Medicare Explained, 2013 Edition

Medicare Explained has been prepared for Medicare beneficiaries and others who need a relatively thorough explanation of the Medicare program with particular emphasis on services covered in institutional settings and services provided by physicians and suppliers.

Published annually, Medicare Explained includes changes made during 2012 by law and regulation amendments and updates to program manuals issued by the Centers for Medicare and Medicaid Services (CMS).

Medicare Explained includes:

• Analysis of legislative, regulatory and agency guidance issuance on available benefits
• Exclusions from Medicare
• The administration of the Medicare program
• Medicare payment rules under Parts A, B, C, and D
• Details on the process for submitting beneficiary claims as well as the appeals process

The 2013 Edition has been updated to include:

• Expanded discussion of accountable care organizations
• Updated discussions of health care reform impact on reimbursement systems for 2013
• Expanded discussion of new quality of care initiatives