Medicare Explained, 2016 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 2015 by law and regulation amendments and updates to program manuals issued by the Centers for Medicare and Medicaid Services (CMS).

• Analysis of legislative, regulatory, and agency guidance issuance on available benefits
• Medicare coverage and exclusions
• 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

• Updated discussions of health care reform impact on reimbursement systems for 2016
• Discussion of quality of care initiatives
• Updated discussion of hospital and physician reimbursement and outpatient services