Introduction Checklist for Skilled Nursing Facility (SNF) Appeals Quick Screen: Should My SNF Care Be Covered By Medicare? Skilled Nursing Facility Appeal Details Additional Information The “Improvement Standard” … [Read more...] about Self-Help Packet for Skilled Nursing Facility Appeals Including “Improvement Standard” Denials
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Advocacy Tips: Medicare Administrative Law Judge (ALJ) Hearing Process
1. First Steps Review the Center for Medicare Advocacy’s Self-help Packets and coverage guidelines regarding the particular level of care involved in the appeal at: … [Read more...] about Advocacy Tips: Medicare Administrative Law Judge (ALJ) Hearing Process
Expedited v. Standard Medicare Appeals: Not Knowing the Difference Could Cost You Your Appeal Rights!
Here’s the Issue Expedited Medicare appeals and standard Medicare appeals are designed to address different things and there are situations where a Medicare beneficiary must pursue both types of appeals. Expedited Appeals – … [Read more...] about Expedited v. Standard Medicare Appeals: Not Knowing the Difference Could Cost You Your Appeal Rights!
CT Medicare Home Health TPL Project Year Five Instruction Packet
For Services Provided From: May 1, 2012 through October 31, 2012 The individuals identified on the attached list (Form A) were eligible for both the state Medicaid program and the federal Medicare program during the period described … [Read more...] about CT Medicare Home Health TPL Project Year Five Instruction Packet
Comments on Improvement Standard Settlement Due January 10, 2013
This Notice to Class of Proposed Settlement of Class Action and of Fairness Hearing describes the proposed settlement in the Improvement Standard case. If you wish to object to the settlement, you must do so in writing via letter or card … [Read more...] about Comments on Improvement Standard Settlement Due January 10, 2013
Special Report – Independence of Medicare Administrative Law Judges Threatened by Office of Inspector General’s Recommendations
In November, the Office of Inspector General (OIG) issued a report entitled, "Improvements are Needed at the Administrative Law Judge Level of Medicare Appeals." The report can be found at … [Read more...] about Special Report – Independence of Medicare Administrative Law Judges Threatened by Office of Inspector General’s Recommendations
October 2012 – Updates on Medicare Appeals and Complaints
National Medicare Advocates Alliance Issue brief #18 1. PRESENTATIONS ADMINISTRATIVE REVIEW PROCESS: LITTLE SUCCESS, LONG DELAYS Based upon the Center’s extensive experience with the Medicare administrative appeals … [Read more...] about October 2012 – Updates on Medicare Appeals and Complaints
New Procedures for Review of Quality of Care Complaints
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
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
August, 2012 – Medicare and ACA Messaging: Fighting Fiction with Facts
NATIONAL MEDICARE ADVOCATES ALLIANCE CALL Monday, August 13, 2012 – 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 August, 2012 – Medicare and ACA Messaging: Fighting Fiction with Facts