Ombudsman’s offices represent long-term care residents on issues such as admissions and discharges, food, physical environment and abuse.
Not being officially admitted — a status known as observation care — can have financial consequences for beneficiaries, and patients had often complained they were not informed.
Many seniors are denied coverage because therapists mistakenly believe that they must be making improvements to qualify for coverage.
According to a settlement four years ago, Medicare was supposed to make clear to therapists that their services are covered even if beneficiaries are not improving. But that is not yet widely accepted.
Federal officials release names of insurers who ranked poorly in a recent review of their online directories’ accuracy.
People in these facilities are now guaranteed more flexibility on food and roommate choices, as well as improved procedures for grievances and discharges.
Thousands of people mistakenly think that if they have insurance, they can wait to sign up for Medicare Part B. Generally, insurance other than that provided by a current employer will not exempt them from Medicare’s strict enrollment requirements.
Some insurers have been allowed to move customers on the health law’s marketplaces into their Medicare Advantage plans when they become eligible for Medicare, but seniors complain they didn’t always know it was happening.
The government is sending emails and letters to some seniors to warn them that if they are eligible for Medicare and stay on the health law’s exchange, they will have to repay any subsidies they receive and if they miss their Medicare enrollment opportunity, they will face a life-long penalty.
Lawmakers approve bill to help Medicare patients with “observation care” costs.
A guide to help Medicare patients receiving observation care.
Concerns raised as health insurers automatically move members of their marketplace or individual plans who are eligible for Medicare.
The decision runs counter to a Senate committee that voted to strip the $52 million appropriation for the State Health Insurance Assistance Program, which helps beneficiaries understand their Medicare coverage and helps them with billing issues.
The changes announced Tuesday seek to eliminate the backlog by 2021.
It’s not clear yet if the full Senate or House will concur in the plan to cut funding for the State Health Insurance Assistance Program, which operates in all states and gives beneficiaries free advice on enrollment in drug and insurance plans, appealing coverage decisions and applying for financial subsidies.
Although there is widespread agreement on the need to let people know if they haven’t been admitted, the language proposed by federal officials hasn’t satisfied everyone.
Investigators from the GAO call for HHS to improve oversight of the Medicare appeals process and streamline it to make sure repetitive claims are handled more efficiently.
A pilot project in which doctors provide primary care at home for very frail Medicare beneficiaries saved $25 million in 2014, and nine of the 14 practices participating earned bonuses totaling nearly $12 million.
In the past eight months, Medicare officials have quietly granted the special enrollment periods to more than 15,000 Medicare Advantage members in seven states, the District of Columbia and Puerto Rico.
Congress left it to states to determine whether private Medigap plans are sold to the more than 9 million disabled people younger than 65 who qualify for Medicare. The result: rules vary across the country.