Questions

CMS Releases “2 Midnights” Rule

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New provision is aimed to decrease the number of extended observation stays, while decreasing the number of short inpatient stays billed under Part A that should be billed under Part B as outpatient services.

New provision is aimed to decrease the number of extended observation stays, while decreasing the number of short inpatient stays billed under Part A that should be billed under Part B as outpatient services.

Question: Why does CMS want to decrease the number of extended observation stays?
Answer: Extended observation stays have a negative impact on beneficiaries since they require a 20 percent co-pay for the service and do not count towards the 3 inpatient day stay required for Medicare coverage skilled nursing facility (SNF) admissions.

The Centers for Medicare & Medicaid Services released its controversial “2 midnights” rule in the 2014 Medicare Inpatient Prospective Payment System (IPPS) final rule.

Under the “2 midnights” rule CMS has set both a benchmark and a presumption for when an inpatient satay would be considered appropriate.  If the inpatient stays spans two midnights, CMS will presume that the stay is reasonable and necessary. In addition, admitting clinicians can use the “2 midnight stay” as a benchmark in determining when it is appropriate to admit a patient as an inpatient rather than keeping the patient in an outpatient status in an observation unit. Read more


Time to Pick a Medicare Part D Plan

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Question: Can I be penalized for not joining a Medicare prescription drug plan when I’m first eligible?
Answer: Yes. If you don’t join a Medicare prescription drug plan when you’re first eligible or go without prescription drug coverage for a period of 63 or more days in a row after you qualify, you may have to pay a late-enrollment penalty.

Seniors get to choose a new Medicare Part D prescription drug plan each year during an annual enrollment period from Oct. 15 to Dec. 7. About 22.7 million people, or 43 percent of Medicare’s 52 million beneficiaries, are enrolled in these drug policies.

Medicare Part D

Shop around every year because premiums, covered medications, out-of-pocket costs and the plans offered change each year.

 

Medicare officials recommend seniors shop around for a new plan even if they are happy with their current coverage because premiums, covered medications, out-of-pocket costs and the plans offered change each year. Read more


What People Who Live to 100 Have in Common

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Question: I’ve heard that people who are more social live longer. Why is that?
Answer: Yes, many studies suggest that staying socially connected predicts greater life expectancy. Being social reduces stress and is helpful in getting care and support from others.

U.S. residents in several states live considerably longer than the rest of the country.

U.S. residents in several states live considerably longer than the rest of the country.

U.S News and World Report

A growing number of Americans are living to age 100. Nationwide, the centenarian population has grown 65.8 percent over the past three decades, from 32,194 people who were age 100 or older in 1980 to 53,364 centenarians in 2010, according to new Census Bureau data. In contrast, the total population has increased 36.3 percent over the same time period.

Centenarians in the United States are considerably different from the overall population. Here’s a look at some of the characteristics of people who live to age 100:

Female Gender

It is overwhelmingly women who live to age 100. In 2010, 82.8 percent of centenarians were female. For every 100 females age 100 or older, there are only 20.7 males the same age. Females also make up 61.9 percent of those in their 80s and 72.2 percent of people in their 90s. “We know that women are more social than men. Other studies have found that staying socially connected predicts greater life expectancy,” says Gary Small, a professor on aging and director of the UCLA Longevity Center in Los Angeles, who is not affiliated with the Census Bureau report. “If you are social, it may reduce stress levels because you can talk about your feelings and things that stress you out and it seems to help many people. If you need a ride to the doctor or you fall, they can take you to the hospital or help you find the best doctor.”

Less Diversity

Centenarians are considerably less diverse than the overall U.S. population. In 2010, some 82.5 percent of centenarians were white, versus 72.4 percent of the total population. Black or African Americans were unique in that their proportion of the centenarian population (12.2 percent) is about the same as their percentage of the total population (12.6 percent). Asians made up 2.5 percent of the centenarian population, while they make up 4.8 percent of the total population. And Hispanics represent 5.8 percent of centenarians, but 16.3 percent of the population. Read more