Planning for Life

Don't Miss Out on Your 100 Days of Medicare SNF Care

Posted by Harry S. Margolis on September 15, 2020

By Harry S. Margolis


You probably know that Medicare does not pay for long-term care, just for "medical" care from a doctor or other health care professional or in a hospital. But there's a partial exception to this rule. Medicare will pay for up to 100 days of care in a skilled nursing facility (SNF) as long as the following two requirements are met:

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Topics: Medicare, skilled nursing facility

What is Settlement Planning?

Posted by Harry S. Margolis on April 1, 2020

A settlement or award of damages in a personal injury case means the end of litigation. It’s the biggest step – but only the first step – in assuring your financial future. You need to make sure that the award is maximized, that the funds are safeguarded, and that you preserve your eligibility for public benefits. This involves a number of issues, including:

Resolving Liens – Personal injury settlements and awards to minor or disabled plaintiffs are often subject to claims by Medicare, Medicaid (MassHealth), or private insurers. These must be resolved prior to any distribution of funds. It's often best that this be done as part of settlement negotiations, because a lien holder—the state, federal government, or insurance company—has an incentive to help the case settle. Your personal injury attorney will resolve any of these liens as part of the litigation.

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Topics: Medicare, special needs planning, MassHealth, personal injury settlement

What to Do About Medicare Observation Status

Posted by Harry S. Margolis on February 27, 2020

Medicare-Observation-Status-Hospital-By Harry S. Margolis

Hospitals are more and more frequently designating patients as being in the facility for observation only without admitting them as full hospital patients. The problem with this has to do with the source of payment under Medicare and ultimately, whether subsequent care in a skilled nursing facility will be Medicare covered.

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Topics: Medicare, residents rights, observation status

Reminder: There is No Such Thing as a Medicare Improvement Standard

Posted by Anthony Bushu on March 8, 2017

By Harry S. Margolis

hospital-discharge-protections-medicare-legal-guide.pngFor decades, Medicare, skilled nursing facilities, and visiting nurse associations have applied the so-called "improvement" standard in determining whether residents were entitled to Medicare coverage of the care. The standard, which can be found nowhere in Medicare law, only permitted coverage if the skilled treatment was deemed to contribute to improving the patient's condition, which can be difficult to achieve for many ill seniors.

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Topics: Medicare, nursing homes

Cure vs. Care: The Whacked Out World of Medicare Reimbursement

Posted by Harry S. Margolis on December 31, 2013

By Harry S. Margolis

The other day, on Diane Rehm's National Public Radio program, Katy Butler, author of Knocking on Heaven's Door: The Path to a Better Way of Death, described how caring for her father after a severe stroke essentially killed her mother. It sounded like part of this had to do with her mother's unwillingness to accept help. But a large part of it has to do with a Medicare system and medical establishment whose whole focus is on curing patients, rather than caring for them.

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Topics: Medicare, end-of-life

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