Since its implementation in 1965, Medicare has excluded coverage for hearing aids and related audiology services despite the large numbers of older Americans that have hearing loss. The cost of not treating audiology problems must be measured when considering the value and cost of adding coverage.
Topic: Part B
Medicare claims for DME (Items that have a medical purpose and repeated use) are suitable for coverage, and appeal if they have been denied, if they meet specific criteria.
While Medicare coverage of dental services does not include routine services, as discussed below, coverage for medically necessary dental and oral health care is supported by the Medicare statute, its legislative history, and even CMS policy.
A discussion of items and Services covered under Medicare Part B.
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.
Comments on the proposed rule concerning Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program and Fee Schedule Adjustments, Access to Care Issues for Durable Medical Equipment; and the Comprehensive End-Stage Renal Disease Care Model (CMS-1651-P)
CMS states that its main objective is to ensure that physicians are prescribing the most effective prescription drugs in order to improve patient treatment and to rein in drug spending.
It is increasingly well-documented that untreated hearing loss often leads to a variety of serious health problems and injuries.
The premium increase, expected to be over 50% for beneficiaries who do not already have premiums taken from their Social Security, will instead be about 15%.
Providing necessary infusions and injections at home reduces the risk of infection and other health consequences for beneficiaries who are already medically compromised. These important services should be covered for beneficiaries in traditional Medicare.
A major cause of the Part B increase is likely the parallel increase in so-called "outpatient" Observation Status, the use of which has more than doubled since 1999.
Part B premiums are expected to increase.