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 [...]
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 [...]
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 [...]
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 [...]
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 [...]
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 [...]