Standard Appeals Process for Part A and Part B:1. RedeterminationNo minimum claim amount Must be filed within 120 days of receipt of "Initial Determination" Filed with Medicare Contractor Reviewed and decided by … [Read more...] about Appeal Steps
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October 2014 – The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) & Other Isues
1. LEGISLATIVE UPDATE: THE IMPACT ACT OF 2014On October 6, 2014, President Obama signed into law the “Improving Medicare Post-Acute Care Transformation Act of 2014” or IMPACT Act. The bill resulted from a bipartisan, … [Read more...] about October 2014 – The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) & Other Isues
August 2014 – Restructuring of Medicare’s Quality Improvement Organizations (QIO) & Other Issues
1. CHANGES TO MEDICARE’S QUALITY IMPROVEMENT ORGANIZATIONS (QIOs) CMS has restructured its Quality Improvement Organization (QIO) Program to separate the beneficiary complaint review functions from the quality improvement … [Read more...] about August 2014 – Restructuring of Medicare’s Quality Improvement Organizations (QIO) & Other Issues
Senior Policy Attorney Toby S. Edelman Testifies about Observation Status before Congress
Center for Medicare Advocacy Senior Policy Attorney Toby S. Edelman will testify before the House Ways and Means Health Subcommittee on Tuesday, May 20, 2014 at 9:30 AM regarding current hospital issues in the Medicare program, specifically the … [Read more...] about Senior Policy Attorney Toby S. Edelman Testifies about Observation Status before Congress
Multiple Sclerosis & Medicare
I have Multiple Sclerosis, but am under 65 years of age. Can I receive Medicare benefits? I have been told that my condition is stable. Can I still receive Medicare home health benefits? Can I receive Skilled Nursing Facility coverage … [Read more...] about Multiple Sclerosis & Medicare
December 2013 – Improvement Standard Update: CMS Issues Manual Provisions Pursuant to Jimmo, and Other Issues
1. PRESENTATION: CMS MANUAL PROVISIONS ISSUED PURSUANT TO THE JIMMO SETTLEMENTThe Center for Medicare Advocacy is pleased to announce that the Medicare Policy Manuals have been revised pursuant to the Jimmo vs. Sebelius Settlement. … [Read more...] about December 2013 – Improvement Standard Update: CMS Issues Manual Provisions Pursuant to Jimmo, and Other Issues
Three Observation Status Bills Have Been Introduced; Only Congressman Courtney’s Has Immediate Promise
>Hospitals' increasing use of observation status harms more Medicare beneficiaries daily as patients hospitalized for multiple days are denied coverage of subsequent care in a skilled nursing facility because their time in the hospital was … [Read more...] about Three Observation Status Bills Have Been Introduced; Only Congressman Courtney’s Has Immediate Promise
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
CMA to Congress about Medicare Proposals: Protect Beneficiaries, Improve Access to Care
Post-Acute CarePost-acute care refers to a range of services that support the individual’s continued recovery from illness or injury, or management of a chronic illness or disability. On June 19, 2013 the House Ways and Means … [Read more...] about CMA to Congress about Medicare Proposals: Protect Beneficiaries, Improve Access to Care
Comments on Post Acute Care (PAC) Reform Proposals
August 19, 2013Senate Finance Committee House of Representatives, Committee on Ways and Means United States CongressSubmitted electronically to: postacutecarereform@finance.senate.gov and postacutecarereform@mail.house.govRe: Comments … [Read more...] about Comments on Post Acute Care (PAC) Reform Proposals