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Attorney Barry R. Crimmins is someone that you can depend on personally.
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Home Health Care Patients With Chronic Conditions Are Having Trouble Getting Medicare

January 26, 2018 By Barry Crimmins

Home Health CareMedicare is supposed to provide up to 35 hours a week of home care to those who qualify, but many Medicare patients with chronic conditions are being wrongly denied such care, according to Kaiser Health News. For a variety of reasons, many home health care agencies are simply telling patients they are not covered.

Medicare is mandated to cover home health benefits indefinitely. In addition, Medicare is required to cover skilled nursing and home care even if a patient has a chronic condition. Unfortunately, many home health providers are not aware of the law and tell home health care patients that they must show improvement in order to receive benefits.

According to a Kaiser Health News article, confusion over whether or not improvement is required (it is not) is one part of the problem. Another issue is that home health care workers are afraid they will not get paid if they take on long-term care patients. In an effort to crack down on fraud, Medicare is more likely to audit providers who provide long-term care. This encourages providers to favor patients who need short-term care.

In addition, Medicare’s Home Health Compare ratings website may be having a negative effect on home health care agencies' willingness to provide for long-term care patients. One measure of care qualification is whether a patient is improving. Because patients with chronic conditions don't necessarily improve, they could lower an agency's rating. Also, under a rule that just went into effect, home health care agencies cannot dismiss a patient without a doctor's note. This may make agencies even more reluctant to take on long-term care patients.

If you are wrongly denied Medicare home health benefits, you can appeal, although you may have to be persistent to get coverage. The Center for Medicare Advocacy has a self-help packet for navigating appeals.

 

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Elder Law News, October 2023

Getting older comes with opportunities and challenges, but fear not, we have your back! Are you concerned about Alzheimer’s? While there’s no known cure, proactive steps can help with prevention. Meanwhile, guess what? Signing up for Medicare Savings Programs just got simpler! The Feds have streamlined the process, making it easier to tap into helpful benefits.

Elder Law News, July 2023

Looping our readers in on the issues that impact the senior community is always a priority. And this month, there’s much to share.

June newsletter

Elder Law News, June 2023

As a trusted counsel for all things relating to eldercare in Massachusetts, I wanted to share pressing topics impacting our beloved seniors.

march newsletter

Elder Law News, March 2023

As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

BRC Newsletter March

Elder Law News, September 2022

As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

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