Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced Thursday.
Medicaid is paying the lowest average price for 78 high-use and high-expenditure brand-name and generic drugs, a new federal report finds.
A whistleblower can pursue charges that long-term care pharmacy Omnicare ignored skilled nursing companies' overdue bills in exchange for certain kinds of business, a federal district court recently ruled.
The Centers for Medicare & Medicaid Services has seen enough and wants to gain more control over drug-prescribing practices for the Medicare Part D program.
In light of reports that Medicare Part D prescribing practices are endangering seniors — many of them in long-term care facilities — the Centers for Medicare & Medicaid Services has issued a proposed rule that would give the agency more power to oversee and control the prescription drug program.
In light of widespread inappropriate claims, providers will face heightened scrutiny for Medicare claims for hospice medications, the Centers for Medicare & Medicaid Services stated in a letter this week.
My mom called me to relay her "tragic" story of trying to sign up for a Medicare Part D plan. She hadn't signed up for one, and didn't feel that she needed one, but at lunch her girlfriends were discussing the pros and cons of their plans and asked Mom what plan she was on.
Senator Jay Rockefeller wants provider groups to support his Medicare Part D plan for a drug rebate bill that calls for money from pharmaceutical companies to replace funds lost from the sustainable growth rate (SGR) removal.
I am getting mixed information from experienced staff members as to what has been passed along by our pharmacy company about discharging patients with their controlled and scheduled medications. No one can give me a definite answer whether this is legal or not. Can you help?
Long-term care pharmacies are struggling with an Affordable Care Act provision related to short-cycle dispensing of brand name oral solid drugs, according to a recent letter from the Long Term Care Pharmacy Alliance and the National Community Pharmacists Association.
About 90% of seniors, including dually eligible Medicare and Medicaid beneficiaries, are happy with Medicare's prescription drug program, a new survey reveals.
It's well established that nursing home residents frequently struggle with conditions such as heart failure and depression. It's also true that critics of nursing home care are quick to blame these conditions on substandard care
The vast majority of the medications used by people who are dually eligible for Medicare and Medicaid can find what they need through Medicare Part D formularies, a federal report finds.
A new Medicare overhaul proposed by two Republican senators on Thursday would save an estimated $200 billion to $500 billion over 10 years by way of "premium support."
Medicaid's net unit drug costs are much lower than costs under Medicare Part D, which is attributed to higher Medicaid rebates for brand name medications, according to a new report.
Medicare's prescription-coverage program cuts healthcare costs by about $12 billion. That's because the benefit reduces admissions to nursing homes and hospitals, according to a new study.
Congressional Democrats are calling for a full review of the Medicare Part D program following a recent audit that found that many program sponsors have been overcharging beneficiaries by underestimating manufacturer rebates in their bids.
A number of key healthcare reform provisions affecting the long-term care industry began Jan. 1, right before the new session of Congress comes back to Washington, according to The Hill.
In preparation for the Medicare Part D open enrollment period, the Centers for Medicare & Medicaid Services said it has streamlined its coverage options and eliminated choices it considered repetitive. But critics of the changes charge that eliminating such options undermines the spirit of President Obama's pledge, "If you like your plan you can keep it."
A number of Medicare beneficiary advocacy groups have voiced support for a plan from the Department of Health and Human Services to simplify the Medicare Part D program. They want to reduce the number of available plans.
The Centers for Medicare & Medicaid Services recently disclosed that 234 drug manufacturers that sell drugs covered by Medicare Part D have signed a pledge to provide a 50% discount to seniors who fall into the coverage gap, or doughnut hole.
Vice President Joe Biden and Health and Human Services Secretary Kathleen Sebelius reassured seniors Thursday that there will be a 50% discount for those who fall into the Medicare Part D "doughnut hole" beginning next year.
The Medicare Part D prescription drug program saved more than $33 billion in 2007 due to the use of generic drugs, according to a new government report.
The average monthly Medicare Part D premium will rise by about $1 to $30 beginning next year. That is the same time that new benefits designed to begin closing the coverage gap kick in, health officials said Wednesday.
Many seniors are still wary of healthcare reform, but Democrats hope some of the new law's provisions will help win over reluctant elders, according to recent reports.
Antibiotic use by seniors has increased as a result of better drug coverage under the Medicare Part D drug program, according to a study by the University of Pittsburgh Graduate School of Public Health.
The Centers for Medicare & Medicaid Services on Monday took the next step in its bid to close the Medicare Part D coverage gap: It released a drug maker agreement that will secure 50% savings for beneficiaries next year.
As another round of $250 Medicare prescription drug rebate checks goes out in the mail, healthcare officials are reminding seniors to be aware of potential scams.
Health and Human Services Secretary Kathleen Sebelius discussed the next round of Medicare Part D rebate checks for seniors this week at a Seniors Forum in New Hampshire.
Some low-income seniors in Vermont received good news Monday: State officials said they are giving up in their attempt to collect the $250 Medicare Part D rebate checks.