managed care in Medicare and Medicaid has been growing at a rapid pace in recent years. The Center for Medicare Advocacy has written widely on the dangers of turning these successful community health care programs over to … [Read more...] about Privatization: Not Right for Medicaid, Not Right for Medicare
Medicare Paid $5.1 Billion to SNFs that Did Not Provide Care-Planning and Discharge-Planning (February 2013 OIG Report)
In its most recent report on nursing home payments and quality, February 2013, the Office of Inspector General (OIG), Department of Health and Human Services (HHS) reports that many skilled nursing facilities (SNFs) failed to provide adequate care … [Read more...] about Medicare Paid $5.1 Billion to SNFs that Did Not Provide Care-Planning and Discharge-Planning (February 2013 OIG Report)