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What Would Work Better for You? Deciding Between Traditional Medicare and a Medicare Advantage Plan

In last week’s Alert, we posed 10 questions to ask before deciding between traditional Medicare and a Medicare Advantage Plan. This week we discuss what your answers may mean.

What Would Work Better for You? Deciding Between Traditional Medicare and a Medicare Advantage Plan

What Would Work Better for You? Deciding Between Traditional Medicare and a Medicare Advantage Plan?

Medicare Home Health Benefit’s Face-to-Face Encounter Requirement

As a condition of payment for Medicare home health benefits, a physician must certify that a patient is confined to the home, needs skilled services, receiving the services under a plan of care established and periodically reviewed by a physician, and under the care of the physician.

Observation Status Impedes Access to End-of-Life Skilled Nursing Facility Care

When hospitals classify some or all of their stay as “outpatient,” these patients will often not qualify for Medicare SNF coverage and may forego care.

10 Questions to Ask Before Deciding Between Traditional Medicare and a Medicare Advantage Plan

10 Questions to Ask Before Deciding Between Traditional Medicare and a Medicare Advantage Plan

CMS Rescinds Erroneous Medicare Nursing Home Policy

The policy changes, issued this September, misstated and limited nursing home (SNF) coverage and care available under Medicare.

Barriers to Medigap Coverage for Beneficiaries Under Age 65

Younger Medicare beneficiaries with disabilities face restricted access to Medigap coverage and prohibitive premium costs.

CMS Suspends New Applications for MA “Seamless Conversion” Enrollment

The Center applauds CMS’ decision to both impose a moratorium on approving plans and issue information concerning what plans have already been approved. Absent rescinding the authority of plans to conduct seamless conversion enrollment altogether, we urge CMS to incorporate much stronger consumer protections.

Minimal Social Security COLA Increase Will Likely Lead to Dramatic Part B Premium Increases for Some, Large Deductible Increase for All, Unless Congress Intervenes

Although Medicare premiums won’t be announced until later this Fall, as a result of this small increase to COLA, Part B premiums are projected to increase significantly.

Don’t be Fooled by the Federal Nursing Home Five-Star Quality Rating System

Providing composite scores is intended to help consumers make sense of the large amounts of material on Nursing Home Compare, but composite scores do a disservice to the public when nursing facilities’ self-reported information boosts facilities’ ratings into higher levels.

New Nursing Home Requirements of Participation: A Missed Opportunity

Residents’ advocates had hoped that the Centers for Medicare & Medicaid Services (CMS) would use the opportunity of comprehensively revising the RoPs, for the first time in more than 25 years, to correct the most serious problem in nursing home standards of care – the absence of a requirement for sufficient numbers of well-trained, well-supervised nursing staff, including the need for registered nurses around the clock. CMS did not.

An Open Letter to CMS About Fraud

CMS’ war on fraud seems to be indiscriminate, full of tactical errors and collateral damage. Rather than carefully targeting the perpetrators of fraud, a wide net is cast, resulting in legitimate claims for necessary care sinking into a sea of denials.

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