Based on recent experience, the Center for Medicare Advocacy provides this Practice Tip for providers and advocates for patients who need to change from an improvement mode to maintenance mode for nursing or therapy.The Center is seeing decisions … [Read more...] about Practice Tip: Orders Needed for Maintenance Skilled Care
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GAO Issues Report Concerning CMS Oversight of Medicare Advantage Provider Network Adequacy
This week, the General Accounting Office (GAO) issued a report entitled “Medicare Advantage: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy” (August 2015, publicly released September 28, 2015). This report … [Read more...] about GAO Issues Report Concerning CMS Oversight of Medicare Advantage Provider Network Adequacy
CMS Reopens Public Comment Period for Proposed Revisions to the Nursing Home Requirements of Participation
On July 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published proposed rules to revise the nursing home Requirements of Participation (RoPs) – the federal rules that govern the standards of care that facilities must meet in … [Read more...] about CMS Reopens Public Comment Period for Proposed Revisions to the Nursing Home Requirements of Participation
CMA Comments re: Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model
September 15, 2015Submitted electronicallySheila Hanley Director, Policy and Programs Group Center for Medicare & Medicaid Innovation Centers for Medicare & Medicaid Services HealthPlanInnovation@cms.hhs.govRE: Medicare … [Read more...] about CMA Comments re: Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model
Center Comments on Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016
September 8, 2015Andy Slavitt, Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1631-P P.O. Box 8016 Baltimore, MD 21244-8016Delivered Electronically through … [Read more...] about Center Comments on Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016
September 2015 – Proposed Rules for Nursing Facilities are Inadequate & Other Issues
ADMINISTRATIVE UPDATE1. Proposed Requirements of Participation for Nursing FacilitiesOn July 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published proposed rules to revise the nursing home Requirements of Participation … [Read more...] about September 2015 – Proposed Rules for Nursing Facilities are Inadequate & Other Issues
Better Medicare Coverage of Speech Generating Devices
Over the past week, problems with Medicare coverage of Speech Generating Devices (SGDs) have been favorably addressed through both final Administrative and Congressional action.Prior to these actions, Medicare only covered SGDs to generate … [Read more...] about Better Medicare Coverage of Speech Generating Devices
41. Medicare’s Appeals Process Is an Important Beneficiary Protection that Must Be Fixed
One of the most fundamental rights set out in the Constitution is the right to due process of law when government action harms an individual. “Due process” means both notice and an opportunity to be heard. In other words, individuals are … [Read more...] about 41. Medicare’s Appeals Process Is an Important Beneficiary Protection that Must Be Fixed
38. Medicare Makes Hard Things a Bit Easier
By Jenny Gore Dwyer, Washington StateIn 2005 my husband was diagnosed with ALS. ALS is also known as Lou Gehrig's disease...or "the Ice Bucket Challenge" disease...remember last August when everyone was dumping ice over their heads? … [Read more...] about 38. Medicare Makes Hard Things a Bit Easier
Observation Status: Virginia Requires Hospitals to Notify Patients of their Observation Status
Effective July 1, 2015, Virginia has become the fifth state to enact legislation requiring hospitals to inform patients when they are in Observation or other outpatient status, and the consequences of not being admitted as inpatients. Senate … [Read more...] about Observation Status: Virginia Requires Hospitals to Notify Patients of their Observation Status