The recent settlement of criminal and civil charges against Johnson & Johnson for off-label marketing of Risperdal for nursing home residents once again brings the issue of antipsychotic drugs and nursing homes to public attention. A group … [Read more...] about Misuse of Antipsychotic Drugs in Nursing Homes: Are We Making Any Progress?
Weekly Alert
New CMS Proposed Homebound Policy Would Leave Medicare Beneficiaries Without Coverage
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
New CMS Rules Do NOT Change Requirement for 3-Day Qualifying Inpatient Hospital Stay
The Center for Medicare Advocacy has heard that some Medicare beneficiaries believe that new federal rules authorize Medicare to pay for their nursing home care if they are inpatients in a hospital for two midnights. This belief is NOT … [Read more...] about New CMS Rules Do NOT Change Requirement for 3-Day Qualifying Inpatient Hospital Stay
New Report: Expanded Dental Coverage Needed to Confront Health Crisis
As policymakers consider proposals to slash successful community programs including Medicare and Medicaid, older Americans and their families continue to face barriers to necessary health care, including access to dental coverage and services. A new … [Read more...] about New Report: Expanded Dental Coverage Needed to Confront Health Crisis
The Health Care Reform Marketplace is NOT for People with Medicare!
Beware of Scammers Trying to Sell Marketplace Plans to People with Medicare The Health Insurance Marketplace, created by the Affordable Care Act (ACA), opened for business on October 1, 2013. Uninsured people can shop for and purchase health … [Read more...] about The Health Care Reform Marketplace is NOT for People with Medicare!
The Medicare Annual Coordinated Election Period Has Begun!
During the Annual Coordinated Election Period, which runs from October 15th through December 7th, people with Medicare can change their choice of health coverage (whether they receive that coverage through a private Medicare Advantage plan or … [Read more...] about The Medicare Annual Coordinated Election Period Has Begun!
Caution: Home Health Episode Payment Caps
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
United Healthcare Dramatically Reducing CT Medicare Advantage Plans – Check in YOUR State
For 2014, United Healthcare (UHC) is cutting 2,250 doctors from its Connecticut Medicare Advantage (MA) network. UHC is also closing one of its MA plans in New Haven County that serves 2,900 people and taking similar actions in other states. … [Read more...] about United Healthcare Dramatically Reducing CT Medicare Advantage Plans – Check in YOUR State
Health Insurance Marketplaces Open – What Does it Mean for You?
On October 1, 2013, online health insurance Marketplaces opened in every state. These Marketplaces, which are a central feature of the Affordable Care Act (ACA), allow uninsured Americans to shop for and purchase health insurance. The Marketplaces … [Read more...] about Health Insurance Marketplaces Open – What Does it Mean for You?
Medicare Secondary Payer: Web Portal to Collect Data on Conditional Payment Amounts and Claims Detail
The Medicare Secondary Payer (MSP) program is designed to reduce costs to the Medicare program by requiring other insurers of health care for beneficiaries to pay primary to Medicare. It applies in three situations: where there is liability … [Read more...] about Medicare Secondary Payer: Web Portal to Collect Data on Conditional Payment Amounts and Claims Detail