During the past year, the Center for Medicare Advocacy has received an alarming increase in complaints from Medicare Advantage enrollees who, despite requiring skilled nursing facility (“SNF”) care, receive Notices of Medicare Non-Coverage (“NOMNCs”) … [Read more...] about New from the Center: Form to Contest Multiple Medicare Denials Issued by Medicare Advantage Plans
Self Help Packet
The Jimmo v. Sebelius Settlement Agreement: An Issue Brief for Medicare Providers
January 2020 Download this Brief Table of Contents What is the Jimmo Settlement Agreement? Does Jimmo Apply to My Practice? What Does Jimmo Mean for My Patients? Are Providers Implementing Jimmo? How Do PDPM and … [Read more...] about The Jimmo v. Sebelius Settlement Agreement: An Issue Brief for Medicare Providers
Jimmo “Improvement Standard” Appeal Letter Template
[Date] [Attorney’s Name] [Address] Re: [Beneficiary’s Name], Medicare No. [XXXXX] To Whom It May Concern: I am writing on behalf of my client, [Full Name], to request an expedited reconsideration. The skilled nursing facility (SNF) … [Read more...] about Jimmo “Improvement Standard” Appeal Letter Template
Medicare Home Health Coverage Booklet
WHAT IS NEEDED TO QUALIFY FOR MEDICARE HOME HEALTH COVERAGE? The patient must be homebound. (This does not mean the patient can never leave home. For example, patients can leave home occasionally, go to adult day care, religious services, … [Read more...] about Medicare Home Health Coverage Booklet
Cobertura De Medicare Para Salud Domiciliaria
¿QUÉ SE NECESITA PARA CALIFICAR PARA COBERTURA DE SALUD DOMICILIARIA DE MEDICARE? El paciente debe ser confinado. (Esto no significa que el paciente nunca puede salir de su hogar. Por ejemplo, los pacientes pueden salir del hogar … [Read more...] about Cobertura De Medicare Para Salud Domiciliaria
Checklist for Medicare Nursing Home “Improvement Standard” Denials
With support from the John A. Hartford Foundation, the Center for Medicare Advocacy has produced a new Checklist to help Medicare beneficiaries and their families respond to unfair Medicare denials for skilled nursing facility care based on an … [Read more...] about Checklist for Medicare Nursing Home “Improvement Standard” Denials
Checklist for Medicare Home Health Care “Improvement Standard” Denials
With support from the John A. Hartford Foundation, the Center for Medicare Advocacy has produced a new Checklist to help Medicare beneficiaries and their families respond to unfair Medicare denials for home health care based on an erroneous … [Read more...] about Checklist for Medicare Home Health Care “Improvement Standard” Denials
Medicare Fully Informed Project
Providing Medicare Beneficiaries with Complete, Objective Information to Help Them Make the Best Enrollment Decision Updated for 2019 The Center for Medicare Advocacy and the National Committee to Preserve Social Security and Medicare have … [Read more...] about Medicare Fully Informed Project
Self-Help Packet for Ambulance Appeals
Introduction Checklist for Ambulance Appeals Quick Screen – Should My Ambulance Transport Be Covered By Medicare? Ambulance Transport Appeal Details Additional Information Glossary of Terms Medicare Regulations for Coverage … [Read more...] about Self-Help Packet for Ambulance Appeals
Self-Help Packet for Medicare “Observation Status”
Introduction How to Use This Packet Observation Status Self-Help Federal Regulations – Requirements for Medicare Coverage for Skilled Nursing Facility Care Pertinent Federal Regulations for Medicare … [Read more...] about Self-Help Packet for Medicare “Observation Status”