Medicare is for:
•People 65 and over
•People of any age who have kidney failure or long term kidney disease
•People who are permanently disabled and cannot work
Medicare is applied for at the local Social Security office.
Some people qualify for both Medicaid and Medicare, Medicaid is sometimes used to help pay for Medicare premiums. People who qualify for both programs are called 'dual eligible'.
This week the Supreme Court will hear oral arguments in the case of King v. Burwell, where the continued existence of the Affordable Care Act (ACA) is once again in jeopardy. Regardless of the merits of the case, I think we can all agree that media coverage of the ACA has exclusively been focused on its emphasis... Read more »
As predictable as an episode of “I Love Lucy“, this past week saw many reactions to the just published report issued by the Office of Inspector General at HHS on “Adverse Events in Skilled Nursing Facilities.” By now, the media mill has chewed through the report and spat out the juicy bits (here), while a... Read more »
Continuing from Monday’s post, below are a few final comments from the presenters at the 2014 AHLA, Long Term Care and the Law Conference: Medicare may begin to use bundled payment. Managed Medicaid and Medicare Advantage plans (MA) will be more aggressive with using post-acute care as a cost containment tool. Providers who can achieve quality will... Read more »
Traveling to Las Vegas, in search of a few days respite from this tiresome winter weather, recently brought me to the 2014 AHLA, Long Term Care and the Law Conference. The theme of this year’s conference should have been, “tremendous change is coming and some have a good idea what it will look like, but how... Read more »
In December of last year, the Senate Special Committee on Aging,currently chaired by Senator Bill Nelson with Senator Susan Collins serving as its ranking member, convened a hearing on the future of long term care policy. With 74 million boomers beginning to enter the long term services and supports (LTSS) ecosystem, the importance of this subject cannot be overstated. The... Read more »
The Holy Grail of reducing expenditures associated with providing medical and long term care services (LTC) to this complex population is propelling states to look to managed care organizations (MCOs) for answers. The reasoning is something like: since MCOs are capable of managing the expenditures of younger Medicaid beneficiaries, surely they will be able to... Read more »
With the potential federal government shutdown, the Syrian civil war and the Navy Yard killings in the news, it is not surprising that the recently released final report of the federal Commission on Long-Term Care received scant attention in the media. Although a few perfunctory articles appeared, the recommendations neither stimulated public debate about how... Read more »
In Illinois on January 1, 2014, those individuals who are beneficiaries of both the Medicare and Medicaid programs may begin to enroll in a redesigned health care delivery system. These new managed care plans will hopefully be easier to navigate, reduce inefficiencies, save costs and deliver improved health outcomes for this population. Learn more by... Read more »
New reports (here and here) on the changing landscape of long term services and supports (LTSS) for older adults continue to drive home the need for a national strategy to finance and develop a functional and affordable LTSS network. Their publication provides an interesting backdrop to the initial meetings of the new Commission on Long-Term Care. The 15-member commission remains one... Read more »
A flurry of activity, envisioned by Obamacare (ACA) and driven by fiscal necessity, is beginning to transform how providers of long term services and supports (LTSS) address the needs of older adults. Despite the growing interest in how the ACA will change healthcare delivery for working Americans, there is not much public coverage on the changes, which... Read more »