Medicare EHR attestation deadline set for Feb. 29

Posted by:  :  Category: Medicare

Under the Medicare EHR Incentive Program, health care practitioners can earn up to a total of $44,000 ($48,400 in federally designated health professional shortage areas) over the six-year life of the program if they install EHR systems that are certified for use under the program and achieve compliance with the program’s EHR utilization criteria, known as “meaningful use” standards.
Source: newsfromaoa.org

Video: Rider Drug Ad – Medicare D Enrollment

Medicare Provider Enrollment Toolkit and PECOS help

Medical practices have long suffered with a cumbersome Medicare provider enrollment process. As an alternative to the paper enrollment form (CMS-855), the Centers for Medicare & Medicaid (CMS) developed the Internet-based Provider Enrollment, Chain and Ownership System (PECOS).
Source: mgma.com

Trouble with Medicare enrollment, Idaho seniors? You might be in luck.

You should also know that The Idaho Statesman does not screen comments before they are posted. You are more likely to see inappropriate comments before our staff does, so we ask that you click the “report abuse” button to submit those comments for review. You also may notify us via email at onlinenews@idahostatesman.com Note the headline on which the comment is made and tell us the profile name of the user who made the comment. Remember, you may find some material objectionable that we won’t and vice versa.
Source: idahostatesman.com

Enrolling In Medicare Parts A and B

Medicare Part B premiums will vary, but they are usually less expensive if you have them deducted from your social security benefits.   Those who are above certain income thresholds will be accessed higher premiums than those who are not.   In general, Part B premiums are approximately $100 a month for most Medicare recipients.
Source: ohioinsureplan.com

Sick of the ads? Medicare Part D deadline looms

“In 2009, there were 46 (Medicare Part D) drug plans in the state of Minnesota. For 2012, there are 33 plans.” said Karen Lenius, who serves as coordinator of the Retired and Senior Volunteer Program (RSVP) at Mahube Community Council, as well as being the Becker County coordinator on aging.
Source: parkrapidsenterprise.com

Medicare Advantage open enrollment continues through Dec. 7th

Another critical factor in choosing a Medicare Advantage plan is confirming if your medical providers will accept and submit claims to the plan.  All of these can change from year to year.  You cannot assume a Medicare Advantage plan which met your needs one year will necessarily meet your needs in the upcoming year.  A review is important. If your plan is continuing in 2012 and you’re happy with what it’s offering next year you don’t need to do a thing. Your enrollment will continue into next year. 
Source: involvementonline.org

Medicare General Enrollment Begins January 2nd: An Opportunity for Some Individuals and States to Expand QMB Coverage 

Secure a Form 795 from the Social Security Administration (SSA) (available online at www.ssa.gov/online/ssa-795.pdf) and type into the large blank (lined) space the following:  "I wish to enroll for Hospital Insurance under Medicare on a monthly premium basis, which is in addition to my current coverage for Medical Insurance (or"I also wish to apply for Medical Insurance" if the client does not have Part B).  I understand that the State will pay my premium based on my eligibility for Medicaid (Medical Assistance) as a Qualified Medicare Beneficiary.  I also understand that if I am terminated under Medicaid (Medical Assistance) as a Qualified Medicare Beneficiary, I will have to pay my premium if I want to keep my Medicare Hospital Insurance."  The beneficiary should give the form to SSA with her/his application for Part A, but also make a copy for her/himself to take to the Medicaid agency to apply for QMB benefits.
Source: medicareadvocacy.org

How To Enroll In Medicare Part D

Ensure eligibility. To be eligible for Plan D, you must first be enrolled in Medicare Part A (hospital insurance) or Medicare Plan B (medical insurance).  You must be at least 65 years old and an American citizen in order to qualify for either Plans A or B. If you are receiving Supplementary Salary Income (SSI) from Social Security, then you may also be eligible. You may sign up for Plan D anytime or three months before you will be enrolled, and three months after enrollment. The best time to enroll for prescription drug coverage is anytime within that six-month period; doing so at a later date may make you liable for penalties and cost you more in premiums. If you don’t enroll within that six-month period of eligibility, you may do so between Nov. 15 and Dec. 31. And should your existing plan be discontinued, or if special circumstances arise, you may also be able to apply for enrollment.
Source: waysandhow.com

Medicare’s 2012 open enrollment drug and health plan data now accessible online

Those in the Part D coverage gap, or donut hole, will continue to receive 50 percent discounts on covered brand name drugs due to passage of the Affordable Care Act. On average, Medicare Advantage premiums will be four percent lower in 2012 than in 2011, and plans expect enrollment to increase by 10 percent. Average premiums for Part D prescription drug plans will also decrease to $30 in 2012, about 76 cents less compared to the average 2011 premium.  The premium amount is based on bids submitted by Part D plans for the 2012 plan year. Benefits in 2012 remain consistent with those offered in 2011.
Source: thisisreno.com

Alabama Medicare Supplements

Posted by:  :  Category: Medicare

Alabama Medicare Supplements talks about some of the key points that Medicare beneficiaries in the Yellow Hammer state should pay attention to when shopping for Medicare Supplemental Insurance aka Medigap Insurance. Many people are unaware that all companies who offer the same lettered Medicare Supplemental Plans must offer the same coverage for the letter that coinsides with that plan. This means that Plan F is no different with one insurance company than Medicare Supplement Plan F through another company. This is why is so so important to pay attention to the price. Log on to www.medicaresupplementsmadeeasy.com today to get the most up to date Medicare Supplement information and the most affordable Medicare Supplements. All our quotes and service work is free so log on or call us today at 1 800 218 7935 Video Rating: 5 / 5
Source: bestlongtermcare.org

Video: Alabama Medicare Supplements

Plan A of the Medicare Supplemental Insurance Alabama

The Original Medicare is barely enough to cover all of the rising health expenses these days. It is therefore a good choice for its beneficiaries to look for and avail of additional health insurances to help shoulder these costs. As a resident of this state, you can opt to purchase a Medicare supplemental insurance Alabama from private insurance companies. The starting standardized plan that is required to be offered by all insurers is Plan A which is considered as the basic benefit package. It is the least costly out of all the plans and it is designed to cover the essential benefits.
Source: cryptoenhance.com

HIPP Program Benefits Medicare Recipients, Saves Money for the State

To bolster the Agency’s efforts, Alabama Medicaid contracted with Health Management Systems (HMS) to help identify and enroll additional Medicaid recipients who would benefit from enrollment in the HIPP program. During the planning stage, officials from the Agency and HMS met to discuss strategies on how to connect with ideal HIPP candidates. Promotional strategies include direct mail campaigns targeted toward individuals that fall within specific segments of the state’s Medicaid eligibility file, online resources such as a membership application, and partnerships with Medicaid caseworkers and others that can refer Medicaid recipients through their daily interaction with this group.
Source: heraldnewsmedia.com

VIVA MEDICARE Plus Earns Highest Quality Rating Score in Alabama for Second Year in a Row : e Yugoslavia

[…] • Visiting medicare.gov, where they can get a personalized comparison of costs and coverage of the plans available in their area. The popular Medicare Plan Finder tool has been enhanced for an efficient review of plan choices. Spanish Open Enrollment information is available. • Calling 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about coverage options. TTY users should call 1-877-486-2048. Multilingual counseling is available. • Reviewing the 2012 Medicare and You handbook. It is also accessible online at: medicare.gov/publications/pubs/pdf/10050.pdf —  and it has been mailed to the homes of people with Medicare. • Getting one-on-one counseling assistance from the local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found at medicare.gov/contacts/organization-search-criteria.aspx, on the back of the 2011 Medicare and You handbook, by calling Medicare or through a listing of national stand-alone prescription drug plans and state specific fact sheets that can be found at cms.hhs.gov/center/openenrollment.asp.Source: mtdemocrat.com […] Source: mtdemocrat.com Source: medicaresupplementalco.com
Source: medicaresupplementalco.com

The Blue Cross and Blue Shield of Minnesota Foundation Awards

Posted by:  :  Category: Medicare

Running Amok Again by elycefelizThe Blue Cross and Blue Shield of Minnesota Foundation Awards $2.2 Million to Improve Health Grants help develop healthier neighborhoods and children Blue Cross Blue Shield of Arizona Seeking Healthy, Kid-Friendly Recipe Contributions for Walk On! Cooking Challenge As part of Blue Cross Blue Shield of Arizona s 2012 Walk On! program, Phoenix and Tucson residents ages 9-12 are invited to enter the Kids Cooking Challenge, which encourages children to share their favorite healthy side dishes for a chance to win prizes. Blue Cross to renovate Jefferson building to match RenCen Blue Cross Blue Shield of Michigan plans to renovate its seven-story Jefferson Avenue building to better match the glass fa ade at the Renaissance Center across the street, where this spring it will wrap up a move of 3,000 workers from Southfield.
Source: medicare-news.com

Video: Minnesota Channel – Medicare Rx: Enrollment Countdown

Minn. health care ratings group plans to examine newly available Medicare data

Chase: That’s why it’s been important to have experience in working with this data over time. In releasing this data, Medicare is saying it’s only going to give it to groups like us that have some experience with this because we realize we have to do some things around risk adjustment to make sure that it’s fair for everybody when you’re presenting the data. We’ve got a pretty robust process where we’re working with clinicians to identify what the measures would be. We don’t always get 100 percent agreement but we get pretty good agreement across the market about what we put out being fair and reasonable for people to look at.
Source: publicradio.org

New Medicare reimbursement guidance issued 

New guidance released by the Centers for Medicare and Medicaid Services is expected to streamline Medicare reimbursement for injured plaintiffs. Under the Medicare Secondary Payer Act, Medicare is entitled to reimbursement for medical bills where there is a primary payer such as an insurer or tortfeasor. In October, the CMS began requiring liability insurers to gather data …
Source: minnlawyer.com

Rochester Medicare Regulatory & Reimbursement

Minnesota Medical Office Jobs: Whether you are a recent medical secretary or medical transcriptionist graduate or a skilled professional, Mayo Clinic is a place where you can achieve your goals and discover career and personal fulfillment. We invite you to explore a medical secretary or transcriptionist career with Mayo Clinic in Rochester, Minn. Here you will be a valued member of an outstanding healthcare team, and you will experience the exceptional environment of one of the world’s leading healthcare institutions.
Source: mayo-clinic-jobs.com

New bipartisan plan for Medicare may give ‘cover’ to Republicans 

By Alex Wayne and Heidi Przybyla Bloomberg News A bipartisan proposal to give the elderly a choice between the government’s Medicare program and private insurance plans is intended as a “framework” to overhaul the entitlement, Rep. Paul Ryan said Thursday. Ryan, a Wisconsin Republican who heads the House Budget Committee, proposed replacing Medicare with a private insurance …
Source: politicsinminnesota.com

Humana expects more Medicare members in 2012

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Source: carinsuranceminnesotaquote.com

Adrienne’s Corner: Minnesota Moonbat Muslim Keith Ellison wants to lower voting age to 16…

really?  Really?? “Why shouldn’t 16-year-old vote?” Ellison tweeted last week, according to Minnesota’s Fridley Patch. “They can drive. Some have jobs. Let’s empower our youth.”How about this, Keith.  Let’s put the voting age back to 21 except for active duty service men and women.  Part of the problem in this country can be attributed to uninformed, uneducated, and functionally illiterate voters.  While I’ll admit that the difference between 18 and 21 is not huge, it would be a start.  Might I remind you that young people and blacks put our current disaster of a president in the White House (interspersed with the out-of-touch radical commie Marxist types that you find in universities.  Oh wait, they’re teaching the kids.  What could go wrong?) Check out:
Source: blogspot.com

Mitt Romney’s tax bracket

The 8501st dollar of his taxable income is taxed at the same 15% rate as yours, mine, and Warren Buffet’s, but his last dollar will be in the higher bracket. His bracket is always going to be higher than his effective rate. Punching a million dollar income, all taxable, into SmartMoney(.com)’s effective rate calculator yields a marginal rate of 35% (the top rate right now), and an effective rate of 32%. If the taxable is $1M and the total is $2M, that gets us to 35% marginal, and 15.99% effective. To have an income as presumably large as his, and still have such a small fraction of it taxable, must be nice.
Source: publicradio.org

Associate General Counsel – Medicare Operations

UnitedHealthcare Medicare & Retirement, a division of UnitedHealth Group is seeking an attorney with: seven plus years of experience with law firm, corporation, or government; health care experience a plus; significant experience identifying risk areas related to regulated business activities; proven success in collaborating across a matrixed business and legal environment. This person will advise Medicare & Retirement business on issues related to risk identification and mitigation regarding operations and finance; acquire deep knowledge of the industry and the specific business practices; review the work of others; develop innovative approaches; sought out as an expert; serve as a leader/mentor. For additional information please contact Barb Siani at: barbara_siani@uhc.com
Source: mnbenchbar.com

Shell Companies Defraud Medicare : South Carolina Nursing Home Blog

MSNBC had a great article on Reuter’s investigation into the use of shell companies to steal taxpayer funds from Medicare.  The story had many examples including a fake AIDS clinic in Miami which had bilked Medicare of more than $4.5 million. The scheme involved forming at least 29 other shell companies — paper-only firms with no real operations. The shells functioned as a vital tool to hide the Medicare deceit. Hundreds of others have used the veil of corporate secrecy to help steal hundreds of millions of dollars from one of the nation’s largest social service programs, a Reuters investigation has found. Basic checks by Reuters of Medicare providers show shell companies remain prime tools in perpetrating fraud. Simply by reviewing the incorporation records of Medicare providers in two buildings there, reporters uncovered information that one government official said could prompt "a serious criminal investigation" of some of the companies. The fraud rings merge stolen doctor and patient data under the auspices of a shell company and then bill Medicare as rapidly as possible. Other shell companies are often layered on top to camouflage the fraud. Some of the shells purport to be billing companies; they form a buffer between the sham entities and Medicare. Others pay kickbacks to doctors and patients who sign off on bogus medical claims or sell their Medicare ID numbers to enable the shell company to bill the government. Still other shells act as fronts to launder the profits. The key to this kind of fraud, known as a "bust-out" scheme, is for each of the fake companies to bill as much as possible before authorities catch on. Last year, "improper payments" resulted in $48 billion in losses to the Medicare program, nearly 10 percent of the $526 billion in payments the program made, according to a Government Accountability Office report last March. Exactly how much of those payments moved through shell companies remains unclear. That’s because neither Medicare nor law enforcement agencies systematically track how often such companies are used in the frauds. And not until 2007 did the federal government form task forces to exclusively target Medicare fraud rings. But recent indictments issued by those task forces indicate that shell-perpetrated fraud is pervasive. Reuters examined indictments issued since 2007 in the eight states that have Medicare fraud task forces in place. The examination found that shell companies were involved in more than a third of the fraudulent Medicare claims identified by the task forces — $1 billion of the $2.9 billion uncovered. The indictments and other cases indicate that at least 300 shell companies posed as legitimate Medicare providers and billing firms, or laundered payments from Medicare. Shell companies remain a significant tool of deception to swindle hundreds of millions of dollars from taxpayer-supported Medicare. In one of the largest cases of Medicare fraud ever charged, the operation was enabled by shell companies. In October 2010, federal prosecutors indicted 44 members of an Armenian organized crime ring. Their network, which stretched from Los Angeles to Savannah, Ga., used 118 shell companies in 25 states to pose as Medicare providers, billing more than $100 million, according to federal indictments in three states. The difficulty of spotting — and stopping shell-perpetrated Medicare fraud is compounded by incorporation laws that vary from state to state and make forming fake businesses easy. Intentionally submitting false corporate information constitutes fraud in every state. But none check the validity of corporate records when a company incorporates or collect information on the "beneficial owners" — those with a controlling interest in the corporations. In Florida, FBI agents say almost every Medicare fraud scheme involves shell companies. As part of their investigation, Reuters asked analysts from the Recovery Accountability and Transparency Board to use its software programs to examine the companies. The board monitors $787 billion in stimulus funds for fraudulent activity using sophisticated computer systems; last year, it had worked with Medicare officials to look for patterns of fraud. Devaney, who is also the inspector general for the Department of the Interior, says the board’s analysis of the 26 Medicare providers led investigators to another 15 Medicare entities associated with those providers. He believes the findings could prompt a "serious criminal investigation." CMS, which runs Medicare, says it doesn’t have the resources to analyze incorporation records for each of its 1.5 million providers and suppliers. Those records are separately maintained by each state. Medicare claims filed by each of the fake clinics were accompanied by all the right doctor, patient and treatment codes, say law enforcement officials and fraud investigators. CMS says it has been handcuffed in combating shell companies that posed as legitimate providers because it lacked the resources to extensively review the backgrounds and addresses of providers. Less than 5 percent of all payments were subjected to audits. The healthcare reform law passed in March 2010 allocates $350 million over the next 10 years to fight fraud in Medicare and Medicaid, its sister program for the poor. The law also imposes stiffer sentences for the scam artists. CMS is installing new fraud-fighting computer analytics to check the backgrounds of doctors and providers to ensure, for example, that Medicare ID numbers aren’t being stolen. The programs may help connect the people to the corporations they’re running about 75 percent of the time, says Peter Budetti, deputy administrator and director of program integrity at CMS. New providers also will be subject to automated enrolment screening. Their names will be checked against databases that include the federal government’s banned contractor lists, state and federal criminal dockets, and state licensing records. Although the new screening system will have access to state incorporation records, CMS acknowledges it will still struggle to pierce the shell-company veil because states don’t collect information on the real owners when corporations are formed or sold.
Source: scnursinghomelaw.com

Email address to download medicare forms

Posted by:  :  Category: Medicare

What's In My Bag... by Amy DiannaLet him look to you, Ulysses, and to the other princes to save his ships from burning. First it is clear from the following consideration that D follows B. And should we not enquire what sort of knowledge has the power of effecting such a change? Secrecy could not have been more desirable for Mrs. It happens, too, at times that nature of iron Shrinks from this stone away, accustomed By turns to flee and follow. They all stared in timid bewilderment at the strange, long-haired commander dressed up in feathers and gold. Next day she received a box containing the Sacred Host, which was left at her house for her to partake of. Moreover, on the subject of Rhetoric there exists much that has been said long ago, whereas on the subject of reasoning we had nothing else of an earlier date to speak of at all, but were kept at work for a long time in experimental researches. Solon marvelled at his words, and earnestly requested the priests to inform him exactly and in order about these former citizens.
Source: typepad.com

Video: Medicfusion Custom Forms – Medicare ABN Form

Change the Wind: On Newt Gingrich and Getting Played Like a Fiddle

But the facts are, it’s much easier to rely on these stereotypes to pander to mostly all white crowds in debates in a southern state and then feign righteous indignation when called into account. It’s easier to attack the journalist than it is to tell the truth. And it’s much easier to for people in tough economic times to scapegoat their most vulnerable fellow Americans than to demand serious answers to serious questions. It’s also easier for a political party to sanction this silliness than it is to work hard at serious solutions that broaden its appeal.
Source: changethewind.org

alliancetocrushcancer: HELP…I need help filling out Medicare forms; I don’t understand this explanation of benefits (EOB)…

Does this sound like you? You are not alone. Complicated Medicare forms are confusing, maddening and just not FUN. Call S.H.I.N.E. they can help – 800-963-5337 or www.floridashine.org – Drexel Collins is the local S.H.I.N.E. coordinator. S.H.I.N.E. stands for Serving the Health Insurance Needs of Elders but they can assist anyone on Medicare.
Source: blogspot.com

Ways to get best quotations for Treatment Supplement Insurance policies : Clemleddy Construction

There is undoubtedly an alternative approach for enjoying the top deal on personal computer medigap insurance coverage. If you recognize the significant names involving Medicare Supplement Insurance agencies and any address of their total respective acknowledged websites, you can easily visit the ones websites Medicare Supplemental Insurance do any window shopping for the facilities which is available from these suppliers on buying Medigap procedures. You can confer with your general physician and to know about your overall health plus approximately receive an anticipatory idea for the required insurance coverage and keeping that in mind can find the best appropriate Medigap policy matching to ones own existing health care policy.
Source: clemleddyconstruction.com

Aetna medicare prior authorization form // google simplicity parts 3314h

H5736_7F_81010 (1/12/2009) 1 AETNA MEDICARE OPEN SM PLAN PROVIDER TERMS AND CONDITIONS OF PAYMENT Table of Contents 1. Introduction sources: Verizon what does a red i indicate on my text message Reset security code kyocera laylo Temas window7 para blackberry States of the union bronze coin set for sale Sybool bb Valium vs orfidal
Source: freeblog.hu

Stay away from Delays on your Medicare Job application by Doing Forms Efficiently

You might solve this matter through the help of an remarkable and superb plan it is possible to supplement your own original Medicare policy. And this treatment plan is termed medigap medical care insurance plan. It is useful of having all some great benefits of your Medicare health insurance plan. It allows you to get all some great benefits of the preceding plan. But you need to do the initial first for you to claim almost all expenditures. It is actually called Medicare supplement plan sole because such plans cover Medicare Supplement Plans e gap relating to the Original Medicare policy and the whole bill payable which means the name is going to be this. Now it must be told that each these kinds of medigap options are applied by a lot of private businesses and purchased by these individuals only. No governmental body are designed for this package.
Source: colouredlenses.org

“The Basics” Chiropractic Medicare: Chiropractic Medicare Compliance Guide & CD of Forms ~Newsletter 12/12/11

Newsletter December 12, 2011 Chiropractic Medicare Compliance Book & CD Ready for 2012 We are taking orders! Dear Doctors and Staff, It is finally completed!  After 2 1/2 months of late nights, hard work, critical thinking and research, “The Basics” Chiropractic Medicare Compliance Guidebook and CD are finished. Most of my fellow Chiropractors are aware we “must be in Medicare Compliance” by the end of 2012.  Our Medicare Compliance Program is ready. Just add your office data, names, address and a few additional personnel changes, then print the policies, procedures, guidelines, etc., that have already been completed for you. Knowing the importance of learning the correct way to do Medicare by federal standards and becoming Medicare Compliant is the important thing to do in Medicare in 2012.  We have a program and its ready to be implemented in your office. My Compliance Guide will save you and your staff hours of hard work. (I know that for a fact!) REMINDER NOTE:  We are presently in the window to change your Medicare provider status. You can change to Participating Provider or to Non-participating Provider, the time to do that is NOW!
Source: blogspot.com

CBO: Raising Medicare Age Means More Uninsured With Reduced Access To Care

Posted by:  :  Category: Medicare

empty by donbuciakShifts in the sources of health insurance (and loss of insurance for some people) would affect the health care people receive and what they pay for it. Some people would end up without health insurance. People without health insurance are likely to receive lower quality care and pay more than insured people do. Many, but not all, people who end up with a different source of insurance would pay higher premiums than they would for Medicare and spend more out of pocket. The quality of health care could differ as well, in various ways. For example, people with private health insurance might have better access to physicians than they would under Medicare. Some people on Medicaid could have more difficulty obtaining services, but others could have access to health care with lower out-of-pocket costs than they would have under Medicare. The provisions of PPACA would make not having health insurance through Medicare or an employer less onerous than it would be otherwise. Virtually everyone affected would have access to health insurance, either through Medicaid or through exchanges. Although in many cases the premiums in the exchanges would be higher than 18. Some dual Medicare and Medicaid enrollees currently qualify for full Medicaid benefits; others qualify only for assistance with certain types of Medicare cost sharing. they are for Medicare, the insurance would be priced without regard to health status and with limited adjustments for age.
Source: talkingpointsmemo.com

Video: Medicare Age-In

No Savings from Raising Medicare Age

How so? The chief argument for increasing the eligibility age is that people live longer today than they did 30 or 40 years ago, so total benefits really won’t go down. But longer life expectancy isn’t a universal phenomenon. The life expectancy of people who are in the bottom half of the income distribution barely budged between 1977 and 2007, rising from 80 to 81. Longevity for people in the top half of the income distribution, on the other hand, leaped to 87 in 2007 from 81 in 1977. “This would be a very regressive way to cut benefits,” Carroll said.
Source: gooznews.com

Raising Medicare’s Eligibility Age Would Save Money, But Also Shift Costs

Politico Pro: Rise In Medicare Age Would Save Money, Shift Costs Raising the Medicare age would encourage people to work longer, slightly boost the number of older uninsured people and save Medicare $148 billion over a decade — while shifting some of the costs to Medicaid, private employers and the new health exchanges, according to a CBO issue brief released Tuesday. The congressional budget agency brief summed up some of its previous analysis of Medicare and how it would interact with possible changes to Social Security. The report assumes that the Medicare age would be raised from 65 to 67 very gradually — two months at a time until 2027 (Kenen, 10/10).
Source: kaiserhealthnews.org

Brad DeLong: Raising the Medicare Eligibility Age Is a Really Bad Idea Blogging: Is This a Problem with the Media or with the Congressional Budget Office?

Director’s Blog: Raising the Ages of Eligibility for Medicare and Social Security: If the eligibility age was raised above 65, fewer people would be eligible for Medicare, and outlays for the program would decline relative to those projected under current law. CBO expects that most people affected by the change would obtain health insurance from other sources, primarily employers or other government programs, although some would have no health insurance. Federal spending on those other programs would increase, partially offsetting the Medicare savings. Many of the people who would otherwise have enrolled in Medicare would face higher premiums for health insurance, higher out-of-pocket costs for health care, or both.
Source: typepad.com

Raising Retirement and Medicare Ages Can Backfire :: Futurist.com: Futurist Speaker Glen Hiemstra

Then there is the recent proposal being floated to save some Medicare spending by increasing the eligibility age from 65 to 67 here in the U.S. This would be a disaster for many, many people age 65-67, who could not afford private health insurance (if they could get it) and may no longer be covered by employers. And it may not save much money for the government. It is Insurance 101 to keep younger, healthier people in your program. In fact a recent analysis shows that while there may be a small saving in Medicare itself, the costs to individuals, employers, and states, plus higher costs to remaining Medicare enrollees will be more than twice any anticipated savings. Uh oh. Maybe this idea needs to be re-thought.
Source: futurist.com

Eligibility Age for Medicare May Increase

Previously, the Congressional Budget Office has stated that the age increase would save about $162 billion.  After a senator requested a new analysis of the figures, that amount has been changed, as it did not originally factor in the premiums that would be lost from the seniors who would no longer qualify.  Some do not feel that this is enough of a savings to warrant the change.  And while it may not affect the deficit greatly, it could create the necessary funds to create the “doc fix,” which some suggest to be a permanent resolution to the temporary pay raise Congress would allow for Medicare doctors annually.  While President Obama supports the age increase, the opposition is still great.  There are some who believe that seniors could benefit from losing eligibility, as they may be able to acquire better access to doctors and facilities through a private health insurance policy, as opposed to the Medicare Advantage program.  The debate is heated, but only time will tell the outcome.
Source: insuranceflash.org

Increasing Retirement Ages Would Reduce Spending, Limit Benefits: CBO

If the eligibility age is increased by two months every year beginning in 2014 for people who were born in 1949 until the age reaches 67 in 2027 for people born in 1960, of the 5.4 million people who would be affected in 2021, about 5% would become uninsured, the CBO predicts. About half of those would obtain insurance through their employer or their spouse’s employer. The remaining 2.3 million people would receive coverage “in equal parts” through Medicaid, through Medicare disability benefits, or through the health care exchanges that will become available in 2014 through the Affordable Care Act.
Source: advisorone.com

3 Reasons Why We Should Raise Medicare’s Eligibility Age

In attempting to address the problems of Medicare and medical expenses on the whole, members of Congress should look to the history of the program. The House Ways and Means Committee, when charged with assessing the costs of the program, projected that total costs for the first year would run no more than $1.3 billion when total spending in the first year actually was $4.6 billion. The committee did not improve its accuracy over time, projecting that hospital spending would amount to just $3.1 billion in 1970 when it was actually $7.1 billion. John Goodman, president of the National Center for Policy Analysis, explains that these chronic projection mistakes are because analysts failed to account for increased demand as 19 million people were given free access to unlimited health care. Today, Congress makes the same mistakes in different ways, failing to account for a dynamic market that undermines direct controls and ignores price-controlling efforts.
Source: reason.com

What CBO Says About Raising Eligibility Ages for Medicare and Social Security

The Committee for a Responsible Federal Budget indicates that such a move would not only reduce taxpayer costs, but also reduce health costs for most seniors. While increasing the eligibility ages for Medicare and Social Security is a good step forward, it should be advanced as part of a package of reforms needed to put these programs on sound financial footing. The Heritage Foundation’s Saving the American Dream plan includes eligibility age increases as part of its proposals to transform Medicare and Social Security. In concert with other structural reforms, this plan would ensure that future generations in need of program benefits can count on them. Entitlement reform can be done, and Congress should not delay in communicating that to the American people.
Source: heritage.org

Retirement Healthcare for Middle Income Baby Boomers

Healthcare is one of the major retirement “wild cards” for Boomers and seniors. Poor health can strip people of the enjoyment of their retirement years and their quality of life. Financial fallout from healthcare-related expenses can devastate savings. Download the study here In this new study the Bankers Life and Casualty Company Center for a Secure Retirement reports findings from middle-income Boomers and seniors on their retirement healthcare outlook: their view of the connection between health and retirement satisfaction, their experience with Medicare and understanding of the program, and the expectations of middle-income Baby Boomers approaching Medicare age.
Source: annuitynewsnow.com

Medicare Supplemental Insurance the best security for old age

There will be big differences in the premium with the different private insurance companies but the benefits of medigap plan A through L will be same. So the benefits will be same but cost may be different. Medigap insurance plans may also cover some extra things that Medicare doesn’t give cover to. If you are having an original Medicare and you have a Medicare supplemental plan, Medicare will pay its share of the costs of Medicare-covered services. After that your insurance plan pays its share. In every insurance company the medigap insurance don’t helps you cover in any long-term care, like care in a nursing home, vision or dental care, hearing aids, eyeglasses, and private duty nursing. Insurance companies selling these policies are must have Plan A available. Medigap open enrollment period is the best time to buy medigap insurance. This period is only for 6 months and it begins on the first day of the month in which you’re both either 65 or older and enrolled in Medigap Plan B. In some cases have additional open enrollment periods, including whose age less than 65. In this particular period any insurance company can’t use medical underwriting.
Source: ezinemark.com

CMS Announces $523 Medicare, Medicaid, & CHIP Enrollment Application Fee for 2012 : Health Industry Washington Watch

Posted by:  :  Category: Medicare

2012 application fee for institutional providers (excluding physicians and nonphysician practitioners) enrolling in Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) will be $523 – up from $505 in 2011. CMS uses a broad definition of institutional entities subject to the application fee; it applies to “any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A, CMS-855B (not including physician and non-physician practitioner organizations), CMS-855S or associated Internet-based PECOS enrollment application.” As authorized under CMS’s February 2011 final Medicare/Medicaid/CHIP provider screening rule, institutional providers must pay the application fee when initially enrolling in the Medicare or Medicaid programs or CHIP; revalidating their Medicare, Medicaid or CHIP enrollment; or adding a new Medicare practice location (unless a hardship exemption applies).
Source: healthindustrywashingtonwatch.com

Video: Submitting Your Medicare Enrollment Application

Medicare Enrollment or Claims to be Denied 1/3/2011

PECOS is Medicare’s internet based Provider Enrollment, Chain and Ownership System. It replaces the paper CMS-855I and 855R forms. The online process is easier and quicker with a 45 day turn around, down from 60 days for paper applications. PECOS can be used for initial enrollment or to view or change enrollment information. You can now also track your enrollment application through the submission process, which could not be done previously with the paper form. In addition to enrolling and tracking the application, providers can now change, add or reassign benefits and even withdraw from the program through the system. Just like the paper application process, PECOS needs to be updated whenever there is a Reportable Event that affects information on the enrollment record such as ownership, change in address of practice location, licensure, etc. Changes must be reported within 30 days of a reportable event. A full list of Reportable Events can be found at: www.cms.gov/MedicareProviderSupEnroll.
Source: advancedmd.com

New DME Suppliers on the Hot Seat for Fraud Investigations

In a recent fact sheet, CMS indicated that it is implementing new, stricter requirements for DME suppliers and that it plans to expand the DME Competitive Bidding program to an additional 91 areas of the country, including 21 areas that are the result of an expansion of DME competitive bidding under PPACA.  By 2013, CMS has indicated that the program will cover 100 areas of the country, and over 18 million Medicare fee-for-service beneficiaries living in these areas should save money through this new program, while continuing to have access to quality medical equipment from accredited suppliers they can trust.  CMS believes that the programwill save the Medicare program and beneficiaries approximately $28 billion during the next ten years, including more than $17 billion in savings for Medicare, and over $11 billion for beneficiaries as a result of lower coinsurance and premium payments.
Source: wolterskluwerlb.com

The Medicare Enrollment Process

Each health plan has it’s own method of processing enrollment applications to becoming a participating provider. Medicare is definitely one payer to consider. Learn about the Medicare Enrollment Process.
Source: about.com

Time frame to enroll in supplement insurance to medicare

There are lots of supplemental insurance providers who provide discounts during start enrollment. In some instances, the applicant’s achieve reduction can be as broad as 15%. This savings will carry more than into subsequent years helping to have premiums lower as the insured grows older. Additionally, some insurance businesses will need underwriting for typical supplements, like idea J, if the applicant is much more than three months past their 65th birthday. If applying throughout originate enrollment, health underwriting will not be required for understanding J.
Source: sagacheapinsurance.com

Audit Proof Income: Submitting Your Medicare Enrollment Application

This video explains how to complete the Medicare provider enrollment application in the Internet-based Provider Enrollment, Chain and Ownership System (PECOS). http://www.palmettogba.com/palmetto/providers.nsf/ls/Jurisdiction%2011%20Part%20A~8JJKBN2453?opendocument&utm_source=J11AL&utm_campaign=J11ALs&utm_medium=email
Source: blogspot.com

Obtaining Affordable Medicare health insurance Supplement Insurance plan

Should you drop cluster coverage involuntarily as well as voluntarily, you can get yourself a medigap plan Supplement devoid of questions questioned. Some pension health packages or cluster Medicare Aid plans find expensive the ones decide independently to shed this policy. Part D is known as a prescription decide to cover, a minimum of partially, the buying price of doctor recommended medications. supplements have got 12 different plans and each one of the plans brought different coverage which includes a host associated with benefits. For those who have a fastened monthly cash flow and will need regular medical assistance there may be nothing a lot better than a Medicare health insurance supplement approach.
Source: londonsportscouncil.org

Stimulus Dollars: Medicare vs. Medicaid

Posted by:  :  Category: Medicare

Budget vs Budget by boris.rasinDuring position you place Many fat Tele-class series HITECH and Meaningful Use: What You Need to Know, Sheryl Cherico, Inventor a variety of MDTechPro, a countrywide medicine and health The house Business, clarified A good deal of Marketing information Whilst relates Which in turn stimulus dollars And so meaningful use. A wide selection of points were definitily exalted forms of beforehand associated with the tele-class And additionally afterward in regards to Unquestionably the discrepancies From Each Medicare government software program Perfectly Medicaid government Program.
Source: personalhealthcaretips.com

Video: Medicare vs Medicaid

Medicare vs. Medicaid, the difference

Medicaid, on the other hand, is a program that is provided by the states. Medicaid is typically referred to as Public Aid. In Illinois, Medicaid is administered by the Department of Health and Family Services. In order to qualify for Medicaid assistance, a person must need financial assistance and be at defined asset levels. For example, to qualify for Medicaid assistance in a skilled nursing facility, an individual must have less than $2,000 in assets. Medicaid also has provisions, called the Spousal Impoverishment Standard, which allows for a spouse to keep assets including the house, stocks, and other personal assets while the other spouse qualifies for assistance in a skilled nursing facility or supportive living facility.
Source: mysundaynews.com

Doctors vs. Obamacare: Can your physician simply ‘opt

The Federal Reserve is self serving and privately owned in violation to the Constitution, charging interest on illegally printed money. Money printed from nothing! In America On June 4, 1963, a virtually unknown Presidential decree, Executive Order 11110, was signed with the authority to basically strip the Federal Reserve Bank of its power to loan money to the United States Federal Government at interest. With the stroke of a pen, President Kennedy declared that the privately owned Federal Reserve Bank would soon be out of business. Five months later A UNITED STATES PRESIDENT, PRESIDENT JOHN F. KENNEDY was MURDERED BY COMMUNIST! “If you lend money to one of my people among you who is needy, do not be like a moneylender; charge him no interest. Exodus 22:25 Hath given forth upon usury, and hath taken increase: shall he then live? he shall not live: he hath done all these abominations; he shall surely die; his blood shall be upon him. Ezekiel 18:13 Usury is unlawful; expressly prohibited by GOD!     In ancient Babylon their priest sacrificed babies to their gods baal, and molech.   In America the communist under their socialist programs have sacrificed over 50 million American babies to their god satan! Leviticus 20:2-5 2Again, thou shalt say to the children of Israel , Whosoever he be of the children of Israel , or of the strangers that sojourn in Israel , that giveth any of his seed unto Molech; he shall surely be put to death: the people of the land shall stone him with stones. 3And I will set my face against that man, and will cut him off from among his people; because he hath given of his seed unto Molech, to defile my sanctuary, and to profane my holy name. 4And if the people of the land do any ways hide their eyes from the man, when he giveth of his seed unto Molech, and kill him not: 5Then I will set my face against that man, and against his family, and will cut him off, and all that go a whoring after him, to commit whoredom with Molech, from among their people.   Luke 22:35-36 Then Jesus asked them, “When I sent you without purse, bag or sandals, did you lack anything?” “Nothing,” they answered. 36 He said to them, “But now if you have a purse, take it, and also a bag; and if you don’t have a sword, sell your cloak and buy one.     Jeremiah 50:16Cut off the sower from Babylon, and him that handleth the SICKLE in the time of harvest: for fear of the oppressing sword they shall turn every one to his people, and they shall flee every one to his own land. Jeremiah 50:23How is the HAMMER OF THE WHOLE EARTH CUT ASUNDER AND BROKEN! how is Babylon become a desolation among the nations! BABYLON = the HAMMER and SICKLE!     Jeremiah 50:14 “ Put yourselves in array against Babylon all around, All you who bend the bow; Shoot at her, spare no arrows, For she has sinned against the LORD.
Source: patriotupdate.com

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

Unicare Health and Life Insurance and the Policy Store Bring to Its Members Healthwise Knowledgebase: Healthwise Knowledgebase is a Comprehensive Resource of Decision Making Information Created for Medical Consumers.

Posted by:  :  Category: Medicare

Find quotes resources to help you choose the best find a good company solve claims problems. Anthem is a trusted health & care plan provider. Our portfolio features a line of care, pharmacy, dental, and disability products. Cigna is a global service company that offers accident, dental, disability related health services in an effort to help the. Notice to UTAH members of AIM Limited Medical Benefit If you are a resident of UTAH who purchased limited medical through membership in the. Aetna offers a variety of plans for individuals. Families the Self-Employed are underwritten by Aetna Insurance Company. Learn about from our experts. We offer coverage and benefits information provide quotes from various companies. insurance plan estimates derive from numerous things, not just your present Someone who is good overall health still buds might be incurred far more for. This current, accurate detailed industry guide for financial service professionals examines life simultaneously from the viewpoints of the. However, fact is that life is a very important aspect of ensuring your family with the future it deserves. Securing your mortgage. Every state in the United States requires that you pass the Insurance Exam before you are able to begin selling products. Source: healthknowle.info
Source: medicaresupplementalco.com

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

unicare authorization form

Authorization to Disclose Protected Health Information (PHI) The Health Insurance Portability and Accounting Act (referred to as HIPAA) enacted the privacy provisions … unicare authorization form Authorization Section A: Individual authorizing use and/or disclosure. Section C: Expiration and revocation. Expiration: This authorization will expire (complete one … unicare authorization form Access our secured site to check eligibility, claims, certifications, referrals and much more unicare authorization form UniCare’s pharmacy benefit has a mandatory generic program. This Multi-Source Brand Prior Authorization program promotes the utilization of appropriate generic … unicare authorization form CANCELLATIONS. If you are unable to attend a scheduled appointment, please call and cancel the appointment (214-824-6700) preferably one day in advance. unicare authorization form UniCare Medicare Prescription Drug Plan Individual Enrollment Form UniCare MedicareR x Rewards Key Code Step 1: Please provide information about you. unicare authorization form 11/5/2009 · CLAIM FORM Telephone: 1 (866) 679-0831 USE THIS ADDRESS TO MAIL … unicare authorization form MONTHLY BANK DRAFT AUTHORIZATION ® Registered Mark of WellPoint, Inc. UT2031 2/05 UniCare Life & Health Insurance Company INSTRUCTIONS: 1 Complete and sign the … unicare authorization form 8/18/2009 · Prior Authorization Forms Cheat Sheet Medicare Stand Alone Plans Advantra Rx http://www.advantrarx.com/framesetdef.asp?Community=Provider&PlanID=81 Aetna … unicare authorization form Included in this section: Introduction. General Guidelines. Common Reasons for Rejected and Returned Claims. Professional License Number and … unicare authorization form Qmnd Vgbx Jtgq Ugpe Wsov
Source: over-blog.com

UniCare to stop providing health insurance in Texas

UniCare is planning to stop providing health insurance to more than 180,000 customers in Texas. “UniCare is financially sound,” spokesman Tony Felts said Tuesday. “However, there are just some competitive pressures in the Texas market that made it difficult for UniCare to continue to be able to offer affordable health insurance and the outstanding customer service that goes along with it.” Felts did not explain what those competitive pressures were. The Indianapolis-based company has entered into an agreement with Health Care Service Corp., the parent company of Blue Cross/Blue Shield of Texas, to provide guaranteed replacement coverage with “benefits and rates similar to what they had with UniCare,” Felts said. John Greeley, a spokesman for the Texas Department of Insurance, said Blue Cross/Blue Shield has pledged “approximately equal premiums” as long as customers switch by Dec. 1. However, customers don’t have to switch to Blue Cross. UniCare, a subsidiary of health benefits company WellPoint Inc., will continue to offer life, disability, dental and vision coverage in Texas, Felts said. The company also will continue to contract with Texas to provide benefits to 20,000 Medicaid enrollees across the state. Most UniCare customers probably will have switched by the end of the year, Felts said. But others are expected to remain with the company until their policies expire sometime in 2010, Felts said. UniCare has about 200 employees in Texas; none are in Austin. Although much of the staff will lose jobs, some people will remain in Plano and Houston to work on the remaining business, Felts said. UniCare is also pulling out of Illinois, where another 180,000 people will have to find new coverage. Felts said the decisions to halt business in Texas and Illinois were not connected to federal efforts to overhaul health care. Of the roughly 180,000 customers in Texas, UniCare has provided health insurance for 26,000 people who work for small employers; 19,000 people who work for large employers; and 127,000 people with individual policies. The other 12,000 people had policies with UniCare HMO that they obtained through their employers.
Source: visioneyeinsurance.com

prior authorizathion unicare prescription

Rugged Prior Nodulized Form. for your plan if you need to request prior authorization or an. Kelly ServicesKendleKendle InternationalKenexaKey People LimitedKIENBAUM … prior authorizathion unicare prescription UniCare’s pharmacy benefit has a mandatory generic program. This Multi-Source Brand Prior Authorization program promotes the utilization of appropriate generic … prior authorizathion unicare prescription UniCare Health Plans of Texas, Inc. State Sponsored Business Provider Bulletin February 15, 2009 Revised June 9, 2009 UniCare Health Plans of Texas, Inc … prior authorizathion unicare prescription Health Insurance Company Plan Name Customer Service Phone Number Prior Authorization Phone Number Website Aetna Medicare Aetna Medicare Rx Essentials 1-877-238-6211 1 … prior authorizathion unicare prescription The inclusion of a medication on the UniCare ® Prescription Drug Formulary does not necessarily mean that it is appropriate for everyone or that it is the only drug … prior authorizathion unicare prescription Humana Prior Authorization Forms. related to web 1.Prior Authorization This guide helps prescribers determine which Humana medication resource to contact for prior … prior authorizathion unicare prescription 8/18/2009 · Prior Authorization Forms Cheat Sheet Medicare Stand Alone Plans Advantra Rx http://www.advantrarx.com/framesetdef.asp?Community=Provider&PlanID=81 Aetna … prior authorizathion unicare prescription 9/27/2010 · Prior Authorization Forms Cheat Sheet Medicare Stand Alone PlansAdvantra Rxhttp://www.advantrarx.com/framesetdef.asp?Community … prior authorizathion unicare prescription PDF about WellPoint Pharmacy Prior Authorization Forms – Express Scripts Prior Authorization Forms – WellPoint Authorization Form – WellPoint Prior Auth Forms – Blue … prior authorizathion unicare prescription Most insurances do not require a referral but if you have a plan that requires one, please contact your physician and have them fax the referral preferably 2 days … prior authorizathion unicare prescription Mcqm Zwud Bmcy Addy Evip
Source: over-blog.com

Illinois Medicare Part D Plans

Keep in mind that there are two ways to receive Medicare drug benefits. You can enroll in a stand-alone plan or join a Medicare Advantage plan that includes Part D coverage. If you are going to stay with original Medicare or purchase a Medigap policy your only option will be to enroll in a stand-alone Part D plan.
Source: partdplanfinder.com

Who Would of Thought it? Unicare and the Policy Store are Letting You Know that the Thyroid Gland, Though Not Thought of Normally, is Definitely a Gland to be Concerned About if it is not Operating Properly.

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: bowelirritable.net

Understanding About Medicare Supplemental Coverage Online

When turning 65, there are a few different options for senior health insurance. In many cases, a Medicare gap insurance plan can be a good fit for new enrollees. Take Sue for instance. Sue has a home in Florida, but lives in Illinois for most of the year. Your woman needs to have access to physicians in both areas, therefore she needs a strategy that offers any doctor of her selecting. She decides to get a Medigap Plan G, because Medicare Supplement Insurance gives the girl the freedom to choose any kind of doctor.
Source: unicarehealthinsurancereview.com

List of the Best Health Insurance Companies in Illinois California Long Term Care Insurance Services

Brokerage firms are a good option to consider because they can give you advice on which option best suits your needs. They can also give choices for reducing premiums and help you determine the best policy for people with special needs.  You can get information from these firms regarding special state programs like COBRA, The Trade Adjustment Assistance Reform Act, Illinois KidCare, Medicare, Illinois’ High Risk Pool for People with Health Problems and other similar programs.
Source: californialongtermcareinsuranceservices.com

Hip Replacement Class Action Suits And How Medicare And Health Insurers Will Be Getting All The Money : Pennsylvania Injury Law Report

Posted by:  :  Category: Medicare

Crossing of Old Canton Road by / // /The most widespread medical implant failure in the United States in decades, involving thousands of all-metal artificial hips that need to be replaced prematurely, has entered the money phase. Medical and legal experts estimate the hip failures may cost taxpayers, insurers, employers and others billions of dollars in coming years, contributing to the soaring cost of health care. The financial fallout is expected to be unusually large and complex because the episode involves a class of products, not a single device or just one company. The case of Thomas Dougherty represents one particularly costly example. He spent five months this year without a left hip, largely stuck on a recliner watching his medical bills soar. In August, Mr. Dougherty underwent an operation to replace a failed artificial hip, but his pelvis fractured soon afterward. The replacement hip was abandoned and then a serious infection set in. Some of the bills: $400,776 in charges related to hospitalizations, and $28,081 in doctors’ bills….The so-called metal-on-metal hips like Mr. Dougherty’s, ones in which a device’s ball and joint are made of metal, are failing at high rates within a few years instead of lasting 15 years or more, as artificial joints normally do.The wear of metal parts against each other is generating debris that is damaging tissue and, in some cases, crippling patients.
Source: pennsylvaniainjurylawreport.com

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

HealthSpring Shareholders Approve Merger

The first baby boomers will hit their retirement years soon and will opt for managed care plans. Health insurers are thus looking to acquire providers of managed care plans to the seniors, which in turn will help them generate higher revenues. Also, managed-care plans for Medicare are expected to generate incremental revenue of $10 billion by 2015, which would make such acquisitions valuable.
Source: dailymarkets.com

Crucial Analysis in Medicare RAC Plan

A view is the fact that Recovery Review Contractors contain made it easier intended for CMS, and CMS thinks about the same lines. It is merely because the quantity of recovery which usually RAC features recovered. The total recovered, is that it good adequate? This may be a question to become answered. Overall looking in the statistics that recovery level is excessive. Payments are built for services that have been medically pointless or failed to meet that Medicare medical related guide lines in the setting the location where the service has been provided (e. gary. a claim originating from a hospital medicare supplement insurance three colonoscopies in the same beneficiary about the same date in service, whereas only 1 colonoscopy in one day is scientifically necessary; or bodily therapy provided with the inpatient setting if your therapy has been safely together with effectively provided with the outpatient setting). One other scenario is if your payments are built is false coding.
Source: fusionextreme.com

MHA Press Room: CDC: Adult, childhood obesity rates unchanged in 2009

In related news, HBO announced Jan. 13 it will partner with the CDC, Institute of Medicine, National Institutes of Health, Kaiser Permanente and Michael & Susan Dell Foundation on “The Weight of the Nation,” an HBO series and public health campaign debuting in May. The initiative will include a nationwide community outreach campaign and IOM report recommending strategies and actions to accelerate progress in curbing obesity.
Source: typepad.com

Ask The Experts: Retirement

Posted by:  :  Category: Medicare

Q. I am 64 and don’t have enough credits to get Social Security. I will turn 65 in October. Will I be eligible for Medicare? If not, do I still sign up for it? My husband retired from Ford Motor Company and is 61. He will turn 62 in April. He plans on getting on Social Security at that time. Will I then be able to get Medicare?
Source: federaltimes.com

Video: New Port Richey’s Advanced Medicare

Research Roundup: Raising Medicare’s Eligibility Age

Journal Of The American College Of Radiology: Imaging And Insurance: Do The Uninsured Get Less Imaging In Emergency Departments? – Using data from the 2004 National Hospital Ambulatory Medical Care Survey, researchers compared treatment among patients who were uninsured, those covered by Medicaid and those with other types of insurance and found that the uninsured patients received 8 percent fewer imaging tests than patients with non-Medicaid insurance and that Medicaid enrollees received 10 percent fewer than those with other insurance. They conclude: “Further research is needed to understand whether insured patients receive unnecessary imaging or if uninsured and Medicaid patients receive too little imaging” (Moser and Applegate, January 2012). Archives Of Pediatrics And Adolescent Medicine: The Interplay Of Outpatient Services And Psychiatric Hospitalization Among Medicaid-Enrolled Children With Autism Spectrum Disorders — For children with Austism Spectrum Disorders (ASD), barriers to care — such as lack of qualified practitioners and poor insurance coverage — increase the chances that they will be hospitalized for psychiatric reasons. The researchers looked at a large national sample of Medicaid-covered children with ASD to see if “increasing outpatient services results in reduced use of costly and restrictive service.” The researchers found that each $1,000 increase in spending on outpatient services like respite care over 60 days “resulted in an 8% decrease in the odds of hospitalization” (Mandell et. al., 1/2) New England Journal Of Medicine:  Fitness Memberships And Favorable Selection In Medicare Advantage Plans — Researchers used national figures from the Centers for Medicare and Medicaid Services to see what kind of changes occurred when 11 Medicare Advantage plans incorporated a gym membership as a part of their covered benefits: “Persons enrolling in plans after the addition of a fitness-membership benefit reported significantly better general health, fewer limitations in moderate activities, less difficulty walking.” The authors noted that creating an insurance risk pool for Medicare Advantage plans, as well as  for small business and individual plans, violates the 2010 health law. However, a benefits package that caters to a healthier subset of seniors may have the same effect as creating a risk pool (Cooper and Trivedi, 1/11).
Source: kaiserhealthnews.org

Brad DeLong: Raising the Medicare Eligibility Age Is a Really Bad Idea Blogging: Is This a Problem with the Media or with the Congressional Budget Office?

Director’s Blog: Raising the Ages of Eligibility for Medicare and Social Security: If the eligibility age was raised above 65, fewer people would be eligible for Medicare, and outlays for the program would decline relative to those projected under current law. CBO expects that most people affected by the change would obtain health insurance from other sources, primarily employers or other government programs, although some would have no health insurance. Federal spending on those other programs would increase, partially offsetting the Medicare savings. Many of the people who would otherwise have enrolled in Medicare would face higher premiums for health insurance, higher out-of-pocket costs for health care, or both.
Source: typepad.com

Eligibility Age for Medicare May Increase

Previously, the Congressional Budget Office has stated that the age increase would save about $162 billion.  After a senator requested a new analysis of the figures, that amount has been changed, as it did not originally factor in the premiums that would be lost from the seniors who would no longer qualify.  Some do not feel that this is enough of a savings to warrant the change.  And while it may not affect the deficit greatly, it could create the necessary funds to create the “doc fix,” which some suggest to be a permanent resolution to the temporary pay raise Congress would allow for Medicare doctors annually.  While President Obama supports the age increase, the opposition is still great.  There are some who believe that seniors could benefit from losing eligibility, as they may be able to acquire better access to doctors and facilities through a private health insurance policy, as opposed to the Medicare Advantage program.  The debate is heated, but only time will tell the outcome.
Source: insuranceflash.org

Health Care Organizational Ethics: Raising the Age for Medicare Eligibility

This week the Congressional Budget Office released a report on proposals to raise the age of eligibility for Medicare and Social Security. The CBO concludes that raising Medicare eligibility to 67 would reduce federal spending by $148 billion between 2012 through 2021. By 2030, Medicare’s net spending would be reduced by 5% – 4.7% of GDP rather than 5%. Those numbers sound good. But reducing federal expenditures doesn’t reduce the need for medical care. Some lucky folks (I’m in that category) (a) have employment that provides health insurance and (b) are happy to continue working. Some who would rather retire will continue to work, increasing health care costs for their employer (and fellow employees). Some will scramble to find alternatives which will cost them more than Medicare would. And some will become uninsured, at an age when this is progressively risky. Overall costs – to individuals, employers and other government programs would probably go up more than the $148 billion reduction in Medicare outlays. The CBO does not comment on the fact that employers are not clamoring for ready-to-retire employees to stay on the job simply to avoid being uninsured. Raising the Medicare eligibility age isn’t meaningful cost reduction – it’s simply a form of hot potato, dumping the costs into other accounts. It intensifies the fragmentation of our health system, and worsens overall quality of care. In my view, the proposal is born out of despair about achieving constructive Medicare reform in which health professionals, patients and families collaborate on behalf of improved care (basically more compassion and less technology) and reduced costs. From 35 years of practice in a not-for-profit HMO setting I know this kind of collaboration is possible. But it requires a spirit of cooperation and trust that is not easy to find in our toxic political environment. 
Source: blogspot.com

City considers different fee system for waste haulers

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

Increasing Retirement Ages Would Reduce Spending, Limit Benefits: CBO

If the eligibility age is increased by two months every year beginning in 2014 for people who were born in 1949 until the age reaches 67 in 2027 for people born in 1960, of the 5.4 million people who would be affected in 2021, about 5% would become uninsured, the CBO predicts. About half of those would obtain insurance through their employer or their spouse’s employer. The remaining 2.3 million people would receive coverage “in equal parts” through Medicaid, through Medicare disability benefits, or through the health care exchanges that will become available in 2014 through the Affordable Care Act.
Source: advisorone.com

What CBO Says About Raising Eligibility Ages for Medicare and Social Security

The Committee for a Responsible Federal Budget indicates that such a move would not only reduce taxpayer costs, but also reduce health costs for most seniors. While increasing the eligibility ages for Medicare and Social Security is a good step forward, it should be advanced as part of a package of reforms needed to put these programs on sound financial footing. The Heritage Foundation’s Saving the American Dream plan includes eligibility age increases as part of its proposals to transform Medicare and Social Security. In concert with other structural reforms, this plan would ensure that future generations in need of program benefits can count on them. Entitlement reform can be done, and Congress should not delay in communicating that to the American people.
Source: heritage.org

3 Reasons Why We Should Raise Medicare’s Eligibility Age

3) Raising the Medicare eligibility age would make additional reforms easier. The most important likely effect is political. Reforming Medicare is difficult in part because of resistance by beneficiaries, who hold a lot of political influence; indeed, the fact that some beneficiaries might have to pay more for their insurance (CBO estimates that nearly all would still end up insured) is the primary argument cited by opponents of raising the eligibility age object to the change. That people who benefit from a program like it and/or get financial rewards from it, however, is not much of an argument for refusing to accept reforms, especially with an obviously unsustainable entitlement like Medicare. Diminishing the beneficiary class is likely to diminish resistance to further change, and while it’s not enough, it might ultimately make reform easier. 
Source: reason.com