HHS makes ownership data for all Medicare-certified hospitals publicly available
The Department of Health and Human Services released on the Centers for Medicare & Medicaid Services website detailed information on the ownership of more than 7,000 hospitals certified to participate in the Medicare program. The data elements include: * Enrollment information such as organization name, type, practice location addresses (e.g., off campus), National Provider Identifier […]
Medicare and home health care – defining the care Medicare buys
Medicare home health care covers skilled services for homebound beneficiaries who need part-time or intermittent care. To qualify, you must be confined to your home, meaning leaving requires considerable effort or assistance. Your doctor must certify that you need skilled nursing care, physical therapy, occupational therapy, or speech therapy, and must establish a care plan […]
What is the Medicare Shared Savings Program?
Medicare Shared Savings Program (MSSP) is a program created by the Centers for Medicare & Medicaid Services (CMS) that promotes accountability among providers and reduces costs for beneficiaries. As part of the MSSP, providers are encouraged to form Accountable Care Organizations (ACOs) to provide high-quality coordinated care at a lower cost to Medicare beneficiaries. ACOs […]
Medicare to cover medically necessary conditions requiring dental services
Medicare covers dental services when they are medically necessary and directly related to specific medical conditions or treatments. Since January 1, 2023, Medicare has expanded coverage for certain dental procedures that are integral to treating covered medical conditions. Medicare now covers dental services in these specific situations: reconstruction of a ridge when performed during surgical […]
Medicare to cover medically necessary conditions requiring dental services
Medicare covers dental services when they are medically necessary and directly related to specific medical conditions or treatments. Since January 1, 2023, Medicare has expanded coverage for certain dental procedures that are integral to treating covered medical conditions. Medicare now covers dental services in these specific situations: reconstruction of a ridge when performed during surgical […]
Does Medicare Cover Physical Therapy?
Physical Therapy Coverage by Medicare Outpatient physical therapy, occupational therapy, and speech therapy are covered by Medicare Part B. Private practice therapists, outpatient hospital departments, and skilled nursing facilities provide these services. What are the Limits on Physical Therapy? The Medicare therapy spending cap has been eliminated as of 2019. Therefore, Medicare does not limit […]
“Brain training” is the fastest growing Medicare Advantage fitness benefit
Brain training has emerged as the fastest growing Medicare Advantage fitness benefit since the Centers for Medicare & Medicaid Services began tracking distinct fitness benefit categories in 2019. When CMS required insurance plans to differentiate between physical fitness, wearable fitness trackers, and memory fitness programs, it revealed a significant trend in beneficiary preferences. Federal data […]
What is a Medicare Supplement Guaranteed Issue plan?
The Guaranteed Issue Rights (also known as Medigap Protections) are your rights when insurance companies are required to offer you certain Medigap policies. In these situations, an insurance company: – Must sell you a Medigap policy – Must cover all your pre-existing health conditions – Can’t charge you more for a Medigap policy because of […]
Medicare Treatment for Alcoholism and Substance Use Disorders
Mental illness and substance abuse disorders are covered by Medicare, but special rules limit coverage and reimbursement. Mental health, behavioral health, and substance abuse disorders are not as well covered by Medicare as other services. Treatment for Alcoholism and Substance Use Disorders Alcoholism and substance use disorders can be treated both inpatient and outpatient under […]