On April 6, 2012, the Centers for Medicare & Medicaid Services (CMS) issued Transmittal 17, which revises and creates new procedures for the review of quality of care concerns[1] by Quality Improvement Organizations (QIOs).[2] Effective May 7, … [Read more...] about New Procedures for Review of Quality of Care Complaints
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Making Sense of Medicare’s Preventive Service Benefits
September 20, 2012 With the Balanced Budget Act of 1997 (BBA1997), Congress began an expansion of preventive benefits and services available through Medicare.[1] The Medicare Modernization Act of 2003 (MMA) added additional preventive … [Read more...] about Making Sense of Medicare’s Preventive Service Benefits
Medicare Cost-Sharing for Qualified Medicare Beneficiaries
Balance Billing is Prohibited. Period. New Guidance released jointly by the Center for Medicaid and CHIP Services (CMCS) and the Medicare-Medicaid Coordination Office (MMCO) once again highlights and advises about an issue that has created … [Read more...] about Medicare Cost-Sharing for Qualified Medicare Beneficiaries
Federal Judge Refuses to Dismiss Medicare Beneficiaries’ Challenge to the Medicare “Improvement Standard”
Plaintiffs in a lawsuit filed by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of Medicare beneficiaries with long-term and chronic conditions have overcome a major hurdle. In a comprehensive 35-page decision, a federal judge … [Read more...] about Federal Judge Refuses to Dismiss Medicare Beneficiaries’ Challenge to the Medicare “Improvement Standard”
Why Medicaid Matters to Medicare Beneficiaries and Their Families
Medicare and Medicaid, which together serve over 95 million Americans,[1] are our two major national public programs offering secure and stable access to health care for beneficiaries, and peace of mind to the their families. Medicaid is under … [Read more...] about Why Medicaid Matters to Medicare Beneficiaries and Their Families
Help CMA Protect Medicare and Health Care
Donations from individuals like you help the Center for Medicare Advocacy fight on behalf of individuals across the country. We want to share a story with you about just one of those people. Mrs. B. has lived with multiple sclerosis for decades. She … [Read more...] about Help CMA Protect Medicare and Health Care
Concern over Skilled Nursing Facilities’ Upcoding Medicare Reimbursement Should Not Be Allowed to Deprive Residents of Necessary Care
Between 2006 and 2008, skilled nursing facilities (SNFs) increasingly billed for residents' care at higher-paying reimbursement categories (upcoding) under Medicare's prospective payment system. Medicare uses Resource Utilization Groups … [Read more...] about Concern over Skilled Nursing Facilities’ Upcoding Medicare Reimbursement Should Not Be Allowed to Deprive Residents of Necessary Care
Quick Medicare Facts & Statistics
"...Medicare has been a boon to the elderly and their children. Surveys show that beneficiaries are overwhelmingly satisfied with their care. Before Medicare, only 56 percent of the elderly had hospital insurance; the program has contributed to … [Read more...] about Quick Medicare Facts & Statistics
Lawsuit Filed to Block Illegal Denials of Services to Medicare Patients with Chronic Illness
For Immediate ReleaseJanuary 18, 2011Contact: Matt Shepard 860-456-7790 _____________________ Center for Medicare Advocacy Lead Counsel in National Class-Action Suit Burlington, VT − Today, The Center for Medicare Advocacy and co-counsel … [Read more...] about Lawsuit Filed to Block Illegal Denials of Services to Medicare Patients with Chronic Illness
New Medicare Home Health Regulations: Improvement is Not Required to Obtain Coverage
The Centers for Medicare & Medicaid Services (CMS) issued new regulations on November 17th regarding coverage for home health services. The new regulations clarify Medicare coverage for home health services, including physical therapy, … [Read more...] about New Medicare Home Health Regulations: Improvement is Not Required to Obtain Coverage