For many years, the Medicare Payment Advisory Commission (MedPAC) has reported that the Medicare program overpays skilled nursing facilities (SNFs) for rehabilitation services and underpays SNFs for certain residents needing specialized services and … [Read more...] about CMS Reins in Overpayments to Skilled Nursing Facilities
Search Results for: home health
CMA REPORT: MEDICARE COVERAGE FOR OFF-LABEL DRUG USE
September, 2010 While the Medicare prescription drug benefit provides assistance for many people with their drug costs, the requirements for coverage of the off-label use of a drug are onerous and often result in beneficiaries not being able to … [Read more...] about CMA REPORT: MEDICARE COVERAGE FOR OFF-LABEL DRUG USE
Extended Observation Stays in Acute Care Hospitals: Criticism, Legislation and Discussion
"Observation" is the term used to describe the outpatient status of a patient who is in a hospital, but not as an inpatient. Although the Medicare Manuals limit observation to 24-48 hours, many beneficiaries nationwide are experiencing extended stays … [Read more...] about Extended Observation Stays in Acute Care Hospitals: Criticism, Legislation and Discussion
Accountable Care Organizations Should Increase Care Coordination in Traditional Medicare
By January 1, 2012, the Secretary of Health and Human Services (the Secretary) must establish a Medicare Shared Savings Program (MSSP) that promotes accountability for a defined patient population, coordinates items and services under traditional … [Read more...] about Accountable Care Organizations Should Increase Care Coordination in Traditional Medicare
The Centers for Medicare & Medicaid Services Advises States About Medicare Savings Program Enrollment
Introduction Long-awaited guidance from the Centers for Medicare & Medicaid Services (CMS) concerning implementation of various provisions of the Medicare Improvements for Patients and Protections Act of 2008 (MIPPA), Pub. L. 110-275, was … [Read more...] about The Centers for Medicare & Medicaid Services Advises States About Medicare Savings Program Enrollment
Serious Deficiencies in Nursing Facilities are Understated and the Problem May Get Worse
Nursing facilities that choose to participate in the Medicare or Medicaid programs, or both, must undergo an annual survey to determine their compliance with federal standards of care, which are called Requirements of Participation.[1] Facilities … [Read more...] about Serious Deficiencies in Nursing Facilities are Understated and the Problem May Get Worse
Medicare for People with Chronic Conditions
People with chronic conditions and long-term illnesses are too often denied Medicare coverage on the grounds that they will not improve, need "maintenance services only," have "plateaued" or are "chronic and stable". Taken together, these reasons … [Read more...] about Medicare for People with Chronic Conditions
Part D And People Who Are “Medically Needy”
Warning: this Alert may cause headaches. Those readers who have ever roamed the Serbonian Bog[1] that is Medicaid will feel right at home. THE MEDICAID BOG The so-called Medically Needy - Medicare beneficiaries whose Medicaid eligibility depends on … [Read more...] about Part D And People Who Are “Medically Needy”
Medicare Coverage of Power Mobility Devices: Tips and Reminders
When it comes to obtaining Medicare coverage for Mobility Assistive Equipment (MAE),[1] coverage criteria, particularly patient assessment standards, continue to be misunderstood by providers and beneficiaries. The spectrum of fraud and abuse … [Read more...] about Medicare Coverage of Power Mobility Devices: Tips and Reminders
New Rules Offer Better Protection for Medicare Patients
Medicare patients who are hospitalized sometimes find themselves being told to leave the hospital too soon, before they can safely be cared for at home or at a nursing home.[1] The protections provided for hospital patients in this … [Read more...] about New Rules Offer Better Protection for Medicare Patients