Center For Medicare Advocacy

Court paves way for fight over inpatient stays, SNF coverage

Court paves way for fight over inpatient stays, SNF coverage

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Debate over Medicare beneficiaries' hospital stays being classified as inpatient — a designation crucial to receive skilled nursing coverage — will continue, thanks to a court's order last week.

Poor staffing led to poor care, state says in lawsuit

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New Mexico has filed suit against one of the nation's largest nursing home operators for providing what it claims were inadequate resources that led to poor care and improper billing. One leading patient advocate called the action a "new and novel approach" to the "chronic and longstanding problem of inadequate nurse staffing in nursing facilities."

'Improvement standard' lives on, Medicare refuses to cover Jimmo herself

'Improvement standard' lives on, Medicare refuses to cover Jimmo herself

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Medicare officials continue to cite an "improvement standard" as a reason for withholding benefits from Glenda Jimmo, whose 2012 legal victory was supposed to end this type of denial, Kaiser Health News reported Monday. The situation shows why both beneficiaries and providers are confused about current policy, and why some nursing homes continue to expect business-as-usual, an expert told McKnight's.

High-profile consumer advocacy group sues over broken Medicare appeals process

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Long-term care providers have been outspoken in their criticism of the Medicare appeals process, which has all but ground to a halt. Now a class-action lawsuit says Medicare beneficiaries also are being harmed by the excessively long delays.

Long-term care leaders watchful after Supreme Court limits the Affordable Care Act contraception rule

Long-term care leaders watchful after Supreme Court limits the Affordable Care Act contraception rule

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Two hotly anticipated Supreme Court rulings handed down Monday elicited measured responses from prominent long-term care stakeholders. In one case, Hobby Lobby succeeded in its battle against the Affordable Care Act's rules over contraception coverage. The other decision dealt a blow to home healthcare unions.

Profile: On the side of seniors

Profile: On the side of seniors

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For those who work with Medicare beneficiaries, Judith Stein is a well-known powerhouse. Since founding the Center for Medicare Advocacy in 1986, she's led numerous major cases involving Medicare denials.

Judge dismisses observation stay lawsuit

Judge dismisses observation stay lawsuit

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A Connecticut federal court judge has dismissed a lawsuit brought by a group of 14 Medicare beneficiaries denied skilled nursing care coverage after a hospital stay.

Time squeeze for LTC panel

Time squeeze for LTC panel

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The Congressional Long-Term Care Commission is on an "extraordinarily short time frame" that merits an extension, a member told McKnight's in June.

Tight timeline forces LTC commission to narrow its ambitions, member says

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With its report due by the end of September, the Congressional Long-Term Care Commission is setting its sights on what can be accomplished in an "extraordinarily short time-frame," according to member Judith Stein, executive director of the Center for Medicare Advocacy.

Observation stay case debated in court

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Government lawyers and opponents of Medicare's "observation stay loophole" recently squared off in federal court, when a judge convened the first hearing in the Bagnall vs. Sebelius case. Richard Bagnall and other seniors denied Medicare coverage for skilled nursing care brought the case in 2011.

Observation stay challenge heads to court

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Government lawyers and opponents of Medicare's "observation stay loophole" squared off in court on Friday, when a federal judge convened the first hearing in the Bagnall vs. Sebelius case.

"Improve"-ing Medicare

"Improve"-ing Medicare

Under a proposed settlement, a nationwide class of beneficiaries will be certified, numerous parts of the Medicare Benefit Policy Manual will be rewritten, and the Centers for Medicare & Medicaid Services (CMS) will carry out an educational campaign for providers, Medicare contractors and adjudicators.

Lawmaker touts legislation fighting 'observation stay' Medicare loophole

Lawmaker touts legislation fighting 'observation stay' Medicare loophole

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Proponents of a bill to cut out the "observation stay" Medicare loophole got a boost from a House of Representatives member Wednesday.

Advocates for dual eligibles are concerned about the fast pace of demonstration project timeline

Advocates for dual eligibles are concerned about the fast pace of demonstration project timeline

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Medicare advocates are concerned about the speed with which the federal government is implementing care coordination plans for dual eligibles, according to reports.