Medicare looks to ease physician revocation rules

Posted by:  :  Category: Medicare

Other proposed changes to government regulations included rolling back a mandate that all hospitals have a director for outpatient services. CMS would remove the requirement and allow hospitals to decide if a director is needed, said CMS Administrator Donald M. Berwick, MD. Revisions also would remove outdated technical requirements for e-prescribing so they reflect current standards.
Source: medictoday.info

Video: Submitting Your Medicare Enrollment Application

Medicare Delays Provider Enrollment Revalidation Until 2015

The Centers for Medicaid & Medicare Services (CMS) has delayed the requirement that physicians revalidate their Medicare enrollment under the program integrity screening provisions of the Affordable Care Act. According to CMS, the revalidation effort, originally scheduled for March 23, 2013, will be pushed back through 2015. Physicians will be among the last to revalidate.
Source: wordpress.com

CMS Requires Provider Revalidation

These revalidation requests began in September with an initial mailing of approximately 89,000 letters sent to providers.  Nationally, there will be approximately 1.5 million letters sent to providers over the next year.  These letters are being mailed to listed provider remittance addresses, correspondence addresses or location addresses, so it’s possible that your facility will receive more than one letter.  No action is required until you receive a written request from Palmetto or your FI/MAC.  You are required to respond within 60 days of the date of the letter.
Source: hfsconsultants.com

Ability Chicago Info Blog: Physicians must revalidate Medicare enrollment by 2013 : article Aug 2011

Doctors are concerned that enrollment problems could lead some in good standing to get kicked out of the program Washington — Roughly 750,000 physicians in the Medicare program soon will be asked to revalidate their individual enrollment records during a massive anti-fraud effort required by the health system reform law. The Centers for Medicare & Medicaid Services hopes to weed out only the people who shouldn’t have billing privileges, but physicians are concerned that legitimate health professionals could get caught up in the enrollment sweep by mistake. CMS gradually will send revalidation requests by mail to more than 1.4 million health professionals — more than half of whom are doctors — between now and March 23, 2013, the agency announced on Aug. 10. Physicians who have enrolled since March 25, 2011, will not be required to revalidate, because their applications were scrutinized under new screening criteria, CMS said. Those receiving a request would have 60 days to recertify their enrollment information, which for some doctors will be similar to the process they first used to sign up with the program. “Failure to submit the enrollment forms as requested may result in the deactivation of your Medicare billing privileges,” CMS stated in the notice. Previous revalidation efforts have targeted much smaller segments of physicians, such as those who had not updated their enrollment within the past five years or medical suppliers in areas known to be at high risk for fraud. Medicare administrative contractors across the country process about 27,000 new enrollments and more than 30,000 reassignments, or changes to billing and payment information, each month. Doctors have described Medicare enrollment as tedious and confusing at times. Attempts to strengthen safeguards in the process have created problems for those caring for Medicare patients in recent years. In March, CMS implemented additional program integrity defenses mandated by the health reform law to prevent fraud. Physician practices have reported long wait times for new applications to be approved since then. “We have very significant concerns with this revalidation effort in light of the problems physicians have had with enrollment and revalidation efforts in the past,” said American Medical Association President Peter W. Carmel, MD. “The AMA is making this a priority and urging CMS to reconsider this action.” Physician practice administrators are being told to watch for the letters requesting revalidation, said Allison Brown, a senior advocacy adviser with the Medical Group Management Assn. in Washington. Practices are urged to begin revalidation as soon as they receive a request, she said. Physicians can revalidate using paper applications or by using CMS’ online enrollment system, called PECOS, the Provider Enrollment, Chain and Ownership System, which CMS says is the most efficient way to submit necessary information. But even if every practice complies with the letters as soon as they receive them, the plans to revalidate all health professionals who enrolled before March 25 would require contractors to process thousands of additional applications a day on top of the ones they already receive. Practices also must wait until their Medicare contractor sends them a request before they can revalidate. “We may end up with enrollment backlogs just given the scope of the revalidation effort,” Brown said. Bureaucratic brick walls The Neurology Medical Group of Diablo Valley in Pleasant Hill, Calif., saw the hassles of the Medicare enrollment process when it attempted to change the practice address for a neurologist who was starting at the medical group in September 2009. The initial enrollment application sent in August 2009 went missing. A second application was denied on a technicality, and a third application was approved in February 2010. But the Medicare contractor would backdate the physician’s enrollment status only to late November 2009. The contractor has denied the practice $30,000 in Medicare charges billed by the neurologist between September and November of 2009. “It was insufferably delayed, so we could not serve Medicare patients,” said Steven Holtz, MD, a neurologist at the group. The practice recently hired another neurologist, who will start on Sept. 1. The practice sent the physician’s Medicare enrollment application in July, but the contractor returned the application and noted that it was sent too early, said Nadia George, the practice administrator. Resending it on Aug. 1 resulted in an approval two weeks later, but that was short-lived. “The next day I received an email that said [the application] was rejected,” she said. She followed up with a phone call to the contractor’s enrollment department and was told the application appeared to be approved. George is planning to have the new hire treat one Medicare patient before Sept. 1 and have him submit a claim to ensure that the physician is in the Medicare system. Such an experience is not unique. Physicians tend to find enrolling in the Medicare program an unnecessarily long, complicated and bureaucratic process, said Donald Waters, executive director of the Alameda-Contra Costa (Calif.) Medical Assn. It’s a task often left to professional credentialing staff and practice administrators. But even the most experienced staffers encounter problems with confusing language on enrollment forms and vague instructions that cost physician practices time and money, Waters said. The MGMA’s Brown said CMS has planned improvements to the enrollment website. Changes would allow physicians to sign online applications electronically, instead of having to print a certification statement for the application and mail it to a contractor. The improvements could be implemented by January 2012, she said. # Source: American Medical Association By Charles Fiegl, amednews staff, Aug 29, 2011 http://www.ama-assn.org/amednews/2011/08/29/gvl10829.htm
Source: blogspot.com

Revised Medicare Provider

Medicare Provider-Supplier Enrollment Applications (CMS-855).  While the revised forms may be used immediately, the previous 2008 versions may be used through October 2011. In addition, CMS has released a new CMS-855O application form to be used for the sole purpose of enrolling to order and refer items and/or services to Medicare beneficiaries; this form must be used immediately. 
Source: healthindustrywashingtonwatch.com

Medicare Provider Enrollment Revalidation

Providers and suppliers should submit revalidation only after receiving the request from their MAC to do so. Providers and suppliers will have 60 days from the date of the letter to submit the required completed enrollment forms. Failure to submit enrollment forms as requested may result in the deactivation of Medicare billing privileges. Revalidation can be completed through the Internet-based Provider Enrollment Chain and Ownership System (PECOS) or a paper application; currently, federally qualified health centers only may submit paper enrollment applications. Please note: CMS forms 855A, 855B, 855I, 855O, 855R and 855S all have been revised as of July 1, 2011, and should be used for the provider enrollment revalidation. The new forms can be found by searching “855” on the CMS website.
Source: healthcarereforminsights.com

Providers and Suppliers Must Keep Their Medicare Enrollment Information Current on ADVANCE for Respiratory Care and Sleep Medicine

Obviously, Medicare providers and suppliers need to know what enrollment information must be updated and the time in which the information must be updated. CMS regulations require Medicare providers and suppliers to update their enrollment information within 30 days of any adverse legal action, any change in ownership, any change in location, or any change in general supervision. Medicare providers and suppliers are required to notify the Medicare carrier or contractor of any other changes in their enrollment information within 90 days of the change. However, durable medical equipment, prosthetics, and orthotics suppliers are required to report all changes in their enrollment information to the National Supplier Clearinghouse within 30 days.
Source: advanceweb.com

Honoring the 13th Amendment: Physician Rights, Medicare & You

Ambiguity arises because Medicare laws uses variants of ―participate‖ in two very different ways: 1. Sec. 1866. [42 U.S.C. 1395cc] (a)(1) 14 defines a physician as ―qualified to participate‖ in Medicare and ―eligible for payments‖ if he or she voluntarily chooses to file ―with the Secretary an agreement…‖ This is the fundamental ―Enrollment Process.‖ Sec. 1848. [42 U.S.C. 1395w–4] (g)(4)(A)15 ―Physician Submission of Claims‖ can only apply to an enrolled physician (―qualified to participate‖ under Sec. 1866. [42 U.S.C. 12 Sec. 1842. [42 U.S.C. 1395u] (b)(6)(A) ―The term ―participating physician‖ refers … to a physician who at the time of furnishing the services is a participating physician (under subsection (h)(1)); the term ―nonparticipating physician‖ refers, with respect to the furnishing of services, to a physician who … is not a participating physician … (as defined in subsection (h)(1)).‖ ―(h)(1) Any physician … may voluntarily enter into an agreement with the Secretary to become a participating physician …. For purposes of this section, the term ―participating physician or supplier‖ means a physician … who … enters into an agreement with the Secretary which provides that such physician … will accept payment under this part on an assignment-related basis for all items and services furnished to individuals enrolled under this part during such year.‖ (Emphasis added) 13 Sec. 1848. [42 U.S.C. 1395w–4] (g)(1)(A) ―Limitation of actual charge.—In the case of a nonparticipating physician … or other person (as defined in section 1842(i)(2)) who does not accept payment on an assignment-related basis for a physician’s service furnished with respect to an individual enrolled under this part, the following rules apply: (i) Application of limiting charge.—No person may bill or collect an actual charge for the service in excess of the limiting charge described in paragraph (2) for such service. (ii) No liability for excess charges.—No person is liable for payment of any amounts billed for the service in excess of such limiting charge.‖ (Emphasis added) 14 Sec. 1866. [42 U.S.C. 1395cc] (a)(1) AGREEMENTS WITH PROVIDERS OF SERVICES; ENROLLMENT PROCESSES ―(1) Any provider of services (except a fund designated for purposes of section 1395f (g) and section 1395n (e) of this title) shall be qualified to participate under this subchapter (Medicare) and shall be eligible for payments under this subchapter if it files with the Secretary an agreement…‖ (Emphasis added) 1395cc] (a)(1)) who is eligible to ―submit a claim for such service on a standard claim form specified by the Secretary to the carrier on behalf of a beneficiary…‖ 2. Sec. 1842. [42 U.S.C. 1395u] (h)(1) defines a “participating” physician as one who agrees to accept payment from Medicare on an assignment-related basis for all items and services. Although Sec. 1842 is silent on the prerequisite enrollment requirement, Sec. 1866 makes it clear that only a physician who chooses to file ―with the Secretary an agreement…‖ is ―qualified to participate‖ in Medicare and is ―eligible for payments‖ from Medicare. Although still silent on the prerequisite enrollment requirement, Sec. 1842 further defines a “non-participating” physician as one who does not agree to accept payment on an assignment-related basis for all claims paid by Medicare. Sec. 1842’s specific definition of ―non-participating‖ is confusing, and some may apply it erroneously to describe a physician who does not enroll in Medicare and thus is not obligated to Medicare at all. Sec. 1848(g)(1)(A) ―Limitation of Actual Charges‖ can also only apply to an enrolled physician “qualified to participate‖ under Sec. 1866. [42 U.S.C. 1395cc] (a)(1) who must ―submit a claim to the carrier” but is “non-participating” under Sec. 1842. [42 U.S.C. 1395u] (h)(1). Before the issue of ―participating‖ or ―non-participating‖ is reached a physician must have already voluntarily enrolled. Medicare acknowledges that ―mandatory claim submission provisions of Sec. 1848(g)(4) apply to a physician who ―must submit a claim to Medicare‖ and ―must be enrolled in the Medicare program‖16 but may sometimes overlook the choice that physicians have to either enroll or not enroll in the program.
Source: americasmedicalsociety.com

Are You Submitting a Handwritten Medicare Enrollment Application?

Medicare enrollment application forms are fillable on your computer.  This means that you can fill out the information required by typing into the open fields while the form is displayed on your computer monitor.  Filling out the forms this way before printing, signing and mailing means more easily-readable information – which means fewer mistakes, questions, and delays when your application is processed.  Be sure to make a copy of the signed form for your records before mailing.
Source: posterous.com

Medicare looks to ease doctor revocation rules

Other proposed changes to government regulations included rolling back a mandate that all hospitals have a director for out-patient services. CMS would remove the requirement and grant hospitals to decide if a director is needed, stated CMS Administrator Donald M. Berwick, MD. Revisions also would remove outdated technical requirements for e-prescribing so they reflect current standards.
Source: emedist.com

Revised 855S Enrollment Application

After October 31, 2011, DMEPOS suppliers will no longer be permitted to use the 07/09 version of the CMS-855S application and will be required to utilize the updated 07/11 version. The 07/11 version is available and may be used for submissions now. The newest version of the application has been updated to capture additional information pertinent to processing by the National Supplier Clearinghouse. If a supplier submits the 07/09 version after October 31, 2011, the application will not be processed and it will be returned to the supplier.
Source: hallrender.com

CMS Posts Medicare Learning Network Enrollment Fact Sheet to Help Educate Ordering Physicians

The Centers for Medicare & Medicaid Services has issued new educational materials for physicians and other ordering and referring practitioners. This fact sheet provides education on the enrollment requirements for eligible ordering/referring providers. In the fact sheet CMS spells out who the requirements apply to as follows:
Source: wordpress.com

Medicare Providers Must Begin to Revalidate Enrollment By March 2013

Between now and March 2013, MACs will be sending notices to individual providers/suppliers; please begin the revalidation process as soon as you hear from your MAC. Upon receipt of the revalidation request, providers and suppliers have 60 days from the date of the letter to submit complete enrollment forms. Failure to submit the enrollment forms as requested may result in the deactivation of your Medicare billing privileges. The easiest and quickest way to revalidate your enrollment information is by using Internet-based PECOS (Provider Enrollment, Chain, and Ownership System), at https://pecos.CMS.hhs.gov.
Source: wordpress.com

Medicare beneficiaries on a Medicare Supplement plan who wish to change their Medicare Part D coverage in 2012 do so during the AEP. / eHealth

About eHealth eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, the nation’s leading online source of health insurance for individuals, families and small businesses. Through the company’s website,www.eHealthInsurance.com, consumers can get quotes from leading health insurance carriers, compare plans side by side, and apply for and purchase health insurance. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 180 of the nation’s leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia, making it the ideal model of a successful, high-functioning health insurance exchange. Through eHealth’s technology solutions (www.eHealthTechnology.com), eHealth is also a leading provider of health insurance exchange technology. eHealth provides a suite of hosted e-commerce solutions that enable health plan providers, resellers and government entities to market and distribute products online. eHealth, Inc. also provides online tools to help seniors navigate Medicare health insurance options through PlanPrescriber.com (www.planprescriber.com) and eHealthMedicare (www.eHealthMedicare.com).
Source: ehealthinsurance.com

SLP and Audiology Medicare Providers Must Revalidate Enrollment

All speech-language pathologists (SLPs) and audiologists who enrolled in Medicare prior to Friday, March 23, 2011, will need to revalidate their enrollment at some point between now and March 2013. This is due to new risk screening criteria required under the Affordable Care Act (ACA) which was implemented by the Centers for Medicare and Medicaid Services (CMS) in March 2011. The new risk screening criteria places providers and suppliers in one of three screening categories – limited, moderate, or high. These categories represent the level of risk to the Medicare program and determine the degree of screening that will be done by the Medicare Administrative Contractor (MAC) processing the enrollment application that will be submitted for revalidation. SLPs and audiologists enrolled as individuals or group practices are placed in the limited category. The enrollment process for providers and suppliers in the limited category remains unchanged.
Source: wordpress.com

Difference between Medicare and Medicaid

Posted by:  :  Category: Medicare

Medicare has four parts. Medicare Part A covers hospital insurance, which includes hospital care, nursing, home healthcare, and hospice. Medicare Part B covers medical insurance, which takes care of doctors’ services, outpatient care, home healthcare, and some preventive services. Medicare Part C, also known as Medicare Advantage, helps people get the benefits and services covered by Medicare Parts A and B. Part C may include some extra advantages as well. Medicare Part D covers the cost of prescription drugs. Unlike Medicare, Medicaid is not divided into parts.
Source: knowitsdifference.com

Video: Michael Moore on Medicare & Medicaid

Colors of Lupus Urges Congress to Protect Medicare, Medicaid

Tags: 501 c 3, access, act, American, Ang, attention, Autism, auto immune disease, Bay, behalf, blood, body, brain, budget, budget control, Cancer, cannot, Care, case, Cause, Colors, Committee, control, control act, country, Coverage, creation, Cure, Cuts, D-Nev, deficit, deficit reduction, diagnose, diagnosis, director, disease, doesn, emergency, establishment, Everything, Example, Executive, Fall, forego, funding, grant, health, health care programs, Hospital, Hui, joint, joint select committee, kidneys, killer, kind, las vegas nev, life, Lim, look, loss, Lupus, matter, Medicaid, Medicare, medicare medicaid, mission, money, morning, Nevada-based, Nevadans, Nov, November, organization, organs, part, permane, Point, population, Prescription, preventative measures, Protect, PRWeb, quality, Reduction, research, result, room, Select, soft tissue, southern nevada, spending, Supercommittee, support, System, test, time, tissue, today, treatment, Trillion, turn, urgency, Urges, vulnerable citizens Comment (RSS)  
Source: cheyennebluegrass.org

Medicare, Medicaid, Social Security

[…] Over 50 million Americans get social security benefits, and the average monthly paycheck is a little over $1,000.  Most of these workers have contributed to the system for decades before receiving benefits. Thus they may claims some entitlement to these benefits. It is worth noting, however, that current beneficiaries probably contributed for past beneficiaries. Younger and more able workers are not contributing to pay the bill for current beneficiaries.Source: over50web.net […]
Source: over50web.net

Getting To Know Medicaid Benefits

Medicaid and Medicare are health insurance programs that provides medical coverage to those with limited income or resources. Doctor visits, prescriptions, medical testing and some dental or vision treatments may be covered under these program. The benefits offered by Medicaid/Medicare may cover people with disabilities, the elderly, pregnant women, children or families. To qualify for Medicaid or Medicare a person/family must meet certain income and resource restrictions, meaning these benefits are reserved for those in need.
Source: leedisability.com

Medicare vs. Medicaid:Your Own Choice

best medicare supplement difference between medicare and medicaid excellent medical transcription house of lords how does medicare work how to apply for medicare important difference in uk vs us health insurance models improving your health by medicare supplement leads insurance price hikes local social office medical insurance companies medical record medical records medical transcription medical transcription companies medical transcription service medical transcription solution medicare advantage plans medicare benefits medicare part a and part b medicare supplement insurance medicare supplement leads medicare vs medicaid medicare vs medicaidyour own choice medicare work open referral open referral clients open referrals process outsourced medical transcription private medical insurance service delivery costs supplemental insurance supplemental insurance for medicare the benefits of medicare program transcription service office vs us health what is medical transcription mt what is the difference between medicare and medicaid
Source: apssupplements.com

Telling the Supercommittee: The Solution Should Not Make More Problems

California would not be in a position to make up the difference—I’m not sure many states would be—and as a result the state would have to make up the difference through cuts or tax increases. To give a sense of scale, just a $15 billion cut if done proportionately would force a bigger cut to Medi-Cal (around $180 million/year) than the cut California made in 2009 to eliminate dental and 9 other benefits (which was around $125 million). Our Governor Brown was very concerned about an earlier “blended rate” proposal because of the risk to the state’s general fund, and it’s something to watch closely. THE PROBLEM VS. THE SOLUTION: California needs to watch this process very carefully. In particular, it should send a strong message that we want a deficit solution that doesn’t add to other problems. A solution should not increase unemployment or poverty at a time when we need an economic recovery; it shouldn’t shift costs to patients already struggling with high health bills; it shouldn’t stick states with additional costs at a time when states need help themselves. There are solutions, but some actually make the problem worse.
Source: californiaprogressreport.com

Comparing Medicare vs Medicaid

Medicaid: this program is known to cover more than Medicare. Some of the many services it covers include: hospitalization, laboratory services, x-rays, clinical treatment, family planning, nursing services, and surgical dental care.
Source: retireeasy.com

Viewpoints: Private Vs. Public Medicare; N.J. Medicaid Tough Choices; IPAB’s Cost Controls

Detroit Free Press: Ending Medicare As We Know It Over the course of their working lives, an American couple earning the median household income will pay about $140,000 into Medicare; after turning 65, the same couple will collect, on average, more than three times that much in Medicare benefits. You don’t need a Ph.D. in actuarial science to recognize that this is unsustainable, especially as the ratio of retirees to workers grows. So far, though, neither major party has advanced an alternative that will preserve seniors’ access to quality health care without bankrupting the country (6/11).  Kaiser Health News: A Health Policy Reality Check (Guest Opinion)  When the Republican House voted earlier this year to repeal the health law, their slogan was “repeal and replace.” Last month, House Ways and Means Chairman Dave Camp, R-Mich., admitted the House would offer no replacement. … Two final questions: Do any Republicans still believe in the goal of universal coverage? What is the basis for moving forward together from here? (John McDonough, 6/12).
Source: kaiserhealthnews.org

Kansas Announces Sweeping Medicaid Restructuring

The original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

TA Associates Completes Investment in Senior Whole Health

Founded in 2004, Senior Whole Health addresses the needs of “dual eligibles”, individuals who qualify for Medicare – those aged 65 or over – and Medicaid – based on financial need. The company’s vision is to be a national leader in integrated healthcare that is simple, comprehensive, humane and respectful of its members. Senior Whole Health, ranked as the fastest-growing private company in the nation by Inc. magazine in 2008, integrates all Medicare, Medicaid and Medicare Part D Pharmacy benefits into a cohesive, comprehensive and easy to use plan. Senior Whole Health members and providers have 24/7 phone access to a Senior Whole Health Nurse Care Manager, and the company’s Community Resource Coordinators arrange and organize services and act as advocates for members. In addition, Senior Whole Health members and their caregivers have access to an array of home and community-based services to support members in their residence of choice – home, assisted living center, nursing home or other location.
Source: homehealthprovider.com

Medicaid for Section 8 Tenants

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Source: home-care-assistance.com

Unicare Life and Health Insurance Company and the Policy Store Want to Help You Stop Smoking by Making This Information Available

Posted by:  :  Category: Medicare

UNICARE serves 1.7 million medical members and is the national operating subsidiary of WellPoint Health Networks Inc., the nation’s second largest publicly traded health care company. WellPoint serves the health care needs of more than 15 million medical members and approximately 46 million specialty members. WellPoint offers a broad spectrum of quality network-based health products including open access PPO, POS and hybrid products, HMO and specialty products. Specialty products include pharmacy benefit management, dental, utilization management, vision, mental health, life and disability insurance, long term care insurance, flexible spending accounts, COBRA administration, and Medicare supplements. UNICARE can be found on the web at http://www.unicare.com.
Source: bestlongtermcare.org

Video: Unicare Medicare Advantage Plans – Compare to 180+ Companie

Medicare Health Insurance

Medigap supplement Quotes are incredibly important for those people who are just turning 65 or signing up for Medigap health insurance for the first time. There are several methods people use to get Medicare supplement Quotes, nevertheless the easiest and most effective way to get supplement insurance details are to contact an insurance broker (like us) who specializes in Medigap supplement insurance. We are able to give a Medicare supplement Quote from multiple insurance providers and can provide valuable understanding of upcoming changes that may affect Medigap supplement Plans plus your current supplemental insurance coverage.
Source: unicarehealthinsurancereview.com

UniCare to Reimburse AHIP Online Certification Course Fee

UniCare recently announced that we would be using the new AHIP Certification Course to meet CMS requirements for marketing representative certification. The cost of this course is $149. However, UniCare was able to secure a negotiated rate of $100 which we pass on to you.
Source: ritterim.com

Dr. Eric Adelman, DO, Port Orange, FL

Dr. Eric Adelman, DO, Dermatologist, has an established clinical practice in Port Orange, FL. Dr. Adelman is male. Dr. Adelman has more than 9 years experience as a physician. He is based at 1720 Dunlawton Ave, Ste 2, Port Orange, FL.
Source: trialx.com

Unicare Medicare Supplement Quotes

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Source: choosinghealthinsurance.net

Top Best Tabs sites! Buy RISPERDAL PURCHASE RISPERDAL 1MG MEDICARE ONLINE,WITHOUT PRESCRIPTION!Fedex Delivery Overnight FREE Pills IN ALABAMA

Posted by:  :  Category: Medicare

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Source: imakemichiganwork.org

Video: Mississippi Conservative: Medicare Debate Ryan Plan Vs Obama Plan Facts not Fiction

Viewpoints: The Role Of IT In Transforming Health Care; The GOP Raises Super Committee Stakes

The original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

Medicare Supplemental Insurance and Medicare Advantage Plans in Mississippi

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Source: medicaresupplementadvantageplans.com

SLP and Audiology Medicare Providers Must Revalidate Enrollment

All speech-language pathologists (SLPs) and audiologists who enrolled in Medicare prior to Friday, March 23, 2011, will need to revalidate their enrollment at some point between now and March 2013. This is due to new risk screening criteria required under the Affordable Care Act (ACA) which was implemented by the Centers for Medicare and Medicaid Services (CMS) in March 2011. The new risk screening criteria places providers and suppliers in one of three screening categories – limited, moderate, or high. These categories represent the level of risk to the Medicare program and determine the degree of screening that will be done by the Medicare Administrative Contractor (MAC) processing the enrollment application that will be submitted for revalidation. SLPs and audiologists enrolled as individuals or group practices are placed in the limited category. The enrollment process for providers and suppliers in the limited category remains unchanged.
Source: wordpress.com

Nursing Home’s Failure to Notify Leaves Beneficiary Not Liable for Custodial Care Services

A Medicare beneficiary is not liable for custodial care services rendered by a Mississippi nursing home because the facility failed to give adequate notice the services were not covered by Medicare, a federal appeals court panel ruled on October 25.  The case (Mississippi Care Center of Morton LLC, Sebelius, 5th Cir., No. 10-60595, Oct. 25, 2011)  concerned the application of 42 C.F.R. 411.404, which states a beneficiary is considered to have known custodial care or services that are not reasonable and necessary are not covered services under Medicare, provided the beneficiary received adequate notice the services are not covered under Medicare.  
Source: hallrender.com

Daily Kos: Iowa Republicans: Cut defense before Social Security, Medicare

Consider if one or more of these tags fits your diary: Civil Rights, community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don’t fit in any of these tags. Don’t worry if yours doesn’t.
Source: dailykos.com

In the Richublican World, Only CEO’s Will Prosper : Mississippi Litigation Review & Commentary

You may think you fit into the Richublican world. But you don’t. They let you think you do. You don’t. Do you have a mansion in Palm Beach, homes in Martha’s Vineyard and Aspen and an apartment in Manhattan? No you don’t. These guys view people who make $500,000 a year as lower middle class. And they’re coming for everyone. Yes, that means you doctors. How’s it going to feel when Medicare and Medicaid get massive cuts to free up even more cash for the CEO elite?  
Source: mslitigationreview.com

MHA Federalist: Senate holds hearing on health care delivery reform

Kaplan described his organization’s efforts to adapt the Toyota Production System to improve health care quality and lower costs, while Poulsen shared his organization’s recommendations for improving quality and avoiding waste. Other witnesses at the hearing included Centers for Medicare & Medicaid Services Deputy Administrator Jonathan Blum; Mark Fendrick, M.D., co-director of the Center for Value-Based Insurance Design; and Rhode Island Health Insurance Commissioner Chris Koller.
Source: typepad.com

TrailBlazer loses Medicare contract, job cuts possible

TrailBlazer spokesman, Billy Quarles said his company currently provides services to Medicare and customer service to healthcare providers in Texas, Oklahoma, New Mexico and Colorado. Their contract runs out next August. The new contract would have included three additional states: Arkansas, Louisiana and Mississippi, to their service area. Losing out means, when their current contract ends in August, they’ll lose their current jurisdiction and they’re likely have to lay off workers.
Source: kxii.com

APNewsBreak: Farmers avoiding fed loan program

In this Aug. 30, 2011 photo, Keith Beavers exam­ines his dam­aged tobacco crop on his farm in Mount Olive, N.C. When it comes to nat­ural dis­as­ters, this has been a “mon­ster” year for farm­ers, one agri­cul­ture offi­cial said. An Asso­ci­ated Press review of dis­as­ter loans issued nation­wide found the Farm Ser­vice Agency made fewer than 300, total­ing just $32.6 mil­lion, for the fis­cal year end­ing Sept. 30. To put that in per­spec­tive, Texas alone is esti­mated to have $1.5 bil­lion in drought losses this year. (Asso­ci­ated Press File
Source: delgazette.com

Raising Medicare Eligibility Age to 67 is a huge, indirect Cut to Social Security

Posted by:  :  Category: Medicare

WASHINGTON, D.C. Nov. 3, 2011 – On Tuesday, Erskine Bowles, co-chair of the president’s deficit commission recommended that the Super committee raise Medicare’s earliest age of eligibility to 67. If Congress were to follow this advice, out-of-pocket health care costs’ could consume as much as 45 percent of the Social Security checks of 65 and 66 year olds, according to a new analysis which builds on a Kaiser Family Foundation report. According to that report, 3.3 million people aged 65 and 66 would pay more out-of-pocket for health care if they were no longer eligible for Medicare. “Erskine Bowles is proposing to take billions of dollars right out of the pockets of the nation’s seniors and their families and billions more out of local communities,” said Eric Kingson, co-chair of the Strengthen Social Security Campaign. “Americans overwhelmingly disagree with cuts to Social Security, Medicare and Medicaid. They know that these programs didn’t cause the deficit and they are sick of the 99 percent being asked to pay for the failures of the one percent. The 99 percent cannot afford these cuts, neither can the communities where they live.” Existing Social Security beneficiaries, aged 67 and older would also see their out-of-pocket health care costs increase, and consequently, their Social Security benefits reduced because on average, the healthiest, least expensive members of the Medicare risk pool, those aged 65 and 66, would be removed. It is estimated that Part B premiums, which are automatically deducted from Social Security checks, would increase by 3 percent in 2014 on top of increases produced by rapidly rising health care costs. “The so-called Super committee appears unwilling to force the 1 percent to sacrifice even a small amount. In contrast, both Democratic and Republican members of the Super committee have proposed tremendous sacrifices by the 99 percent, including by seniors who have spent their lifetimes, often in physically demanding jobs, contributing to our country. Both the Democrats and Republicans have offered plans which reportedly cut Social Security and increase the out-fo-pocket health care costs of seniors, people with disabilities and others who depend on Social Security and Medicare. If they decide to follow the advice of Wall Street multi-millionaire Erskine Bowles, and increase Medicare’s eligibility age to 67, they will shift costs to those least able to afford it – the sickest and the oldest among us,” said Nancy Altman, co-director of Social Security Works. “At a time when the 99 percent are already struggling, the Super committee seems poised to compound their hardship.” Costs to Social Security beneficiaries could also be substantially higher than estimated. The Kaiser Family Foundation report assumes the health insurance exchanges and subsidies enacted under the 2010 Patient Protection and Affordable Care Act (ACA) will be fully implemented by 2014. If any or all of four key provisions of the ACA are scaled back or repealed the increase in out-of-pocket health care costs due to raising the Medicare eligibility age would be significantly higher and consume a much greater proportion of Social Security benefits. Below are specific dollar amounts seniors would lose through Medicare cuts: · Out-of-pocket health care costs would increase, on average, by $4,300 in 2014 for 960,000 people aged 65 and 66 who purchase coverage through a health insurance exchange and have incomes exceeding 400 percent of the federal poverty level ($43,560), making them ineligible for subsidies available to exchange participants with lower incomes. · Out-of-pocket costs would increase, on average, by $1,200 for 240,000 people aged 65 and 66 who purchase coverage through a health insurance exchange and have incomes between 300 and 400 percent of the federal poverty level ($32,670-$43,560). · Out-of-pocket costs would increase, on average, by $2,200 for 1.1 million retirees with employer-sponsored retiree health plans if the increased cost to employers did not cause them to terminate these plans. · Out-of-pocket costs would increase, on average, by $500 for 1 million retirees with employer-sponsored health plans if the increased cost to employers did not cause them to terminate these plans. The Strengthen Social Security Campaign is comprised of more than 320 national and state organizations representing more than 50 million Americans from many of the nation’s leading aging, labor, disability, women’s, children, consumer, civil rights and equality organizations. www.strengthensocialsecurity.org
Source: yubanet.com

Video: New Port Richey’s Advanced Medicare

State Dual Eligible Proposals Don’t Focus On Managed Care For Medicare Beneficiaries

The original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

Can I receive Medicare or Medicaid benefits at the same time as I receive Social Security disability benefits?

The Social Security Administration runs two programs that provide disability benefits: Social Security Disability Insurance (“SSDI”) and Supplemental Security Income (“SSI”). SSDI provides benefits to insured workers with disabilities, or in other words, those who: (1) have been employed for at least five of the last ten years; (2) have paid FICA (“Federal Insurance Contributions Act”) taxes; and (3) have a “disability” as the Social Security Administration defines the term. A disability, for purposes of Social Security, is a serious medical condition that lasts (or has lasted) for more than a year and prevents someone from being gainfully employed. In addition, SSDI will provide benefits to the disabled children of insured workers, so long as the children became disabled before they reached the age of 22, as well as to the disabled surviving spouses of insured workers who have died.
Source: johntnicholson.com

Chicago Hispanic Newspaper, Lawndale News, Hispanic Bilingual Newspapers, Su Noticiero Bilingue

The Super Committee in Washington, charged with reducing the federal deficit, is currently considering significant changes to Medicare, including raising the eligibility age. Increasing the Medicare eligibility age to 67 would increase overall health care costs and shift these increased expenses to individuals, employers and state governments. Taking into account additional costs to individuals, Illinois employers and businesses, and the Illinois state government; raising the Medicare eligibility age would cost Illinois around $524 million per year. The Medicare Prescription Drug Savings and Choice Act of 2011 introduced by U.S. Senator Dick Durbin (D-IL) and Representative Jan Schakowsky (D-IL) would save Medicare at least $20 billion per year by creating a Medicare-administered Part D prescription drug benefit which is able to negotiate for lower prescription drug prices. “The proposed changes in Medicare would be harmful to the Illinois health care delivery system, shift costs to patients and reduce access to care,” said State Representative Jan Schakowsky. “Increasing the eligibility age for Medicare is just another attack on a program millions of Americans rely on and cherish. There are serious ways to reduce Medicare spending, such as requiring CMS to negotiate Medicare Part D prescription drug prices, combating Medicare fraud and abuse, and improving efficiencies, without passing the buck to seniors and needlessly putting their health and financial security at risk.”
Source: lawndalenews.com

Romney Unveils Plan To Revamp Medicare, Medicaid

The Wall Street Journal: Romney Proposes Voucher Option For Medicare Plan The Romney Medicare plan could become a hallmark of the presidential campaign of 2012 should he win the Republican nomination. Democrats had already planned to make the Ryan Medicare plan, which they call privatization, a centerpiece of their efforts to unseat Republicans in Congress. Now Mr. Romney has thrust the future of Medicare more directly into the presidential race. Ben LaBolt, a spokesman for the Obama re-election campaign, charged that Mr. Romney’s budget proposal “would leave millions of older Americans to fend for themselves” under a privatized Medicare. Romney campaign aides reject the term “privatization” to describe their approach (Weisman and O’Connor, 11/5).
Source: kaiserhealthnews.org

Sponsoring 74 y/o Mother From Canada

I am planning on sponsoring my 74 y/o mother with Canadian citizenship who lives in Canada to come live in the USA. Does anyone have experience doing this? I am curious if the only option for Medicare is to pay the full part A premium which I believe is $451 monthly? Are there any treaty allowances which would provide for a reduced rate? She receives CPP and OAS in Canada. Thanks for any replies!
Source: canuckabroad.com

The White House Won't Touch Social Security. Great! Now, About Medicare

As the distinguished physician and policy expert Ezekiel Emanuel pointed out (yes, he’s Rahm’s brother): “Cost-shifting cuts don’t actually reduce health care spending; they just shift costs from the government to the private sector.” If you do that enough, with foolishly-designed industry giveaways like raising the Medicare age, you’ll create even more economic chaos and doom seniors to a life of poverty.
Source: californiaprogressreport.com

Separating Fact from Fiction – Medicare Eligibility

Joppel, a decision support tool, website and call center for Medicare beneficiaries, seniors and caregivers is the Medicare division of HealthCompare Insurance Services Inc. Joppel provides a wealth of information, offers expert guidance from licensed agents, and utilizes a consumer-friendly on-line tool for those eligible for Medicare. If you or a loved one is about to become eligible for Medicare, you should visit the Joppel site today.
Source: freepressreleases.com

Vigilant Counsel News Blog

Can an employer reduce or eliminate benefits for a current employee when the employee becomes eligible for Medicare? No, because doing so is probably a violation of the federal Age Discrimination in Employment Act (ADEA) and also a violation of the Medicare rules, according to a recently released informal discussion letter from the federal Equal Employment Opportunity Commission (EEOC) (ADEA: Coordinating Medicare with Current Employees’ Benefits, August 2, 2011). In the discussion letter, the EEOC reminds employers that the ADEA exemption that allows employers to drop employer-sponsored health coverage upon Medicare eligibility applies only to retiree coverage, not to current employees. And, because dropping coverage for current employees upon Medicare eligibility is an age-based action, the employer must meet the ADEA’s “equal benefit or equal cost” defense to pass muster under the ADEA, meaning that the employer must provide older employees the same benefits as are provided to younger employees, or else they must incur the same cost to provide benefits, even if the benefits that may be purchased for that cost are less than what may be purchased for younger employees. Finally, the EEOC noted, the Medicare program itself requires employers to offer current employees, who are Medicare-eligible the same benefits under the same conditions as those employees who are not Medicare-eligible.
Source: vigilantcounsel.org

Understanding the Medicare Benefits for Senior Citizens1

What does the Part D cover? The Medicare Prescription Drug Coverage is a type of health insurance program that are being run by insurance companies or other private companies that have been approved by the Medicare program. The two ways for you to get this coverage is through the Medicare Prescription Drug Plans and through Medicare Advantage Plans. The Medicare Prescription Drug Plans help immensely by adding coverage of drug prescriptions to the Original Medicare plans. The Medicare Advantage Plans also covers the Part D aside from covering both Parts A and B of your Medicare plan.
Source: 1800homecare.com

Register Now for Nov. 15th ACO Medicare Shared Savings National Provider Call

Posted by:  :  Category: Medicare

A Notice of Intent to Apply (NOI) memo is currently available on the Shared Savings Program Application page at in the “Downloads” section. Submitting the NOI is the first step in the application process. A copy of the Shared Savings Program application will be posted to this website prior to the National Provider Call. CMS will send out an announcement when the application is available on the website. Call participants are encouraged to review the application prior to the call.
Source: wordpress.com

Video: Medicare Provider, Assisted Living

Health Law Alphabet Soup: ACOs, MLR And Other Implementation News

Politico: Gallup: Uninsured Adults Rising None of the components of President Obama’s health care law that have taken effect appear to be affecting insurance coverage of adults over 26, according to a new poll Friday. The percentage of adults with no health insurance is the highest on record, with 17.3 percent of adults being uninsured in the third quarter of 2011, statistically tying the high set in the second quarter, Gallup found. Three years ago, in the third quarter of 2008, only 14.4 percent of adults lacked health insurance. Gallup cautions, however, that the record high coincides with a methodological change that samples cell-phone only respondents, which tend to be younger and thus more likely to be uninsured. Thus, some of the increase in the figure could be linked to this change (Mak, 11/11).
Source: kaiserhealthnews.org

North Carolina Medical Society

The Centers for Medicare and Medicaid Services (CMS) will host a National Medicare Provider Call, Tuesday, November 15, 2011, 1:30 pm – 3:00 pm, to discuss the application process for the Medicare Shared Savings Program and the Advance Payment Model. This call-in forum is designed to help providers participate in the Medicare Accountable Care Organizations to improve quality of care for Medicare patients. A question and answer session will follow the presentation.
Source: ncmedsoc.org

Revised Medicare Provider

Medicare Provider-Supplier Enrollment Applications (CMS-855).  While the revised forms may be used immediately, the previous 2008 versions may be used through October 2011. In addition, CMS has released a new CMS-855O application form to be used for the sole purpose of enrolling to order and refer items and/or services to Medicare beneficiaries; this form must be used immediately. 
Source: healthindustrywashingtonwatch.com

American College of Phlebology : Press Room : CMS 2012 Medicare Shared Savings/ACO program information

CMS has posted the application for the 2012 Medicare Shared Savings/ACO program.  The 21 page application can be submitted between December 1 and January 20 for participation beginning April 1, 2012 and between March 1 through March 30 for participation beginning July 1, 2012.  CMS will host a National Provider call on Tuesday, November 15, 1:30 to 3:00 pm eastern, to provide more details about the program application process. In order to receive the call-in information, you must register for the call.  Registration will close at 12pm on Tue Nov 15 or when available space has been filled.  No exceptions will be made.  Please register early.  To register, please visit http://www.eventsvc.com/blhtechnologies.
Source: phlebology.org

Medicare Provider Enrollment Revalidation

Providers and suppliers should submit revalidation only after receiving the request from their MAC to do so. Providers and suppliers will have 60 days from the date of the letter to submit the required completed enrollment forms. Failure to submit enrollment forms as requested may result in the deactivation of Medicare billing privileges. Revalidation can be completed through the Internet-based Provider Enrollment Chain and Ownership System (PECOS) or a paper application; currently, federally qualified health centers only may submit paper enrollment applications. Please note: CMS forms 855A, 855B, 855I, 855O, 855R and 855S all have been revised as of July 1, 2011, and should be used for the provider enrollment revalidation. The new forms can be found by searching “855” on the CMS website.
Source: healthcarereforminsights.com

Get Ready for Network Shock

• CMS has created totally new and rigid network adequacy standards for all MA Plans wanting to build or expand; • Provider access time and distance standards now exist for every MA eligible county; • CMS now defines the required contracted provider counts for every physician and facility specialty for each County; • Minimum bed counts are now also required for hospitals and related services; • MA Plans must contract with 35 physician specialties and 25 hospital and ancillary types to demonstrate adequacy to CMS; • Ninety percent (90%) of the all Medicare beneficiaries in the county must be able to access every required physician and facility specialties using the time and distance standards; • CMS commissioned new analytic software they use to calculate MA Plan’s network adequacy;  • The new software objectively determines if your network passes or fails.  If you don’t own or have access to this software you are at an extreme disadvantage; • The applications from Plans failing to attain ninety percent (90%) adequacy in each of the 60 required provider specialties are now routinely denied;  • Your Application will be in jeopardy if even one physician or ancillary specialty fails to meet the new rigorous CMS standards.
Source: gormanhealthgroup.com

CMS Announces Medicare Providers Must Begin to Revalidate Enrollment By March 2013

In the continued effort to reduce fraud, waste, and abuse, CMS implemented new screening criteria to the Medicare provider/supplier enrollment process beginning in March 2011. Newly-enrolling and revalidating providers and suppliers are placed in one of three screening categories limited, moderate, or high each representing the level of risk to the Medicare program for the particular category of provider/supplier, and determining the degree of screening to be performed by the Medicare Administrative Contractor (MAC) processing the enrollment application. More information on the screening categories is here.
Source: managemypractice.com

Medicare Providers Must Begin to Revalidate Enrollment By March 2013

Between now and March 2013, MACs will be sending notices to individual providers/suppliers; please begin the revalidation process as soon as you hear from your MAC. Upon receipt of the revalidation request, providers and suppliers have 60 days from the date of the letter to submit complete enrollment forms. Failure to submit the enrollment forms as requested may result in the deactivation of your Medicare billing privileges. The easiest and quickest way to revalidate your enrollment information is by using Internet-based PECOS (Provider Enrollment, Chain, and Ownership System), at https://pecos.CMS.hhs.gov.
Source: wordpress.com

Serving Seniors on Medicare (Mobile)

Medicare/DME Sales — We Will Train Five Star Senior Services is expanding its regional Sales and Service team. . . We are a provider of technologically advanced, heat-therapy bracing equipment and power wheelchairs. We market directly to the senior, Medicare-eligible community and their healthcare partners. This is a low-pressure, commission-based opportunity that requires a professional, service-oriented attitude utilizing a consultative, compassionate approach. You will be calling primarily on senior centers, churches, and retirement communities. Secondary markets would include physicians, physical therapy practices, and chiropractors. Training provided on group and individual basis. This can be done on a full- or part-time basis and is available throughout the region. First year, realistic full-time earnings should exceed $40,000 and could be as high as $70,000, depending on work ethic and motivation. Please visit our website (***/Opportunity), listen to “Our Story & Strategy” to learn more, and if you are still interested we invite you to complete the brief application online . . . Thank you and God Bless. Come be a Partner in Our Vision. . .
Source: telecommuteanywhere.com

cost dedicated low server: How to Get a Replacement Medicare Card

Posted by:  :  Category: Medicare

GIMME SOME OF THAT GOOD 'OLE OBAMA DOUBLESPEAK by SS&SSDo you charge a backup Medicare card? You may, if you are a Medicare almsman in charge of medical services, if you never accustomed your Medicare card, or if your agenda has been lost, stolen, or destroyed. You will charge the afterward advice to accept your Medicare backup card: Your aftermost acquittal bulk or the ages and year of your aftermost acquittal if you accustomed allowances in the accomplished year. You will charge your name, amusing aegis number, date of birth, and blast number. You additionally may charge your abode of bearing and mother’s beginning name for character purposes.
Source: blogspot.com

Video: Social Security Surplus Myth Part I

Social Security is Home for the Holidays

There’s an even better way to conduct your business: online at www.socialsecurity.gov. There you’ll find a wealth of information and online services. For example, you can apply online for Social Security benefits or for Medicare, and then you can check on the status of your pending application. If you already receive Social Security benefits, you can go online to change your address, phone number, or your direct deposit information, get a replacement Medicare card, or request a proof of income letter.
Source: patch.com

Medicare Replacement Card

This leads to a difficult decision for healthy individuals, do I pay $300 – $400 monthly premium to protect myself in the unlikely event that I fall extremely ill or have an accident requiring a surgery? The answer to this question is a High deductible major medical insurance policy with an HSA or Health Savings Account. The HSA plans have three major advant […]
Source: medicare-supplement-advisor.org

How Do I Obtain A Replacement Medicare Card?

When ordering a Medicare Card you have a few options. You can do this by internet, the telephone, or you can visit one of your local Social Security Offices. To order a Medicare Card by internet you can visit www.socialsecurity.gov/medicarecard, to complete the application. To order by telephone, the toll free number is 1-800-772-1213. If you prefer to order your card in person, you can call the toll free number to find the nearest Social Security Office or go to www.socialsecurity.gov/locator and type in your zip code to find the location nearest you.
Source: seniorcorps.org

Medicare: FCC Honors Innovators of Accessible Communications Technologies

arizona california medi-cal dental Drug Plan electronic health record Health HIV How Social Security Works How to File a Claim for Medicare How to get a new medicare replacement card HUD M.D. Medicaid medicaid card Medicaid Services Medicare medicare card MedicareCard.com medicare card help MedicareCard Replacement medicare card replacement Medicare claims process medicare coverage Medicare has Two Parts Medicare Help Medicare Part A Hospital Insurance Coverage Medicare Premium Amounts for 2010 Medicare Prescription Drug Coverage Meeting Announcement MyMedicare.gov National Institutes of Health Need a Replacement Card? Order a Medicare Card by Phone or Online NIH NIMH Obama Part A (Hospital Insurance) Part B (Medical Insurance) part of the National Institutes of Health protecting my social security number replacement social security card Social Security social security card some disabled people under age 65 Supplier Enrolled in Medicare VA
Source: medicarecard.com

How to Replace a Lost Medicare Card

Medicare is a program funded by US government which provides affordable health care to citizens above the age of 65. A red, white and blue Medicare card wiil be given to citizens as a proof . Whenever you are seeking healthcare under medicare program, production of medicare card is a must.If your card has been destroyed, lost or stolen, you need to get a replacement card as early as possible. Here I will describe the process of getting a replacement medicare card.
Source: infobarrel.com

Medicare Replacement Card

There are many ways to receive your replacement card. You can call the Social Security Administration on (800) 722 1213, or call in at one of their many offices. Another way is to use the power of the World Wide Web. Just go to https://s044a90.ssa.gov/apps6z/IMRC/main.html to apply for a replacement card, then you will have the proof that you belong to the Medicare program. If the state originally issued you the card, you will have to speak to the local Medicaid office.
Source: medicare-benefits.com

Top 10 Hot Pages About “Social Security” – quote of business letter

Obama sends you 85,000 documents isn’t http://www.huffingtonpost.com/social/BobRobertsFeltRedundant/solyndra-subpoena-obama-administration_n_1076871_116581332.html…and he won a one-year reduction of Social Security taxes that would put 2 percent of pay back into…
Source: blogspot.com

Open Question: A friend of mine threw my Licence, medicare card, bank cards and master cards away? How hard is it to reclaim?

Immediately call the banks that issued the bank card and mastercard and tell them that those cards were lost or stolen. If you do not do this and someone else finds the cards and uses them, you will lose a lot of money. After you call, the banks will send you replacement cards.
Source: blogspot.com

Replacing lost documents after a disaster : The Smithville Times

For Federal civil service records, you may fax your request to (314) 801-9269. Include your full name, Social Security number, name of agency, and dates of service. Sign your request and include the fax number or mailing address where the information should be sent. Current federal employees should contact the Office of Personnel Management at www.opm.gov for information concerning your benefits and employment.
Source: smithvilletimes.com

Nothing found for Whatismedicare How

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Source: abxnet.com

Does Medicare Cover Cochlear Implants Or Pay for Hearing Aids and Hearing Aid Batteries for Hearing Impaired Partially Deaf?

Posted by:  :  Category: Medicare

OBAMACARE WATCH: MORE DARKNESS THAN LIGHT AND OF COURSE TAXES AND PENALTYS by SS&SSIndividuals with Medicare Part B coverage may wonder if it covers cochlear implants for the hearing impaired or partially deaf senior, or if there is a way for Medicare to pay for hearing aid. Surprisingly, Medicare will cover cochlear implants for patients that meet Medicare guidelines for cochlear implant candidacy. However, unfortunately Medicare Part B does NOT cover hearing aids, so seniors that have only Medicare Part B coverage would need to pay 100 percent of the cost of hearing aids. And Medicare Part B will only cover diagnostic hearing exams in very limited cases, so it is likely that most seniors would not have those visits covered either.
Source: seniornewscoverage.com

Video: MDHearingAid Acoustitone MAX Hearing Aid.

Romneys Plan Would Fundamentally Change Medicare

Joe Baker, president of the Medicare Rights Center, a N.Y.-based consumer advocacy group, discounts Romney’s claims that having more seniors in private plans will save Medicare money. The Medicare Advantage program, he said, “has not brought down costs, so to think that there’s a new version that willy nilly by itself will bring down costs is a fantasy….It’s really cover for the real goal, and that is to end Medicare as we know it and by doing that, have more money come out of the pockets of consumers and save the federal government money.”
Source: localnewstucson.com

Cigna Medicare Rx Healthy Rewards

[…] Maybe, the first thing you need to do is check how your drugs are covered with their plans.  Make sure your drugs are listed in their formulary, and what tier they are.  Also consider the cost of the plan premium as well as your co-pay costs.  It does not make a lot of sense to join the program just for the Healthy Rewards if you are paying extra for your drugs.  However, if you are trying to decide between this plan and another that covers your drugs about the same then go for the plan with the extras.Source: medicare-plans.net […]
Source: medicare-plans.net

What is NOT Covered by Medicare Part A and Part B in 2011

What is not covered by Medicare part b (12),what is not covered by medicare (5),does humana cover hearing aids (3),humana hearing aid coverage (3),medicare- part b coverage in the philippines approved by obama (2),humana diabetic toenail (1),what is not covered by medicare part a and b (1),does humana pay for hearing aids (1),What are not covered by medicare part b (1),tems that are not covered by Medicare Part A or Part B include (1),not covered medicare part b (1),does medicare Part B cover hearing aids (1),humanna/partd (1),not covered by Medicare Part B? (1)
Source: medicareadvantagesupplementplans.com

UnitedHealth Looks to Boost Medicare Sales Selling Hearing Aids

“Even before health reform, we heard across the board from customers that this was a benefit they wanted,” said Lisa Tseng, chief executive officer of Hi HealthInnovations, a newly formed UnitedHealth unit handling the sales and marketing of the hearing devices. “The high cost of hearing aids and the difficulty getting tested mean that people put off treatment. Our goal is to make it affordable and easy.”
Source: agentnavigator.com

Why won’t medicare pay for hearing aids for the elderly?

I have written two senators and has a positive response did not answer this question. A m? I think, the p? Hearing Loss is, if not the n? number of people over a problem they have, which is quite high on the list. Good hearing aids are expensive. If Medicare pays for motorized wheelchairs,? Why? not pay at least part of the cost of aud? phones?
Source: causesgenitalherpes.com

Healthspring expands in Tennessee to Cookeville, Knoxville, and Sevier Co.

Posted by:  :  Category: Medicare

Jessica Sundheim by On BeingCookeville has their first HMO medicare advantage plan, with 0 to 26 dollar premium plans available, which is great news for those wanting a medicare advantage plan, as last year the only options were upwards of 40 dollars per month and had less benefits. It is also great for those in the Sparta and Carthage areas that use the Cookeville Regional Hospital, as this plan can now be used at the Cookeville hospital and has access to plenty of doctors in the Cookeville area. Now if we can get the Humana HMO in Cookeville, and both plans in Crossville next year, we could have great choice for Medicare advantage hmo and medicare advantage ppo.
Source: lifeplanningtn.com

Video: Tennessee Medicare

Medicare Q&A: Can I enroll in a Medicare Supplement if I’m under 65?

Federal law does not require insurance companies to sell Medigap plans to people under age 65, however, some states require insurance companies to sell you a policy, at certain times, even if you are under age 65. In Tennessee, Medicare beneficiaries who are under 65 are able to enroll in a Medigap Plan as of January 1, 2011.
Source: bernardhealth.com

Griffith Reminds Seniors About Medicare Enrollment

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Source: etnweb.com

Receiving Reasonable Medicare Product Insurance plans

Underneath the new laws, organizations Medicare Supplemental Insurance Texas certain qualifications would be given permission to find patient-protected Treatment data to offer public reports around the health consideration services with clinics, docs and the work place. These assessments will incorporate Medicare together with Medigap Insurance policies claims info with privately owned sector statements data to indicate which health providers necessary under some most cost-effective together with highest-quality expert services. This methodology is a component of the Budget friendly Care Act made for improv health-related, mak families pro-active in relation to their wellness, and generat down health-related costs.
Source: losebackfat.org

Tennessee Medicare Advantage

All Medicare Supplement plans are uniform comparing just like plans provided by various insurance companies. Medicare Supplement Plans are marked with letters such as Plans A through N. One of the vital very popular Medicare Supplement plans in Tennessee is Plan F. Since all plan F plans are as well, all you have to compare is the amount difference between the different vendors selling Plan F or any other plan that you have an interest in. Since a Medicare Supplement does not include coverage for medicine, you would be well advised to purchase a Medicare Plan D plan in Tennessee to pay your prescription desires.
Source: bloguay.com

Request for Care Centers: Submit Data on Impact of Medicare Cuts

Request for Care Centers: Submit Data on Impact of Medicare Cuts We are now into the first month of the new and greatly reduced Medicare SNF PPS rates. Aging Services is currently working with LeadingAge to collect information on the impact of both the rate cuts and additional therapy policy changes which will also result in reduced revenues.  Read more
Source: leadingagetennessee.org

Medicare Questions in Tennessee: Am I over

Upon turing 65, most individuals enroll in both Medicare Part A and Medicare Part B benefits. If you started receiving Social Security Benefits early, or enroll online, by phone, or at your local Social Security office — you will automatically be enrolled in Part A and B with an effective date the 1st day of the month you were born. Example: You’ve been receiving your Social Security benefits since age 62.5 and are turning 65 August 8 of this year. If you do not do anything, you should receive a Medicare card in the mail with a Part A and Part effective date of 8/1/2011. In most cases, there is nothing wrong with enrolling in A and B — however, for some individuals, delaying Medicare B would be beneficial. If you are insured through you or your spouse’s employer because you or your spouse plans to continuing working past the age of 65 — having Part B may be unnecessary. In most cases, you can save at least $115.40 per month in Part B premiums by opting out. When the time comes that you or your spouse decides to retire, you can opt back in/ enroll in Part B without facing late enrollment penalties. The best thing you can do to determine what your best healthcare strategy is upon turning 65 is make an appointment with one of Bernard Health’s licensed, non-commissioned advisors. Medicare open enrollment is right around the corner and if you have Medicare questions, want to evaluate your Medicare insurance options, or just want to better understand your current individual or group insurance benefits — so give us a call today!
Source: bernardhealth.com

Free seminars help to demystify Medicare coverage

Posted by:  :  Category: Medicare

Call 800-MEDICARE (800-633-4227) for a booklet on Medicare options, including a detailed explanation of covered benefits and monthly premiums of plans. The site also gives star ratings for many of the Medicare plans. If you need individual help, you can call the Medicare hot line to talk to a counselor who will help you search for options over the phone and will mail you a summary of what you discuss. You also can go to www.medicare.gov and do the comparison yourself. Click on health plan finder, enter your ZIP code or county and the type of plan you want, such as a Medicare Advantage or Med- igap policy. The site also gives star ratings, with the best plans getting a five-star rating.
Source: insurance4cheap.us

Video: 2009 Taste of Tuscany

Medicare, Obamacare and You

This weekend, Gov. Mike Huckabee is honoring America’s veterans! Watch as he hosts a special salute to our troops from Branson, Missouri … with special guest Tony Orlando! – Huckabee – Saturday, 8p ET
Source: foxnewsinsider.com

Incident: Accendo Insurance Company, RxAmerica (CVS Caremark), Molina Medicare, Windsor Health Plan, et al. Data Breach

Note that these estimates are based on the Ponemon Institute’s 2009 direct costs figures from their 2009 Annual Study: Cost of a Data Breach. We multiply $60.00 by the number of records to obtain this figure. Keep in mind that depending on the breach, the direct costs are not always suffered by the breached organizations. In the case of credit card number breaches, the direct costs can often be suffered by banks and card issuers. Also note that this is only an estimate.
Source: datalossdb.org

FMO for Molina Medicare in FL

MedicarePlanSolutions – you are correct. Street level for FL is 450, but CMS allows reimbursement of expenses above and beyond the 450, plus overrides to managing agents for business written by their subagents. As I was saying before, if you are interested in a 473 or 493 contract level (depending on your production level and number of sub-agents), feel free to contact me at the above phone number. I also immediately vest ALL of my contracts.
Source: insurance-forums.net

Living a Normal Life With Controlled Diabetes

Risk factors for diabetes include being over the age of 45, high blood pressure, Polycystic Ovarian Syndrome, inactive lifestyles, high cholesterol, gestational diabetes, had a baby over nine pounds, family history, or you are overweight. If you fall into any of these categories, start the process now to reverse the damage. Proper health now can dramatically effect your future. If left untreated, diabetes can lead to serious complications such as high blood sugar levels, neuropathy, eye problems, such as cataracts, glaucoma, retinopathy or even blindness. Kidney failure, heart attack or stroke, gum disease, and internal damage of organs are also serious complications.
Source: excellencetriathlon.org

Find Job Openings, Career Employment Opportunities, Post Jobs

With sophisticated technology we are able to present in real-time almost every newly listed job that has just been posted with thousands of sites. We simply aggregate (that is where we derive our name) each new job as it is posted with all the major sites. Now you don