Medicare Explained, 2012 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 2011 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 the 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 2012 Edition has been updated to include:

Expanded discussion of accountable care organizations

Explanations of new annual election period and "blended benchmark" for Medicare Advantage plan payments

Updated discussions of health care reform impact on reimbursement systems for 2012

Explanations of new requirements for quality improvement organizations