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Important Changes in Medicare

twig's picture

From the New York Times, good news for people with chronic health issues that are unlikely to improve:

Should the federal government cover the costs of many kinds of treatments for patients who aren’t going to get any better?

It didn’t, for many years. But after the settlement of a landmark class-action lawsuit this week, Medicare will soon begin paying more often for physical, occupational and other therapies for large numbers of people with certain disabilities and chronic conditions like Alzheimer’s disease, multiple sclerosis and Parkinson’s disease.

The article goes on to explain that although it may take some time for the changes to take effect, patients could start asking for the expanded services now (see page 2 of story).

...some patient advocates see no reason for people not to demand coverage that maintains their condition or slows deterioration right now, given that Medicare was supposed to be paying for it all along.

[emphasis added]


Alexa's picture
Submitted by Alexa on

patients to receive much needed therapy. I noticed that the HHS spokesperson declined to comment, even though the settlement had been reached (just not finalized by the Court). I suppose that is standard procedure.

I am concerned about one change to Medicare enacted under the ACA. Apparently, the Act phases out reimbursement payments from the federal government to hospitals for uncollected Medicare patients' bills or accounts.

Are we to believe that hospitals won't pass these losses on to "consumers?" Or even worse, could they begin to require deposits or co-pays from Medicare patients prior to hospitalization. Hopefully, Medicare regulations disallow this.

But it is a good day for those who desperately need therapy to make their lives tenable. Thank you for this encouraging story, twig. I needed to hear one.

Submitted by hipparchia on

I am concerned about one change to Medicare enacted under the ACA. Apparently, the Act phases out reimbursement payments from the federal government to hospitals for uncollected Medicare patients' bills or accounts.

that would be the dsh (disproportionate share hospitals) programs, and they're sorta complicated. basically, the federal govt gives money to hospitals, through both medicare and medicaid, to hospitals to help make up for people who can't pay their hospital bills.

the theory behind that part of ppaca is that once everybody has insurance, they'll all be able to pay all their hospital bills and the dsh progrms will no longer be needed. actually, even the designers of ppaca realize that this isn't 100% true and that SOME dsh-type of fallback program will still be needed, so the ppaca plan is to cut the funding for dsh programs way back, rather than eliminate it entirely.

the reality is that the ppaca-designed insurance is NOT going to cover everybody's medical bills. it will be interesting [in a watching-train-wrecks kind of way] to see where the hospitals try to get that money from in the future. i'm guessing that the hospital industry and the insurance industry will lobby to get the dsh programs re-expanded [or some other govt handout to big medicine developed] and that their wishes will be granted and we won't actually see a huge problem with this.

Alexa's picture
Submitted by Alexa on

hope that you're right regarding the hospital/insurance industry getting the "dsh" programs re-expanded. Got several relatives (with combined approximately 175 years of experience in insurance) who say that for sure the losses will be passed on to the "consumer." (They actually use that jargon now, instead of client.)

It would be devastating for some seniors if that had to come up with massive co-pays prior to every hospitalization.

Actually, "train-wreck" is a great description of the entire bill. It is hard for me to wrap my head around the fact that the "designers" of this bill actually thought that it made sense to set up a system that would put the poorest citizens in the position to have the least coverage. (If I remember correctly, the exchange will offer policies with 60/40 coverage.) Incredible, and so unnecessary.

BTW, I'm taking your advice about Twitter, and following news outlets,etc., with lots of followers.

It will be the perfect vehicle for getting out various C-Span videos, video clips, committee hearings, etc., that I want to share. And much quicker than writing a blog. Thanks for the hints.

Submitted by hipparchia on

there are other, worse, possibilities, of course. the republican party, and far too many democrats, are out to destroy medicare [and social security] entirely and ppaca is one gateway through which they can do it if we don't stop them.

Submitted by lambert on

... though twitter is quicker, you also don't get responses like this one using it.

Alexa's picture
Submitted by Alexa on

and it is my intention to post some of those "Tweets" here, for just that reason.

It will take weeks to go through several long congressional hearings in order to make 'short clips' for dissemination, but I'm going to do it as time permits.

I discovered by accidentthe other day that some of the hearings are NOT embeddable directly to the comment, or Quick Hit sections, but they do embed in "Tweets."

Hence, "Tweets" it will be. I won't necessarily post all of them here, but I plan to post the most pertinent ones, for sure.