The Center for Medicare Advocacy received an e-mail inquiry from an individual requesting assistance advocating for her sister, Mrs. B. Mrs. B is a Medicare beneficiary enrolled in a Medicare Advantage plan and in need of home health … [Read more...] about Case Study: Home Health Coverage and Medicare Advantage Plan Responsibilities
Medicare only covers home health care if, among other requirements, the beneficiary is homebound. As of November 19, 2013, the Centers for Medicare & Medicaid Services (CMS) will require new criteria for purposes of meeting the homebound … [Read more...] about New CMS Proposed Homebound Policy Would Leave Medicare Beneficiaries Without Coverage
Legislation was introduced on October 4th that could lead to a cap on the home health services available to a Medicare beneficiary. In the midst of a government shutdown, Representatives Matheson (D-Utah) and Guthrie (R-Kentucky) introduced the … [Read more...] about Caution: Home Health Episode Payment Caps
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
One of the deficit reduction proposals being discussed to achieve savings from Medicare is to introduce new cost-sharing for home health care. As a means to ward off such potential home health co-payments, some instead suggest capping Medicare … [Read more...] about Warning: Medicare Payment Limits Are Bad for Health!
The Center for Medicare Advocacy has represented Medicare beneficiaries since 1986. As one of the few advocacy organizations in the nation solely serving Medicare beneficiaries, we strongly oppose home health episodic payment caps or any other such … [Read more...] about Annual Medicare Payment Limits for Home Health – Even Worse Than Co-Pays for Beneficiaries
One of our clients, Mrs. Brown, who has been living alone with Multiple Sclerosis and various related health problems since 1986. She is declining. Currently, she is essentially bed bound and has to rely on assistance from at least one other person … [Read more...] about A Client Profile