LITIGATION UPDATERecent Litigation VictoriesBagnall v. Sebelius (Observation Status) No. 3:11-cv-01703 (D. Conn., filed 11/3/2011). In November 2011, the Center for Medicare Advocacy and the National Senior Citizens Law Center filed … [Read more...] about February 2015 – Live to Fight Another Day: Bagnall, Lessler & Other Issues
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50 Insights for Medicare’s 50th Anniversary
As part of our recognition of Medicare’s first 50 years, this week begins our Medicare Matters: 50 Insights for Medicare’s 50th Anniversary. Help us spread the word – on Twitter, Facebook – in … [Read more...] about 50 Insights for Medicare’s 50th Anniversary
December 2014 – The Year Ahead & Other Issues
LEGISLATIVE UPDATEThe Year Ahead1. Legislative & Budget Landscape in a New CongressIn the 114th Congress staring in January 2015, Republicans will control both the House of Representatives and the Senate. What will this … [Read more...] about December 2014 – The Year Ahead & Other Issues
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
Delivery and Set-Up Guidelines for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
The Centers for Medicare & Medicaid Services (CMS) is charged with the implementation and oversight of the DMEPOS program.[1] Since the rollout of the DMEPOS competitive bidding program (CBP) in July, 2008, there has been confusion over … [Read more...] about Delivery and Set-Up Guidelines for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
Durable Medical Equipment (DME)
Quick Guide to Identify Coverable ItemsMedicare claims for DME (Items that have a medical purpose and repeated use) are suitable for coverage, and appeal if they have been denied, if they meet the following criteria:ADDITIONAL … [Read more...] about Durable Medical Equipment (DME)
June 2014 – Losing Your Voice: Medicare Coverage of Speech Generating Devices During Part A Stays & Other Issues
1. MEDICARE’S COVERAGE OF CAPPED RENTAL ITEMS DURING PART A INSTITUTIONAL STAYS: LOSING ACCESS TO SPEECH GENERATING DEVICES (SGDs)CMS Changes Its Coverage of Speech Generating DevicesThrough a new interpretation of longstanding … [Read more...] about June 2014 – Losing Your Voice: Medicare Coverage of Speech Generating Devices During Part A Stays & Other Issues
CMA Community News – May 2014
A Word from the Executive DirectorAs you will see in this issue, Center staffers have been busy this month testifying before Congress and meeting with lawmakers and policy leaders to educate them about issues affecting access to health care for … [Read more...] about CMA Community News – May 2014
April, 2014 – Ongoing Medicare Appeal Concerns & Other Issues
1. LITIGATION UPDATESJimmo v. Sebelius (Improvement Standard) No. 11-cv-17 (D.Vt. filed 1/18/11). As reported during previous Alliance calls, the Settlement in Jimmo was approved on January 24, 2013 during a scheduled fairness … [Read more...] about April, 2014 – Ongoing Medicare Appeal Concerns & Other Issues