The recent settlement of criminal and civil charges against Johnson & Johnson for off-label marketing of Risperdal for nursing home residents once again brings the issue of antipsychotic drugs and nursing homes to public attention. A group … [Read more...] about Misuse of Antipsychotic Drugs in Nursing Homes: Are We Making Any Progress?
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New CMS Proposed Homebound Policy Would Leave Medicare Beneficiaries Without Coverage
Medicare only covers home health care if, among other requirements, the beneficiary is homebound. As of November 19, 2013, the Centers for Medicare & Medicaid Services (CMS) will require new criteria for purposes of meeting the homebound … [Read more...] about New CMS Proposed Homebound Policy Would Leave Medicare Beneficiaries Without Coverage
Examining Inappropriate Use of Antipsychotic Drugs, Part Two: How Surveyors Describe How, When, and Why They Cite Antipsychotic Drug Deficiencies (Note: Nearly 200 pages)
Examining Inappropriate Use of Antipsychotic Drugs, a Report in three Parts, looks at antipsychotic drug use in skilled nursing facilities (SNFs) and nursing facilities (NFs) from two perspectives. First, it analyzes the antipsychotic drug … [Read more...] about Examining Inappropriate Use of Antipsychotic Drugs, Part Two: How Surveyors Describe How, When, and Why They Cite Antipsychotic Drug Deficiencies (Note: Nearly 200 pages)
October, 2013 – Medicare Annual Election Period, and the ACA Marketplace and Other Issues
Call-in Number: 1 (888) 206-2266 Pass Code: 9874704 NOTE: We ask people calling from the same location to gather around one telephone. This frees up lines and holds down costs. Please ensure your line is on MUTE for the duration of … [Read more...] about October, 2013 – Medicare Annual Election Period, and the ACA Marketplace and Other Issues
October, 2013 – Medicare Annual Election period, and the ACA Marketplaces and Other Issues
1. PRESENTATION: MEDICARE ANNUAL ELECTION PERIOD & THE MARKETPLACES Medicare Annual Coordinated Election Period (ACEP) – 10/15/13 – 12/7/13 During the Annual Coordinated Election Period (ACEP) people with … [Read more...] about October, 2013 – Medicare Annual Election period, and the ACA Marketplaces and Other Issues
Medicare Secondary Payer: Web Portal to Collect Data on Conditional Payment Amounts and Claims Detail
The Medicare Secondary Payer (MSP) program is designed to reduce costs to the Medicare program by requiring other insurers of health care for beneficiaries to pay primary to Medicare. It applies in three situations: where there is liability … [Read more...] about Medicare Secondary Payer: Web Portal to Collect Data on Conditional Payment Amounts and Claims Detail
Disappointing Decision from Court in Challenge to “Observation Status” Highlights Need to Pass Legislation
On September 23, a federal judge in Connecticut dismissed a lawsuit filed by the Center for Medicare Advocacy and the National Senior Citizens Law Center on behalf of Medicare beneficiaries who have been placed on "observation … [Read more...] about Disappointing Decision from Court in Challenge to “Observation Status” Highlights Need to Pass Legislation
Observation Status Round Up
While Observation Status continues, recent weeks have seen a great increase in awareness of the problem. In addition, support for legislation to end Observation Status has grown rapidly. What is Observation Status? Observation Status … [Read more...] about Observation Status Round Up
Observation Status: New Final Rules from CMS Do Not Help Medicare Beneficiaries
Effective October 1, 2013, new rules for inpatient hospital reimbursement under the Medicare program[1] make final two sets of proposed rules that the Centers for Medicare & Medicaid Services (CMS) published in the Spring 2013 – the … [Read more...] about Observation Status: New Final Rules from CMS Do Not Help Medicare Beneficiaries
Medicare’s National Mail Order Program for Diabetic Testing Supplies
On July 1, 2013, Medicare Part B will implement a national mail-order competitive bidding program specifically for diabetic testing supplies. [1],[2] The program applies to all zip codes in the 50 United States, the District of Columbia, Puerto … [Read more...] about Medicare’s National Mail Order Program for Diabetic Testing Supplies