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You are here > Home > Reading Lists > Law, Ethics, Malpractice, Accreditation & Compliance > Social Security and Medicare Answer Book Social Security and Medicare Answer Book, 4th Edition David A. Pratt, Aspen Health Law & Compliance Center; Wolters Kluwer Law & Business Hardcover Book: 850+ pages ISBN 0735591466 978-0735591462 Aspen Publishing December 2010 (click button below for best currently available price for this title) Fully Updated to Include the Impact of the 2010 Health Care Reform Legislation!!   Social Security and Medicare Answer Book provides the specific guidance you need so you can ensure your clients receive maximum benefit under the law. Social Security and Medicare Answer Book contains separate, in-depth sections devoted to: Social Security: You'll find detailed explanations of the types of benefits available, who qualifies, how to apply, and what to do if you are denied benefits. You'll learn how to calculate benefits and when and how benefits may be lost. Medicare Part A: You'll find detailed explanations of the coverage and rules for each of the categories covered under Part A, namely, inpatient hospital care, skilled nursing facilities, home health services, and hospice care. Medicare Part B: You'll get full details on the specific services covered under Part B, including outpatient and partial hospitalization, home health services, nurse-midwife services, dental/eye care services, mental health services, and prescription drugs. Medicare Advantage: Sometimes called Medicare Part C (formerly Medicare + Choice), you'll get in-depth explanations of the expanded range of choices potentially available to Medicare beneficiaries including provider-sponsored organizations, private fee-for-service plans, and medical savings accounts. Medicare Part D: Learn the details of the best known feature of the sweeping Medicare reforms providing for the voluntary prescription drug program. It has also been updated to include: A detailed discussion of the changes enacted by the Medicare Improvements for Patients and Providers Act of 2008, the federal stimulus legislation (the American Recovery and Reinvestment Act of 2009), the 2010 health care reform legislation, recent regulations, and developments since the Part D prescription drug benefit went into effect A discussion of the data contained in the 2010 Trustees' Reports New questions about the Recovery Audit Contractor (RAC) Program And more! Table of Contents: Introduction Social Security Medicare The Financial Condition of Social Security The Financial Condition of Medicare The Outlook for the Future Reform Proposals How Big Is the Social Security Financing Problem 1. Overview of the Social Security System Function and Operation of the Social Security System Social Security Benefits 2. Coverage Under the Social Security Act Overview of Coverage Defining Employer and Employee Self-Employment Coverage Officers, Directors, Partners, and Stockholders Direct Sellers, Traveling Salespeople, and Commission Drivers Manufacturers' Representatives Life Insurance Agents Crews on Fishing Boats Railroad Employees Foreign Students and Other Nonimmigrant Aliens Members of the U.S. Uniformed Armed Forces Federal Government Employees Family Employment State and Local Government Employees Domestic Workers 3. Social Security Taxes and Earnings Tax and Income Apportionment Employers and Employees Wages Domestic Workers Tips Self-Employment Income 4. Benefits Programs Retirement Benefits Disability Benefits Benefits for Dependents Survivor's Benefits The American Recovery and Reinvestment Act of 2009 5. Application for Benefits and Proof of Entitlement Application for Benefits Calculating Benefit Payment Amounts Evidence for Benefits 6. Entitlement for Disability Determining Disability Evidentiary Requirements Resumed Employment and Benefit Termination Ticket to Work Act 7. Payment of Benefits Calculation of Benefits Maximum Family Benefit Procedures for Payment of Benefits Persons Who Can Receive Payments Benefits Under Foreign Social Security Systems Procedures for Payment of Benefits The American Recovery and Reinvestment Act of 2009 8. Administrative Review Process Hearing Before an Administrative Law Judge Representatives' Fees Review by the Appeals Council Review by Federal District Court 9. Loss of Benefits Retirement Test Excess Earnings Recipients of Dependent's or Survivor's Benefits Earnings of Insurance Agents 10. Introduction to Medicare How Medicare Works The Four Parts of Medicare Coverage and Claims Obtaining Information 11. Eligibility for Medicare Part A Part B 12. Medicare Secondary Payer Rules Other Insurance Group Health Plans 13. Medicare Claims and Appeals General Rules Rules Relating to Part A Claims Rules Relating to Part B Claims Rules Relating to Medicare HMOs Rules Relating to Medicare Advantage Organizations Health Privacy Additional Requirements Under ERISA Rules Under the 2003 Medicare Legislation Revised Rules Under the 2005 and 2009 CMS Regulations General Rules Under the 2005 and 2009 CMS Regulations Initial Determinations ALJ Hearings Medicare Appeals Council Review The Recovery Audit Contractor (RAC) Program Claims and Appeals Under the Medicare Advantage Program (Part C of Medicare) Claims and Appeals Under the Medicare Prescription Drug Program (Part D of Medicare) 14. Medicare Financing Financing of Medicare Part A Financing of Medicare Part B 15. Benefits Under Medicare Part A Inpatient Hospital Care Skilled Nursing Facility Care Home Health Services Hospice Care 16. Benefits Under Medicare Part B Specific Services Covered Other Services Paying for Services 17. Medicare Exclusions General Exclusions Services Provided to Specific Groups Specific Services Additional Covered Items and Services Medical Errors 18. Medicare Supplemental (Medigap) Insurance Benefit Plans Choosing a Medigap or Other Policy Cost of Medigap Open Enrollment Filing and Payment of Claims Protections Against Loss of Medigap Coverage Medigap Coverage and the Medicare Part D Drug Benefit Private Contract 19. Medicare Advantage Plans Types of Plans and Procedures Election of Plans and Termination of Enrollment Benefits and Services Premiums Information About Medicare Advantage 20. Changes Enacted by the 2003 Medicare Legislation and Subsequent Laws The Part D Prescription Drug Benefit Prescription Drug Coverage Under Part B Enrollment in Part B Medicare Advantage and Competition Medicare Services Medicare Administration Medicare Appeals Medigap Policies Studies and Reports Financial Impact 2008 and 2009 Medicare Legislation Medicare Changes Under the 2010 Health Care Reform Legislation The 2010 Legislation Medicare Part A Early Retirees Health Care Quality Improvement Medicare Advantage Medicare Supplement (Medigap) Policies Medicare Part D The Independent Medicare Advisory Board Protection of Benefits Preventative Services Dual Eligible Beneficiaries Aspen Publishers, headquartered in New York City, is a leading information provider. We publish in the full range of formats, including updated manuals, books, periodicals, CDs, and online products. Our proprietary content is complemented by 2,500 legal databases, containing over 11 million documents. 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