In order for Medicare Part A to pay for a patient’s stay in a skilled nursing facility (SNF), the patient must first have spent at least three consecutive days as an inpatient in an acute care hospital.[1] For many Medicare beneficiaries, … [Read more...] about A Model to Waive the Three-Day Inpatient Hospital Stay Requirement for Care in a Skilled Nursing Facility
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July 2016 – Proposed Medicare Appeals Rules & Other Issues
PROPOSED RULE TO REVISE MEDICARE ADMINISTRATIVE APPEALS PROCESS As discussed during previous Alliance calls, there is a significant backlog of cases at the third and fourth levels of the Medicare administrative appeals process, the administrative … [Read more...] about July 2016 – Proposed Medicare Appeals Rules & Other Issues
July 2016 – Proposed Medicare Appeals Rule & Other Issues
NATIONAL MEDICARE ADVOCATES ALLIANCE CALL Monday, July 11th, 2016 – 2:00 P.M., Eastern Time Call-in Number: 1 (888) 206-2266 Pass Code: 9874704 NOTE: We ask people calling from the same location to gather around one … [Read more...] about July 2016 – Proposed Medicare Appeals Rule & Other Issues
ALS-MAP: Webinar 1 Q&A
Medicare Access Project for People Living With ALS Medicare Overview – With an Emphasis on the Home Health Care Benefit Frequently Asked Questions and Answers General Home Health Questions "Homebound" … [Read more...] about ALS-MAP: Webinar 1 Q&A
Center Comments on Proposed Changes to Physician Payments
June 27, 2016 Centers for Medicare & Medicaid Services Department of Health & Human Services Attention: CMS–5571–P P.O. Box 8013 Baltimore, MD 21244–8013 Submitted electronically to: www.regulations.gov … [Read more...] about Center Comments on Proposed Changes to Physician Payments
Exley v. Burwell: Fairness Hearing on Class Action Settlement about Delays in ALJ Appeals Rescheduled to August 1, 2016
As previously reported, a court preliminarily approved settlement in the case of Exley v. Burwell, 3:14-cv-1230 (JAM) (D. Conn.), in March of this year. Since then the government requested and the plaintiffs agreed to a revision in the proposed … [Read more...] about Exley v. Burwell: Fairness Hearing on Class Action Settlement about Delays in ALJ Appeals Rescheduled to August 1, 2016
Case Study: Enrolled In a Medicare Advantage Plan Without Her Knowledge Through “Seamless Conversion Enrollment”
October 21, 2016 - Update on Seamless Conversion: CMS is revisiting the seamless conversion enrollment policy and is temporarily suspending its acceptance of any new seamless enrollment proposals. Read more... Ms. M., a Medicare beneficiary … [Read more...] about Case Study: Enrolled In a Medicare Advantage Plan Without Her Knowledge Through “Seamless Conversion Enrollment”
Center Comments on Proposed Part B Payment Model
May 9, 2016 Centers for Medicare & Medicaid Services Department of Health & Human Services Attention: CMS–1670–P Mail Stop C4–26–05 7500 Security Boulevard Baltimore, MD 21244–1850 Submitted … [Read more...] about Center Comments on Proposed Part B Payment Model
Coverage for Medically Necessary Oral Health Care Is Unduly Restricted By Medicare’s Dental Policy
Medicare coverage for medically necessary oral health care is supported by the Medicare statute, its legislative history and, in some instances, even CMS policy. For this purpose, “medically necessary oral health care” refers to … [Read more...] about Coverage for Medically Necessary Oral Health Care Is Unduly Restricted By Medicare’s Dental Policy
May 2016 – Medicare’s Coverage of Oral Health & Other Issues
MEDICARE’S COVERAGE OF ORAL HEALTH Current Centers for Medicare & Medicaid Services (CMS) policy[1] broadly bars Medicare coverage for practically all dental services. The Center for Medicare Advocacy firmly believes that … [Read more...] about May 2016 – Medicare’s Coverage of Oral Health & Other Issues