Anyway, while lying down on the sofa with this painful neck (from holding the heavy garden hose at shoulder level while my left hands fiddled with the removal of dried leaves, twigs, and branches from Maw’s tomato plants and flowering geraniums), I finished the Beneficiary’s letter regarding the “Request for Hearing”. The provider is appealing the claim/urging the ALJ to “render a Fully Favorable Decision on the Record“.
The scary part is that the “Beneficiary” may incur additional financial liability (on at least Part B). There may still be a chance for Part A. This means that we the people of the United States of America are truly on the “death panel”. And today’s mail is a sign/symptom of what is yet to come/has come to past and as a result we may have choose to refuse future hospitalization services altogether to avoid the potential for financial ruin.
Here are some useful reference contained from within the body/text of the attached:
- 42 CFR §405.1032;
- 42 CFR §405.1000(g);
- 42 CFR §405.1038(a);
- 42 CFR §405.956(b);
- 42 CFR §405.976(b);
- Centers for Medicare & Medical Services (CMS) Medicare Benefit Policy Manual, Publication 100-02, Chapter 1, Section 10;
- Medicare Program Integrity Manual, Chapter 6, Section 6.5.2;
- Section 1879 of the Social Security Act;
- CMS Ruling 95-1 was previously titled HCFA Ruling 95-1;
- Medicare Financial Management Manual (Pub. 100-06), Chapter 3 on Overpayments, §70.3;
- Section 1879(c) of the Social Security Act; and
- CMS 1599-R.
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