Medicare's limitation on liability (LOL) protections[1] apply when a provider believes that an otherwise covered Medicare item or service will be denied because the item or service is not reasonable and necessary[2] or is for custodial care.[3] … [Read more...] about The Medicare Advance Beneficiary Notice of Non-Coverage (ABN): A Tool for Limiting Beneficiary Liability
Medicare Summary
2012 Medicare Premiums, Deductibles and Co-Pays
On October 27, 2011 the Centers for Medicare and Medicaid Service (CMS) released notices detailing the Medicare Part A and Part B premiums and Deductibles for calendar year 2012. Hospital Deductible: $1,156 per spell of illness Hospital … [Read more...] about 2012 Medicare Premiums, Deductibles and Co-Pays
Annual Enrollment Starts October 15 and Ends December 7 for Medicare Part C & Part D Plans
Fall is the time for Medicare beneficiaries to explore their options regarding Part D prescription drug and Part C Medicare Advantage plans. In years past, the annual enrollment period began in mid-November and lasted to the end of the year, … [Read more...] about Annual Enrollment Starts October 15 and Ends December 7 for Medicare Part C & Part D Plans
2011 Medicare Trustees Report
The Medicare Trustees issued their annual report on Medicare's financial status on Friday, May 13, 2011. According to this year's report, the Hospital Insurance (HI) Trust Fund has sufficient reserves to pay out the full amount of … [Read more...] about 2011 Medicare Trustees Report
Send Us Medicare Summary Notices (MSNs)
The Center is concerned about the use of MSNs that do not reveal to beneficiaries that their service was denied based on a National Coverage Determination. Such an MSN will instead provide a misleading explanation, such as "Medicare does … [Read more...] about Send Us Medicare Summary Notices (MSNs)
Quick Medicare Facts & Statistics
"...Medicare has been a boon to the elderly and their children. Surveys show that beneficiaries are overwhelmingly satisfied with their care. Before Medicare, only 56 percent of the elderly had hospital insurance; the program has contributed to … [Read more...] about Quick Medicare Facts & Statistics
Medicare Annual Enrollment Period Started November 15, 2010: Time to Review Coverage Options
The Annual Coordinated Election Period for Medicare Advantage and Medicare Part D drug coverage started November 15, 2010 and goes through December 31, 2010. During this period, Medicare beneficiaries who do not have a Part D plan can enroll in one, … [Read more...] about Medicare Annual Enrollment Period Started November 15, 2010: Time to Review Coverage Options
2011 Medicare Cost Sharing Details
On November 9, 2010, the Centers for Medicare and Medicaid Service (CMS) released three notices detailing the Medicare Part A and Part B premiums and Deductibles for calendar year 2011. See, 75 Fed. Reg. 68790-68802 (Nov. 9, 2010). Advocates need to … [Read more...] about 2011 Medicare Cost Sharing Details
CMS Issues Final Rules for Medicare Appeals
On December 9, 2009, the Centers for Medicare & Medicaid Services (CMS) issued final regulations for the Medicare Claims Appeals Process (Parts A & B combined) and for the application of certain appeals provisions to the Medicare prescription … [Read more...] about CMS Issues Final Rules for Medicare Appeals