Medicare-covered outpatient physical, speech and occupational therapy services are subject to an annual dollar-amount payment cap. As a result, many Medicare beneficiaries have their therapy terminate prematurely when they reach the cap. … [Read more...] about Medicare Therapy Caps: A Call for Repeal
Hospice is a program of care and support for people who are terminally ill. To qualify for Medicare hospice coverage, a doctor certifies that a person is terminally ill, with an expectation of six months or less to live. Once a person … [Read more...] about Medicare Hospice Care: We Want Your Stories!
As of December 6, 2013, Centers for Medicare & Medicaid Services (CMS) Policy manuals have been updated to reflect the settlement in Jimmo vs. Sebelius, No.11-cv-17 (D.VT, January 24, 2013). The manuals now make it clear that improvement is … [Read more...] about Medicare Policy Manuals Revised as Required by Jimmo Settlement
The Center for Medicare Advocacy (the Center) has reported on the misuse of antipsychotic drugs by nursing homes for many years, discussing Congressional hearings and federal reports and the high personal and financial cost of the misuse of the … [Read more...] about CMA Report on Inappropriate Use of Antipsychotic Drugs in Nursing Homes – Part Two: What the Surveyors Say
Overview The current Medicare physician payment formula, known as the "Sustainable Growth Rate" (SGR), was designed to control the growth in aggregate Medicare expenditures for physicians' services. If … [Read more...] about Replacing the Broken Medicare Physician Payment Formula: At What Cost for People with Medicare?
Media reports over the past several years have suggested that Medicare beneficiaries have trouble finding doctors who will accept their insurance. The perceived threat of a Medicare provider shortage has been used to advocate for a slew of … [Read more...] about Kaiser Family Foundation Report Finds Medicare Beneficiaries Have Very Good Access to Doctors
The misuse of antipsychotic drugs by nursing homes has been the subject of Congressional hearings and Government reports for many decades. More than 300,000 nursing home residents take antipsychotic drugs and, as the Inspector General found, … [Read more...] about CMA Report: Examining Inappropriate Use of Antipsychotic Drugs in Nursing Facilities
Dual Eligible Special Needs Plans (D-SNPs) are a type of Medicare Advantage (MA) plan that enrolls only individuals dually eligible for Medicare and Medicaid. Though results have been mixed, D-SNPs were created as a possible route to better … [Read more...] about Dual Eligible Special Needs Plans: Considerations for Reauthorization
>Hospitals' increasing use of observation status harms more Medicare beneficiaries daily as patients hospitalized for multiple days are denied coverage of subsequent care in a skilled nursing facility because their time in the hospital was … [Read more...] about Three Observation Status Bills Have Been Introduced; Only Congressman Courtney’s Has Immediate Promise
As part of a new three-year grant, Atlantic Philanthropies will match new and increased contributions received by the Center for Medicare Advocacy. Atlantic Philanthropies will match a total of $325,000 in new or increased funding during three … [Read more...] about Atlantic Philanthropies Awards Center for Medicare Advocacy Three-Year Matching Grant for New and Increased Contributions