On August 19, 2011, the Centers for Medicare & Medicaid Services (CMS) announced Round 2 of its DMEPOS competitive bidding program.[1] Bidding is to begin in January 2012. Round 2 adds more product categories for competitive bidding … [Read more...] about CMS to Begin Round Two of Its Competitive Bidding Program for the Provision of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
Weekly Alert
Medicare Reimbursement For Skilled Nursing Facilities Remains High For 2012 Despite Reductions In Overpayments
In final rules setting out Medicare reimbursement rates for skilled nursing facilities (SNFs) for Fiscal Year (FY) 2012 (which starts October 1, 2011), the Centers for Medicare & Medicaid Services (CMS) reduced reimbursement by $3.87 billion, or … [Read more...] about Medicare Reimbursement For Skilled Nursing Facilities Remains High For 2012 Despite Reductions In Overpayments
The Changing Demographics of Nursing Home Care: Greater Minority Access… Good News, Bad News
A major public policy goal in the United States is "rebalancing" the long-term care system – reducing what was formerly, for many people, a near-total reliance on nursing facilities and increasing the use of home and community-based … [Read more...] about The Changing Demographics of Nursing Home Care: Greater Minority Access… Good News, Bad News
Amended Appeal Rules for Employer and Individual Health Plans
On June 24, 2011, the Centers for Medicare & Medicaid Services (CMS), in conjunction with the Internal Revenue Service (IRS) and the Employee Benefits Security Administration (EBSA), released amendments to a set of interim final rules regarding … [Read more...] about Amended Appeal Rules for Employer and Individual Health Plans
What Does the Debt Ceiling Agreement Mean for Medicare?
This week, Congress passed, and the President signed, the Budget Control Act of 2011. The bill raises the nation's debt ceiling and makes debt and deficit reductions in federal spending over the next 10 years.[1] Between now and … [Read more...] about What Does the Debt Ceiling Agreement Mean for Medicare?
CMS Revises Its Medicare Secondary Payer Collection Letters Following Haro v. Sebelius Decision
The Medicare Secondary Payer (MSP) program authorizes the Centers for Medicare & Medicaid Services (CMS) to recover compensation payments from beneficiaries who have private insurance that should be primarily responsible for their medical … [Read more...] about CMS Revises Its Medicare Secondary Payer Collection Letters Following Haro v. Sebelius Decision
New Initiatives to Improve Services for Dual Eligibles
The Centers for Medicare & Medicaid Services (CMS) recently announced several new initiatives focused on improving care for people who are eligible for both Medicare and Medicaid (dual eligibles).Two initiatives relate to providing fully … [Read more...] about New Initiatives to Improve Services for Dual Eligibles
House Plans Vote to Slash Medicare and Social Security through Balanced Budget Amendment
Next week, the House of Representatives is scheduled to vote on a proposal that will directly impact and harm Medicare beneficiaries, Social Security recipients, and others that rely on critical safety net programs. The Goodlatte-Walsh Balanced … [Read more...] about House Plans Vote to Slash Medicare and Social Security through Balanced Budget Amendment
Lower-Premium Pre-Existing Condition Insurance Plans Take Effect in Many States
One year ago on July 1, 2010, Secretary of Health and Human Services Kathleen Sebelius announced the availability of new insurance coverage for individuals who were denied insurance because they had a pre-existing condition.[i] These plans, … [Read more...] about Lower-Premium Pre-Existing Condition Insurance Plans Take Effect in Many States
Real Solutions to Save Medicare Dollars in Skilled Nursing Facilities
For many years, advocates for nursing home residents have argued that when residents are denied good care, the costs of trying to treat and correct avoidable conditions and bad resident outcomes are high. Advocates refer to this phenomenon as … [Read more...] about Real Solutions to Save Medicare Dollars in Skilled Nursing Facilities