The Social Security Administration (SSA) has released state by state information on numbers of individuals whose Part D low income subsidy (extra help) will end March 31 if they do not respond to SSA’s request for information concerning their … [Read more...] about Help Someone Retain Part D Extra Help
Weekly Alert
More Nurses in Nursing Homes Would Mean Fewer Patients Headed to Hospitals
Nursing home residents are frequently hospitalized. Residents who have recently been admitted from the hospital are frequently rehospitalized.[1] Many of these hospitalizations, which "can cause discomfort for residents, anxiety for … [Read more...] about More Nurses in Nursing Homes Would Mean Fewer Patients Headed to Hospitals
Medicare General Enrollment Ends March 31st: Opportunity for Some to Access QMB Coverage
The 2011 Medicare Part A and B general enrollment period runs from January 1st through March 31, 2011. Medicare Part A enrollment (to purchase Part A – for those who are not entitled to receive it without paying a premium) has become … [Read more...] about Medicare General Enrollment Ends March 31st: Opportunity for Some to Access QMB Coverage
The Burden of Out-of-Pocket Costs on Medicare Beneficiaries
Medicare provides a vital foundation for the health and wellness of Americans who are 65 or older or have significant disabilities. The program currently covers a portion of health care costs for over 47 million individuals throughout the United … [Read more...] about The Burden of Out-of-Pocket Costs on Medicare Beneficiaries
Medicare Secondary Payer Collection Requirements for Insurers Threaten Beneficiary Rights
The Medicare Secondary Payer (MSP) program seeks to conserve funds by prohibiting Medicare payment for health care that could be covered by another insurer. Thus, when a Medicare beneficiary experiences an injury that might be covered by liability, … [Read more...] about Medicare Secondary Payer Collection Requirements for Insurers Threaten Beneficiary Rights
Extension of Time to Enroll In a Prescription Drug Plan for Medicare Beneficiaries Who Lost Coverage
Some Medicare beneficiaries lost prescription drug coverage at the end of 2010 because their Medicare Advantage (MA) plan or prescription drug plan (PDP) either did not renew its contract with the Centers for Medicare & Medicaid Services (CMS) or … [Read more...] about Extension of Time to Enroll In a Prescription Drug Plan for Medicare Beneficiaries Who Lost Coverage
Concern over Skilled Nursing Facilities’ Upcoding Medicare Reimbursement Should Not Be Allowed to Deprive Residents of Necessary Care
Between 2006 and 2008, skilled nursing facilities (SNFs) increasingly billed for residents' care at higher-paying reimbursement categories (upcoding) under Medicare's prospective payment system. Medicare uses Resource Utilization Groups … [Read more...] about Concern over Skilled Nursing Facilities’ Upcoding Medicare Reimbursement Should Not Be Allowed to Deprive Residents of Necessary Care
Judge Rejects “Eden Alternative” Defense In Nursing Home Appeal
The nursing home industry has called for major changes in the federal survey process by which federal and state survey agencies determine whether facilities are complying with federal standards of care and providing residents with high quality of … [Read more...] about Judge Rejects “Eden Alternative” Defense In Nursing Home Appeal
2011 Poverty Levels Affect Eligibility for Many Federal Programs
Federal poverty level (FPL) guidelines for 2011 were published in the Federal Register January 20, 2011. 76 FR 3637 (January 20, 2011). The guidelines provide the baseline for eligibility levels for many public benefits, including health … [Read more...] about 2011 Poverty Levels Affect Eligibility for Many Federal Programs
New Hospice Regulations are a Mixed Bag for Beneficiaries Seeking High Quality End of Life Care
Hospice care is available for Medicare beneficiaries who are certified by a hospice physician as having a life expectancy of six months or less if the terminal illness runs its normal course. In 1983, the hospice benefit was designed to cover … [Read more...] about New Hospice Regulations are a Mixed Bag for Beneficiaries Seeking High Quality End of Life Care