Are you a provider offering Medicare hospital and/or outpatient services? Are you applying to be a Medicare provider? Or are you a Medicare beneficiary filing an appeal? If you answered yes to any of the above questions, it is important you know who serves as your regional Medicare Administrative Contractor (MAC) and what a MAC does. Which regional MAC covers … [Read more...] about What is a Medicare Administrative Contractor & Why Should I Care?
Many people are talking about the sequester that went into effect March 1st and the myriad of cuts. While the news reports no cuts in Medicare benefits, a 2% payment cut to providers will be imposed. The assumption is that the payment cut will not affect beneficiaries, yet it is unclear if the cost of this cut can be passed on to some beneficiaries. The 2% cut applies to … [Read more...] about Will Beneficiaries Bear Extra Medicare Costs Due to the Sequester?
"Observation status" is a hot topic amongst advocates and beneficiaries and is again back in the court room. Lois Frarie, a 93 year old retired teacher in Monterey, California, was left with a $19,000 bill for her skilled nursing home care after 4 days in the hospital. How can this be? While Medicare does cover up to 100 days of SNF care, it only does so if a beneficiary is … [Read more...] about Medicare’s Proposed Changes to Hospital Admission Rules Don’t Address Root Concerns
Round 2 of Medicare's Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) competitive bidding program starts July 1, 2013. This round expands the DMEPOS competitive bidding program to beneficiaries in 91 major metropolitan areas across the country, and adds new product categories and a mail-order competition for diabetic testing supplies. In California, … [Read more...] about Round 2 of DMEPOS Competitive Bidding Program Starts July 1st
Medicare beneficiaries can no longer be denied necessary skilled maintenance services provided in the home health, nursing home or outpatient therapy settings on the basis of showing no improvement, according to a settlement agreement approved on January 24, 2013. Legally this has always been the case. Yet, in practice, thousands of Medicare beneficiaries have been denied … [Read more...] about Settlement Agreement Confirms Medicare Coverage for Skilled Maintenance Services Regardless of “Improvement”