Medicare and Medicaid Law
Medicare is part of the Federal Government's Social Security Division and provides all United States citizens 65 years of age or older with long term care as well as coverage for the disabled. Eligibility is determined by various criteria set forth in the programs' policies. Whereas Medicaid, a federal and state program, ensures that individuals with lower incomes have access to health care. The criteria for Eligibility varies from state to state.
State Medicaid Plan
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Articles on HG.org Related to Medicare and Medicaid Law
- A Medicaid Work Requirement for Texas?One of the ideas being floated to help rein in the cost of Medicaid is to impose a work requirement for the program.
- What Triggers a Medicare or Medicaid Billing Fraud Investigation?Medicare and Medicaid billing mistakes can result in a fraud investigation with potentially serious consequences. You can be required to pay back up to three times the amount you were paid for improperly billed services. And, if the government believes the improper billing was intentional, you can face serious criminal charges, the loss of professional licenses, and exclusion from the Medicare and Medicaid programs.
- ABLE Accounts for Families with Special NeedsFamilies who have children with special needs often try to plan ahead to anticipate the needs of the child with disabilities. It is often very costly to provide for the basic needs of a child in this situation. However, parents who take steps to try to safeguard resources for their disabled child’s use may wind up causing a child to lose benefits. ABLE accounts may be able to fill in the gap for these families.
- Spouse in Long-Term Care and the Need to Update Estate PlanThere are certain times when individuals need to update their estate planning documents like their will, trust or power of attorney designations. Many individuals are familiar with common times, like when they get married or have children. However, another important time to update an estate plan is if a person’s spouse has started to receive long-term care.
- What Are the Uses for a Miller Trust?A Miller Trust is a special type of trust that adjusts a person’s income downward, usually in an attempt for the individual to retain eligibility for certain types of governmental benefit programs. Most often, these trusts are used for the purpose of establishing eligibility for the Medicaid program.
- Facts about a Special Needs TrustSpecial needs trusts are designed to help individuals have a better quality of life while retaining eligibility for government benefits. Individuals who have disabilities often have needs that are not covered by health insurance or government benefits. Because they may have limited income, special needs trusts help provide some of these supplemental needs without supplanting government benefits.
- NYC Bureau of Fraud Investigation "Interviews" about MedicaidA letter from the NYC Bureau of Fraud Investigation means that you are the target of a fraud investigation. How you respond to the letter can mean the difference between a minor inconvenience and criminal charges. You should get advice from an experienced Medicaid lawyer before you speak to the investigator. Anything you say to the investigator can and will be used against you.
- Avoiding Criminal Charges at the NYC Bureau of Fraud Investigation for Medicaid FraudEvery year, hundreds of New Yorkers face criminal charges because they provided false information on their Medicaid application or re-certifications. Your case does not have to end this way. In fact, most Medicaid fraud investigations are settled with no criminal charges at all. The key is how you respond to the Medicaid fraud investigators.
- What is a Special Needs Trust and when Should I have One Made?A special needs trust is a special type of trust that is used to supplement the needs of someone with a disability without causing him or her to lose other benefits to which he or she is entitled to receive. These trusts must often follow very specific guidelines to ensure that the beneficiary continues to maintain eligibility for governmental programs.
- Protecting the Elderly in TexasA state's elderly residents are among their most vulnerable residents. Recent Texas legislative issues/news announces a new state law scheduled to take effect in September. No longer will nursing homes with multiple citations for repeated violations get a break from hefty fines imposed by regulators.
- All Health Care and Social Law Articles
Articles written by attorneys and experts worldwide discussing legal aspects related to Health Care and Social including: defective drugs, failure to diagnose, informed consent, medical law, medical malpractice, medication errors, pharmaceutical law, social security, social services law, surgical errors.
Medicare and Medicaid Law - US
- Affordable Care Act
On March 23, 2010, President Obama signed into law the Affordable Care Act. The law puts into place comprehensive health insurance reforms that will hold insurance companies more accountable and will lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans.
- Center for Medicare and Medicaid Services
The Centers for Medicare and Medicaid Services (CMS) is a branch of the U.S. Department of Health and Human Services. CMS is the federal agency that administers the Medicare program and monitors the Medicaid programs offered by each state.
- Conditions of Participation (CoPs) and Conditions for Coverage (CfCs)
CMS develops Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) that health care organizations must meet in order to begin and continue participating in the Medicare and Medicaid programs. These minimum health and safety standards are the foundation for improving quality and protecting the health and safety of beneficiaries. CMS also ensures that the standards of accrediting organizations recognized by CMS (through a process called "deeming") meet or exceed the Medicare standards set forth in the CoPs / CfCs.
- Department of Health and Human Services (HHS)
The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.
- Medicaid - Overview
Good health is important to everyone. If you can't afford to pay for medical care right now, Medicaid can make it possible for you to get the care that you need so that you can get healthy – and stay healthy. Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. Depending on your state's rules, you may also be asked to pay a small part of the cost (co-payment) for some medical services.
- Medicaid Insurance - Wikipedia
Medicaid is the United States health program for eligible individuals and families with low incomes and resources. It is a means tested program that is jointly funded by the state and federal governments, and is managed by the states. Among the groups of people served by Medicaid are certain eligible U.S. citizens and resident aliens, including low-income adults and their children, and people with certain disabilities. Poverty alone does not necessarily qualify an individual for Medicaid. Medicaid is the largest source of funding for medical and health-related services for people with limited income in the United States.
- Medicare Insurance - Wikipedia
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over, or who meet other special criteria. The program also funds residency training programs for the vast majority of physicians in the United States. Medicare operates as a single-payer health care system.
- My Medicare - United States Government
MyMedicare.gov is part of the Medicare.gov web site. MyMedicare.gov is an optional, free, and secure site designed to help you check the status of your eligibility, enrollment, and other Medicare benefits. It also allows you to access your claims information almost immediately after it is processed by Medicare and provides you with preventive health information 24 hours a day, seven days a week.
- Patient Protection and Affordable Care Act
This is the major health care reform bill, signed into law by President Obama on March 23, 2010. It would expand health care coverage to 31 million currently uninsured Americans through a combination of cost controls, subsidies and mandates. It is estimated to cost $848 billion over a 10 year period, but would be fully offset by new taxes and revenues and would actually reduce the deficit by $131 billion over the same period.
- Social Security Administration
We deliver services through a nationwide network of over 1,400 offices that include regional offices, field offices, card centers, teleservice centers, processing centers, hearing offices, the Appeals Council, and our State and territorial partners, the Disability Determination Services. We also have a presence in U.S. embassies around the globe. For the public, we are the “face of the government.” The rich diversity of our employees mirrors the public we serve.
- Social Security Law - Medicare
Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those who have disabilities and those who have permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease). The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.
Organizations Related to Medicare and Medicaid Law
- American Seniors Association
Known nationally as "the conservative alternative to the AARP," the American Seniors Association works hard to fulfill its mission to provide seniors with the choices, information, and services they need to live healthier, wealthier lives. Our members' dignity and security matter most to us, and that's why thousands of Americans every year turn to the American Seniors Association for the help they need.
- Caregivers Action Network
The National Family Caregivers Association educates, supports, empowers and speaks up for the more than 65 million Americans who care for loved ones with a chronic illness or disability or the frailties of old age. NFCA reaches across the boundaries of diagnoses, relationships and life stages to help transform family caregivers' lives by removing barriers to health and well being.
- National Association of State Medicaid Directors (NASMD)
The National Association of State Medicaid Directors (NASMD) is a bipartisan, professional, nonprofit organization of representatives of state Medicaid agencies (including the District of Columbia and the territories). Since 1979, NASMD has been affiliated with the American Public Human Services Association (APHSA). The primary purposes of NASMD are: to serve as a focal point of communication between the states and the federal government, and to provide an information network among the states on issues pertinent to the Medicaid program.