Center for Medicare Advocacy

Federal Judge OKs A Class Action Lawsuit Over Appeals In Medicare Observation Cases

Two of the greatest sources of frustration for Medicare recipients and their families are observation status and the government’s incredibly complex appeals process. On Monday, a federal judge in Hartford CT, certified a class action lawsuit aimed at addressing both. The judge’s eventual decision in the case (Alexander v. Price) could have far-reaching effects on both the burgeoning use of [...]

By |2017-08-02T13:11:48-04:00August 2nd, 2017|Hospitals|1 Comment

A Judge Orders Medicare To Clarify When It Will Pay For Rehab and Skilled Nursing

Imagine your mom has a stroke. Once she is stabilized, she is sent to a skilled nursing facility for rehab. Then she goes home and gets some home health care and additional physical therapy. Medicare may pay, but for how long? For many years, that was decided by the “improvement standard.” In other words, as long as this care helped [...]

By |2016-08-24T11:48:14-04:00August 24th, 2016|Medicare|2 Comments

What Ever Happened to the Long-Term Care Commission?

Nearly two months ago, Congress created a commission to recommend reforms to the current long-term care system. So what has happened since? Not much. Leaders of Congress have appointed members to serve on the panel but President Obama—who has three of 15 picks-- has not yet made his choices. The commission can’t select a chairman, find a staff, or set an agenda [...]

By |2013-02-25T21:31:30-05:00February 25th, 2013|Aging, long term care reform, Medicaid, nursing homes|1 Comment

Medicare Settlement Does Not Expand Long-Term Care Benefits

Last week, Medicare agreed to expand its skilled nursing care and rehabilitation therapy benefit for some people with chronic disease, including many elderly. This added care, which came in a settlement of a lawsuit brought by a Vermont woman named Glenda Jimmo, the Center for Medicare Advocacy, and others is potentially very important for some Medicare beneficiaries. But the settlement [...]

By |2012-10-31T21:57:40-04:00October 31st, 2012|Aging, Health Care, Medicare, nursing homes|0 Comments

What the Ongoing Battle over Medicare’s Observation Stays Means for Seniors

While many seniors and their families may not be aware of it, consumer groups, hospitals, and nursing homes are fighting a major battle with Medicare over how the federal program pays for patients who are cared for in a hospital, but not admitted to the hospital. Seniors caught in this regulatory purgatory may have to pay thousands of dollars for [...]

By |2012-09-05T19:48:32-04:00September 5th, 2012|Aging, Hospitals, Medicare, nursing homes|1 Comment

Drugs, Dementia and Nursing Homes

The overuse of antipsychotic drugs “is one of the most common and longstanding, but preventable practices causing serious harm to nursing home residents today,” Toby Edelman of the Center for Medicare Advocacy told the Senate Aging Committee last week. She said these drugs are often used off-label (that is: for purposes other than the ones for which the FDA approved [...]

By |2012-04-26T18:48:55-04:00April 26th, 2012|dementia, nursing homes|3 Comments