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  • Welcome and Housekeeping  (David Lipschutz, Moderator)
  • Litigation Update   (Gill Deford)
    • Jimmo – Improvement standard
    • Bagnall (Observation)
    • Other litigation
  • Re-Review of Previously Denied Claims Pursuant to the Jimmo Settlement (Ali Bers)
    • Overview
      • Claims Eligible for Review
      • Deadlines and Request Form
  • Due Process and Medicare Appeals
    • Denial rate of beneficiary appeals at lower levels of review (Gill Deford)
    • Office of Medicare Hearings and Appeals  (OMHA) (Margaret Murphy)
      • Medicare Appellant Forum – (2/12/14)
      • ALJ scheduling backlog
      • Instructions/advice for beneficiary-initiated appeals
    • Rights of Surviving Spouses to Appeal Medicare claims (Ali Bers)
      • Pattern of surviving spouses (and others) being told by Medicare that they cannot appeal a deceased beneficiary’s Medicare claim unless they produce court documentation of their authority to represent the estate
  • Legislative Update:  The Federal Budget and Medicare (David Lipschutz)
    • Short-Term Medicare “Doc Fix” Passed (Physician payment, or “SGR”)
      • Extenders: QI program and therapy cap exceptions process
      • Other provisions
    • Dueling Budgets: President Obama v. House Budget Chairman Paul Ryan
  • Regulatory Update
    • CMS’ Final FY2015 Call Letter (David Lipschutz)
      • Medicare Advantage payment rates
      • Other provisions
    • Windsor and Medicare Enrollment (Alfred Chiplin)
      • Pursuant to the Windsor decision (Supreme Court DOMA decision), the Dept. of Health and Human Services (HHS) has issued updated eligibility and enrollment guidance for same sex couples
  • General Medicare Q&A (Moderator)
  • Wrap-up  (Moderator)
    • Keep informed: Myths and Truths, other information and updates on the Center’s Website
    • Next Call

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