New York Anti Subrogation Law Trumps Medicare Advantage Plans Recovery “Right” Under Medicare Secondary Payer Law 

Posted by:  :  Category: Medicare

42 USC §1395y(b)(8) Allocation bad faith Centers for Medicare & Medicaid Services (CMS) Centers for Medicare and Medicaid Services CMS Franco Signor Franco Signor LLC Gary E. Seger et. al. vs. Tank Collection Hadden Hadden v. U.S. Jeffrey J. Signor Katie Fox Liability Medicare Set-aside Arrangement LMSA Mandatory Insurance Reporting Medicare Medicare & Medicaid Schip Extension Act of 2007 Medicare beneficiary Medicare reimbursement amount Medicare Secondary Payer Medicare Secondary Payer (“MSP”) Medicare Secondary Payer Act Medicare Secondary Payer Compliance Medicare Secondary Payer Compliance: How to Mitigate Exposure in the Medicare Beneficiary Personal Injury Case Medicare Secondary Payer Liability Medicare Secondary Payer Manual Medicare Secondary Payer Statute Medicare Trust Fund MMSEA MSP MSP compliance MSP private cause of action; Geer v. Amex Assuance Co. ORM Responsible Reporting Entity Roy A. Franco RRE SCHIP Extension SCHIP Extension Act Sebelius Section 111 Section 111 Mandatory Insurance Reporting Section 111 reporting User Guide wrongful death
Source: francosignor.com

Video: United Healthcare Oxford Medicare Advantage Denies Coverage

Is this the future for Medicare Locals? (With musical references)

Our inability to link patients with practices with any degree of certainty, and the so-called ‘denominator problem’ that creates, seems likely to remain as the Achilles’ heel of practice-level monitoring for the foreseeable future.  Unless and until we are able definitively to associate patients with practices it will fall to Medicare Locals to take responsibility for population health outcomes.  Tools such as those developed by the English Public Health Observatories should play a key part in assessing the extent to which they succeed in that task.
Source: com.au

Healthcare Advocate: Insurer, Hospital Contract Dispute Threatens System

“The bottom line is that we are unequivocally determining is either a cancer studious can continue to entrance his caring with a oncologist he’s worked with for years, either a lady in a late initial trimester of pregnancy can continue caring with a OB-GYN she’s seen for 5 years or either a studious with a critical mental illness can say his attribute with his long-term psychiatrist,” she said.
Source: insuranceforphysician.com

Insurers looking for Medicare hikes

Insurers are increasing finding it difficult to win rate approvals in an economy where average Americans have struggled with employment and stagnating income. The insurers themselves face pressure to raise revenues and return profits to investors.
Source: ctnews.com

Pharmacies, Medical equipment Suppliers, OXFORD, MICHIGAN, (MI) USA

,  DM02-COMMODES,  URINALS,  BEDPANS,  DM03-CONTINUOUS PASSIVE MOTION (CPM) DEVICES,  DM04-CONTRACTURE TREATMENT DEVICES: DYNAIC SPLINT,  DM05-BLOOD GLUCOSE MONITORS/SUPPLIES (NON-MAIL ORD),  DM06-BLOOD GLUCOSE MONITORS/SUPPLIES (MAIL ORDER),  DM07-GASTRIC SUCTION PUMPS,  DM08-HEAT & COLD APPLICATIONS,  DM09-HOSPITAL BEDS (ELECTRIC),  DM10-HOSPITAL BEDS (MANUAL),  DM11-INFRARED HEATING PADS SYSTEMS AND/OR SUPPLIES,  DM12-EXTERNAL INFUSION PUMPS AND/OR SUPPLIES,  DM13-INSULIN INFUSION PUMPS AND/OR SUPPLIES,  DM15-NEGATIVE PRESSURE WOUND THERAPY PUMPS/ SUPPLIES,  DM16-NEUROMUSCULAR ELECT STIMULATORS (NMES)/SUPPLIES,  DM18-PNEUMATIC COMPRESSION DEVICES AND/OR SUPPLIES,  DM20-SUPPORT SURFACES: PRESSURE REDUCING BEDS/MATS/PADS,  DM21-TRACTION EQUIPMENT,  DM22- Transcutaneous Electrical Nerve Stimulation (TENS) AND/OR SUPPLIES,  DM23-ULTRAVIOLET LIGHT DEVICES AND/OR SUPPLIES,  M01-CANES AND/OR CRUTCHES,  M02-PATIENT LIFTS,  M03-POWER OPERATED VEHICLES (SCOOTERS),  M04-SEAT LIFT MECHANISMS,  M05-WALKERS,  M06-WHEELCHAIRS (STANDARD MANUAL & RELATED ACCESSORIES),  M07-WHEELCHAIRS (STANDARD POWER & RELATED ACCESSORIES),  M10-WHEELCHAIR SEATING/CUSHIONS,  OR02-ORTHOSES: PREFABRICATED (NON-CUSTOM FABRICATED),  OR03-ORTHOSES: OFF-THE-SHELF, PD06-OSTOMY SUPPLIES,  PD08-TRACHEOSTOMY SUPPLIES,  PD09-UROLOGICAL SUPPLIES, R01-CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICES & RESPIRATORY ASSIST DEVICES,  R02-HIGH FREQUENCY CHEST WALL OSCILLATION DEVICES/ SUPPLIES,  R03-INVASIVE MECHANICAL VENTILATION,  R04-INTERMITTENT POSITIVE PRESSURE BREATHING IPPB ( Intermittent positive pressure breathing) device ,  R05-INTRAPULMONARY PERCUSSIVE VENTILATION DEVICES,  R06-MECHANICAL IN-EXSUFFLATION DEVICES,  R07-NEBULIZER EQUIPMENT AND/OR SUPPLIES,  R08-OXYGEN EQUIPMENT AND/OR SUPPLIES,  R10-RESPIRATORY SUCTION PUMPS,  R12-VENTILATORS ACCESSORIES AND/OR SUPPLIES,  S01-SURGICAL DRESSINGS,  S02-DIABETIC SHOES AND INSERTS,
Source: usa-hospitals.com

Advantages Associated With Supplemental Medicare Plan

It won’t go unnoticed that Medicare health coverage has been of great help in ensuring that people who were not once covered by any health policy enjoy the right nowadays. Most of the insurance companies were hesitant if not refused to offer health care support to the disabled, senior citizens and also terminally ill patients. These groups of people are now able to receive the various Medicare plans available through private insurance companies, and some of the plans are even subsidized to reduce the cost of obtaining health covers. Nonetheless, there are still a few scenarios that are not covered by the normal Medicare plans making the insured pay extra cost for the additional medical services. At times the costs may be high and burdensome to the patient. For this reason, one has to take an additional plan to complement their primary Medicare so that they can enjoy full Medicare services at affordable prices. One of the advantages of taking supplemental Medicare indemnity is that the charges asked for by the insurance companies is affordable. Its affordability is in the form of low deductibles, low premiums and low coinsurance. Due to this fact, many low income earners are able to boost their insurance through the additional complementary Medicare plan hence receiving better coverage for less.
Source: worldhealthtalk.net

Can’t raise taxes? Hike Medicare premiums instead

Posted by:  :  Category: Medicare

Healthcare in America: Who's Paying Who? And Who's Getting What? (g1a2d0014c1) by watchingfrogsboil2012 Election Airlines/Airports/Airplanes/Air Travel/Fares/Fees California (CA) China Computer Security Curious News Europe/EU/Euro-Zone Federal Reserve Bank Finance & Business Florida (FL) Gov Rick Perry (R-Texas) Health HealthDay News Health News IRAs/401k/Pensions Jigsaw Puzzle Jobs/Employment/Unemployment Kids/Children/Teenagers Medicaid Medicaid Reform/Medicaid Cuts Medicare Medicare Reform/Medicare Cuts Military/Defense/US Armed Forces National Debt/Deficits New York (NY) Organized Labor/Unions/Strikes/Public/Private Political Opinion Politics Pres Barack Obama (D) Republicans (GOP) Retirement Retirement Savings/Withdrawals Scam Scams/Cons Senior Citizens Snow/Winter Recreation Social Security Social Security Benefits Social Security Reform/Social Security Cuts Taxes Travel UK/Britain/England US Debt Ceiling/Debt Limit Waste/Fraud/Abuse Yahoo
Source: elder-gateway.com

Video: Social Security Benefits will Increase, Offset by Higher Medicare Premiums

Republican plan would hike Medicare premiums

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Source: fiftyplusadvocate.com

TRUTH OR CONSEQUENCES: Payroll Tax Cut Extension: GOP Embraces Raising Medicare Premiums On High

The House is expected to vote Tuesday on a year-end economic package that includes a provision raising premiums for “high-income” Medicare beneficiaries, now defined as those making $85,000 and above for individuals, or $170,000 for families.
Source: loveisunlimd.com

Lubbock County Register: Republican ObamaCare Disinformation On Medicare Premiums EXPOSED!!

LCR EXPOSE!! http://factcheck.org/2011/04/premium-nonsense-on-medicare/ The above link exposes republicans scare tactics on ObamaCare’s effect on Medicare Part B premiums. There will be substantial increase on higher income people on social security. This website uses public record from Medicare Actuary Department. Shame On The Republicans!! This means you,Jerry!! LCR EXPOSE!!
Source: blogspot.com

State Roundup: Iowans And Wellmark Premium Hikes; Fla. Medicare Audit

Des Moines Register: Wellmark Customers Grill Executive Over Premium Increase The Wellmark Blue Cross/Blue Shield vice president faced dozens of angry customers and tried to explain why the health insurer wants to increase their premiums by 9.4 percent. … Barbed questions flew throughout the hearing before the state insurance commissioner, who will decide whether to grant Wellmark’s proposed increase for 86,000 Iowans who buy their own insurance policies (Leys, 12/10). Bloomberg: Texas Pension Predicts Health Shift Will Save $20M A Year The Texas Employees Retirement System, the state’s second-largest public pension, figures it will save about $20 million next year by shifting most of its retirees to a Medicare Advantage health-insurance plan. … [Catherine Terrell, a pension spokeswoman] said about 70 percent of the plan’s more than 71,000 retirees and dependents have accepted coverage managed by Humana Inc. (HUM) starting next month (Mildenberg, 12/12).
Source: kaiserhealthnews.org

House bill to raise Medicare premiums for wealthy

The extension of payroll tax cuts and jobless benefits are at the heart of President Barack Obama’s jobs program. House Republicans also plan to include a provision to avert a 27 percent cut in payments to doctors who treat Medicare patients.
Source: sfexaminer.com

Higher Medicare Premiums For The Wealthy?

In addition to the extension of payroll tax cuts and jobless benefits that are at the heart of President Barack Obama’s jobs program, House Republicans plan to include a provision to avert a 27 percent cut in payments to doctors who treat Medicare patients. All three face a Dec. 31 deadline for action.
Source: addictinginfo.org

Pondering 2012 Medicare Coverage? Read These pieces of Tips Initially!

Posted by:  :  Category: Medicare

With the high cost of living these days, making medicare a focal point to the day to day lives of many seniors and the fact that it acts in a similar way to a single payer healthcare system is at least helpful. There are some eligibility requirements for one to be accepted into the program, you have at least got to 65 years old to apply and this is why lots of people try to plan wisely so they will be well set up by the time they reach that one age. So many seniors take advantage of AARP Medicare Complete, for so many people (about 90%) medicare is no where near enough. For this reason they may end up searching for supplement plans this gets them out of a lot of tricky situations in which they would have otherwise been tied to the following benefits:
Source: autoinsurance-newjersey.org

Video: Medicare.gov Ad with Leslie Nielsen

Medicare open enrollment continues through Dec. 7

During this Open Enrollment Period, Medicare recommends that people treat their Medicare number as they do their Social Security number and credit card information. People with Medicare should never give their personal information to anyone arriving at their home uninvited or making unsolicited phone calls selling Medicare-related products or services. Beneficiaries who believe they are a victim of fraud or identity theft should contact Medicare. More information is available at www.stopmedicarefraud.gov
Source: ramonasentinel.com

As Open Enrollment Ends, People with Medicare save $1.5 billion on prescriptions

Thanks to the Affordable Care Act, the Medicare prescription drug coverage gap known as the donut hole is starting to close. Through the end of October, 2.65 million people with Medicare have received discounts on brand name drugs in the donut hole.  These discounts have saved seniors and people with disabilities a total of $1.5 billion on prescriptions – averaging about $569 per person.  For State-by-State information on the number of people who are benefiting from this discount in 2011, visit this page.
Source: medicare.gov

Medicare’s Open Enrollment Deadline is Today

Rep. Mazie Hirono: "Thanks to the Affordable Care Act, Medicare now provides our seniors with better choices, greater benefits such as annual wellness exams, and lower costs." Official Photo, 112th Congress.
Source: mauinow.com

Medicare’s Dec. 7th Open Enrollment Deadline Nears

• Online: Since the beginning of Open Enrollment (October 15) , online activities have surpassed 26 million page views across the Medicare Plan Finder web tool and open enrollment sections of www.Medicare.gov.  • On the phone: 1-800-MEDICARE (1-800-633-4227) continues to be an important 24/7 resource for personalized assistance during Open Enrollment.  More than 3.4 million calls have been handled and wait times continue to fall within acceptable customer service thresholds. • Face-to-face: At Open Enrollment events across the country, Medicare has been working closely with its partners across the nation to provide counseling opportunities for people with Medicare in their home communities.  More than a thousand events with Medicare beneficiaries have been held across the country – and thousands of SHIP counseling sessions have been conducted.  CMS and its partners have shared unbiased drug and health plan information at senior activity centers, through education-oriented media partnerships and phone banks and with other advocacy partners in unique local venues and faith-based communities. These events also highlight Medicare’s preventive services, including flu and pneumococcal shots and health screenings. For more information contact your local Area Agency on Aging, State Health Insurance Program or other unbiased senior advocacy organizations. Contact information for local telephone or face-to-face enrollment resources and year round assistance can be found on the back pages of your Medicare & You handbook.     
Source: paramuspost.com

Wednesday marks Medicare enrollment deadline for most Idaho seniors

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Source: koze950.com

Ability Chicago Info Blog: Medicare Basics

YouTube Uploaded by CMSHHSgov on Dec 2, 2011 This video in American Sign Language (ASL) provides an overview of Medicare, including Medicare Parts A, B, C & D. It also discusses Medicare-covered preventive services and the difference between the Medicare and Medicaid programs. For Medicare Basics webpage, visit: http://www.medicare.gov/navigation/medicare-basics/medicare-basics-overview.aspx?AspxAutoDetectCookieSupport=1
Source: blogspot.com

Annual Enrollment Period Ends… What If You Missed It? 

[1]For a more detailed discussion of these enrollment periods, see, e.g., previous Weekly Alerts, including: “Annual Enrollment Starts October 15 and Ends December 7 for Medicare Part D and Part D Plans” (September 22, 2011) available at: http://www.medicareadvocacy.org/2011/09/annual-enrollment-starts-october-15-and-ends-december-7-for-medicare-part-c-part-d-plans/; “Medicare Advantage and Part D Enrollment Updates”(October 6, 2011) available at: http://www.medicareadvocacy.org/2011/10/medicare-advantage-and-part-d-changes-and-enrollment-updates/; “45 Day Disenrollment Period for Medicare Advantage Members”(January 6, 2011), available at: http://www.medicareadvocacy.org/2011/01/45-day-disenrollment-period-for-medicare-advantage-members/; “When a Medicare Advantage Plan Does Not Renew Its Contract” (November 4, 2010 ), available at: http://www.medicareadvocacy.org/InfoByTopic/MedicareAdvantageAndHMOs /10_11.04.NonRenewal.htm. Also see, e.g., the Center’s website at: http://www.medicareadvocacy.org/medicare-info/medicare-part-d/#enrollment. [2] Chapter 2 of the Medicare Managed Care Manual (CMS Pub. 100-16, updated August 19, 2011, revised November 16, 2011):https://www.cms.gov/MedicareMangCareEligEnrol/Downloads/FINALMAEnrollmentandDisenrollmentGuidanceUpdateforCY2012-REV11.16.2011.pdf Chapter 3 of the Medicare Prescription Drug Benefit Manual (CMS Pub. 100-18, updated August 19, 2011, revised November 16, 2011):https://www.cms.gov/MedicarePresDrugEligEnrol/Downloads/FINALPDPEnrollmentandDisenrollmentGuidanceUpdateforCY2012-REV11.16.2011.pdf
Source: medicareadvocacy.org

Medicare health insurance supplement designs: rules to get followed

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSFootwear seen which the Medicare policy you happen to be hav will never cover for any total payment charged for the medical treatment plan. Now it all sometimes becomes a great problem for a lot of to display that supplemental cost. For of which very reason this can be the Medicare add to, in various other words often called the Medicare supplement policies that can help you get relieved of the extra problem of medical-related cost. It is a fact that while in the original Medicare insurance policies at this time there always continue be several gaps which is why it doesn?t pay for the health attention services that you can need. Therefore for anybody who is the among the many beneficiaries belong to the original Medicare insurance plane, you may well be in the necessity to buy Medicare insurance supplement insurance policies. In various other words it is usually known because the Medigap insurance as a result of reason go without shoes bridges Medicare Supplemental Insurance gap between your policy coverage belong to the original Medicare insurance plans and then the total medical-related bill you have to pay. This can be a type of health insurance coverage policy that can help you pay for a lot of the costs while in the original Medicare insurance program plus for that part go without shoes doesn?t take care of.
Source: worldaims.info

Video: GOP TRIES TO HIDE SHARRON ANGLES EXTREME VIEWS ON ABOLISHING MEDICARE AND SS IN NEVADA

Medicare and Medicaid Dodge The Budget Bullet (For Now)

Of course, we’re not yet out of the woods. Just as it became clear last summer that we’d have to wait until the winter for some kind of budget solution from Congress, it now seems that we’ll have to wait for the upcoming election season. In turn, expect things to intensify even further and for budget discussions to become all the more drastic.
Source: sundvicklegacycenter.com

Heller Payroll Tax Bill Protects Millionaire Tax Breaks, Slashes Medicare

“Dean Heller’s legislation is nothing more than another assault on Medicare,” said Nevada State Democratic Party spokesperson Zach Hudson.  “After saying he was proud to be the only member of Congress to vote twice to kill Medicare by turning it over to private insurance companies, Heller is now continuing his attack on the program by again introducing legislation that slashes seniors’ healthcare.  Nevadans have a clear choice between Shelley Berkley’s commitment to creating jobs and protecting seniors, and Dean Heller who wants to slash Medicare to protect tax breaks for billionaires and Wall St. bankers.”
Source: wordpress.com

Don’t Tinker With Our Medicare

2012 election 2012 elections Americans for Tax Reform Amodei Arms Trade Treaty AT&T Brian Sandoval Cain CCSD CD2 Clark County Commission Clark County Republican Party Clark County School District CLC Conservative Leadership Conference Dean Heller debt ceiling Dina Titus economy FCC First Friday Gary Johnson GOP green energy Harry Reid Herman Cain jobs Joe heck John Hambrick Kate Marshall Mark Amodei Medicare Michael Roberson national debt Nevada Nevada Legislature Nevada Supreme Court Newt Gingrich NPRI NSHE Obama Obamacare Oceguera PLA project labor agreement public policy public sector unions redistricting Rick Perry Ross Miller Sandoval Shelley Berkley small business Social Security solar energy Super Committee taxes unemployment unions UNLV College Republicans
Source: nevadanewsandviews.com

Nevada Medicare Advantage Plans

www.medicareplansofamerica.com Nevada Seniors get more protection with medicare advantage plans. Get an online medicare insurance plan quote today. Medicare enrollment is open to Seniors 65 and up for the most part in Nevada. Learn more about new medicare options in NV. Additional Nevada Medicare Supplement sites: www.2011medicareadvantageplans.com www.trinitymedcare.com Video Rating: 0 / 5
Source: nevadachatta.com

Nevada Supreme Court Rules Common Law Doctrine of Unconscionability Preempted By Medicare Advantage Law

The Court then addressed whether the arbitration provision was enforceable or whether the state common law doctrine of unconscionability was preempted by the Medicare Act.  The express Medicare preemption statute provides that federal “standards” established under the Medicare Act supersede “any State law or regulation” with respect to MA plans.  42 U.S.C. §  1395w-26(b)(3).  Citing Uhm v. Humana, Inc., 630 F.3d 1134 (9th Cir. 2010), the Court determined that the arbitration provision was encompassed by the preemption statute because it constituted marketing materials due to its placement in the Evidence of Coverage and because CMS’ regulations governing marketing materials can be considered “standards” for purposes of the preemption statute.  See Opinion, at pp. 9-10.  The Court further ruled that Medicare preemption of “any State law or regulation” extends to generally applicable common law, in light of the preemption statute’s legislative history and the Uhm decision.  See Opinion, at p. 10.  Thus, because the common law doctrine of unconscionability would specifically regulate the MA plan in this case, the Court determined that it was encompassed by the preemption statute.  In reaching this decision, the Court noted that allowing a state court to review a Medicare contract and possibly find it unconscionable, despite the fact that CMS approved the same contract as part of its review of a plan’s marketing materials, is an unacceptable result under the Uhm decision.  See Opinion, at p. 11. 
Source: crowell.com

Pharmacies, Medical equipment Suppliers, NEVADA, MISSOURI, (MO) USA

,  DM02-COMMODES,  URINALS,  BEDPANS,  DM03-CONTINUOUS PASSIVE MOTION (CPM) DEVICES,  DM05-BLOOD GLUCOSE MONITORS/SUPPLIES (NON-MAIL ORD),  DM06-BLOOD GLUCOSE MONITORS/SUPPLIES (MAIL ORDER),  DM07-GASTRIC SUCTION PUMPS,  DM09-HOSPITAL BEDS (ELECTRIC),  DM10-HOSPITAL BEDS (MANUAL),  DM12-EXTERNAL INFUSION PUMPS AND/OR SUPPLIES,  DM15-NEGATIVE PRESSURE WOUND THERAPY PUMPS/ SUPPLIES,  DM18-PNEUMATIC COMPRESSION DEVICES AND/OR SUPPLIES,  DM20-SUPPORT SURFACES: PRESSURE REDUCING BEDS/MATS/PADS,  DM21-TRACTION EQUIPMENT,  DM22- Transcutaneous Electrical Nerve Stimulation (TENS) AND/OR SUPPLIES,  DM23-ULTRAVIOLET LIGHT DEVICES AND/OR SUPPLIES,  M01-CANES AND/OR CRUTCHES,  M02-PATIENT LIFTS,  M05-WALKERS,  M06-WHEELCHAIRS (STANDARD MANUAL & RELATED ACCESSORIES),  M07-WHEELCHAIRS (STANDARD POWER & RELATED ACCESSORIES),  M10-WHEELCHAIR SEATING/CUSHIONS, PD06-OSTOMY SUPPLIES,  PD08-TRACHEOSTOMY SUPPLIES,  PD09-UROLOGICAL SUPPLIES, R01-CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICES & RESPIRATORY ASSIST DEVICES,  R02-HIGH FREQUENCY CHEST WALL OSCILLATION DEVICES/ SUPPLIES,  R03-INVASIVE MECHANICAL VENTILATION,  R04-INTERMITTENT POSITIVE PRESSURE BREATHING IPPB ( Intermittent positive pressure breathing) device ,  R05-INTRAPULMONARY PERCUSSIVE VENTILATION DEVICES,  R06-MECHANICAL IN-EXSUFFLATION DEVICES,  R07-NEBULIZER EQUIPMENT AND/OR SUPPLIES,  R08-OXYGEN EQUIPMENT AND/OR SUPPLIES,  R10-RESPIRATORY SUCTION PUMPS,  R12-VENTILATORS ACCESSORIES AND/OR SUPPLIES,  S01-SURGICAL DRESSINGS,  Oxygen,  Oxygen Equipment and Supplies,  Enteral Nutrients,  Equipment,  and Supplies,  Continuous Positive Airway Pressure (CPAP) Devices and Respiratory Assist Devices (RADs),  and Related Supplies and Accessories,  Walkers and Related Accessories,
Source: usa-hospitals.com

Update: Remit: CPIDs 5533 Kentucky Medicare and 3507 Ohio Medicare: ERA Delay

Posted by:  :  Category: Medicare

Racism by elycefelizUpdate: The payer has resolved the issue and processed all the affected claim files. Original Notice Sent October 26, 2011: Institutional Electronic Remittance Advice (ERA) for CPID 5533 Kentucky Medicare and 3507 Ohio Medicare for check dates of October 20, 2011 to present are delayed due to unavailability of the files at the payer. We are working with the payer to receive all outstanding ERA files as quickly as possible. Action Required : Please be aware of a delay in the delivery of ERA files for the check dates of October 20, 2011 to present. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

Video: Rand Paul In The ’90s: Medicare Is Socialism And Social Security Is A Ponzi Scheme

Kentucky Elder Abuse Attorneys Say Medicare Adjustment Should Not Impact Nursing Home Care

“If a nursing home resident for whom a person is responsible has died or been injured, abused, neglected or harmed in any manner that appears to be suspicious, then someone needs to help them protect their rights,” Hughes said. “An experienced advocate will stand by your side to answer questions, investigate the case and make sure those responsible are held accountable.”
Source: travelnets.info

IMACK: Improved Medicare For All Central Kentucky

Mahan continues, “We need people to work with us to implement our plans for public meetings and participate in them, to write letters to the legislators, to the editor and others and get them involved. We are open to new ideas from participants. We try to do two or three events per year. We held a panel discussion at the downtown library on August 10th.” Adding a lighter note to this serious subject, Bill Mahan also produces songs about healthcare, which are available on YouTube. For more information about the group, Mahan can be reached by email at: billmahan@windstream.net.
Source: suite101.com

Hospitals, government reach Medicare billing settlement

The health system will pay more than $435,000 to settle allegations that it submitted false claims in violation of the Federal False Claims Act. The alleged overbilling covered a four year period between January 2006 and February 2010.
Source: wave3.com

Louisville Medicare Advantage Plan, KY, Change, Switch, Compare, Replace

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist) and these rules can change each year.
Source: bradeninsurance.com

Kentucky Medicare Coverage Choices

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Source: kyfreehealthquotes.com

Louisville Insurance Medicare Health Kentucky Auto Home

Find the lowest insurance rates available on the best auto, home, medicare and health insurance plans to protect their cars, homes, businesses, and families for decades. Braden Insurance Agency has helped hundreds of clients in Louisville, Kentucky.
Source: greatbookmarking.com

Medicare Supplemental Insurance and Medicare Advantage Plans in Kentucky

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Source: medicaresupplementadvantageplans.com

Treatment Supplement Insurance policies: Listing from Coverage

Posted by:  :  Category: Medicare

Medicare saves lives. by cometstarmoonMedicare health insurance supplement insurance cover, or Medicare supplement, is private medical insurance that supplliers sell to fill out the holes in frequent Medicare insurance plan. These supplemental coverage pay most of the health consideration costs this Medicare would not cover. Assum you have both Medicare and also a Medigap protection plan, the only two policies share the amount paid of covered clinical. If you could be in primary Medicare and there are a Medigap protection plan, Medicare should pays it is share of your Medicare-approved concentrations for covered clinical costs. Right after Medicare will pay, then the actual Medigap protection plan pays it is share.
Source: boulevardplaceestate.com

Video: RANT!!!!! DEBT problem; Wisconsin & Ohio; Social Security, Medicare and Taxes

Hospitals prepare for Medicare funding cuts

Originally, if a hospital was within a 35-mile drive of another hospital, it couldn’t be designated critical-access. But Congress later dropped that provision and left it up to states to designate critical-access hospitals. Wisconsin now has 58.
Source: riverfallsjournal.com

Medicare Data On Hospitals, Doctors Made Available

The Wisconsin Health Information Organization, WHIO (pronounced we-o), a statewide group that has been at the forefront of analyzing insurance claims to lessen the variation in the cost and quality of health care – applauded the federal government’s move to allow access to Medicare’s claims database. Its database now has 250 million insurance claims from 3.9 million people in the state. But it doesn’t have Medicare data. That leaves a gap on a significant part of the state’s population. The government announced Monday that Medicare will finally allow its extensive claims database to be used by employers, insurance companies and consumer groups to produce report cards on local doctors and hospitals. (Source: Milwaukee Journal Sentinel)  [Read article]
Source: worh.org

Medicare Extends Enrollment Deadline For Some

Federal officials are extending the Dec. 7 deadline for three days for some people enrolling in a Medicare prescription drug or private health plan because of the crush of last-minute sign-ups. But a spokesman for the Centers for Medicare and Medicaid said the “increased flexibility” is limited only to seniors who contact any of several sources of assistance on or before the close of business Wednesday: counselors with the government-funded State Health Insurance Information Program (SHIP), Medicare’s toll-free information line, 1-800-633-4227; and other Medicare-partner organizations such as the Medicare Rights Center, local agencies on aging, and the National Council on Aging. They can leave messages if necessary requesting help.  (Source: Kaiser Health News)  [Read article]
Source: worh.org

Wisconsin Medicaid, Medicare fraud cases focus on orthotic device sales

According to the U.S. attorney general’s office, Kanter knowingly sold diabetic shoe inserts that failed to conform to Medicare requirements. As part of his plea deal Kanter is barred from participating in any federal healthcare programs for 15 years. Dr. Comfort was sold in March to California-based supplier DJO Global, which paid $254.6 million for the company and agreed to sign a corporate integrity agreement with the Department of Health and Human Services Office of Inspector General.
Source: lowerextremityreview.com

Romney Assails Gingrich For Remarks About GOP Medicare Plan

The Los Angeles Times: Medicare Scrum: Romney Hits Gingrich, Dems Hit Romney Romney’s own healthcare reform plan (which involves, yes, repealing the Democratic healthcare overhaul, he says) also involves reshaping Medicare to add a private insurance option, but he also has suggested he would preserve the government-run system for seniors. The closer he draws then to sounding like the Ryan plan is his plan, the more he may risk exposing himself to attack during a general election contest with Obama. And Democratic advocacy groups have been filling the inboxes of political reporters all week making sure that message is loud and clear (Oliphant, 12/9).
Source: kaiserhealthnews.org

Medicare Open Enrollment: What You Need to Know This Year

Keep in mind that once open enrollment ends, you may still be able to make changes to your Medicare coverage. Many don’t know that Medicare offers “Special Election Periods”providing the opportunity to change Medicare coverage anytime of the year. For example, eligible beneficiaries with diabetes or heart failure are allowed a one-time special election period to enroll in a Special Needs Plan for their condition. In addition, eligible Medicare beneficiaries receiving full Medicaid assistance may switch their coverage at any time of the year.
Source: communityjournal.net

Feds to allow use of Medicare data to rate doctors, hospitals and other health care providers

“There is tremendous variation in how well doctors do, and most of us as patients don’t know that. We make our choices blind,” said David Lansky, president of the Pacific Business Group on Health. “This is the beginning of a process to give us the information to make informed decisions.” His nonprofit represents 50 large employers that provide coverage for more than 3 million people.
Source: profrisk.com

Managed Health Services Presents Summit Award

About The Centene Foundation for Quality Healthcare The Centene Foundation for Quality Healthcare is a non-profit private foundation dedicated to improving the quality of healthcare in the United State. The Foundation serves as a resource to identify and support innovative approaches to improving and increasing the quality of and access to healthcare for low-income individuals and families. This is accomplished through an inspired philanthropic giving plan that seeks to promote efforts and activities that identify and address core causes of unequal access and treatment in healthcare. For additional information, please visit www.centenefoundation.org.
Source: mhswi.com

The Medicare Daily Report: MRC Speaks Out, NCPSSM Says Protect the Middle Class, RomneyCare Copies RyanCare, RomneyCare Not the Gingrich Plan

The Medicare Rights Center is an expert on Medicare and its impact on the aged and disabled.  Why?  Because they actually counsel them and help them deal with the eligibility and coverage problems of Medicare.  You don’t often hear about those problems, although you do hear about ideas for changing eligibility and coverage to save money.  The fact is: there are eligibility and coverage changes that are needed which would HELP people who really need and depend on Medicare — taxpayers who already have contributed to their pre-paid public benefits.
Source: blogspot.com

The Paul Ryan Watch: Lyin’ Paul Ryan and the end of Medicare

Zombie-eyed granny-starver Paul Ryan of Wisconsin is having a tough year. First, he comes out with a plan to “reform” Medicare in the same way that an iceberg once “reformed” the White Star shipping line. Many people including (at the time) Newt Gingrich laughed at his mighty brain. (Why do they all laugh at my mighty brain?) Then bad things happened to some people who thought Paul Ryan had a good idea. Then, everyone in the world who could work an abacus looked at his plan and noticed that, yes, the plan added up to an actual elimination of Medicare even though Ryan planned to spray-paint “Medicare” on an old railroad bridge in Janesville and point to it and say, “See? Medicare is still there.”
Source: blogspot.com

Affordable Care Act Saves Millions for Wisconsin Residents Enrolled in Medicare

Across the country, more than 18.9 million people enrolled in Medicare have used preventive services with no cost to them. In Wisconsin and from coast to coast, seniors are finding that the Affordable Care Act is making prescription drugs more affordable by the Medicare Part D coverage gap, also known as the Medicare Donut Hole. The Affordable Care Act allows seniors to receive 50% discounts on their brand name prescription drugs once they hit the donut hole, saving millions of dollars for Wisconsin seniors.
Source: cwagwisconsin.org

Webinar on Medicare Fraud Now Available 

badgercare plus Better Business Bureau charity scams credit card fraud credit card scams election fraud false claims act fraud alert newsletter Frauds healthcare reform identity theft medicaid fraud Medicare medicare fraud medicare overbilling medicare part D medicare reform medicare reimbursement mortgage fraud phishing scams podcasts prevent medicare fraud storm chasers storm scams tax scams telephone scams Training voter fraud wisconsin bbb wisconsin check fraud wisconsin child care fraud wisconsin election fraud wisconsin fraud wisconsin head start fraud wisconsin healthcare wisconsin medicaid fraud wisconsin medicare wisconsin mortgage fraud wisconsin scam wisconsin scams wisconsin smp wisconsin smp training wisconsin unemployment benefits wisconsin unemployment fraud wisconsin voter fraud
Source: wisconsinsmp.org

No Medicare Cost Controls

Posted by:  :  Category: Medicare

Healthcare Costs by Images_of_MoneyWhen Medicare, the federally run health care financing system for Americans who are 65 or older, passed in 1965, supporters knew the pro- gram would be expensive. Its lack of cost con- trols was the price of passage. Wilbur Cohen, a top health bureaucrat dubbed “The Man Who Built Medicare” by Medical World News, admitted that “the sponsors of Medicare, including myself, had to concede in 1965 that there would be no real controls over hospitals and physicians. I was required to promise before the final vote in the executive session of the House Ways and Means Committee that the federal agency would exercise no control.”
Source: reason.com

Video: What Does Medicare Cost?

The Federal Government’s Deeply Flawed System For Controlling Medicare Costs

Most notably, suppliers’ bids aren’t binding. Companies are free to offer deep discounts on their wares, win a contract, and then decide after the fact not to deliver. There’s no penalty if a bidder doesn’t abide by its commitment. Consequently, the auction process encourages companies to bid so low that they drive out legitimate suppliers. Moreover, CMS chooses as the final price the median among the winning bids, instead of marginal cost, which would drive pricing in a competitive market.
Source: thecre.com

Medicare and Private Health Insurance

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

CMA Responds to the NY Times: Don’t Privatize Medicare!

We provide effective, innovative opportunities to impact federal Medicare and health care policies and legislation in order to advance fair access to Medicare and quality health care. Principals Judith A. Stein, JD Alfred J. Chiplin, Jr. M.Div., JD Toby Edelman, M.Ed., JD David Lipschutz, JD Margaret Murphy, JD Patricia Nemore, JD Brad S. Plebani, JD Larry S. Glatz, M.Ed.
Source: cmahealthpolicy.com

House Vote Scheduled On Payroll Tax Reduction Package

CQ HealthBeat: Prevention Fund Cut Proposal Criticized By Public Health Groups The House Republican proposal to cut $8 billion over a decade from the health law’s Prevention and Public Health Fund is shortsighted and ultimately would cost the country more in future health care dollars, public health and prevention experts said Monday. Under a measure introduced by House Republicans Dec. 9, the prevention fund would be capped at $640 million per year beginning in fiscal 2013. The Congressional Budget Office (CBO) estimates the cut would save $8 billion over 10 years. Mandatory funding allotted to the program by the health overhaul authorized $15 billion for the first 10 years, starting with $500 million and building up to $2 billion per year as of fiscal 2015 (Bristol, 12/12).
Source: kaiserhealthnews.org

Medicare physician reimbursement

But not fixing SGR may well be worse, as it is a fatally flawed cost containment “approach”. The SGR attempts to use price to control cost. The complete failure of the SGR approach to control cost is patently obvious, as utilization continues to grow at rapid rates. This was a problem four years ago, and its done nothing but get worse. Not only does the RBRVS/SGR approach contribute to cost growth, it also ‘values’ procedures – doing stuff to patients – more than listening to them (I realize this is an unfair comparison, for more click here).
Source: joepaduda.com

Medicare Open Enrollment: Looking at Costs

That’s why we want to help you take control over your Medicare coverage.  Look around for all the Medicare information out there, visit our Open Enrollment center, and watch a video about how the Medicare Plan Finder works. After you’ve narrowed your options, you can call the plans you’re interested in to get more details about their benefits and services, or check out their websites.
Source: medicare.gov

Recent Health Articles: Enrollment Still Growing In Medicare Advantage Plans, GAO Says

While the health law’s changes had little impact on MA enrollment this year, more changes may be in store. The GAO report notes that the Congressional Budget Office has predicted that those $136 billion in cuts to MA plans would decrease enrollment by about 35 percent through 2019. The Office of the Actuary at the Centers for Medicare and Medicaid Services has found that the reduction in MA payments would eventually lead to those plans offering less-generous benefit packages.
Source: blogspot.com

Learn how to Qualify For one Free Or Low priced Mobility Child scooter Under Medicare health insurance Insurance

Problems walks: your medical professionsal must present main reasons why it will be impossible so you might walk even inside your home, and perform available household actions, such as travell to the restroom, go in to the kitchen, even thanks to a walk cane, walker, or perhaps rollator. Sufficient shape strength to figure the health care mobility kid scooter: your medical professionsal must agree that your chosen upper shape strength is enough for typically the operation from the medical kid scooter. You must get to steer it while you must get to sit straight in the basket. Must be capable of get in and right out the scooter carefully: Your strength need to be sufficient with the, as described because of your physician. Insufficient shoulder/arm strength to figure a information wheelchair: a physician needs to make sure that that your current arms strength will not be sufficient for any operation of your manual wheelchair. Ought to be will to figure: You will have to be will to apply the health care scooter. Need Medigap Insurance Plans chair: Your general practitioner must anticipate you mak use of this medical scooter for any minimum period of six(6) many months.
Source: kill-popup-ads.com

My Mother's Hospital Bill Reveals The True Cost Of Medicare

Great cogent dialog/byplay…Kudos to all participants. Medicare is not going away so rest easy. It may be tweaked a tad, especially those Medicare Advantage Bush Pork Plans which are restrictive, limiting and confusing, not to mention over-funded last year, to the tune of $9 Billion Dollars more (paid out to plan providers by the government) than if those same senior enrollees simply had medicare and a supplement or medicare and medicaid (if indigent). 10,000 people a day turn 65 and will now be paying in to the system (Part B Premium at the very least along with secondary insurance, co-pays and/or deductibles…excess charges etc etc) These people are taking better care of themselves. They are not malingerers..The house will take in alot more than they will have to pay out. Gary, what your mom went through was a RARE RARE occurrence. You can’t paint everyone with the same brush that mom had to be painted with. There are CPT codes that are routinely updated. Certain procedures/tests/surgeries etc etc call for a certain approved amount to be paid. Mom’s situation fell through the grates, a once in a blue moon situation to be sure. It was dealt with. Doctors enrolled in the medicare program are allowed to bill up to 15% above the approved amount. (Excess charges, meaning they did not take medicare assignment.) Perfectly legal. But that’s the max they can go. The law of large numbers will prevail in medicare’s future with so many having paid in for over 4 decades (employers too) and now at age 65, 10,000 day will pay into the system, many for Part D as well, since they are penalyzed if they don’t. Medicare will be fine with fresh money coming in and hopefully a stronger focus on provider fraud.
Source: chicagonow.com

Big Drug Hikes in Some 2012 Medicare Plans

Washington walked through the Plan Finder with U.S. News, using a hypothetical Medicare participant in Chevy Chase, Md., who takes two prescription drugs: Cimzia for rheumatoid arthritis and Cozaar for high blood pressure. Cimzia is an expensive drug that is placed in the top pricing tier of many drug plans, she said. Cozaar has a generic equivalent, but the branded version was retained for this price comparison. Based on these two drugs alone, there was more than a $1,000 difference in projected 2012 out-of-pocket costs for the 10 cheapest plans out of more than 30 available in Chevy Chase. Plans with the lowest premiums did not always have the lowest out-of-pocket costs.
Source: mytopnews.net

A Person’s Rights When Applying For Supplemental Medicare Cover Health & Beauty Magazine

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSTreatment Estrogen Replacement Therapy Joint Pain Preschool Kids Fda Pointers May Burn Stevensjohnson Syndrome System Rhinos Turn Tammy Richardson Fertility Monitor Richardson Robotic Surgical Monitor Pain Laser Pointers Syndrome Statistics Back Pain Therapy Medical Homes Robotic Surgical System Heart Disease Surgical System Laser Pointers May Homes Problem May Software Health Insurance Staph Infections Bppv Treatment Infections Spreading Estrogen Replacement Infections Burn Victims Wins Fda Rhinos Replacement Therapy Childhood Obesity Health Bppv Disease Spreading
Source: healthbeautymagazine.com

Video: How to Apply For Medicaid in Florida Online

Things to Consider When Applying For Medicare

Make sure check the number of accredited hospitals, medical professionals and procedures within your locality. They should be unlimited. 3. Ask questions: Make sure to ask for the appropriate contact number to answer any questions you might have regarding the plan. While it is important to read thru the materials it would be best if you can talk to a person to explain difficult concepts. Out of Pocket Expenses As a general rule when you apply for Medicare Part A and/or Part B you need to pay additional premiums to be paid by the individual. Now consider alternative HMO and/ or PPO providers. For example, If Mr. A is supposed to pay $100 monthly for Medicare will only pay $90 for a superior HMO policy then it would be in the best interest of Mr. A to just avail of the HMO. Application Proper There are two ways to apply for Medicare. The first is to call the social security service in your locality and be guided by a representative every step of the way. The second option is to go to the office of the local social security service and fill out the appropriate paperwork. Find the listing as well as the phone number and even the website on the yellow pages or on the internet. After that just wait for the paperwork to be processed.  
Source: ezinemark.com

Broker: Get advice when applying for Medicare

Friedman, a Mount Laurel resident who grew up in Moorestown and is a West Point graduate, said that his focus was on group health care, but that increasingly he saw that seniors applying for Medicare needed advice.
Source: agentnavigator.com

Things to Consider When Applying For Medicare

Depending n the parts availed of Medicare costs can increase and decrease. Take into consideration your finances, health, other insurance coverage and job environment then decide which parts to include. For example, if you already have a comparative or higher HMO coverage then there is no need to take out a Part C Medicare plan. However if the Part C coverage that can be availed of is higher then decide if the additional costs is worth it for you.
Source: blogspot.com

Brad Hunter, CPA: Applying for Social Security and Medicare

You should apply for social security benefits 4 months before you want to start the benefits. You should apply for medicare 3 months before the month you turn 65. There is a penalty of 10% of the cost of medicare part B for each year you delay enrolling.
Source: bradhuntercpa.com

HIT Consultant: CMS releases Medicare Shared Savings application

Medicare Shared Savings Program Application 2012 Appendix A-Electronic Funds Transfer (EFT) Authorization Agreement (CMS Form 588) Appendix B-Participant List Appendix C-Data Use Agreement (DUA) Appendix D-Application Reference Guide Refer to the Appendix D-Application Reference Guide document in the Downloads section of this page for further details on how to complete the application.
Source: blogspot.com

The Application for Medicaid

If you are worried about your income and how much you make please note that the income is all about the money that might either be earned and even sometimes that is not earned. If you have cash that is coming from any source in your home this might also determine as to rather or rather not you are approved for Medicaid depending on how much they give you. However, it is still a great idea to fill out the application for medicaid to see if you can get approved. It can help you out in many ways and prevent you from having money problems later on if you need medical help. Due to the time it might take to get approved, I wouldn’t delay the applying for it and more so if you are pregnant or have a current health condition that requires attention immediately.
Source: medicaidvsmedicare.org

Medicaid Application Details

As you complete your Medicaid application, be sure to include accurate information. Additionally, provide any documentation that is requested. This may include: birth certificate; proof of citizenship; recent paystubs; proof of other income; proof of where you live; and an insurance card if you currently have coverage.
Source: retireeasy.com

Broker: Get advice when applying for Medicare

2012 Election Airlines/Airports/Airplanes/Air Travel/Fares/Fees California (CA) China Asia Computer Security Curious News Europe/EU/Euro-Zone Federal Reserve Bank Finance & Business Florida (FL) Gov Rick Perry (R-Texas) Health HealthDay HealthDay News Health News IRAs/401k/Pensions Jigsaw Puzzle Jobs/Employment/Unemployment Kids/Children/Teenagers Medicaid Medicare Military/Defense/US Armed Forces National Debt/Deficits New York (NY) Obesity/Weight Loss/Gain Organized Labor/Unions/Strikes/Public/Private Political Opinion Politics Pres Barack Obama (D) Republicans (GOP) Retirement Retirement Savings/Withdrawals Scam Scams/Cons Senior Citizens Snow/Winter Recreation Social Security Social Security Benefits Social Security Reform Taxes Travel UK/Britain/England Europe US Debt Ceiling/Debt Limit Waste/Fraud/Abuse Yahoo
Source: elder-gateway.com

Joe’s Health Calendar 12/13/11

Studies show that two out of three California seniors will need long-term care at some point in their lives. To prepare for this silver tsunami, the state has launched www.RUReadyCA.org, an independent, easy to use website that offers a host of tools, information and calculators to help each Californian plan for their individually unique long-term care needs. “Long-term care concerns can be emotionally and fiscally taxing, especially for those who wait to prepare,” said Department of Health Care Services Director Toby Douglas.  “It’s critical that Californians work to address this issue before the need arrives. Californians should make long-term care planning an essential part of any retirement planning process.” Created by DHCS’ California Partnership for Long-Term Care (Partnership), the new website walks visitors through various scenarios and the many options to address long-term care needs. Armed with six individualized calculators, the site gives visitors the opportunity to experiment with different scenarios and approaches that meet their specific family, financial and personal dynamics. The Partnership is dedicated to educating Californians to plan for their future long-term care needs and to consider private insurance as a vehicle to fund that care. The Partnership provides access to a select number of private insurance companies that meet strict requirements set by the state of California in order to take the guesswork out of choosing a high-quality insurance company.
Source: esanjoaquin.com

How To Apply For Medicare

[...] The second way to apply for Medicare is to apply right online.  You will need to go to the Social Security website, click on the Medicare tab and you will see a link that says apply for Medicare benefits.  This process is so much more streamlined and much QUICKER!  First of all you will not have to navigate the phone menu for Social Security, and you will also not have to make an appt to go into the Social Security office.  The application will start processing immediately so you will receive your Medicare benefits much faster.Source: medicare-plans.net [...]
Source: medicare-plans.net

DAR File No. 35441 (Rule R414

If the Medicaid eligibility agency receives a signed signature page and the completed application after the application processing period but during the 30 calendar days immediately after the denial notice is mailed, the Medicaid eligibility agency will contact the applicant to ask if the applicant wants to reapply for medical assistance. If the applicant wants to reapply, the Medicaid eligibility agency may use the previous application form it received, but the application date will be the date the Medicaid eligibility agency receives both the signed signature page and completed application form according to the same provisions in Subsection R414-308-3(2).
Source: utah.gov

Berwick: Dont blame Medicare, Medicaid. Its the delivery system

Posted by:  :  Category: Medicare

CENTRAL CITY, COLORADO 1968 by roberthuffstutterHis failure to be confirmed did not affect his ability to get things done, though he would have preferred a longer term. “An agency of this size will do better with longer-term leadership commitment,” he said. Knowing his tenure could be short gave him a greater sense of urgency to achieve things, he said. His most challenging decisions involved state requests to cut Medicaid benefits and writing regulations to encourage doctors and hospitals to form accountable care organizations to work more closely, while not making the requirements overly burdensome. He criticized state efforts to limit hospital coverage for Medicaid recipients, currently under review by federal regulators. Hawaii has proposed a 10-day coverage limit on some enrollees; Arizona has proposed a 25 day limit. “It’s a nonsensical idea,” he said. “If a patient needs twenty days, the patient should get twenty days,” he said. Managed care done right is the best way to provide care, he said, but if states are not ready to take on the responsibility, it can lead to restrictions that prevent people from getting the care they need. Early in his career, Berwick worked for Harvard Health Plan, a nonprofit HMO based in Boston. Berwick said he has not yet decided what to do next beyond spending more time with his family in Boston.
Source: localnewscoloradosprings.com

Video: Colorado Medicare Supplements

Senior Lobby Policy Committee Makes Progress

Program staff works with the internal agency budget staff and OSPB on the projection of the monetary needs for the program based upon historical data, previous expenditures, and requirements for Federal matching dollars, and caseload increases.  In the example of the SFSS, the Division of Aging and Adult Services would submit a proposal for the projection of additional dollars that will be needed in fiscal year 2013-2014.  This information is then shared with CDHS’s upper management and the internal agency’s budget office staff, who must weigh all the requests from each of the different Divisions against the target number/budget received from OSPB.  This is where it gets difficult, as each program has written up a document detailing why that program needs the additional dollars that may have been allocated to CDHS.  Upper management reviews the requests and prioritizes them based upon various needs, such as which ones are required by the Federal government to stay within their guidelines; which ones are a matter of  preservation of life and safety; which ones are based on caseload increases; and which ones are required due to previous state legislation or constitutional requirements.  This is typically when the programs are pitted against each other.  In the example of the Department of Human Services, it covers a very large array of programs for children, seniors, mental health, developmental disabilities, child protection, adult protection, child support, youth corrections, food assistance, job training, child care services, the mental health institutions, the group homes for developmentally delayed, vocational rehabilitation services, veterans nursing homes and refugee services, just to name a few.  As you can see if the state agency is only allowed to increase its overall budget by one percent, this is difficult to do with all the current needs for each program.  At this time CDHS management determines the most pressing needs for the different constituents and programs and develops a recommendation for OSPB.
Source: coloradomedicareclassroom.com

Colorado Medicare Supplement Insurance

For people who are more than the age of 65 and at the moment enrolled in an eligible Medicare plan, Colorado Medicare supplement insurance (which could also be referred to as Medigap) could possibly be a beneficial selection. Medicare supplement insurance, also called Medigap coverage is obtainable in each and every state, although Medicare supplement rates can differ widely. Medicare Supplemental insurance is the policy which is designed to enhance the protection that is afforded by the original Medicare program. Although most of the plans that are there in the original Medicare cover most of the expenses yet there are some gaps that remain in the policy that make the Medicare supplement insurance mandatory for the people to take them. The Best Medicare Supplement Insurance is the one that offers the beneficiary maximum amount of profit or returns on the insurance. Medicare Supplemental Insurance is an option that is available with the people who want to satisfy their insurance related needs in a very detailed manner. It is not that the health related problems will not occur to people in the long run, they obviously will occur but the main thing is that is these problems arise in front of the people then it would be very easy for the people to cope up with the expenditure on their health because of the presence of Medicare supplemental insurance.
Source: greencasket.net

Colorado Medicare Supplement Company is Expanding

DENVER- Colorado Medicare Supplement Company Colorado Medicare Supplement Company announced today that the company will be expanding into at least 6 additional states, including: Alabama, Kansas, Nebraska, New Jersey, Oklahoma, Pennsylvania, and Virginia and West Virginia. This marks a milestone for the 4 year old company as it truly endeavors to become a national player in the medicare supplement market.
Source: develop-haiti.com

GOP Medicare troubles continue: Sham front group gives Tipton seniors award

Freshman Colorado Congressman Scott Tipton received an award recently for his work in support of senior citizens from a group called RetireSafe. Tipton was one of 20 Republicans elected to Congress from swing districts to have received the award, according to RollCall, but the award was fake, or at least the group that gave the award was fake. RetireSafe is an industry front group run by Republican and conservative politics figures and founded by Pharmaceutical Research and Manufacturers of America to push policies that will boost industry profits.
Source: coloradoindependent.com

Colorado State Publications Library: Medicare 101

Attention Seniors: The Colorado Dept. of Regulatory Agencies is going to be holding a public webinar on January 25, 2012, called “Medicare 101.” (Click here to sign up – space is limited). This online presentation will give you helpful tips and information, whether for those just starting Medicare, or those who are already receiving Medicare but have questions. Please note, that if need more information and would like to speak to someone, call the Department’s Medicare consumer information line, 1-888-696-7213. If you can’t participate in the webinar, our library has many publications that can assist you. Some of the helpful publications on Medicare that we have available in our library include Your Medicare Matters, Protect It!; Medicare Drug Insurance and You: Colorado Options 2012; The Big Picture: Medicare and Related Health Insurance; Managing Your Medicare Bills; and Help for Medicare Beneficiaries with Lower Incomes.
Source: blogspot.com

Colorado Medicare Supplement Company is Expanding

DENVER- Colorado Medicare Supplement Company Colorado Medicare Supplement Company announced today that the company will be expanding into at least 6 additional states, including: Alabama, Kansas, Nebraska, New Jersey, Oklahoma, Pennsylvania, and Virginia and West Virginia. This marks a milestone for the 4 year old company as it truly endeavors to become a national player in the medicare supplement market.
Source: tvtalkradio.tv

Colorado Medicare Supplement Company is Expanding

DENVER- Colorado Medicare Supplement Company Colorado Medicare Supplement Company announced today that the company will be expanding into at least 6 additional states, including: Alabama, Kansas, Nebraska, New Jersey, Oklahoma, Pennsylvania, and Virginia and West Virginia. This marks a milestone for the 4 year old company as it truly endeavors to become a national player in the medicare supplement market.
Source: x999x.com

Colorado Medicare Supplement Company is Expanding

DENVER- Colorado Medicare Supplement Company Colorado Medicare Supplement Company announced today that the company will be expanding into at least 6 additional states, including: Alabama, Kansas, Nebraska, New Jersey, Oklahoma, Pennsylvania, and Virginia and West Virginia. This marks a milestone for the 4 year old company as it truly endeavors to become a national player in the medicare supplement market.
Source: wrwnursery.com

Colorado Medicare Supplement

In order to get the best benefits out of the original Medicare plan it is very important to get enrolled for the Colorado Medicare supplement plans. As we are all well aware of the point that Medicare supplement insurance also known as Medicare Supplemental is meant to fill in the gap that is left behind by the original Medicare plan. Without the proper Medicare supplement leads at hand, even the most skilled of insurance agents may be at a loss when it comes to finding the right avenues toward success and prosperity. Blue Cross and Blue Shield of Illinois will host a free seminar on Medicare and Medicare Supplement Plans next week.
Source: textgivesave.com

Deb Fischer Won’t Tell Nebraska Seniors Where She Stands on Paul Ryan’s Medicare Plan

Posted by:  :  Category: Medicare

This article was posted in Evasions on Ryan Plan to Cut Medicare and tagged “Cutting Medicare” “Paul Ryan”, “Deb Fischer”, “Nebraska Senate”, Medicare. Bookmark the permalink. Follow comments with the RSS feed for this post.Comments are closed, but you can leave a trackback: Trackback URL.
Source: fischeronthefence.com

Video: “Promise” — Ben Nelson Defends Medicare, Social Security & Nebraska Seniors

New Nebraska Network:: Ben Nelson Stands Alone Defending Medicare In Nebraska

Nelson has a surprisingly good Democratic record when it matters.  When he votes with the GOP it is usually not the deciding vote.  For instance he did not vote against Elaine until after she already had sufficient votes.  The public option was dead and buried in the Senate months before he voted against it. Like many “Red State” Democrats and “Blue State” Republicans he must cast a certain number of votes against his party. The problem with the “progressive position” is that progressives are not willing to do the necessary work to move the political enviroment.  Conservatives also have this problem in other states.  You need to build strong political support for these positions before we expect politicians to endorse them.  That means registering voters, making phone calls, walking the precincts and all the other things that are necessary to build political support.
Source: newnebraska.net

Medicare Supplemental Insurance and Medicare Advantage Plans in Nebraska

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Source: medicaresupplementadvantageplans.com

EPIC JOURNEY: Crossroads GPS Ads on the Economy

Nonpartisan political handicapper Charlie Cook lists the four Senate races as “toss up.” Stuart Rothenberg lists the races in Massachusetts, Missouri and Montana as “toss up” and the race in Nebraska as “toss up/tilt Republican.” Nelson, the Nebraska incumbent, has yet to decide if he will run for reelection in 2012.
Source: epicjourney2008.com

Should states lead Medicaid

According to the report, states pay only 20 percent of the health care bill for so-called “dual eligibles” — people who qualify for both Medicare and Medicaid. Very little of that 20 percent goes toward hospital stays, where the greatest savings can be achieved. Moreover, giving cash-strapped states more responsibility for overall spending increases the risk of cost-shifting to Medicare, which unlike Medicaid is funded entirely by the federal government. The authors say this could undermine the quality of care for vulnerable beneficiaries.
Source: stateline.org

The cost of doing business

No, this blog is about ignorance—specifically, my ignorance: I have no idea how much the testing that I’m personally responsible for actually costs. Not only do I order these complex, tech-heavy studies, but I also administer and interpret them. Nuclear stress tests, echocardiograms, EKGs, cardiac catheterization—all top-dollar procedures. And yet, I don’t have a clue what any of these costs. Sure, I know that a Lexiscan Cardiolite (a stress test using a nuclear isotope to determine cardiac blood flow) is more expensive than an echocardiogram (a cardiac ultrasound), but by how much? A hundred dollars? A thousand dollars? Heck, I don’t even know how much I earn with each of these studies. I don’t have the slightest clue how much money I make when I surgically implant a pacemaker or perform a transesophageal echocardiogram.
Source: livewellnebraska.com