Medicare Buz

Each day, hundreds of thousands of nursing home residents are given antipsychotic drugs,[1] even though, as documented by the Department of Health and Human Services’s Office of Inspector General in May 2011,[2] these drugs are inappropriate and life-threatening for the vast majority of residents to whom they are given.  Antipsychotic drugs are also extremely expensive.  The Inspector General reported that for the six-month period, January 1-June 30, 2007, erroneous drug claims for atypical antipsychotic drugs for nursing home residents cost $116 million.[3]  This report underestimates the costs of antipsychotic drugs because it looked only at atypical antipsychotic drugs (not conventional antipsychotic drugs as well) and because it looked only at nursing home residents (not other care settings, such as hospitals and assisted living).
Source: medicareadvocacy.org

Video: Medicare Supplement Plans | Questions about Medicare Supplement Plans

Medicare Supplemental Health Insurance Resources Online

When looking into health insurance of any kind the rules, regulations and stipulations often make it so that every word on the policy seems foreign and a bit sketchy. The policy is never laid on it terms that one without industry knowledge would completely understand. Words such as co-payment, deductible, family allowance, preventative vs. routine care often times add confusion in really understanding what is being offered. Health Insurance in general is difficult to understand and often leads us to believe we are being manipulated let alone getting into the next generation of health insurance, Medicare. How is one to determine exactly what is being offered and to finally settle upon a policy that best fits the need with Medicare and Medigap supplemental insurance policies?
Source: business-profit-pro.com

Competition cuts down Medicare fraud

In its report, Medicare said it closely monitored the health of beneficiaries likely to use home equipment in the nine areas involved with the competitive bidding experiment. It then compared the results to data for beneficiaries in other similar areas where competitive bidding has not been instituted yet. Using yardsticks such as emergency room visits and nursing home admissions, it found no significant differences.
Source: fiftyplusadvocate.com

Could your center live on Medicare rates?

Accountable care organization ACO acquisitions American Academy of Family Physicians BCBS branding consumers contracts cost transparency Doctors Express Electronic medical record emergency rooms employers Florida government Healthcare Health system health systems hospitals Humana ICD-10 Procedure Coding System industry insurance investors IT legislation Medicaid Patient patients payers Physician Physician assistant physicians price transparency primary care quality retail clinics Scope of practice social media Telemedicine Texas UCAOA unnecessary care urgent care wait times
Source: wordpress.com

Medicare Competitive Bidding Pilot Reduced Costs by 42%, CMS Says

We find it hard to believe that there were only six negative calls about competitive bidding in the whole last quarter and just 151 over the past year. People for Quality Care (www.peopleforqualitycare.org) is an advocacy organization that talks to Medicare beneficiaries and providers across the country every day and we hear the damage competitive bidding has done.
Source: californiahealthline.org

Medicare to Expand Competitive Bidding on Equipment

Medicare’s competitive bidding efforts got off to a rocky start. Many suppliers complained that the government had accepted low bids from companies that had little experience in the industry, while curtailing opportunities for family-owned businesses that had served their communities for many years. In addition, dozen of economists told the Obama administration that its initial plans for competitive bidding were seriously flawed.
Source: allbusinessnews.org

CMS Settles Medicare Reimbursement Dispute With Hospitals

Modern Healthcare: CMS’ Hospital Settlements Seen Costing At Least $3 Billion Ongoing CMS settlement negotiations with about 2,200 hospitals are expected to cost the federal government at least $3 billion, according to parties involved in the deal. The payments to hospitals will settle several similar years-long federal lawsuits in which those providers alleged CMS officials erred in calculating pay rate cuts needed to offset an increase for rural hospitals required by a 15-year-old law. The settlement process began when a federal appeals court struck down a lower court ruling that sided with the CMS (Daly, 4/12).
Source: kaiserhealthnews.org

CMS Issues Amended Medicare Physician Fee Schedule for Home Health

Specifically, Section 101 of the MMEA averts the negative update that would otherwise have taken effect on Jan. 1, 2011. The MMEA provides for a zero percent update to the physician fee schedule for claims with dates of service Jan. 1, 2011 through Dec. 31, 2011. While the physician fee schedule update will be zero percent, changes to the relative value units (RVUs) for 2011 require CMS make an adjustment to the conversion factor to make the changes budget neutral. The revised conversion factor to be used for physician payment as of Jan. 1, 2011 is $33.9764.
Source: hcafnews.com

If you’d like to learn more about the various Illinois Medicare Advantage plan options in your region, please feel free to get in touch with us at www.abchealthplans.com or by phone at 1-800-707-5795. We are an independent licensed health insurance agency that offers free assistance to those in need of health insurance help. We have been specializing in Medicare plan s since 1991 and one of our agents would be glad to recommend the best type of health plan for your medical situation and budget.
Source: abchealthplans.com

Video: Medicare Insurance Illinois Medicare Advantage Medigap Plans Illinois

Illinois Medicare Supplement Plan G

Remember, simply because providers must offer the same plans does not mean they are all reputable or dependable. And when it comes time to collect on your benefits, a low cost will not help you if the insurance company cannot deliver. Stay with the major names and get peace of mind in knowing you’re insured with a stable, reliable provider. Blue Cross Blue Shield of Illinois, for example, has been providing Medicare supplement insurance to folks just like you for years. Because they are dependable, they will continue to offer competitive prices and great benefits for years to come.
Source: ssiinsure.com

Marathon Pundit: Illinois: Increasing cigarette tax is the wrong fix on Medicaid costs

Financially-moribund Illinois is looking to slash a whopping $2.7 billion from its Medicare budget. For those of you who are wondering–yes, this is the same Illinois that raised personal income taxes by 67 percent last year. Businesses were clobbered too, but they were not hit as hard–their rate went up ‘only’ 46 percent. Yet the Prairie State is still expected to end the fiscal year with an $8 billion deficit. One proposal from Democratic Governor Pat Quinn to make the Medicaid cuts less steep is to hike the cigarette tax by $1 a pack. As I’ve mentioned countless times in this space, revenue from smoking-related taxes almost never matches politicians’ forecasts. The cash shortfall then has to be made up elsewhere. Besides, Illinois’ tax-and-spend-even-more way of doing things has led to the state having the nation’s lowest credit rating. We don’t need more of the same.
Source: blogspot.com

IL Dept of Insurance Recognized for Exemplary Performance of its Senior Health Insurance Program

SPRINGFIELD–(ENEWSPF)–April 17, 2012.  The Illinois Department of Insurance (DOI) has received recognition from the U. S. Centers for Medicare and Medicaid Services (CMS) that Illinois excels in several areas related to exemplary performance for its Senior Health Insurance Program.  The Senior Health Insurance Program (SHIP) is a free statewide health insurance counseling service for Medicare beneficiaries and their caregivers.  SHIP is sponsored by the Illinois Department of Insurance.  CMS notified DOI earlier this month and commended the department for the high ranking received on its National Performance Reporting (NPR) stats. 
Source: enewspf.com

Illinois Winner Romney Supports Ryan Ideas On Medicare, Medicaid

ABC: Fact Check: RNC Ad Hits Obama For ‘Higher Costs’ On Health Care The Republican National Committee is hammering President Obama in a new TV ad over what it calls a ”broken promise”  to bring down health care costs for families. The ad … airs this week in the pivotal swing states of Nevada, New Mexico, Ohio, Virginia, Pennsylvania and Florida, the RNC said. The ad seems aimed at exploiting what a Kaiser Family Health Foundation poll revealed this month as the most widely cited negative perception of Obama’s health care law: increased costs overall (Dwyer, 3/20).
Source: kaiserhealthnews.org

Walsh Votes to Save Medicare

“Everyone knows that if we do not do something about our country’s debt right now, our kids and grandkids will be stuck with the bill. That is unconscionable. Only the Republicans approved a budget that actually balances. The Senate has failed to pass a budget in the past 3 years while the President put forth a budget that never, ever, ever, ever, ever balances.
Source: typepad.com

Affordable Care Act Helps 201,818 on Medicare in Illinois Save $139,094,886.04 on Prescription Drugs

Washington, DC–(ENEWSPF)–March 19, 2012. As the second anniversary of the Affordable Care Act approaches, new data shows that 201,818 Medicare beneficiaries in Illinois saved a total of $139,094,886.04 on prescription drugs because of the new health care law, Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services (HHS), announced today, an average of $689.20 per individual.  Savings for seniors include a one-time $250 rebate check to seniors who hit the “donut hole” coverage gap in 2010 and a 50 percent discount on covered brand-name drugs in the donut hole in 2011.
Source: enewspf.com

When reach the age for medicare does my State of Illinois health insurance for state retired employes change?

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Source: familyencyclopedia.net

Democratic Candidates Say Ryan Budget Will 'Gut Medicare' (VIDEO)

Duckworth, an Iraq War veteran who will face Tea Party lightning rod Joe Walsh (R-8) come November, said most notably Ryan’s plan will “gut Medicare as we know it.” According to the New York Times, Ryan’s budget plan would slash Medicare funding by $205 billion and would turn the government program into a free-market voucher system. Additionally, the Republican budget would reduce the number of tax brackets, which max out at 35 percent, from six to two at 10 percent and 25 percent rates. By 2016, the Ryan plan would reduce the country’s $1.18 trillion deficit to $241 billion compared to the $529 billion deficit proposed by Obama’s budget, which includes large military cuts rather than slashing entitlement programs. The Democratic candidates blasted Ryan’s budget saying it would benefit the country’s richest citizens while cutting essential government services to America’s neediest populations: the poor and elderly. “Everybody understands that we’re going to have to make decisions on where to reduce spending, but to do it on the backs of the people who can afford it the least, to do it in a way that’s going to end Medicare and turn it into something we don’t recognize … is absolutely wrong,” said Brad Schneider, who is challenging incumbent Bob Dold (R-10).
Source: progressillinois.com

What most people think is that they have to keep Medicare part D but the truth is that you are not required to keep any Medicare plan that you receive. Some people will already have insurance through their spouses employer or even through their own and if that is the case, then you might not need any additional insurance. It is a good idea to just see what you need and what you can get extra by calling the number on the back of your Medicare card. What some people don’t understand is that the number on the back of your Medicare card will actually connect you with a real person that will help you with anything that you need.
Source: gulatidental.com

Video: Medicare Part D and Prescription Drugs

2012 Blue Cross Blue Shield of Texas Medicare Part D Plans

With two plans to choose from, Blue Cross Blue Shield of Texas makes it easy to find the right prescription drug coverage that fits your medical needs and your budget. If you’re looking for the most affordable rates, the Value plan offers a lower monthly premium in exchange for a small deductible. With the Value plan, you still get comprehensive coverage with a small copay and discounts on brand name drugs. If you’re looking to have no deductible, the Plus plan offers the same quality coverage for a little more monthly and a small copay for all generic drugs. 
Source: texasmedicarehealth.com

Q1Medicare.com Brings the 2012 Medicare Part D Defined Standard Benefit Parameter Changes Online

The 2012 Donut Hole exit point or Out-of-Pocket threshold will increase slightly from the current 2011 value of $ 4,550 to $ 4,700 in 2012. Therefore, a person in the Donut Hole will need to spend slightly more money in 2012 before entering the Catastrophic Coverage portion of their Medicare Part D plan. On the positive side, 2012 will also bring an increase in the Donut Hole Discount whereby Medicare beneficiaries will receive a 14% discount on generic medications, an increase over the current 2011 7% generic drug discount and continue to receive a 50% discount on brand name drugs.
Source: echeck-merchant-account.com

CMS: Medicare Advantage, Part D To Get 3 Percent Boost In 2013 Reimbursements

Bloomberg: Nursing Homes Won’t Have To Hire Independent Pharmacists The U.S. Centers for Medicare and Medicaid Services backtracked on a plan that would have required nursing homes to hire independent pharmacists to assess residents’ prescriptions. Regulators “decided to further study the issue for future policy considerations,” Jonathan Blum, deputy director of the agency, said in a conference call with reporters late yesterday. The centers said in October it was considering stricter rules to oversee patients’ drug regimens, an announcement that sent the stocks of nursing home pharmacies, including Omnicare Inc. (OCR) and PharMerica Corp. (PMC), tumbling (Wayne, 4/3).
Source: kaiserhealthnews.org

Health Care: Enrollment Period Ends for Medicare Beneficiaries Whose Plan Left the Area

If you receive one of these notices be sure not to panic! I know change is difficult, but sometimes it actually can be a blessing in disguise! First of all, you will have plenty of time to make changes to your Medicare coverage. Secondly, you are always protected under the Medicare system. These protections include special allowances to enable you to change to other Medicare coverage. You are even granted an SEP which allows you to be able to sign up for a Medicare supplement without having to answer health questions! So, if your health has decreased, or if you just want the added protection of the Medicare supplement you are now able to join!
Source: blogspot.com

The Ryan Plan And The Medicare Debate: The Crucial Questions

What level of savings can be reasonably achieved in the Medicare program without compromising beneficiaries’ access to quality care, and how should these savings be realized?  Both sides of the political aisle agree that deficit reduction needs to occur.  Representative Ryan’s prior effort was largely criticized for the depth of the cuts proposed in Medicare.  But this year, his plan trims savings close to the level proposed in President Obama’s budget.  Ryan’s Fiscal Year (FY) 2013 budget proposal projected 6.4 trillion in Medicare outlays over FY2013-FY2022 – approximately $200 billion below the levels in the President’s FY2013 budget proposal.  This emerging consensus on the level of cuts is significant politically as it will serve as a new benchmark in the discussion.
Source: healthaffairs.org

Medicare Part D Open Enrollment to Begin Soon

6. Seek help if you need it: Medicare changes typically come every year. But reviewing options and choosing a new plan can be confusing for consumers or those attempting to help them. For help, you can go to the government’s website as well as volunteer organizations, private-sector plans, and other resources like the AARP (American Association of Retired People) , the National Council on Aging (NCOA), and the Medicare Rights Center. You can also check out the State Health Insurance Plans (SHIPs), which are part of a federal network of State Health Insurance Assistance Programs located in every state.
Source: bnaibrithdenver.org

Take Care With Your Medicare Plan Part D Premiums

Do you have questions about your Medicare plan coverage? Would you be interested in knowing if you’re paying too much, or if there are other better options for you? If so, contact the Allsup Medicare Advisor at (866) 521-7655. You’ll receive impartial Medicare plan selection service and expert guidance on the choice that’s right for you.
Source: allsup.com

Do Medicare cover Viagra for erectile dysfunction? No it do not. (But sometimes it get screwed anyway.)

Based on the findings of the study, titled “Review of Erectile Dysfunction Drugs in the Medicare Part D Program,” the OIG recommended the Centers for Medicare & Medicaid Services (CMS) maintain a comprehensive list of ED drugs that have been approved by the FDA for the treatment of sexual or erectile dysfunction. The OIG also recommended CMS distribute this list to all Medicare Part D plan sponsors.
Source: themeddiva.com

Benefits of Implementing the Medicare Advantage Program

Beneficiaries must be eligible to register in a Medicare Advantage (MA) plan. That means that there are several requirements that must be met by the beneficiary when registering in a MA plan during the registration period, and generally they agree to settle for a year, this is done to receive coverage through Medicare Advantage program. After the registration applies, the beneficiary must receive all care in accordance with the rules that have been planned, respecting network operator, and other restrictions that can be used to control expenses.
Source: birthyearnetwork.org

Garrett Ball is the owner of Medicare-Supplement.US, as well as several other Medicare-related web resources. As an independent broker, Garrett assists people going on, or already on, Medicare with comparing the various Medicare plan options in an unbiased way and in a centralized place. Garrett’s position as an independent agent and experience specializing in this field give him the unique ability to help others navigate the Medicare “maze”.
Source: medicare-supplement.us

Video: Medicare Supplement plan F High Deductible Explanation

The benefit value of Medicare

Relative to the typical large employer PPO plan, Medicare provides somewhat more generous benefits for low-cost individuals ages 65 and older because of the relatively low Part B deductible for individuals who do not use inpatient care; however, Medicare is less generous than the typical large employer PPO plan for seniors with moderate and high costs. Similarly, relative to the FEHBP Standard Option, Medicare is slightly better for low-cost individuals ages 65 or older, but is notably less generous for moderate cost individuals and somewhat less generous for high cost individuals.  Read more
Source: medicareindex.com

Plan F High Deductible Option

What you are doing, in essence, is self insuring for the first $2000 of annual medical expenses that would normally be your share for covered services. Original Medicare will still pay its portion first. For example, a $100 doctor visit would require that you pay the $20 yourself. That $20 would reduce the balance of your deductible for the current year.
Source: affordablemedicareplan.com

2012 Medicare Deductible Amounts

One such Medigap option available for purchase is Plan G.  Plan G covers everything that Plan F does except for the Part B deductible.  If Plan G happened to be $300 less (as can be the case) per year than Plan F and Plan F only covers $140 more in costs, then Plan G is a wise choice.  Plan N might also fall into this category if you live in a state (Ohio for instance) that does not allow for Part B Excess charges.
Source: ohioinsureplan.com

Medicare Part B Premium Deduction for Self Employed

IRS officials said the change came too late to be printed in the Publication 535, Business Expenses, which still states that Medicare Part B premiums are not considered medical insurance premiums for purpose of the self-employed health insurance deduction.
Source: iquote.com

Rim Country Gazette: How Medicare covers hospice care

Medicare will pay for a one-time-only consultation with a hospice medical director or hospice doctor to discuss your care options and how to manage your pain and symptoms.  After that, Medicare covers doctor and nurse services; equipment such as wheelchairs or walkers; supplies such as bandages and catheters; drugs to control pain or other symptoms; hospice aide and homemaker services; physical and occupational therapy; and social worker services.
Source: blogspot.com

Looking for Insurance Articles

The reality is that few people experience the worst case scenario. Very few will actually hit the $2,070 deductible for the year. Some estimates show that only 5% of people accumulate over $2,000 of utilization. There are a number of sources that estimate how much the average senior actually accrues in part A and B co-insurance and deductibles for the year but the average seems to show it is about $900 a year. Given this estimate, the average senior would save about $1,207.00 a year on plan F high deductible. If they have a very healthy year, they will save even more. If they have a catastrophically bad year, they will only save $107 but there is no risk involved. At the end of the day, they will save money period.
Source: lookingforinsurance.net

Pennsylvania Medicare Part D Plans

If on the other hand, you are interested in a Medicare Advantage plan, you can choose a plan that includes Part D coverage. You will be subject to the guidelines of the Advantage plan but should you choose a plan with a low or $0 premium, you may be able to save some money on your Part D.
Source: partdplanfinder.com

With two plans to choose from, Blue Cross Blue Shield of Texas makes it easy to find the right prescription drug coverage that fits your medical needs and your budget. If you’re looking for the most affordable rates, the Value plan offers a lower monthly premium in exchange for a small deductible. With the Value plan, you still get comprehensive coverage with a small copay and discounts on brand name drugs. If you’re looking to have no deductible, the Plus plan offers the same quality coverage for a little more monthly and a small copay for all generic drugs. 
Source: texasmedicarehealth.com

Video: Florida Blue Medicare

Blue Hampshire: Politics ::: Bass & Guinta Commit Medicare Fraud

Medicare fraud is to commit a fraud on the Medicare program by submitting false claims for goods not delivered or services not provided.  There has been plenty of that, perpetrated by doctors and providers and complicit insurance companies.  But, since Frankie used to be in insurance, ratting out his buddies is not in Frankie’s interest. Better to muddy the issue, just as they do with “voter fraud,” which isn’t, either.  Calling something what it isn’t is a good way to obfuscate the real issue. The real issue is making sure middlemen such as insurance companies don’t get paid for providing no benefit to people who need medical or preventive care. By mandating the allowable overhead insurance companies can collect for managing policies and payments, the ACA has restricted the income stream of insurance companies and by proposing to review the rates charged by hospitals and other institutional providers of care, the Independent Payment Advisory Board is going to restrict the provider revenue stream in the interest of insuring that patients actually get good value for dollars spent.
Source: bluehampshire.com

Oklahoma Blue Cross Blue Shield Medicare Part D Drug Coverage

Before exploring your options with a Medicare prescription drug plan, make sure you’re eligible. Generally, you have to be entitled to receive services under Medicare Part A and/or enrolled in Part B. You also have to live in the plan’s service area and can’t be enrolled in any other Medicare Part D plan at the same time.  Keep in mind, if you’re currently insured with a Medicare Advantage plan, you must receive your drug benefits through that plan. However, if you have a Medigap plan, you can add prescription drug coverage. Remember, there are very specific enrollment periods you do not want to miss. If you’re late, you could end up paying a penalty. 
Source: oklahomamedicarehealth.com

Blue Cross Blue Shield of Texas: Blue Medicare RX Selector Tool

This entry was posted in Medicare and tagged Annual enrollment, fort bend, Health insurance, Houston, Insurance, insurance agent, katy, Medicare, Medicare Advantage, medicare d, Medigap, Prescription medication, richmond, rosenberg, sugar land, Texas, TX. Bookmark the permalink.
Source: wordpress.com

Quality Improvement Projects in Michigan Helping Bend the Health Care Cost Curve

“I think there’s no question that when you’re really serious about safety, when you really try to figure out what to do, you can make big progress,” said Lucian Leape, a leading patient safety advocate and health policy professor with the Harvard School of Public Health. He spoke Monday at the Michigan Surgical Quality Collaborative Conference in Detroit, where he praised the work under way here.
Source: bcbsmblog.com

Horizon Medicare Advantage Blue Value with Rx

Please read through the full Horizon Medicare Blue Value with Rx HMO Summary of Benefits attached here for a more thorough review of the plan. I am also available to review this plan with you in a meeting if you wish. Due to marketing regulations, I have decided to list just the basics of the plan and but welcome appointments to discuss your full needs. Contact Mike at NewJerseyInsurancePlans
Source: newjerseyinsuranceplans.com

Medicare Advantage Plans in Philadelphia, PA

Why is it important for residents of Philadelphia and its immediate surroundings? Keystone HMO Select 65 offers exceptional coverage with premiums starting as low as $ 15 a month! This is a unique health plan. If you are looking for a plan with recipes, Keystone HMO Select 65 has that covered too. The Keystone 65 HMO Select, including prescriptions is only $ 42.10/month! First, it is a full coverage with a company you can trust. The new Keystone 65 HMO Select covers many preventive services with no co-payment at all. Visits to primary care physician are covered with a copayment of $ 20, specialized visits have a $ 45 copay, hospitalization of the patient has a copay of $ 215 per day for days 1-8 and no copayments from then. References are required for most specialty services, and must use plan providers except in situations of emergency or urgency.
Source: viewstonews.com

Medicare fraud costs the system an estimated $60 billion each year and contributes to higher health care costs. Scams using the names of federal agencies to fool consumers are on the rise and are particularly dangerous to seniors, who tend to be more trusting, said Sandy Chalmers, administrator of the state Division of Trade and Consumer Protection.
Source: aarp.org

Video: Philadelphia: Medicare Fraud Summit Anti-Fraud Collaboration Panel

Coral Calcium Scam News Alert: Hospice Fraud

• A hospice offering free goods or goods at below market value to induce a nursing home to refer patients to the hospice. • False representations in a hospice’s Medicare/Medicaid enrollment form. • A hospice paying “room and board” payments to the nursing home in amounts in excess of what the nursing home would have received directly from Medicaid had the patient not been enrolled in the hospice. • False statements in a hospice’s claim form (CMS Forms 1450, UB-04 or UB-92). • A hospice falsely billing for services that were not reasonable or necessary for the palliation of the symptoms of a terminally ill patient. • A hospice paying amounts to the nursing home for “additional” services that Medicaid considered included in its room and board payment to the hospice. • A hospice paying above fair market value for “additional” non-core services which Medicaid does not consider to be included in its room and board payments to the nursing home. • A hospice referring patients to a nursing home to induce the nursing home to refer its patients to the hospice. •A hospice providing free (or below fair market value) care to nursing home patients, for whom the nursing home is receiving Medicare payment under the skilled nursing facility benefit, with the expectation that after the patient exhausts the skilled nursing facility benefit, the patient will receive hospice services from that hospice. • A hospice providing staff at its expense to the nursing home to perform duties that otherwise would be performed by the nursing home. • Incomplete or no written Plan of Care was established or reviewed at specific intervals. • Plan of Care did not include an assessment of needs. • Fraudulent statements in a hospice’s cost report to the government. • Notice of Election was not obtained or was fraudulently obtained. • RN supervisory visits were not made for home health aide services. • Certification or Re-certification of terminal illness was not obtained or was fraudulently obtained. • No Plan of care was included for bereavement services. • Fraudulent billing for upcoded levels of hospice care. • Hospice did not conduct a self-assessment of quality and care provided. • Clinical records were not maintained for every patient. • Interdisciplinary group did not review and update the plan of care for each patient.
Source: blogspot.com

Kentucky Health News: Chiropractic clinic to pay $650K for Medicaid and Medicare fraud

Ho Medical Clinic, Kenneth Ho and Ana Moreno allegedly filed false claims when they billed for physician services, though they were performed by a chiropractor (chiropractors are not medical doctors); billed for unnecessary and unreasonable MRI and X-ray services; billed for work performed by unqualified personnel; and received funds for being a rural health clinic when it did not meet Medicare requirements.
Source: blogspot.com

Criminal Justice News: Detroit Medical Clinic Owner Pleads Guilty to Medicare Fraud Scheme

According to the plea documents, Villa owned Blessed Medical Clinic in Livonia, Michigan. Villa admitted that he hired patient recruiters who paid cash bribes to Medicare beneficiaries to attend the clinic and provide their Medicare numbers and other information. Villa admitted that he used the beneficiary information to bill for medically unnecessary diagnostic tests and treatments. According to court documents, Blessed Medical Clinic fraudulently billed Medicare $2.4 million during the course of the scheme.
Source: blogspot.com

You Gotta Know When to Hold 'Em and Know When to Fold 'Em :: Health Care Fraud Blog

So, what do we know? We know that according to statistics kept by the U.S.Sentencing Commission and Department of Justice, 93.6% of federal criminal defendants plead guilty. Of the remaining 6.4% of defendants who go to trial, more than three out of four (75.6%) are convicted. In other words, 97% of all federal criminal defendants are sentenced and 82.8% actually serve time in prison. So, there it is. Cut and dried. Black and white. Hey! Are you hearing me? I’m talking to you! Pay attention! Let me say it again: only 3% (.03%) of all the defendants accused of committing a crime in federal court walk out Scot free. I would venture to say that the statistics for those charged with Medicare fraud are even more lopsided in favor of the government and will report on that once my analysis is completed.
Source: healthcarefraudblog.com

There is plenty of help available for those who aged or disabled that qualify for Medicaid.  Medicaid for low income individuals who are either aged, 65 or older, or disabled is called Supplemental Security Income (SSI) Related Medicaid.  When looking for a customer service center to submit a Medicaid/Medicare Buy In Application make sure to access this link.  Once again, it would be naive to pass up opportunities to receive medical assistance when it is provided by the Federal Government and the state government of Florida.
Source: jwtaxhelp.com

Video: Patty and Richard say, “Apply online for Medicare” (20 seconds) – Social Security

15 Important Advantages of Employing Online Enrollment

For this reason, there is absolutely no threat even in supplying the personal information within the on-line sign up types. Automatic Payment Collection You possibly can safely and securely gather on the web payments produced via plastic cards along with other transaction gateways, including PayPal yet others, with all the internet-dependent enrollment computer software. Course Your Online Sign up It is simple to maintain the a record of the particular signal-upwards method by simply receiving automated proof messages, when every person does filling up the design. Send out Email messages to Your Participants Send out invites, notifications, along with RSVPs in order to event attendees relating to your found and also upcoming plans. The web based sign up software program can routinely send out a new stick to-up e-mail to the participants, notifying them after their own repayment is obtained plus the couch can be earmarked. Integrated Marketing strategy Your effective, but basic marketing strategy can often encourage promising small to big corporations on numerous on the internet websites. You possibly can open up company accounts upon Facebook Twitter, and other web sites to begin the virus-like marketing of this solutions. You can even present savings as well as promo codes for you to any particular or almost all goods to inspire along with convince buyers to obtain and employ the same. Constructed-inside Reports Center You will get many accounts based on your ticket income, enrollment status, and also repayment exchanges. The net reporting device helps you assess along with measure your own event’s functionality info, and even shop your reports within accommodating formats to fit your company as well as. Experience an Immediate Dash panel The online action instrument cluster lets you view and manage the particular occasions enrollment as well as repayment technique from the one platform. You can view the actual profits along with products reputation of your ongoing situations via this activity instrument cluster provided by this kind of Impair-centered examine-within system.
Source: ezinemark.com

Apply for Social Security Benefits Online

Patty Duke applies for benefits If you file online, you’ll be in good company. Stage, screen and TV actress Patty Duke recently celebrated her 65th birthday by going online to file for Social Security and Medicare benefits. As you’ll see if you watch this video, Duke had a bit of help from her husband, Michael Pearce, but her application took only a few minutes to complete. For the past three years, Duke has volunteered her time to promote Social Security’s online services in a series of public service announcements.
Source: aarp.org

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Source: vanara.com

How to Online Apply for Medicare

5. Before starting Medicare insurance process, you will need applied information of social security benefit. If you are an already applicant for benefit, click on the “Continue Application”. Otherwise fill up the right side benefit application and click “Apply for benefit” 6. To continue medical insurance process click on the “Continue Application” button. In the next steps; enter your Social security number and others secure information to apply online. 7. Remember that, the online service are available Monday to Friday (5Am-1Am), Saturday (5am- 11 pm), Sunday (8am-10pm) and any holiday (5am- 11pm). 8. After completing Social security enrollment process, go to the Medicare website. And sign up in Medicare website to order use the service. 9. If you feel that it’s difficult please call at 1-800-772-1213 or visit your nearest office. To apply physically you will need birth certificate, driving license, and social security card and if you have any others proof insurance document.
Source: idealsuggestion.com

Governor Romney has proposed $5 trillion in additional tax cuts over the next decade, over and above the Bush tax cuts. The largest cuts would go to families at the top, while 18 million working families would see their taxes increase by an average of $900, including 150,000 here in New Mexico. The average millionaire would get a $250,000 tax cut, but 34 percent of working New Mexico families with children would see their tax bill go up. Romney would also completely eliminate taxes on all estates, no matter how large. And large corporations would see their tax bills cut by nearly 30 percent at a cost of $1 trillion over 10 years.
Source: scsun-news.com

Video: Dozens charged nationwide in $163M Medicare scam

Highmark (MAC Jurisdiction H) Dates Released

The Centers for Medicare & Medicaid Services (CMS) recently released the Medicare Administrative Contractor (MAC) transition dates for Jurisdictions 4, which covers Texas, Colorado, New Mexico and Oklahoma,  and 7, which covers Louisiana, Arkansas and Mississippi.  As previously reported, CMS is consolidating these two jurisdictions into a new Jurisdiction H, and has awarded the contract for administering all Medicare Part A and B operations to Highmark Medicare Services. After an unsuccessful appeal by TrailBlazer Health Enterprises and Pinnacle Business Solutions, the current MACs for these regions, implementation is moving forward.
Source: lilesparker.com

Pilot ‘competition’ effort saved Medicare $200 million

In its report, Medicare said it closely monitored the health of beneficiaries likely to use home equipment in the nine areas involved with the competitive bidding experiment. It then compared the results to data for beneficiaries in other similar areas where competitive bidding has not been instituted yet. Using yardsticks such as emergency room visits and nursing home admissions, it found no significant differences.
Source: azcentral.com

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New Poll: New Mexicans Overwhelmingly Support Medicare, Medicaid

[...] [...] The poll, which was conducted by Research and Polling, Inc., for six advocacy groups, shows that the vast majority of voters (83 percent) believe Medicaid is important to residents in New Mexico with 66 percent saying Medicaid is very important. Medicaid is the health program for the disabled, seniors in nursing homes, low-income children, and impoverished families. The majority (59 percent) of voters do not believe there should be any reductions in Medicaid spending as a way to reduce the federal debt.Source: nmvoices.org [...]Source: nmvoices.org [...]
Source: nmvoices.org

Of course, reform will continue in some for form or another.  Some of it aimed at driving value, others simply driving profit on niche marketing access to select services. Most health professions, systems and insurers want/need the former.   It is clear to them that from the debate over the enactment of Obamacare, national policy-makers have chosen to pin our future on private health care and private insurance rather than our current mixed public/private bag or a single payer or all-payer alternative.   Only informed consumers making value-based choices will make private markets work.  Without competitive insurance markets and expanded coverage consumer choice will not have the impact on cost containment that it must have.  Without competitive markets and informed consumer choice, the financial incentives communities and care providers need to reduce the cost of unnecessary care are gone and we regress to the mean old price/cost escalation.
Source: nihp.org

Video: Part 2: Romney greeted in Eagan MN by seniors waving “Mitt(s) Off My Medicare!” Signs

The 100 Top U.S. Hospitals

To conduct the 100 Top Hospitals study, Thomson Reuters researchers evaluated 2,886 short-term, acute-care, non-federal hospitals. They used public information — Medicare cost reports, Medicare Provider Analysis and Review (MedPAR) data, and core measures and patient satisfaction data from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website. Hospitals do not apply, and winners do not pay to market this honor.
Source: ftnnews.com

Rochester Medical Supply Tech Job

Job Posting Number: 11744BR Job Posting Title: Medical Supply Tech Job Posting Category: Other Patient Care Support Services Work Site: MN – Rochester Building: Brackenridge Building Department: Mayo Clinic Store Job Description: Responsible for providing technical support in supplying appropriate DME products. Deciphers prescription to ensure accurate data entry, insurance claims submission and product selection. May act as a liaison between patient and insurance company. Interacts with patients to ensure quality service. Basic Qualifications: High school diploma required. Direct customer interaction experience necessary. One year retail experience within the last five years required, or three years health care experience in lieu of. Other Qualifications: Two years post secondary education a plus. Computer capability and keyboarding experience required. Good math aptitude, spelling skills, and cash register fundamentals necessary. Proven ability to work in a fast paced environment, to be able to multi-task and to make decisions affecting patient care. Knowledgable on Medicare and Medicaid billing. Understands third party billing issues. Basic knowledge of PC Windows and Microsoft Word required plus ability to be proficient on Mayo Clinic and internal store software. Must be team oriented and have strong skills in communication, problem solving and organization. License or Certification: DME Train and Store technician certification as defined by Mayo Clinic Store. Benefit Eligible: Yes Exemption Status: Non-Exempt Hours/Pay Period: 60 Compensation Detail: Education, experience, and tenure may be considered along with internal equity when job offers are extended. The minimum pay rate is $14.64 per hour. Staffing Specialist: Chad Musolf Mayo Clinic is an affirmative action / equal opportunity educator and employer.
Source: mayo-clinic-jobs.com

PoliGraph: Cravaack Medicare claim misses on numbers

The feature examines statements made by Minnesota politicians and checks them for accuracy. Based on data analysis, document reviews and interviews with non-partisan analysts, statements are rated either true, false or inconclusive. PoliGraph is a collaboration between Minnesota Public Radio News and the Humphrey School of Public Affairs at the University of Minnesota. More
Source: publicradio.org

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Source: governmentjobsin.org

Daily Kos: New poll: Cutting Medicare, Social Security are non

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Source: dailykos.com

St. James Phlebotomist Job

Job Posting Number: 12148BR Job Posting Title: Phlebotomist Job Posting Category: Clinical Labs Work Site: MCHS – SW MN – St. James Department: Laboratory Job Description: Procures the appropriate specimen in a safe, accurate, and professional manner wtih the proper technique. Enters laboratory tests into the computer information system, ensuring compliance with Medicare regulations. Oversees referred testing, including laboratory tests, Department of Transportation specimens, and pathology and cytology specimens. Performs other teting as requested. Communicates effectively and works cooperatively with others, and promotes customer service, to optimize job performance and foster working relationships. Participates in activities inside and outside of department, including committees, special events, system initiatives, continuing education. Basic Qualifications: Experience : Experience working in a medical field, preferably laboratory or patient-care related. One year in a similar position. Education: High school diploma required. Medical assistant or certified phlebotomist training preferred. Other Qualifications: Training: Military trained, on the job, or preceptor. License or Certification: Basic Life Support (BLS) certification. Drivers License required. Benefit Eligible: Yes Exemption Status: Non-Exempt Hours/Pay Period: 80 Schedule Details: Monday through Friday, 8:30am-5:00pm Staffing Specialist: Amber Lyon Mayo Clinic is an affirmative action / equal opportunity educator and employer.
Source: mayo-clinic-jobs.com

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Source: wordpress.com

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Source: allthearticles.com

Medicare Supplemental Health Insurance Resources Online

When looking into health insurance of any kind the rules, regulations and stipulations often make it so that every word on the policy seems foreign and a bit sketchy. The policy is never laid on it terms that one without industry knowledge would completely understand. Words such as co-payment, deductible, family allowance, preventative vs. routine care often times add confusion in really understanding what is being offered. Health Insurance in general is difficult to understand and often leads us to believe we are being manipulated let alone getting into the next generation of health insurance, Medicare. How is one to determine exactly what is being offered and to finally settle upon a policy that best fits the need with Medicare and Medigap supplemental insurance policies?
Source: business-profit-pro.com

Medicare Leads: Going into the Minds of seniors

Speaking of insurance and how important it is for everyone to be secured is in a small sense, a necessity for peace. People would sleep better knowing that their doors are locked and it’s that kind of peace of mind that security helps with. Now when it comes to Medicare, we first have to understand the type of people who look for this type of insurance.
Source: americanleadproviders.com