Former Medicare chief Dr. Donald Berwick said Obama administration officials should abandon a rule that is leaving many older Americans without coverage for expensive rehabilitation care after they leave the hospital. The Medicare rule requires recipients to be admitted as a hospital inpatient for at least three days before the federal health insurance program for seniors and the disabled will pay for follow-up nursing home care. The problem is that an increasing number of patients are spending days in the hospital under “observation’’ status, often without realizing they were never officially admitted. “The patient ends up holding the bag and…
The U.S. Department of the Treasury and the Internal Revenue Service (IRS) has ruled that same-sex couples, legally married in jurisdictions that recognize their marriages, will be treated as married for federal tax purposes. The ruling applies regardless of whether the couple lives in a jurisdiction that recognizes same-sex marriage or a jurisdiction that does not recognize same-sex marriage. A press release by the Treasury Department says that the Department and the IRS will use a “place of celebration” rule in recognizing same-sex unions (recognition that was illegal before the Supreme Court struck down part of the Defense of Marriage…
Health care leaders on the House Ways and Means Committee have reintroduced a bill (H.R. 2925) to strengthen anti-fraud efforts in Medicare by going after bad actors. The legislation from Reps. Kevin Brady (R-Texas) and Jim McDermott (D-Wash.), who lead the panel's Health subcommittee, would allow federal officials to stop Medicare payments to individuals who have been involved with fraudulent entities in the past. The measure passed the House by voice vote in 2010. Source/more: The Hill
On Aug. 1, 2013, the federal Commission on Long-Term Care held its third public hearing focused on “Strengthening Publicly and Privately Funded Long-Term Services and Supports” in SD-562 Dirksen Senate Office Building, Washington, D.C. The hearing consisted of four panels of witnesses on four subtopics: Panel 1: Strengthening Medicaid LTSS Panel 2: Strengthening Medicare for LTSS Panel 3: Strengthening Private Long-Term Care Insurance Panel 4: Interaction of Insurance, Private Resources, and Medicaid The 15-member commission was created by the fiscal cliff legislation and is tasked with developing recommendations for Congress on how to reform long-term care. Previous hearings focused on…
On the 48th anniversary of the signing of Medicare and Medicaid into law, the Department of Health and Human Services (HHS) released data showing that the average premium for a basic prescription drug plan in 2014 is projected to remain stable, at an estimated $31 per month. This news comes as seniors and people with disabilities continue to save money on out-of-pocket drug costs. Yesterday, HHS announced that more than 6.6 million people with Medicare have saved over $7 billion on prescription drugs as a result of the Affordable Care Act, an average of $1,061 per beneficiary. The Affordable Care…
Many Medicare patients who require skilled nursing care after a hospital stay are often surprised when they receive a very expensive bill for the skilled nursing care. Medicare beneficiaries can be held as “observation” rather than as an admitted patient even though it may appear to the patient to be a regular stay in the hospital. Medicare will not pay for the subsequent skilled nursing care if the patient’s hospital stay is classified as observation. Learn more. A new investigation shows that whether a Medicare patient is admitted to the hospital or kept for observation depends on what hospital they…
The nursing home industry is facing a major test of its lobbying clout as lawmakers weigh whether to slash its Medicare funding. Nursing homes got a pass in January when Congress approved a short-term “doc fix” for Medicare spending that left hospitals to foot the bill for the second year in a row. But there’s no guarantee that lawmakers will go down that route again, leaving long-term and post-acute care facilities at risk of a significant cut to their reimbursement rates. Anticipating the fight, two leading industry groups merged this month under the banner of the American Health Care Association…
Facing major budget and staff cuts, federal officials are scaling back several high-profile health care fraud and abuse investigations, including an audit of the state insurance exchanges that are set to open later this year as a key provision of the Affordable Care Act. The Department of Health and Human Services’ Office of Inspector General, which investigates Medicare and Medicaid waste, fraud, and abuse, is in the process of losing 400 staff members, about 20 percent of its workforce from its peak strength of 1,800 last year. About 200 will have departed by the end of the year, and the…
When President Lyndon B. Johnson signed Medicare and Medicaid into law on July 30, 1965, he stated, “No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings they have so carefully put away over a lifetime so they might enjoy dignity in their later years. No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations.” As a result of these two programs, millions of Americans have been able to gain access to the…
Join David Wingate as he presents recent and upcoming changes in the laws and regulations and how this will affect care providers and individuals who require care on a short-term or long-term basis.
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