Guidance released recently by the Centers for Medicare & Medicaid Services (CMS) sheds new light on an issue that has created hardships for beneficiaries and challenges for advocates trying to help them. The guidance addresses two issues: balance … [Read more...] about Medicare Cost-Sharing for Dual Eligibles: Who Pays What for Whom?
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Illegal “Improvement Standard” for SNF Coverage Terminated
Over the years, contractors that review Medicare claims have denied coverage for Medicare services inappropriately on the grounds that the beneficiary's condition will not improve. The Center for Medicare Advocacy, through individual appeals and … [Read more...] about Illegal “Improvement Standard” for SNF Coverage Terminated