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Author Archives: mshepard

By V.W., a Medicare Beneficiary from Colorado I am a 77 year old woman. I only used Medicare back in the earlier part of this decade, in 2002 and 2005, when I had accidents that required surgery to repair broken bones. The “out of pocket” costs for those surgeries were in the $10,000+ range each. Thanks … Read more

Today, in concert with the White House Conference on Aging, the Administration announced the results of a concerted effort on the part of the Centers for Medicare and Medicaid Services (CMS) and the Social Security Administration (SSA) to improve the information available to individuals becoming eligible for Medicare.  The Medicare program has complicated rules about how … Read more

By an Anonymous Beneficiary from Iowa   In the last year I lost both of my parents.  They were 92 and 94 years old when they passed away.  They had been married for 69 years and died within less than 10 months of each other. In the last decade of their lives, due to their … Read more

Many healthcare institutions are required to provide discharge planning for their Medicare patients as part of their “Conditions of Participation” in the Medicare program.  Under the Medicare program, discharge planning services are required for hospital inpatients, long-term care hospital and rehabilitation inpatients, skilled nursing facility residents, patients in swing-beds, and hospice patients.  Discharge planning services … Read more

In the annual update to Medicare reimbursement of acute care hospitals for outpatient care (July 8, 2015)[1] the Centers for Medicare & Medicaid Services (CMS) includes proposed revisions to the “Two-Midnight Rule” and its enforcement. If the proposed changes lead to an increased number of patients being formally admitted as inpatients (rather than, as now, … Read more

Effective July 1, 2015, Virginia has become the fifth state to enact legislation requiring hospitals to inform patients when they are in Observation or other outpatient status, and the consequences of not being admitted as inpatients.  Senate Bill 750[1] requires hospitals to provide oral and written notice to patients who are receiving “onsite services” (including … Read more

Former residents at 12 nursing facilities owned by Golden Living in Arkansas (or their special administrators, guardians, or attorneys-in-fact) filed a lawsuit challenging the facilities’ chronic understaffing between December 2006 and July 1, 2009.  Plaintiffs moved for class certification on three claims – breach of the facilities’ standard admission agreement, violation of the Arkansas Long-Term … Read more

By P. B., a Medicare Beneficiary from Colorado I would not have been able to have a career, care for others at work, care for my mother after my career or be able to NOT be a dependent at retirement time. All this is because of a prescription that is allowed because I have Medicare. I … Read more

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in … Read more

By Marilyn Moon, Institute Fellow, American Institutes for Research (Center for Medicare Advocacy Luminary) Medicare is a successful program that is extremely popular with its beneficiaries who rank it higher than others do their private insurance plans.  And polls always show that people are willing to pay more for Medicare.  So why do politicians persist in … Read more