HHS Inspector General Scrutinizes Medicare Observation Care Policy
The difference between inpatient and observational care status can have a big effect on Medicare beneficiaries — both in terms of the bills they face and the post-hospital options available to them.
Facing A Tight Deadline, Long-Term Care Panel Holds First Meeting
The commission, set up by Congress to offer recommendations on paying for services to help seniors and disabled people, has only a few months left to do its work.
FAQ: Medicare Beneficiaries May See Increased Access To Physical Therapy Or Some Other Services
For years, seniors were told that they had to show improvement to keep getting skilled care but a lawsuit has changed that standard.
Firm Relies On Medicare Experience As It Prepares To Open Federal Health Exchange Calls Centers
Vangent already handles more than 60,000 calls a day about Medicare but will soon add an expected 200,000 questions about the marketplaces set up by the health law.
Medicare Seeks To Limit Number Of Seniors Placed In Hospital Observation Care
The proposal, part of the annual payment update, would help ease confusion over when beneficiaries are admitted to the hospital
Advocates Head To Court To Overturn Medicare Rules For Observation Care
Some hospital stays are not considered in-patient care, but seniors often don’t know that until they find they don’t qualify for full Medicare coverage.
A basic guide and resources if you want to get Medicare to reverse a coverage decision.
Seniors Need To Be Tenacious In Appeals To Medicare
Consumer advocates say that efforts to get Medicare to reverse a decision denying coverage of care are frequently rejected at first, but the chances of success are much better for beneficiaries who keep appealing until they reach the level handled by an administrative law judge.
State Insurance Officials Raise Concerns About ‘Rate Shock’ For Young People
If young adults can’t afford health insurance policies available in 2014 under the health care law, state insurance officials are worried they won’t buy them. And that could drive up the cost of insurance for the mostly older, sicker people who do purchase coverage. That’s a potential problem even in states like California and Rhode Island, […]
Insurance Commissioners Reject Calls To Limit Seniors’ Medigap Policies
The group argues that increasing cost-sharing would stop people from seeking necessary care.
Providers File The Bulk Of Medicare Appeals
Health care providers who appealed to Medicare judges won more often than patients did, according to a report by the inspector general at the U. S. Department of Health and Human Services. Hospitals, physicians, medical equipment suppliers and other providers also filed 85 percent of the cases decided by the administrative law judges in fiscal […]
Medicare Extends Enrollment Period For Those Affected By Sandy
Medicare beneficiaries battered by Superstorm Sandy have one less problem to worry about: Federal officials have extended the Dec. 7 deadline to enroll in a private medical or drug plan for next year for those still coping with storm damage. The Centers for Medicare & Medicaid Services “understands that many Medicare beneficiaries have been affected by […]
Medicare Trying To Nudge Seniors Out Of Plans With Low Ratings
Government is sending letters to a half million beneficiaries to alert them to their plans’ poor performance.
Enrollment Season Opens For Medicare Advantage And Drug Plans
Today, Medicare beneficiaries can begin choosing their drug and medical coverage for 2013, and most seniors are expected to stick with the same policies they have already, despite price changes and a rating system that shows some plans may be better than others. Seniors have been reluctant to change plans, even if there are cheaper […]
Medicare Seeks To Cut Number Of Seniors Denied Nursing Home Coverage After Hospital Stays
The government is testing new hospital payment rules to see if fewer beneficiaries will be classified as observation patients, which can be a costly designation for seniors.
Rep. Courtney Pushes Bill To Expand Medicare Coverage Of Nursing Home Stays
Congress may be in recess, but Rep. Joe Courtney (D-Conn.) isn’t taking a vacation just yet. He went to a New London nursing home Wednesday to drum up support for legislation that would help residents such as a 98-year-old woman whose life savings were wiped out by nursing home bills Medicare wouldn’t pay. That woman’s niece, […]
Medicare Drug Discounts At Risk If Court Strikes Health Law
The pharmaceutical industry agreed in the health debate to reduce brand-name drug costs by 50 percent for Medicare beneficiaries who reach the coverage gap known as the doughnut hole.
Study: Hospital Observation Stays Increase 25 Percent In 3 Years
The number of Medicare patients who enter the hospital for observation rose dramatically even though Medicare enrollment and hospital admissions declined slightly, according to a study by gerontologists at Brown University in Providence, R.I. The researchers analyzed medical records and hospital claims for 29 million people in traditional Medicare from 2007 to 2009. They found […]
What’s In A Name: Health Exchanges, Marketplaces … Or Swap Meets
If a Medicare staff recommendation is approved, health insurance exchanges may be up for a rebranding.
$18 For A Baby Aspirin? Hospitals Hike Costs For Everyday Drugs For Some Patients
People who are not admitted to the hospital
