On February 1, 2017, the Centers for Medicare & Medicaid Services (CMS) issued its draft 2018 Call Letter, an annual set of proposed rules, guidelines and clarifications for Part C Medicare Advantage (MA) and Part D plans that wish to participate … [Read more...] about CMS Releases Final 2018 Call Letter: Too Little for Consumers
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March, 2017 – Updates on Litigation, Health Reform, Observation Status & Other Issues
Welcome and Housekeeping (David Lipschutz, Moderator) Litigation Update (Ali Bers)Jimmo (Improvement standard) Barrows (formerly Bagnall) (Observation) Sherman (Lower level Medicare appeals) Other … [Read more...] about March, 2017 – Updates on Litigation, Health Reform, Observation Status & Other Issues
March 2017 – Updates on Litigation, Health Reform, Observation Status & Other Issues
LITIGATION UPDATEBarrows v. Price (formerly Bagnall v. Sebelius, Barrows v. Burwell), No. 3:11-cv-1703 (D. Conn.) (Observation Status). In November 2011, the Center for Medicare Advocacy and Justice in Aging filed a proposed class action … [Read more...] about March 2017 – Updates on Litigation, Health Reform, Observation Status & Other Issues
Center Comments on Draft 2018 Medicare Advantage Call Letter
March 3, 2017VIA ELECTRONIC SUBMISSION AdvanceNotice2018@cms.hhs.govCynthia G. Tudor, Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Baltimore, MD 21244Re: Advance … [Read more...] about Center Comments on Draft 2018 Medicare Advantage Call Letter
Look for the Moon!
Beginning no later than March 8, 2017, hospitals are required to give written and oral notice to Medicare patients when they are placed in “outpatient” observation status for 24 hours and are not formally admitted as inpatients.[1] The … [Read more...] about Look for the Moon!
Issue Brief: CMS Issues New Rules Governing Medicare Appeals
CMS recently finalized significant changes affecting Medicare appeals, particularly at the Administrative Law Judge (ALJ) level of review. These changes apply to appeals of payment and coverage determinations for items and services furnished to … [Read more...] about Issue Brief: CMS Issues New Rules Governing Medicare Appeals
January 2017 – The Fight to Protect ACA, Medicare and Medicaid & Other Issues
Welcome and Housekeeping (David Lipschutz, Moderator) The Fight to Protect the ACA, Medicare and Medicaid - Updates (David Lipschutz and Kata Kertesz) Affordable Care Act (ACA) Congressional … [Read more...] about January 2017 – The Fight to Protect ACA, Medicare and Medicaid & Other Issues
January 2017 – The Fight to Protect the ACA, Medicare and Medicaid & Other Issues
THE FIGHT TO PROTECT THE ACA, MEDICARE AND MEDICAIDThe President-Elect and Republican leaders in Congress have promised to repeal, and at some point, “replace” the Affordable Care Act. They also plan to gut the Medicaid program … [Read more...] about January 2017 – The Fight to Protect the ACA, Medicare and Medicaid & Other Issues
HHS Inspector General: Observation Status is a Growing Problem for Patients
HHS Inspector General: Observation Status is a Growing Problem for PatientsIn a new report, Vulnerabilities Remain Under Medicare’s 2-Midnight Hospital Policy,[1] the HHS Inspector General documents and confirms what Medicare beneficiaries … [Read more...] about HHS Inspector General: Observation Status is a Growing Problem for Patients
The Promise and Failure of Medicare Home Health Coverage
1.The ProblemThe Center for Medicare Advocacy has been hearing from people who meet Medicare coverage criteria but are unable to access Medicare-covered home health care, or the appropriate amount of care. These problems have been escalating in … [Read more...] about The Promise and Failure of Medicare Home Health Coverage