US Capitol Building

Senate Dems aim to offer dental, hearing and vision to Medicare

Angie SzumlinskiHealth

Senate Democrats announced late Tuesday the framework for a $3.5 trillion infrastructure package that will expand Medicare to offer dental, hearing and vision benefits. Democrats hope to vote on the package in the coming weeks. It will be passed via reconciliation, a procedural move that allows budget bills to be approved in the Senate by a simple majority and bypass a …

Advance Care Planning Coverage

Angie SzumlinskiCompliance, Training

In 2016 Medicare launched a much-anticipated advance care planning (ACP) benefit that pays physicians to counsel patients about living wills, advance directives, and end-of-life care options. During the ACP process clinicians can help patients determine the type of care they would want in a medical crisis or at the end of life and reassure them that their preferences will be …

CMS – Expanding Vaccine Confidence

Angie SzumlinskiAnnouncements, Featured

A CMS Press Release on May 11, 2021 explained the new rule issued by CMS that is aimed at “expanding efforts to grow COVID-19 vaccine confidence and uptake amongst the nations most vulnerable”. As part of the ongoing response to address the COVID-19 pandemic, and to improve health care access and reduce the risk of severe illness and death from …

Introduction Of Legislation To End Surprise Bills, Improve Affordability And Outcomes For Medicare Patients

Angie SzumlinskiAnnouncements, News

Representatives Joe Courtney (CT-02), Glenn ‘GT’ Thompson (PA-15), Susan DelBene (WA-01), and Ron Estes (KS-04) re-introduced the bipartisan Improving Access to Medicare Coverage Act of 2021, legislation to fix an arbitrary Medicare policy that excludes coverage of skilled nursing care for certain patients, resulting in exorbitant and unexpected out-of-pocket costs. Under current Medicare policy, a beneficiary must have an “inpatient” hospital …

Cognitive Assessment and Care Plan Services

Angie SzumlinskiAnnouncements, Featured

Section 116 of the Consolidated Appropriations At, 2020 P.L., (116-260) requires CMS to conduct provider outreach and education for the Medicare-covered Cognitive Assessment & Care Plan Services (CPT code 99843) to increase awareness of this service and its eligibility requirements. In a recent “Change Request” ®, the requirements for provider outreach and education, including a direct mailing from the Medicare …

OIG Part D – Part A – Hospice Audit

Angie SzumlinskiCase Study, News

Why OIG Did This Review In 2012, the OIG issued a report to the Centers for Medicare and Medicaid Services (CMS) indicating that during 2009, Medicare part D paid for prescription drugs that likely should have been paid for by hospice organizations under the Medicare Part A hospice benefit. They matched Part A and Part D data to identify occurrences …

Expect More RAC Audits

Angie SzumlinskiAnnouncements, News

In 2021, Medicare is celebrating its 55th year of providing health insurance to Americans. The program was first signed into law in 1965 and began offering coverage in 1966. That first year, 19 million Americans enrolled in Medicare for their healthcare coverage. As of 2019, more than 61 million Americans were enrolled in the program. President Biden is broadening the …

Expect More RAC Audits

Angie SzumlinskiNews

In 2021, Medicare is celebrating its 55th year of providing health insurance to Americans. The program was first signed into law in 1965 and began offering coverage in 1966. That first year, 19 million Americans enrolled in Medicare for their healthcare coverage. As of 2019, more than 61 million Americans were enrolled in the program. President Biden is broadening the …

3 Day Hospital Stay

Angie SzumlinskiNews

The Center for Medicare Advocacy published an article regarding the 3-day inpatient hospital requirement for Medicare Skilled Nursing facility coverage. The article explains the process and makes an appeal to congress asking that this rule should be repealed for multiple reasons including: Medical care has changed in the past 55 years. Traditional Medicare and Medicare Advantage need to be aligned. …

What Price?

Angie SzumlinskiHealth, Studies

The cost of a fall among older adults requiring emergency services is unclear, especially beyond the acute care period. In a recent study, medical expenditures (costs) to 1 year among community-dwelling older adults who fell and required ambulance transport, including acute versus post-acute periods, the primary drivers of cost and comparison to baseline expenditures were evaluated. Results showed that the …