ProHealth health Vitamin and Natural Supplement Store and Health
Home  |  Log In  |  My Account  |  View Cart  View Your ProHealth Vitamin and Supplement Shopping Cart
800-366-6056  |  Contact Us  |  Help
Facebook Google Plus
Fibromyalgia  Chronic Fatigue Syndrome & M.E.  Lyme Disease  Natural Wellness  Supplement News  Forums  Our Story
Store     Brands   |   A-Z Index   |   Best Sellers   |   New Products   |   Deals & Specials   |   Under $10   |   SmartSavings Club

Trending News

Is Coconut Oil Healthy? (The American Heart Association Doesn’t Think So)

American Heart Association Renders Itself Obsolete With 1960s Dietary Advice on Coconut Oil

Ginger Fights Obesity

Health Benefits of Artichokes

Putting the Spotlight on Coriander Seed Oil

Migraines? Powdered Ginger May Help

Are Americans Really Getting Too Much Vitamin D? A Critical Look at Recent Media Warnings

Eating more vegetable protein may protect against early menopause

Vitamin C and antibiotics: A new one-two 'punch' for knocking-out cancer stem cells

German Chamomile Oil: A Versatile Essential Oil You Should Have at Home

 
Print Page
Email Article

Medicare Takes Steps To Eliminate Discrimination for Alzheimer’s Patients

  [ 138 votes ]   [ Discuss This Article ]
www.ProHealth.com • January 4, 2002




Discriminatory practice in the Medicare program affecting people with Alzheimer’s will no longer be allowed, according to a new program memorandum issued by the federal Centers for Medicare and Medicaid Services (CMS).

Prior to the new policy, when a patient was given a primary diagnosis of Alzheimer’s disease or any other form of dementia, some Medicare carriers and intermediaries restricted or denied certain medical services immediately, even though they were commonly covered by Medicare in people without Alzheimer’s disease.

The new policy states that contractors may not use computer edits that result in the automatic denial of services based solely on the codes for Alzheimer’s or dementia. Throughout the course of their disease, individuals with Alzheimer’s disease or dementia may benefit from physical, occupational, speech-language and other therapies, all of which were denied by some carriers and intermediaries.

CMS explains, “a claim submitted with only the diagnosis of Alzheimer’s disease may entitle a beneficiary to evaluation and management visits and therapies if a contractor determines that these therapies are reasonable and necessary when reviewed in the context of a beneficiary’s overall medical conditions.”

Providers will be instructed to enter the primary diagnosis or condition as well as the secondary diagnosis that most closely reflect the medical necessity of the service. And, when a beneficiary with dementia experiences a health problem unrelated to the dementia, the provider should submit a claim with a primary diagnosis that most accurately reflects the need for the provided service.

The policy change was advocated for by the Alzheimer’s Association’s Medicare Advocacy Project, a collaborative project of the Association and the American Bar Association Commission on Legal Problems of the Elderly.

According to Leslie Fried of the Alzheimer’s Association’s Medicare Advocacy Project, most people with Alzheimer’s have been in a ‘Catch-22.’ Medical researchers and clinicians encourage the early diagnosis of Alzheimer’s disease in order to maximize the benefits of early intervention and treatment. However, early diagnosis of the disease had often resulted in the denial of Medicare coverage and subsequent denial of access to care.

“The new policy should begin to eliminate the discrimination people with Alzheimer’s had been experiencing. However, for this policy to really make needed medical care available for people with Alzheimer’s, insurance carriers and intermediaries must begin to implement the new ruling,” said Fried. “An education program is needed to alert carriers of the rule. We are encouraged that the process should move quickly since CMS has been very responsive to the needs of this community.”



Post a Comment

Featured Products From the ProHealth Store
Energy NADH™ 12.5mg Ultra ATP+, Double Strength Optimized Curcumin Longvida®

Looking for Vitamins, Herbs and Supplements?
Search the ProHealth Store for Hundreds of Natural Health Products


Article Comments



Be the first to comment on this article!

Post a Comment


 
NAD+ Ignite with Niagen

Featured Products

Ultra EPA  - Fish Oil Ultra EPA - Fish Oil
Ultra concentrated source of essential fish oils
Vitamin D3 Extreme™ Vitamin D3 Extreme™
50,000 IU Vitamin D3 - Prescription Strength
FibroSleep™ FibroSleep™
The All-in-One Natural Sleep Aid
Ultra ATP+, Double Strength Ultra ATP+, Double Strength
Get energized with malic acid & magnesium
Mitochondria Ignite™ with NT Factor® Mitochondria Ignite™ with NT Factor®
Reduce Fatigue up to 45%

Natural Remedies

Optimize Your Immune System Naturally: Thymic Protein A Optimize Your Immune System Naturally: Thymic Protein A
Rejuvenating the Brain - How PQQ Helps Power Up Mental Processing Rejuvenating the Brain - How PQQ Helps Power Up Mental Processing
Health Benefits Are Brewing in Green Tea Health Benefits Are Brewing in Green Tea
SAD? Coping with Seasonal Affective Disorder SAD? Coping with Seasonal Affective Disorder
Block food Cravings At Their Molecular Root Block food Cravings At Their Molecular Root

CONTACT US
ProHealth, Inc.
555 Maple Ave
Carpinteria, CA 93013
(800) 366-6056  |  Email

· Become a Wholesaler
· Vendor Inquiries
· Affiliate Program
SHOP WITH CONFIDENCE
Credit Card Processing
SUBSCRIBE TO OUR NEWSLETTERS
Get the latest news about Fibromyalgia, M.E/Chronic Fatigue Syndrome, Lyme Disease and Natural Wellness

CONNECT WITH US ProHealth on Facebook  ProHealth on Twitter  ProHealth on Pinterest  ProHealth on Google Plus

© 2017 ProHealth, Inc. All rights reserved. Pain Tracker App  |  Store  |  Customer Service  |  Guarantee  |  Privacy  |  Contact Us  |  Library  |  RSS  |  Site Map