RSS

The Centers for Medicare & Medicaid Services (CMS) announced plans to expand its focused surveys on resident assessments and nurse staffing for nursing facilities nationwide (but not in all facilities), beginning in early fiscal year 2015.  Expanded surveys should lead to more accurate reporting of quality measures and staffing data on the federal website Nursing … Read more

The open enrollment period for health insurance coverage for 2015 under the Affordable Care Act (ACA) begins November 15, 2014, and ends on February 15, 2015. More information on the ACA health insurance Marketplace is available at: https://www.healthcare.gov/ Plans With Automatic Enrollment Some individuals who are currently enrolled in a health plan through the Marketplace … Read more

November 13, 2014 Late November begins a time for gatherings with family and friends – Thanksgiving and Chanukah, soon followed by Christmas and New Years. Nursing home residents often want to participate in these gatherings but may worry they will lose Medicare coverage if they leave the facility to do so. Residents and their families … Read more

Medical Equipment Suppliers' Ongoing Opposition to the Competitive Bidding Program and Consequences for Beneficiaries Report prepared by Mario Ramsey, Center for Medicare Advocacy Summer Health Policy Fellow Summary Under Medicare Part B, Medicare will pay for wheelchairs, hospital beds, some walkers; Certain customized items; prosthetic and orthotic devices; capped rental items; oxygen and oxygen equipment. … Read more

Twenty-one months after winning a national class action lawsuit that sought to overturn Medicare's practice of denying skilled maintenance care to patients who did not meet an "improvement standard," plaintiff Glenda Jimmo is finally receiving Medicare coverage for skilled home health maintenance care benefits she was denied in 2007. A federal court case in Vermont … Read more

A Brief Survey of Recent Reports, and a New Special Enrollment Period for 2015 Medicare's Annual Coordinated Election Period (ACEP) for Medicare Advantage and Part D plans began on October 15th and runs through December 7th.  During the ACEP, often referred to as "open enrollment," Medicare beneficiaries who do not have a Part D plan … Read more

The federal nursing home website, Nursing Home Compare, is about to undergo major changes that should significantly improve the accuracy of information about nursing homes that is provided to the public.  The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act of 2014), signed by President Obama on October 6, 2014, supports one of … Read more

Hospital Deductible: $1,260.00 / Benefit period Hospital Coinsurance: Days 0-60: $0 Days 61-90: $315 / Day Days 91-150: $630/ Day Skilled Nursing Facility Coinsurance: Days 1-20: $0 Days 21-100: $157.50/ Day Part A Premium (For voluntary enrollees only) With 30-39 quarters of Social Security coverage: $224.00 / Month With 29 or fewer quarters of Social … Read more

Hospice care is specialized, compassionate care for those diagnosed with a limited life expectancy.  Good hospice care should enhance quality of life for the patient and should support caregivers.  The Medicare Conditions of Participation afford hospice patients certain enumerated rights including the right to choose one's own attending physician.  A new rule promulgated in the … Read more

Fall is the time for Medicare beneficiaries to explore their options regarding Part D prescription drug plans and Part C Medicare Advantage plans.  The Annual Coordinated Election Period (ACEP) for Medicare Advantage and Medicare Part D prescription drug plans will start on October 15th and end on December 7th. This means that Medicare beneficiaries have to … Read more