Some courts have commented on the hostile attitude on the part of CMS in terms of DSH payment adjustment. One of the contested DSH policies concerns the treatment of dual-eligible patient days in DSH calculation.KeoughPartnerChristopherPartnerL.PartnerDennis Barry's Reimbursement Advisor...
Medicare Advantage (MA) plans, privately administered insurance plans that bear risk for Medicare spending, often offer supplemental benefits not covered by traditional Medicare. Supplemental benefits historically included services such as dental, vision, and hearing care, but recently they have become ...
Slightly more than half of traditional Medicare dual eligible beneficiaries reported that they had to skip their regular check up in 2020. In contrast, a little over a third of Medicare Advantage dual eligible enrollees said the same. That year, diagnostics or medical screenings, tre...
For people who have both Medicare and Medicaid (called “dual eligible”) Institutional Special Needs plans (I-SNPs) For people who live in a skilled nursing facility A person who lives in a contracted assisted living facility and needs the same kind of care as those who live in a skilled...
North Carolina Medicaid Fee-for-Service (FFS) Adjusted Spending Rates per Person-Year (PPY) in the Year Before and After New Enrollment in Dual-Eligible Special Needs Plans (D-SNP) or Other Medicare Advantage (MA) Plans View LargeDownload Source: linked 100% Medicare and North Car...
Dual Enrollment Advocate™ and Recert Complete® is a consumer-centric solution bundle to help health plans improve member satisfaction by helping members obtain and retain added benefits through dual-eligible enrollment and recertification services....
The second scenario consisted of raising the Medicaid asset test limits to match the 2016 Medicare Savings Program income limit which would put the asset limits at $7,280 for individuals and $10,930 for couples. This change would increase the number of eligible Medicare benef...
A Dual Special Needs plan (D-SNP) is a type of health insurance plan. It’s for people who have both Medicare and Medicaid. These plans are designed for people who may need more help because of disabilities, age or health conditions. ...
and community&based carehospitalizationslong&term careMedicaidMedicareTo provide the first plausibly causal national estimates of health outcomes for older dual-eligible recipients of Medicaid HCBS relative to nursing home care and to explore possible mechanisms for the effect.#We use 2005 and 2012 ...
Medicare and Medicaid Dual-Eligible Special Needs Plan Enrollment and Beneficiary-Reported Experiences With Care David J. Meyers, PhD, MPH1;Kendra Offiaeli, BA1;Amal N. Trivedi, MD, MPH1;et alEric T. Roberts, PhD2 Author AffiliationsArticle Information ...