Section Newsletter Articles on Medicare and Medicaid

The final rule and other mechanisms to reduce the backlog of Medicare appeals. Will they work? By Michelle E. Lin Health Care Law, June 2017 In recent years, the Medicare appeals process has experienced an unprecedented and sustained increase in the number of appeals. A variety of factors have contributed to this and to the resulting backlog of cases. In this issue of the Health Care Lawyer, attorney Michelle E. Lin examines and explains new regulations designed to improve the appeals process making it more efficient and consistent.
Overview of the healthcare landscape as it relates to Medicaid managed care By Dara M. Bass Mental Health Law, June 2017 A Request for Proposals (RFP) has been issued to determine what the changes to Medicaid might be, and it's likely to create a number of different changes in Medicaid for the state of Illinois.
MEDICARE: Claim review programs could be improved with additional prepayment reviews and better data Health Care Law, June 2016 A summary of the Government Accountability Office (GAO) report, “Medicare: Claim Review Programs Could Be Improved with Additional Prepayment Reviews and Better Data,” GAO-16-394 released May 13, 2016, which looks at the current operations of Medicare audit contractors.
Be (A)ware of Medicare Advantage By Patricia A. Zimmer Insurance Law, June 2015 It may appear to the unwary that this is plain old, run-of-the-mill health insurance. It is not.
Medicare primer, part II By Janet Morgan Senior Lawyers, June 2015 The second part of this two-part series discussing Medicare basics and supplemental insurance.
Be (A)ware of Medicare Advantage By Patricia A. Zimmer Tort Law, March 2015 It may appear to the unwary that this is plain old, run of the mill health insurance. It is not.
Medicare primer By Janet Morgan Senior Lawyers, February 2015 The information contained in this article is a compilation acquired from three major sources: the Senior Health Insurance Program Counselor’s Manual 2014 edition, the Medicare & You 2015 Handbook, and the 2013-2014 Medicare Supplement Premium Comparison Guide.
Medicare Medicaid Alignment Initiative (MMAI): The next chapter of HFS managed care By Sandy Leith Elder Law, June 2014 Highlights from the author's presentation at the Elder Law Bootcamp reviewing what's next in managed care.
Modified policy on Freedom of Information Act disclosure of amounts paid to individual physicians under the Medicare Program Centers for Medicare & Medicaid Services Health Care Law, March 2014 In January, the Centers for Medicare & Medicaid Services (CMS) announced that effective March 18, 2014, it will follow “a new policy regarding requests made under the Freedom of Information Act for information on amounts paid to individual physicians under the Medicare program. . . .” Under this new policy, physicians may find that their Medicare payments in a given year become public information. A summary of this new policy is included in this issue.
News from the trenches—Medicaid update By Anthony B. Ferraro Elder Law, February 2014 A report on the presentations and conversations arranged and conducted by the Illinois Chapter of the National Academy of Elder Law attorneys with representatives of the Office of Inspector General  for the Department of Healthcare and Family Services.
Practice Tip—Review your clients’ Medicare supplement policies By James T. Nyeste Trusts and Estates, November 2013 The author advises that practitioners with elderly clients should get a copy of the client's Medicare supplement policy, since it's possible that the client has a legacy Medicare supplement policy that provides extended coverage.
Medicaid: Alternative measures could be used to allocate funding more equitably Health Care Law, June 2013 GAO Looks at Medicaid Funding Formula: In a recent report the Government Accountability Office (GAO) looked at the funding formula for Medicaid and concluded that alternatives to the current formula might make sense and work in a more appropriate manner. This issue contains a summary of the GAO’s report.  
Farms and the new 2013 Medicare tax increases By Marc C. Lovell Agricultural Law, December 2012 An overview of how the new health care reform measures will affect farmers.
Higher use of advanced imaging services by providers who self-refer costing Medicare millions Health Care Law, December 2012 Self-referral by physicians is controversial. In September, the Government Accountability Office (GAO) released a report looking at the costs to Medicare associated with self-referral for imaging services. In this report, the GAO estimates that in 2010, providers who self-referred made 400,000 more referrals for imaging services than they would have if they were not self-referring. These additional referrals cost Medicare about $109 million. A summary of the report is included in this issue of the Health care Lawyer.  
Top 10 myths of Medicare, Part III By Richard L. Kaplan Trusts and Estates, November 2012 This is the third and final in this series on Medicare.
Top 10 myths of Medicare (Installment two of a three-part series) By Richard L. Kaplan Trusts and Estates, October 2012 Part Two in this series takes a look at Medicare's funding.
And it’s another curve ball—The SMART Act brings more changes to the Medicaid eligibility rules By Constance B. Renzi Elder Law, September 2012 While the SMART Act has made many significant changes to Medicaid in Illinois, this article will focus on the changes impacting the Medicaid eligibility rules for long-term care.
Top 10 myths of Medicare By Richard L. Kaplan Trusts and Estates, September 2012 Part One in this series providing an overview of the most significant myths of Medicare.
Practice Tip: Lawyers beware—Centers For Medicare And Medicaid Services’ updated reporting guidelines have stiff penalties for failure to report By Jay Shultz General Practice, Solo, and Small Firm, July 2012 As anticipated, the Center for Medicare and Medicaid Services released two alerts regarding the reporting of certain settlements, judgments, awards or other payments.
How to obtain a “Zero Interest Letter” from Medicare in a wrongful death action By Scott D. Lane Tort Law, June 2012 A sample letter to assist Plaintiff’s counsel in obtaining a rapid response from Medicare and facilitate distribution of the proceeds recovered.
Medicare issues in workers’ compensation cases—What every practitioner should know By Nicole M. Schnoor Workers' Compensation Law, April 2012 Early recognition of Medicare issues and consideration of funding a non-submitted Medicare Set-aside Agreement can help expedite the overall settlement process and remove the element of surprise when a Medicare issue is encountered late in settlement negotiations.
Summary of DRA changes that will affect your clients and how you process their Medicaid applications By Kerry R. Peck and Diana M. Law Elder Law, December 2011 A summary of the major changes going into effect on January 1, 2012.
Wrapping up the case: a primer By Angelica W. Wawrzynek Young Lawyers Division, December 2011 A how-to for finalizing your first personal injury case.
A quick guide on how to deal with a Medicare lien By Angelica W. Wawrzynek Young Lawyers Division, December 2010 Step-by-step instructions for successfully dealing with Medicare.
New Medicaid rules harm women, seniors By Diana M. Law Women and the Law, October 2010 The Federal Deficit Reduction Act of 2005 imposes harsh penalties against seniors who gift money for any reason to family members and charities, since it presumes the money was transferred to qualify for Medicaid long-term care benefits.
An alternative: Public housing or housing vouchers By Donald A. LoBue Elder Law, February 2010 Some attorneys in the elder law practice spend a considerable amount of time advising clients on how to qualify for Medicaid and Medicare. As a general rule, Medicaid does not come into play until a person with a medical condition needs assisted care.
Medicare: Improvements needed to address improper payments in home health Health Care Law, June 2009 Concerns have been raised that improper payments from practices indicating fraud and abuse may have contributed to Medicare home health spending and utilization.
Case study: An example in combining VA, Medicaid, and Community Care benefits to avoid long-term care placement By Steven C. Perlis Elder Law, April 2009 An example of a situation where several public benefits might be simultaneously available and enable an eligible client to remain at home rather than being forced into an institutional living situation.
In-sites Government Lawyers, December 2008 This column has covered topics such as finding information about Medicare and researching safety ratings of nursing homes. On a related topic, we recently discovered a new e-newsletter for caregivers of those on Medicare.
Nationwide review of the Centers for Medicare & Medicaid Services Health Insurance Portability and Accountability Act of 1996 oversight by Office of Inspector General, Department of Health and Human Services Health Care Law, December 2008 On August 21, 1996, Congress enacted P.L. No. 104-191, the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Sections 261 and 262 of HIPAA established national standards that protect the confidentiality and integrity of electronic protected health information (ePHI) while it is being stored or transmitted between entities.