On the Healthcare Front
Issue #18: August 2023
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when should you call kepro?
- If you are not ready to be discharged from the hospital.
- If your Medicare skilled services are ending too soon. Examples of skilled services include things like physical therapy and nursing services.
- If you have a concern about the quality of care you received.
- If you have a concern about your medical care that needs to be taken care of right away.
Click on the link below for the phone number for your state. These services are free for people who have Medicare.
august is national immunization awareness month
The Centers for Disease Control and Prevention (CDC) has resources on their website: www.cdc.gov
Use the Adult Vaccine Assessment Tool to learn about vaccinations you may need. All you need to do is answer a few quick questions. You can bring the list the next time you see your doctor.
have you heard about 211 — a non-emergency referral service for statewide, nationwide, and community services?
2-1-1 is a special abbreviated telephone number reserved in the North American Numbering Plan as an easy-to-remember three-digit code to reach information and referral services to health, human, and social service organizations.
211 has information you can use in your everyday life, such as accessing affordable health care or finding a COVID vaccine provider near you.
Every call is completely confidential.
Simply call 211 to speak to someone now or search by location for online resources and more contact information.
Search online: www.211.org
The Centers for Medicare & Medicaid Services (CMS) has released news items about Alzheimer’s disease. Since this disease affects millions of Americans, we wanted to share this information from Medicare.
On June 22, CMS shared new details about how people can get drugs that may slow the progression of Alzheimer’s disease covered by Medicare.
Read more about the announcement: Fact sheet
On July 6, the CMS announced that broader Medicare coverage was available for Biogen and Eisai’s Leqembi (the brand name for lecanemab) following the Food and Drug Administration’s move to grant traditional approval to the drug that treats individuals with Alzheimer’s disease.
Read more about the announcement: Press release
Read about Alzheimer’s disease:
Alzheimer’s and Healthy Aging (Centers for Disease Control and Prevention website)
Alzheimer’s Disease Fact Sheet (National Institutes of Health website)
Immediate Advocacy is a free service for people with Medicare. It is used to help people quickly resolve a problem about medical care or services. Immediate Advocacy often involves Kepro calling a healthcare provider or facility on behalf of the patient.
This story is about how Kepro’s free Immediate Advocacy services helped a Medicare patient when there was a breakdown in communication between him (the patient) and a medical supplies/equipment company.
Todd is a very busy electrician. The job involves residential and commercial assignments, which - as you can imagine - includes lots of going up and down ladders and stairs. After 40+ years doing this work, Todd’s knees were in need of repair. After years of being in quite a bit of pain, he decided to finally have the surgery that his doctor had been suggesting – knee replacement surgery. He didn’t really like hospitals – who does really? – but he had confidence in his doctors and had the surgery. The surgery went smoothly, and after a short hospital stay, he was discharged to a skilled nursing facility. Luckily, his friend’s son worked in health care (he was a registered nurse) and provided guidance in how to choose a skilled nursing facility.
Medicare Part A (Hospital Insurance) covers skilled nursing facility care for a limited time (on a short-term basis).
Todd’s stay at the skilled nursing facility allowed him to get the physical therapy he needed before going back home. He lived alone and needed to be able to be independent and do things for himself.
He was told he would need a new brace that allowed for bending of the knee, which would enable him to ride in a car. But after a week had gone by, it still had not been ordered. He tried talking with staff at the skilled nursing facility, but he didn’t know who he should speak with and had a difficult time navigating the situation. That’s when he called Kepro and asked to speak to someone about Immediate Advocacy services.
Todd spoke with a Kepro nurse about his situation – not being able to get a knee brace. The Kepro nurse listened and asked some questions to be sure she understood what was happening. Kepro then called the facility and found the correct person to speak with. Kepro discovered that the brace that was originally ordered was on back order. Then the staff person working on the issue went on emergency leave, and it got lost in the shuffle a bit. After speaking with the Kepro nurse, the facility staff looked for a new brace and finally found one through a local supplier that should arrive in a few days.
The patient was pleased that Kepro helped to identify the issue and provided a speedy solution.
Find nursing homes including rehab services near you: www.medicare.gov
Learn more about Kepro’s free Immediate Advocacy Services by reading more on Kepro's website - Immediate Advocacy Services - or watching a video - Quickly Resolve a Medical Concern Using Immediate Advocacy Services.
Publication No. RI146810-313-8/2023. This material was prepared by Kepro, a Medicare Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.