Medicare

For the fourth time this year the Social Security Administration (SSA) is warning seniors about fraudulent Social Security and Medicare communications targeting their benefits and their wallets.  Jim Borland, acting deputy commissioner for communications at the SSA said in a recent blog post titled Don’t Be Misled by False Medicare or Social Security Ads that […]

Medicare has started mailing new Medicare cards to all beneficiaries in New Jersey.  The new cards wills contain: New number called MEDICARE BENEFICIARY IDENTIFIER (MBI) 11 characters, mix of letters and numbers Random number  – not associated with SSA number, or how collecting benefits IMPORTANT REMINDERS: New cards are FREE. Beware of scams asking for […]

In 2013, the federal government began fining hospitals for high hospital readmission rates in an attempt to curtail premature discharges and to encourage hospitals to engage in better discharge planning.  Staring in October 2018, the federal government will be giving nursing homes bonuses or penalties based upon their Medicare rehospitalization rates. Many health experts believe […]

Last week we hosted our Inaugural Elder Care Symposium regarding the future of elder care! We had an expert panel that discussed the topic of The Landscape of Elder Care Today & Tomorrow.  All of the panelists agreed that there is too much fragmentation in our current health care system.  An example of such fragmentation is Medicare’s […]

In February, Congress passed and the President signed a sweeping spending bill.  Included in the bill are important changes for Medicare beneficiaries.  Among the positive changes included the repeal of the Medicare Part B therapy caps, the accelerated closure of the Medicare Part D ‘donut hole,’ and the move to make Medicare coverage of speech generating devices […]

As we celebrate the life and legacy of Dr. Martin Luther King on Monday, many people overlook the important role that Medicare played in the Civil Rights movement. By threatening to withhold federal funding from any hospital that practiced racial discrimination, as required by Title VI of the Civil Rights Act, passed in 1964, Medicare forced […]

As our loved ones age their need for healthcare and personal assistance tends to increase.  Whether your loved one is in the early stages of dementia, undergoing short term rehabilitation after a hospital admission, or in need of long term nursing home care, accessing the best care and figuring out how best to pay for […]

Medicare health and drug plans make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 – December 7 marks the annual Open Enrollment Period when individuals with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs. Per […]

The Centers for Medicare & Medicaid Services reminds the Medicare community of the Jimmo Settlement Agreement (January 2013), which clarified that the Medicare program covers skilled nursing care and skilled therapy services under Medicare’s skilled nursing facility, home health, and outpatient therapy benefits when a beneficiary needs skilled care in order to maintain function or […]

Decision in Alexander v. Price Means Medicare Patients Could Gain Right to Appeal Placement on “Observation Status” and Avoid Large Medical Bills On July 31, 2017, a Connecticut federal district court issued decision  certifying a nationwide class of hospital patients who may gain the right to appeal their placement on observation status.  In Alexander v. Price, 3:11-CV-1703 (MPS), Judge […]

Although the Republican health care plan was defeated, we still have work to do to have an optimal health care system for all Americans.  The Affordable Care Act known as Obamacare still needs improvement.  The existing American health care system is extremely complex. More than 57 million seniors and disabled adults depend on Medicare, but too many people […]

On February 16, 2017, the Jimmo v. Sebelius court approved a Corrective Statement to be used by the Centers for Medicare and Medicaid Services (CMS) to affirmatively disavow the use of an “Improvement Standard” for Medicare coverage.  The government will use the statement as part of its Corrective Action Plan, which was ordered by the court last […]