Tuesday, September 9, 2014

There is a New Way to File a Complaint with Medicare

By: Susan M. Graham, Certified Elder Law Attorney, Senior Edge Legal, Boise, Idaho

People covered by Medicare occasionally want to complain to Medicare to contest hospital discharge orders, nursing home care, home health services and hospice programs, all paid for by Medicare.

Effective August 1, 2014, the toll-free phone numbers to call have been changed for filing a Medicare complaint. If you are an Idaho Medicare beneficiary and you wish to file a complaint about the quality of care, or to file an appeal, call this toll-free number: (877) 588-1123.

Each state has a quality improvement organization. The formal name is “Quality Improvement Organization (Beneficiary and Family Centered Care).” The purpose of this organization is to work with providers on issues such as reducing hospital readmissions, prevent infections and review beneficiary complaints. In the past, there has been a perception that a conflict of interest existed because the prior organization that handles complaints also advised the providers (hospitals, nursing homes, etc.) With this new system, Medicare beneficiary appeals and complaints will go to independent regional contractors. Lavanta, the contractor that covers Idaho, is based in Maryland and handles the Northeastern and Western states.

Health care is an important part of estate planning. Save this phone number with your health information or paste it on the back of your Medicare card.

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