In the annual update to Medicare reimbursement of acute care hospitals for outpatient care (July 8, 2015) the Centers for Medicare & Medicaid Services (CMS) includes proposed revisions to the “Two-Midnight Rule” and its … [Read more...] about Proposed Revisions to “Two-Midnight” Rule Provide Little, If Any, Relief for Medicare Beneficiaries Stuck in the Hospital in Observation Status
Advancing Access to Medicare and Necessary Care for People with Long-Term Conditions and Injuries With support from the John A. Hartford Foundation the Center for Medicare Advocacy has created a multi-disciplinary Jimmo Implementation Council. … [Read more...] about The Jimmo Implementation Council
1. Comments to Senate Finance Committee Chronic Care Workgroup On June 22, 2015, the Center for Medicare Advocacy submitted comments to the Senate Finance Committee Chronic Care Workgroup in response to the Committee’s May 22, 2015 request … [Read more...] about Center for Medicare Advocacy Submits Comments to Senate Finance Committee and CMS Regarding Important Health Care Proposals
In September 2006, the nursing home industry announced a voluntary quality improvement campaign – Advancing Excellence in America’s Nursing Homes. The campaign, now in its ninth year and third phase, describes its mission: “to make nursing homes … [Read more...] about Advancing Excellence: Very Few Nursing Homes are “Full Active Participants” and Nearly Half of Them Provide Poor Care
Part B of Medicare will generally cover up to 80% of emergent and non-emergent ambulance transports when medically necessary and when transport by any other means could endanger your health. There are also origin/destination requirements; … [Read more...] about Non-Emergent Ambulance Transport: Don’t Lose Out on Coverage
Fast-food workers have been demonstrating for a higher minimum wage and recently, various corporations have increased the wages of their lowest-paid workers. Has the movement come to the health care industry? On May 22, 2015, the … [Read more...] about Is the Movement for a Higher Minimum Wage Coming to Health Care?
As we’ve previously reported, on April 28, 2015 the Senate Finance Committee held a hearing about the tremendous backlog of cases piled up at the Office of Medicare Hearings and Appeals (OMHA), the office that oversees Administrative Law Judges … [Read more...] about Senate Finance Committee Approves Medicare Audit and Appeal Reform Bill
Government contractors administering Medicare benefits are routinely denying coverage to cancer patients for claims involving the surgical removal of decayed and infected teeth caused by an aggressive course of radiation treatment to the head and … [Read more...] about The Medicare Dental Exclusion: Is it Being Used to Deny Vulnerable Beneficiaries Needed Care?
This CMA Alert highlights a recent individual ALJ decision that sets out an important but often unrecognized beneficiary right to a written notice when he or she is about to use hospital “Lifetime Reserve Days.” A hospital’s … [Read more...] about Saga of an Inpatient Hospital Appeal: Notice and Use of Lifetime Reserve Days and Comments on Observation Status
The traditional Medicare program pays individual health care providers for the specific services and care they provide to beneficiaries and guarantees that patients have “freedom of choice” to select their Medicare providers. A … [Read more...] about Bundling Payments for Post-Acute Care