Introduction to Medicare Part D This section constitutes an introduction to Part D. For more detailed information on any of the topics in this section, please click on the links within the topics. There, you will also find relevant legislative, … [Read more...] about Part D / Prescription Drug Benefits
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Part B
What items or services are covered by Medicare Part B? Are routine physical exams covered under the Medicare Part B benefit? What does it mean if my doctor "accepts assignment?" Does Medicare Part B pay for the entire cost of Part B … [Read more...] about Part B
Discharge Planning
Rights and Procedures for Medicare Beneficiaries in Various Care Settings What does "Discharge Planning" plan for? What is the hospital supposed to do to prepare me for discharge? How do I get notified? How can I argue being … [Read more...] about Discharge Planning
Medicare Coverage & Appeals
For other information, follow one of the links below or scroll down the page. Generally, coverage is available when services are medically reasonable and necessary for treatment or diagnosis of illness or injury. Part A … [Read more...] about Medicare Coverage & Appeals
Off-Label Drug Use Is Common and Hurts Nursing Home Residents
Introduction The three-year old, and still ongoing, investigation and criminal prosecution of former staff members of a California skilled nursing facility for improper use of antipsychotic drugs on residents raises issues that go far beyond the … [Read more...] about Off-Label Drug Use Is Common and Hurts Nursing Home Residents
Nursing Home Residents’ Access to Physicians and Pain Medication
Whether federal law and policies are preventing nursing home residents from getting the pain medications they need has become a major concern. In May 2009, the Milwaukee Office of the Drug Enforcement Administration (DEA) received a tip that … [Read more...] about Nursing Home Residents’ Access to Physicians and Pain Medication
CMS Issues Final Rules for Medicare Appeals
On December 9, 2009, the Centers for Medicare & Medicaid Services (CMS) issued final regulations for the Medicare Claims Appeals Process (Parts A & B combined) and for the application of certain appeals provisions to the Medicare … [Read more...] about CMS Issues Final Rules for Medicare Appeals
CMS Issues Final Rules for Medicare Appeals
On December 9, 2009, the Centers for Medicare & Medicaid Services (CMS) issued final regulations for the Medicare Claims Appeals Process (Parts A & B combined) and for the application of certain appeals provisions to the Medicare prescription … [Read more...] about CMS Issues Final Rules for Medicare Appeals
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 Discharge Planning: Think Through Your Needs
Introduction Discharge planning[1] is an important tool for reviewing and making arrangements for on-going healthcare needs across healthcare settings, including hospitals, skilled nursing facilities, home health, or hospice. When focusing on … [Read more...] about Medicare Discharge Planning: Think Through Your Needs