Medicare

The 2013 Settlement in Jimmo v. Sebelius confirmed that Medicare coverage should be determined based on a beneficiary’s need for skilled care (nursing or therapy), not on the individual’s potential for improvement. Unfortunately, more than six years after the Settlement’s approval, Medicare beneficiaries and providers across the country are still having significant problems with the […]

On May 9, 2019, members of the Rothkoff Law team including Jerry Rothkoff, Bryan Adler, Roxanne Crowley, Kaitlin Dirxx, and Chelsea Ganssle traveled to Washington, DC to attend the Center for Medicare Advocacy’s sixth annual National Voices of Medicare Summit and Senator Jay Rockefeller Lecture at the Kaiser Family Foundation.  The theme of the day […]

During the 2016 Presidential campaign, a major issue effecting virtually all American families was noticeably absent from the debate – long-term care coverage.  Hopefully, that is about to change heading into the 2020 Presidential campaign.  Senator Bernie Sanders and his Democratic colleagues in the House  have included a long-term care benefit as part of the […]

The Centers for Medicare and Medicaid Services (CMS) has released the new Medicare premiums, deductibles, and co-payments for 2019:• Basic Part B premium: $135.50/month (was $134.00 in 2018)• Part B deductible: $185 ($183.00 in 2018)• Part A deductible: $1,364 (was $1,340 in 2018)• Co-payment for hospital stay days 61-90: $341/day (was $335 in 2018); Co-paymentfor […]

Telemedicine offers many opportunities to better monitor care in the future.  A new proposal by the Trump administration would authorize Medicare for the first time to embrace telemedicine across the country by paying doctors $14 for a five-minute “check-in” phone call with their patients.  However, the proposal has many critics.  Many physicians say the proposed […]

Modeled after a program that encourages low readmission rates to hospitals, the Centers for Medicare and Medicaid Services (CMS) will introduce a new financial incentive program effective October 1, 2018 for skilled nursing facilities. CMS will withhold 2% of a facility’s Medicare reimbursement until they have shown that they can keep down the number of […]

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 […]