Most of our clients who are elder-care providers are aware of the 100 days of skilled care (Nursing Home Coverage) that Medicare will provide. Due to the COVID crises, an extension of this timeline is available.
Elder-Law Attorney Ira Leff describes this in detail on his website. The summary below is reprinted with permission from his blog.
The Centers for Medicare and Medicaid Services (CMS) announced on March 13, 2020, a COVID extension of the normal 100-day nursing home skilled care benefit. It applies to residents who have been delayed or prevented from ending their current benefit due to the pandemic. The normal requirement of a 60-day break from skilled care before starting a new benefit period is waived and the resident may receive up to another 100 days of skilled care covered by Medicare.
In theory, this waiver makes good sense. However, there are several practical problems which have impeded its implementation.
Many nursing homes don’t understand the waiver and, therefore, don’t provide the proper documentation for the file.
Some QIOs which review coverage appeals for CMS are not familiar with the waiver.
CMS employees at Medicare’s 800 number told callers that there is no process for beneficiaries to apply for the waiver. Only the nursing homes could do so. This position was confirmed by a CMS regional office.
Some Medicare Advantage Plans think that the waiver does not apply to them.
It appears that the Medicare Beneficiaries’ rights have gone by the wayside as a result of this crisis!
Ira can be contacted at info@rialeff.com.
Remember that we're just a click away if you need help.
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He is also a founding Board Member and Finance Director of the Fayette Pregnancy Resource Center and serves on the Board of the National Equal Rights Institute.
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