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    About this Episode

    Relief from the Medicare Part D "donut hole" gets started this month, June of 2010, when Medicare begins sending out the $250 rebate checks that you may have heard about.

    Recent Episodes from Medicare Minutes

    When Is a Hospital Stay Not a Hospital Stay? The Problem of "Observation Status"

    When Is a Hospital Stay Not a Hospital Stay?  The Problem of "Observation Status"
    One condition for Medicare payment for skilled nursing facility care is that a beneficiary be a hospital inpatient for at least three days before admission to the skilled nursing facility.  A primary concern among advocates has been that time in observation status and in the emergency room was not counted by the Medicare program as part of an inpatient hospital stay, even when that time was followed by a beneficiary's formal admission to the hospital as an inpatient.  Recently, however, a new and greater concern has arisen.  Beneficiaries throughout the country report that their entire stays in a hospital, including stays as long as 14 days, are classified by the hospital as "outpatient observation".

    Updates on the Medicare Improvement Standard

    Updates on the Medicare Improvement Standard
    As we have discussed previously  previous Podcasts, people with chronic conditions and long-term illnesses are often denied Medicare coverage because they supposedly:
    • Will not improve, or
    • Need "maintenance services only," or
    • Have "plateaued", or
    • Are "chronic and stable".
    These reasons are referred to as the Medicare "Improvement Standard." Medicare is often the only insurance for this population, so, unfortunately, Medicare coverage denials can result in the loss of necessary health care.  And we are trying to end it.

    Medicare Secondary Payer Issues

    Medicare Secondary Payer Issues
    In this episode of Medicare Minutes we take a look at some issues surrounding the Medicare Secondary Payer (MSP) Program, which seeks to that Medicare doesn not pay for services resulting form injury that should be paid for by another source. For more information on the MSP program, see our topic page, http://www.medicareadvocacy.org/medicare-info/medicare-secondary-payer-program.