The Center for Medicare Advocacy and Justice in Aging invite organizations to sign on to a comment letter responding to CMS’s proposed rule implementing appeal rights for Medicare beneficiaries who are admitted to hospitals as inpatients and … [Read more...] about Organizational Sign-On Letter Commenting on Proposed Rule on Observation Status Appeals
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When Should Medicare Coverage be Available for Home Health Care?
Home health care can be covered by Medicare if it meets the following criteria:Medicare Coverable Home Health ServicesIf the triggering conditions described above are met, the beneficiary is eligible for Medicare coverage of home health … [Read more...] about When Should Medicare Coverage be Available for Home Health Care?
Know Jimmo | Home Health Policy
Medicare Benefit Policy Manual, Chapter 7 – Home Health ServicesSection 20.1.2Coverage of skilled nursing or therapy to perform a maintenance program does not turn on the presence or absence of a patient’s potential for improvement from the … [Read more...] about Know Jimmo | Home Health Policy
Medicare Program Proposes to Increase Medicare Advantage Payment for 2025
On January 31, the Centers for Medicare & Medicaid Services (CMS) released an Advance Rate Notice proposing an overall pay increase to MA plans of 3.7% in 2025 (see CMS fact sheet here). According to CMS, “This is over a $16 billion increase in … [Read more...] about Medicare Program Proposes to Increase Medicare Advantage Payment for 2025
When Should Medicare Coverage be Available for Outpatient Therapy?
Physical, speech-language pathology, and occupational therapies can be covered by Medicare Part B if they meet the following criteria:Other Important Points: … [Read more...] about When Should Medicare Coverage be Available for Outpatient Therapy?
Know Jimmo | The Medicare Policy Manual
Outpatient Maintenance Physical Therapy, Occupational Therapy and Speech Language Pathology Services (Medicare Benefit Policy Manual Ch. 5, §220.2D)Outpatient Physical Therapy, Occupational Therapy and Speech Language Pathology Services “may be … [Read more...] about Know Jimmo | The Medicare Policy Manual
Issue Brief on Substance Use Disorder Treatment for Duals Released
The Legal Action Center recently released an issue brief, “Two Plans Are Not Always Better Than One: Barriers to Substance Use Disorder Treatment for Dual-Eligible Individuals,” that identifies the unique barriers to substance use disorder treatment … [Read more...] about Issue Brief on Substance Use Disorder Treatment for Duals Released
2024 Federal Poverty Guidelines Released
The Department of Health and Human Services (HHS) updates the poverty guidelines at least annually, with new guidelines published recently. The new guidelines are available here: Federal Register :: Annual Update of the HHS Poverty … [Read more...] about 2024 Federal Poverty Guidelines Released
Studies Show Nursing Home Closures Have Declined
Although the nursing home trade associations argue that inadequate reimbursement and a lack of people to hire have led to closures of nursing homes and that closures will become an even greater problem if the Centers for Medicare & Medicaid … [Read more...] about Studies Show Nursing Home Closures Have Declined
Know Jimmo | Right from the Medicare Agency
The Centers for Medicare & Medicaid Services (CMS) reminds the Medicare community of the Jimmo Settlement Agreement (January 2013), which clarified that the Medicare program covers skilled nursing care and skilled therapy services under … [Read more...] about Know Jimmo | Right from the Medicare Agency