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.
Archives: Publications : Page 6
What Would Work Better for You? Deciding Between Traditional Medicare and a Medicare Advantage Plan?
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.
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
The policy changes, issued this September, misstated and limited nursing home (SNF) coverage and care available under Medicare.
Younger Medicare beneficiaries with disabilities face restricted access to Medigap coverage and prohibitive premium costs.
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.
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.
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.
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.
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.