Dorotha C. White Foundation

Patient/Family Rights Patients and family members are not often informed that Medicare beneficiaries are entitled to up to 100 days of coverage per spell of illness under the Social Security Entitlement Act of 1966. Medicare coverage includes rehabilitative and restorative services after a qualifying stay in the hospital. Care facilities should also be keeping families abreast of implications of Medicare and spend down issues related to personal assets being used to pay for health care before the Medicaid benefit can be claimed. Currently, the national average Medicare coverage is 19 days. The full use of the 100 day benefit was upheld in 1986 by a Connecticut District Court in the landmark federal case of Fox v Bowen (link to Federal District Court Case Fox v Bowen 656 F. Supp 1236 (D. Conn. 1986) and Transmittal 262 (link to Transmittal 262: “What they haven't told you about Medicare Coverage”). Thousands of skilled nursing facilities are under-billing Medicare and denying beneficiaries care because of non-compliance by Centers for Medicare and Medicaid Services (CMS) with Fox v. Bowen. Federal District Court Case Fox v. Bowen 656 F. Supp 1236 (D. Conn. 1986) Transmittal 262: "What they haven't told you about Medicare Coverage?"
together we can make a difference

Patient/Family Rights

Patients and family members are not often informed that Medicare beneficiaries are entitled to up to 100 days of coverage per spell of illness under the Social Security Entitlement Act of 1966. Medicare coverage includes rehabilitative and restorative services after a qualifying stay in the hospital. Care facilities should also be keeping families abreast of implications of Medicare and spend down issues related to personal assets being used to pay for health care before the Medicaid benefit can be claimed.

Currently, the national average Medicare coverage is 19 days. The full use of the 100 day benefit was upheld in 1986 by a Connecticut District Court in the landmark federal case of Fox v Bowen (link to Federal District Court Case Fox v Bowen 656 F. Supp 1236 (D. Conn. 1986) and Transmittal 262 (link to Transmittal 262: “What they haven't told you about Medicare Coverage”). Thousands of skilled nursing facilities are under-billing Medicare and denying beneficiaries care because of non-compliance by Centers for Medicare and Medicaid Services (CMS) with Fox v. Bowen.

together we can make a difference