“Quiet Improvement” to Medicare?

On several occasions we have posted about Jimmo v. Sebelius (in the interest of full disclosure, I’m on the board for the Center for Medicare Advocacy (CMA)). I was interested in reading Susan Jaffe’s March 25, 2014 post in the New Old Age Blog, A Quiet ‘Sea Change’ in Medicare.   Describing the impact of the settlement, Ms. Jaffe points out that notice was required to be given to “health care providers, bill processors, auditors, Medicare Advantage plans, the 800-MEDICARE information line and appeals judges — but not beneficiaries.”  The post talks about the impact on individuals receiving care in the community, requirements for certain services. 

The article provides information about how beneficiaries can request reimbursements, and offers beneficiaries some suggestions on what to do if denied coverage. As a last step the article suggests that beneficiaries contact CMA’s lawyers since “[t]hey are meeting regularly with Medicare officials to monitor compliance with the settlement and will tell the agency about coverage denials prohibited in the settlement. Despite Medicare’s efforts to get the word out, the center still receives complaints every week from people denied treatment only because they are not getting better.”

CMA has up-to-date information on its website as well as links to communications from CMS.