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Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

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Appeal Tips

Practice Tip: Office of Medicare Hearings and Appeals Manual Can Be a Useful Tool

February 14, 2019

The Office of Medicare Hearings and Appeals (OMHA) is the agency that administers the Administrative Law Judge (ALJ) hearing program for Medicare Parts A, B, C and D appeals. OMHA has a Case Processing Manual that sets out day-to-day procedures for … [Read more...] about Practice Tip: Office of Medicare Hearings and Appeals Manual Can Be a Useful Tool

Filed Under: Article Tagged With: alert, Appeal Tips, Coverage & Appeals, Weekly Alert

Checklist for Medicare Nursing Home “Improvement Standard” Denials

October 25, 2018

With support from the John A. Hartford Foundation, the Center for Medicare Advocacy has produced a new Checklist to help Medicare beneficiaries and their families respond to unfair Medicare denials for skilled nursing facility care based on an … [Read more...] about Checklist for Medicare Nursing Home “Improvement Standard” Denials

Filed Under: Article, fact-sheet, Self Help Packet Tagged With: alert, Appeal Tips, Jimmo-practice-tip, Skilled Nursing Facility, snf, The Improvement Standard, Weekly Alert

Checklist for Medicare Home Health Care “Improvement Standard” Denials

October 18, 2018

With support from the John A. Hartford Foundation, the Center for Medicare Advocacy has produced a new Checklist to help Medicare beneficiaries and their families respond to unfair Medicare denials for home health care based on an erroneous … [Read more...] about Checklist for Medicare Home Health Care “Improvement Standard” Denials

Filed Under: Article, fact-sheet, Self Help Packet Tagged With: alert, Appeal Tips, Home Health, Jimmo-practice-tip, The Improvement Standard, Weekly Alert

Self-Help Packet for Ambulance Appeals

January 14, 2015

Introduction Checklist for Ambulance Appeals Quick Screen – Should My Ambulance Transport Be Covered By Medicare? Ambulance Transport Appeal Details Additional Information Glossary of Terms Medicare Regulations for Coverage … [Read more...] about Self-Help Packet for Ambulance Appeals

Filed Under: Self Help Packet Tagged With: Appeal Tips

Self-Help Packet for Medicare “Observation Status”

August 5, 2014

Introduction How to Use This Packet Observation Status Self-Help Federal Regulations – Requirements for Medicare Coverage for Skilled Nursing Facility Care Pertinent Federal Regulations for Medicare … [Read more...] about Self-Help Packet for Medicare “Observation Status”

Filed Under: Self Help Packet Tagged With: Appeal Tips

Self-Help Packet for Outpatient Therapy Denials Including “Improvement Standard” Denials

April 1, 2014

Introduction Checklist for Outpatient Therapy Discharges Checklist for Outpatient Therapy Appeals Quick Screen: Medicare Coverage for Outpatient Therapy Outpatient Therapy Appeal Details   Additional Information 1. … [Read more...] about Self-Help Packet for Outpatient Therapy Denials Including “Improvement Standard” Denials

Filed Under: Self Help Packet Tagged With: Appeal Tips, Medicare Part B

Self-Help Packet for Home Health Care Appeals Including “Improvement Standard” Denials

February 22, 2013

Introduction Checklist for Home Health Appeals Quick Screen: Should My Home Health Care Be Covered By Medicare? Home Health Appeal Details Additional Information The “Improvement Standard” Myth and Home Health … [Read more...] about Self-Help Packet for Home Health Care Appeals Including “Improvement Standard” Denials

Filed Under: Self Help Packet Tagged With: Appeal Tips, Home Health, The Improvement Standard

Self-Help Packet for Hospital Discharge

February 22, 2013

Introduction Hospital Discharge Checklist Hospital Coverage Quick Screen Hospital Discharge Rights & Action Steps Glossary of Terms Federal Regulations Introduction The Center for Medicare Advocacy produced this packet to … [Read more...] about Self-Help Packet for Hospital Discharge

Filed Under: Self Help Packet Tagged With: Appeal Tips

Self-Help Packet for Skilled Nursing Facility Appeals Including “Improvement Standard” Denials

February 12, 2013

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

Filed Under: Self Help Packet Tagged With: Appeal Tips

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The Center for Medicare Advocacy produces a range of informative materials on Medicare-related topics. Check them out:

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Jimmo v. Sebelius

Medicare covers skilled care to maintain or slow decline as well as to improve.

Improvement Isn’t Required. It’s the law!

Read more.

Medicare: Build Back Better

By prioritizing Medicare beneficiaries and the health systems that serve them, we can avoid drastic national consequences. The Center for Medicare Advocacy proposes a five-part plan that will make Medicare a bulwark against the worsening health and economic challenges facing the American people.

learn more.

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