The Medicare Annual Enrollment Period Myth

Posted by:  :  Category: Medicare

This entry was posted in Uncategorized and tagged annual election period, annual enrollment period, compare, how to change medigap plans, how to change plans, how to switch medicare supplement companies, medicare, medicare advantage, medigap, part d, plan, plans, quote, quotes, supplement, supplemental, when can you change medicare supplement plans, when can you change medigap plans, when can you switch medicare plans, when is the medicare annual enrollment period, when is the medicare annual enrollment period this year. Bookmark the permalink.
Source: medicare-supplement.us

Video: Learn About Medigap Plans

Best Medicare Supplement Plan

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Source: medicare-supplement-comparison.com

Medicare Supplement Insurance Still Worth The Cost

Even if you supplement Medicare with a Medicare Part D Prescription Drug plan, you may also enroll in one of the ten Medigap plans. During a six-month period that begins on the first day of the month in which you become 65 and you are enrolled in Part B, your application for a Medigap plan is guaranteed to be accepted regardless of your health problems. You may switch to a different plan during this time, and guaranteed acceptance also applies to the application for the other plan.
Source: online-business-expert.com

Medicare Supplement Insurances

In order to get Medicare Supplement Insurances when using a health quote service, you will need to provide basic information such as your age and gender.  You will get a number of different insurance policies from different providers to review the prices and policy figures from all the different providers.  You can pick out those insurance plans that give you exactly what you need and that are within your financial reach.
Source: emhhealthcarejobs.com

AARP Medicare Supplement Plans (2012 Rates, Summaries and Application) « Insurance News from Crowe & Associates

Plan K supplement- Plan K was brought into the market overpriced but is now worth taking a look at after 2 years of rate reductions.   This plan offers a much lower premium but leaves much more potential for out of pocket cost vs. Plan F and N.   Those seriously considering a plan K would likely be better suited to choose the Anthem BlueCross BlueShield Plan F High Deductible Supplement with a monthly premium of about $35.00 a month at this point
Source: croweandassociates.com

U.S. Gauges Fiscal Condition of Social Security & Medicare

Posted by:  :  Category: Medicare

Bailout is Bullsh*t. by eyewashdesign: A. GoldenClara Barton died 100 years ago on April 12, 1912. Between 1861 and 1868, she lived in a Washington, DC boarding house and employed as many as twelve clerks in her “Missing Soldiers Office.”  In 1996 the General Services Administration was preparing the building for demolition when they discovered artifacts eventually proving that this was the lost office of the founder of the American Red Cross. 
Source: c-span.org

Video: Medicare & You: Medicare Part C and D Enrollment

Tricare Help – How can I get information on Medicare Part C?

In addition, prescription drug costs through TFL are less costly than under Medicare Part D. In fact, the Defense Department advises that the only people who may benefit from Part D coverage are those whose incomes are so low that they qualify for financial aid to pay their Medicare Part B premiums. Moreover, enrollment in Part D will preclude your use of the Tricare Mail Order Pharmacy program, under which you can get a 90-day supply of drugs for the same price that you would pay for a 30-day supply from a local retail pharmacy.
Source: militarytimes.com

Medicare Advantage (Medicare Part C)

Currently the new administration in the government is trying to “overhaul” healthcare in this country. Medicare is one of the programs that is intended for these changes. It is imperative that you become aware of any and all changes that take place in your Medicare Advantage policies due to these congressional rules. It is too early to tell yet if these changes will dramatically affect your policies. Make sure if you receive any correspondence from your insurer that you read it carefully to make sure you are aware of any changes.
Source: medicarepart.us

First in Series on Medicare DSH and Top Cost Report Appeal IssuesHall Render Blogs

One key appeal rule change requires cost reports ending on or after December 31, 2008 to have all appeal issues included as Protested Items in Line 30 on Worksheet E, Part A.  Please ensure that your potential appeal issues are being preserved when you file your cost report.  It is also possible to file an amended cost report prior to the issuance of the NPR for that year.  If you protest more than one issue, please ensure that you are itemizing each issue and the impact.
Source: hallrender.com

CMS Releases New Medicare Advantage and Medicare Part D Rules, Implements Several Provisions of ACA : Duane Morris Health Law

On April 12, 2012, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule with comment period (“Final Rules”) implementing changes to the Medicare Advantage program and Medicare’s prescription drug benefit program, referred to as Medicare Parts C and D, respectively. Part C and D plan sponsors and other participants should carefully review the changes, particularly those related to increased transparency and exclusion from Parts C and D. The Final Rules are the latest effort by CMS to improve accountability, transparency, and effectiveness of the Medicare program. 
Source: duanemorris.com

Transcript: Blahous on the 2012 Social Security & Medicare trustees report

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Source: whatthefolly.com

Medicare Waste, Fraud and Abuse

The panel denounced Medicare’s “overly broad use of demonstration authority” and said “limited Medicare dollars should go to truly high-performing plans.” It said “the extension of quality bonuses to the vast majority of plans is likely to result in far greater program costs than the reward system enacted” by Congress, and that by spreading the rewards so broadly, “the demonstration lessens the incentive to achieve the highest level of performance.”
Source: georgia-medicareplans.com

Registration Began for Medicare EHR Incentive Program

Posted by:  :  Category: Medicare

By: Shortly after the new year, eligible physicians and hospitals began registering for the Medicare electronic health records (EHR) incentive program, a prerequisite for obtaining billions of dollars in available federal bonuses. Implementation of this program will streamline health information services and provide more efficient patient care delivery. Here is some information that will help you understand the registration process for the Medicare EHR incentive program, which began on January 3rd. Projected Rollout Not all areas of the country will be implementing registration at the same time, so it is important to have an EHR representative to guide your facility through the process. Registration for the EHR incentive program will launch in January for Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas. In February, registration will open in California, Missouri and North Dakota. According to the Centers for Medicare and Medicaid Services (CMS), the remaining states will launch their EHR incentive program sign-ups in the spring and summer. Resources Available Officials with the CMS and the National Coordinator for Health Information Technology said they hope for broad registration by doctors and hospitals. The CMS website has numerous resources to provide physicians and hospitals with the latest information regarding the program. Any clinician or hospital staff member who will be using EHR technology is encouraged to visit the website for the latest news and updates that will impact implementation of the program at the local level. Registration and Other Deadlines Physicians who want to participate must register in either the Medicare or Medicaid EHR incentive programs, but they must choose only one program — they cannot receive payments from both. However, after receiving a bonus for a given year, a physician may change a program selection once before 2015. To register, consult your EHR representative, who will guide you through the registration process. The CMS website requires a 15-digit number for the certified EHR. If you have a 13-digit number (with two special characters), simply put two zeros (00) before the 13-digit number and omit the dashes. In 2010, standards were set that doctors and hospitals must meet to demonstrate meaningful use of their EHR systems. Physicians can receive as much as $44,000 over a five-year period through Medicare and up to $63,750 over six years through Medicaid. Recently, the first incentive payments were disbursed. The Gastorf Family Clinic of Durant, Oklahoma, a client of eMDs, was the nation’s first physician recipient of the electronic health records incentive payment program administered through Medicare. To get the maximum incentive payment, Medicare eligible professionals must begin participation by 2012. There are a number of key deadlines in 2011 that must be met in the implementation of the EMR program. For more information regarding those deadlines, consult your EHR representative. e-MDs offers a host of affordable, certified EHR solutions for physicians and facilities looking to modernize or enhance their services with the latest electronic health records technology. e-MDs is committed to providing affordable and integrated EHR and Practice Management Software solutions, including clinical, financial and document management modules designed to automate medical practice processes and chart management – delivering the clinical tools needed to succeed in today’s health care environment. You can find additional detailed information about all the different services and benefits an EHR system has to offer your practice by contacting a representative right now at 1.888.344.9836 or sales@e-mds.com, or visiting them online at www.e-mds.com. Heather Preston EMR – e-MDs powerful software can help manage your EMRs. Article Courtesy of Articles Location
Source: articleslocation.com

Video: LifeChoice Oxygen Featured on Good Morning Texas

Medigap Plans Available in Texas for all Seniors

Simply because plans are standardized does not mean different insurance companies will be the same. There are stark differences in cost, dependability and reliability that must be taken into consideration. You may be able to find a great plan for less, but be wise when choosing coverage and stay with household names you know and trust for delivering benefits on time and when you need them most. Companies like United of Omaha or Blue Cross Blue Shield of Texas have worked hard to gain the trust of Texans by providing coverage they can depend on.
Source: medicareinsurancetexas.com

Texas Health Insurance Blog

Hi, I’m Wiley Long, President of eTXHealthinsurance.  If you are looking for health insurance in Texas, let our professional health insurance advisors find you the best Texas Health Insurance Plan to meet your personal needs.  You can get instant Texas Health Insurance rates and compare plans from many companies like Blue Cross Blue Shield of Texas, Aetna of Texas, and many more.  We are proud to serve residents of Texas with a dedication to customer service, large networks, and the best rates available. You can also find Medicare Supplement insurance if you are on Medicare or are about to become eligible for Medicare.
Source: etxhealthinsurance.com

Court: Social Security Beneficiaries Cannot Drop Medicare Eligibility

In the case, five plaintiffs — including former House Majority Leader Dick Armey (R-Texas) — said that they would prefer not to be eligible for Medicare benefits because their private health plans limit coverage for people who qualify for the program (Pecquet, “Healthwatch,”
Source: californiahealthline.org

Durable Medical Equipment Austin Texas Medicare Eligible

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Source: beckfamilync.com

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

Eligibility For Medicare Supplement Insurance

When thinking about acquiring Medicare supplemental insurance quotes in Texas, it truly is important to help keep in thoughts that the distinction in charges from many different providers can differ drastically. Even though the coverage is essentially the same, the price tag an person pays is most certainly not. Getting a quote for supplement insurance coverage is completely crucial ahead of getting a program. Plans typically covered just an individual so if there’s more than one particular person within the household insured by Medicare, they will every single need to acquire their very own supplemental insurance plan. An excellent quantity of men and women make the mistake of believing that Medicare is all of the insurance coverage that they’ll need to have only to locate out also late that the gaps in its coverage have confirmed to become financially devastating.
Source: kenaiguiding.com

Romney Proposes Raising Medicare Eligibility Age in 2022

February 24, 2012 Suehs Signs Rule Banning Abortion Affiliates – “If there was any hope that the state was seeking a compromise with the federal government over Texas’ Women’s Health Program, it’s fading fast. At the direction of lawmakers and Texas Attorney General Greg Abbott, the Texas Health and Human Services commissioner signed a rule on Thursday that formally bans Planned Parenthood clinics and other “affiliates of abortion providers” from participating in the program — something the Obama administration has said is a deal-breaker for the nearly $40 million-per-year state-federal Medicaid program.”
Source: talkleft.com

Social Security may go broke by 2033; Medicare in 2024

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Source: theeagle.com

Medicare Advantage Plans Texas – Eligibility and Plan Options

The Medicare Advantage plan comes as a significant part of the original medicare policy, and incorporates the coverage benefits of the traditional Plan A and Plan B Medicare plans, and other supplemental coverage as well. Any Texas resident can secure a medicare advantage policy, given that the individual qualifies the standard eligibility criteria for the same. To qualify for Medicare Advantage plans Texas, you must live in the constituency or area that has the plan, and must also have both the Medicare Plans Part A and B. However, if you are suffering from some end-stage renal disease, you may not qualify for the same. But a plan cannot drop you if you are diagnosed with the disease while already being a part of the plan.
Source: mclaininsurancegroup.com

JAMA Forum: Innovation Isn’t Easy When it Comes to Medicaid

How can states possibly account for that difference? Where’s the magic in innovation? If states refuse to cut benefits and spend the same per enrollee, then even if the Medicaid expansion of the ACA never takes place, an additional 19 million people need to be dropped from the 2021 Medicaid rolls to meet budget cuts. That’s about one-third of all people on Medicaid. If states cut benefits or somehow slow spending to that of GDP growth, they still need to remove 13.8 million people from Medicaid in 2021, in addition to forgetting the ACA Medicaid expansion. If states act to protect the elderly and blind or disabled persons by holding their spending/benefit reduction to 10% (which is still a large cut), then 27 million people, most of them children and pregnant women, need to be dropped from Medicaid in 2021 even if ACA’s Medicaid expansion never occurs.
Source: jama.com

Iowa House Approves Mental Health Reforms

Posted by:  :  Category: Medicare

The Real Romney by elycefelizCalifornia Healthline: Health Debt Bill Passes Committee When she first found out she had multiple sclerosis, [Melanie] Rowen had health care insurance but her medication was still expensive. “My insurance plan required me to pay 30% of it,” Rowen said. “I couldn’t afford it, but I put it on credit cards.” As she watched her disease progress, she saw her bank account drain away and her health care debt pile up. Assembly member Fiona Ma (D-San Francisco) hopes to prevent similar scenarios with AB 1800 which would establish a limit on annual out-of-pocket expenses for prescription medications for insured Californians (Gorn, 4/25). 
Source: kaiserhealthnews.org

Video: Iowa Medicare Supplement Insurance | Call: 515-994-0471

Iowa Medicare Part D Plans

The above list is relevant if you choose to receive your health coverage from original Medicare or if you have purchased a Medigap policy. But you may choose to enroll in a Medicare Advantage plan. Many Medicare Advantage plans include Part D coverage. If you have decided to enroll in an Advantage plan be sure to review the Part D formulary for that plan as it may vary from a stand-alone plan offered by the same company.
Source: partdplanfinder.com

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

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Source: dailykos.com

Registration Began for Medicare EHR Incentive Program

By: Shortly after the new year, eligible physicians and hospitals began registering for the Medicare electronic health records (EHR) incentive program, a prerequisite for obtaining billions of dollars in available federal bonuses. Implementation of this program will streamline health information services and provide more efficient patient care delivery. Here is some information that will help you understand the registration process for the Medicare EHR incentive program, which began on January 3rd. Projected Rollout Not all areas of the country will be implementing registration at the same time, so it is important to have an EHR representative to guide your facility through the process. Registration for the EHR incentive program will launch in January for Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas. In February, registration will open in California, Missouri and North Dakota. According to the Centers for Medicare and Medicaid Services (CMS), the remaining states will launch their EHR incentive program sign-ups in the spring and summer. Resources Available Officials with the CMS and the National Coordinator for Health Information Technology said they hope for broad registration by doctors and hospitals. The CMS website has numerous resources to provide physicians and hospitals with the latest information regarding the program. Any clinician or hospital staff member who will be using EHR technology is encouraged to visit the website for the latest news and updates that will impact implementation of the program at the local level. Registration and Other Deadlines Physicians who want to participate must register in either the Medicare or Medicaid EHR incentive programs, but they must choose only one program — they cannot receive payments from both. However, after receiving a bonus for a given year, a physician may change a program selection once before 2015. To register, consult your EHR representative, who will guide you through the registration process. The CMS website requires a 15-digit number for the certified EHR. If you have a 13-digit number (with two special characters), simply put two zeros (00) before the 13-digit number and omit the dashes. In 2010, standards were set that doctors and hospitals must meet to demonstrate meaningful use of their EHR systems. Physicians can receive as much as $44,000 over a five-year period through Medicare and up to $63,750 over six years through Medicaid. Recently, the first incentive payments were disbursed. The Gastorf Family Clinic of Durant, Oklahoma, a client of eMDs, was the nation’s first physician recipient of the electronic health records incentive payment program administered through Medicare. To get the maximum incentive payment, Medicare eligible professionals must begin participation by 2012. There are a number of key deadlines in 2011 that must be met in the implementation of the EMR program. For more information regarding those deadlines, consult your EHR representative. e-MDs offers a host of affordable, certified EHR solutions for physicians and facilities looking to modernize or enhance their services with the latest electronic health records technology. e-MDs is committed to providing affordable and integrated EHR and Practice Management Software solutions, including clinical, financial and document management modules designed to automate medical practice processes and chart management – delivering the clinical tools needed to succeed in today’s health care environment. You can find additional detailed information about all the different services and benefits an EHR system has to offer your practice by contacting a representative right now at 1.888.344.9836 or sales@e-mds.com, or visiting them online at www.e-mds.com. Heather Preston EMR – e-MDs powerful software can help manage your EMRs. Article Courtesy of Articles Location
Source: articleslocation.com

What is the Medicaid Estate Recovery Program?

* Member States should continue to offset the costs of medical care consists of: * Nursing home or other long-term outpatient services; * Home and Community Services; * Services for prescription drug addiction and at the same time the recipient has received a nursing facility or home care services and community and * At the discretion of the State, all other matters covered by state Medicaid.
Source: hddrecovering.com

Obama’s $8 Billion Cynical Ploy

But along came a Government Accounting Office (GAO) report released yesterday which recommends that HHS cancel the project. The GAO said the project “dwarfs all other Medicare demonstrations” in its impact on the budget and criticized its poor design. “The design of the demonstration precludes a credible evaluation of its effectiveness in achieving CMS’s [Centers for Medicare & Medicaid Services] stated research goal,” according to the report. As the Wall Street Journal puts it in this editorial, “there’s no control group to test which approaches work better. It’s a demonstration project without the ability to demonstrate.” Senator Orrin Hatch of Utah, the senior Republican on the Finance Committee, and Representative Dave Camp, chairman of the Ways and Means Committee, released a statement in which they said they were concerned that the government might be “using taxpayer dollars for political purposes, to mask the impact on beneficiaries of cuts in the Medicare Advantage program.”
Source: commentarymagazine.com

If The Health Care Overhaul Goes Down, Could Medicare Follow?

Posted by:  :  Category: Medicare

Canberra Medicare Stall 7 by Greens MPsSo why are experts so worried? One reason is that the law changed the payment rates for just about every type of health care professional who treats Medicare patients. Every time Medicare sets a payment rate, it needs to cite a legal authority. And for the past two years that legal authority has been the Affordable Care Act. So if the law is found unconstitutional every one of those changes “doesn’t exist anymore because the law doesn’t exist.”  (Source: Kaiser Health News)  [Read article]
Source: worh.org

Video: Rally outside Cory Gardner’s office to save Medicare

Medicare’s Dirty Little Secret It’s already insolvent.

A sensible solution would be to offer Medicare beneficiaries the option of a defined-contribution program — as proposed by House Republicans and Mitt Romney. Seniors would be budgeted an annual contribution, which could be adjusted to reflect costs associated with their health status and financial wherewithal. For the federal budget, the result is a capped exposure to Medicare — one that would adjust to reflect the number of seniors and inflation.
Source: healthinsbrokers.com

Returning a Medicaid Dental Overpayment: Part II

To be clear, we recognize that many dental offices may have copied draft Compliance Plans off of the internet or purchased a sample plan from their local association.  While they may fully intended to follow through with personalization of the draft document, in most of the cases we have seen, more pressing events have taken precedence and these dentists have not had the time or expertise to complete the project.  As a result, we recommend that you engage qualified legal counsel to assist you with this project.  The benefits of an effective Compliance Plan can be significant, and could conceivably mean the difference between an aggressive investigation and a mere cursory review by the government once they learn that you have taken multiple steps to better ensure that your operations and practices fully comply with applicable Federal and State requirements.
Source: lilesparker.com

It’s Ayn Rand Bashing Time, Once Again

The critics entirely misunderstand the Randian philosophy. Suppose Ragnar Danneskjold (my favorite character in Atlas) breaks into the illegitimate government’s coffers, liberates (it is logically impossible to steal from an illicit state) some treasure, and turns it over to Hank Rearden. Is that a just act? Of course. Indeed, it is one of the high points of Atlas, a book which, I assume, has never been read and understood by her present critics. But the act of liberation and then transfer to Rearden consists of two parts. One, seizing the money from the government, and, two, subsequently giving it to Rearden. If the entire act is to be legitimate, then each of the two constituent parts of it must be proper. Two wrongs cannot make a right. Thus, in Rand’s view, it is entirely proper to relieve the (illegitimate) government of its ill-gotten gains (the first part of this dual act). Was the U.S. a legitimate laissez faire government during the years that Ayn Rand accepted payments from Social Security and Medicare? To ask this question is to answer it: of course not. Thus, it would have been entirely proper for Ragnar to raid the Social Security and Medicare offices and make off with their stolen wealth, and, then, to give the proceeds to an innocent, such as Ayn Rand. If so, where is the hypocrisy of Ayn Rand accepting payments directly from these government bureaus? It simply does not exist. Similarly, she and all other libertarians are fully justified in mailing letters with the US post office and thus accepting the implicit subsidy therein, and, also, walking on the socialist sidewalks, driving on the socialist roads, using money issued by our central bank, eating subsidized food, etc. It is improper to give money to the illicit state, not to take from these bureaucrats. Did Ayn Rand ever contribute money to the semi-socialist-fascist government? If she did, then and only then would her critics have a case. But, of course, she never came within a million miles of doing any such thing.
Source: psychologytoday.com

Hall of Record: Cut 2% Annually From Federal Spending

  In one infamous case, a New York dentist once billed that state’s Medicaid program for 991 procedures in a single day. In 2005, the New York Times reported that New York’s Medicaid program “has become so huge, so complex and so lightly policed that it is easily exploited,” and that “a chief state investigator of Medicaid fraud and abuse in New York City said he and his colleagues believed that at least 10 percent of state Medicaid dollars were spent on fraudulent claims, while 20 or 30 percent more were siphoned off by what they termed abuse, meaning unnecessary spending that might not be criminal.”
Source: blogspot.com

Scam on Senior Citizens: The Truth about Obama’s Medicare Advantage Cuts, Government Accountability Office “Smelled a Rat” Hiding in President’s Political Ploy (video)

Tags: 2012 election, 2012 reelection, America, America’s health care, Barack Obama, bonus, bonuses, CMS, Congress, Democrat lies, Democrats, demonstration project, doctor, elderly, elderly people, election, federal government, fraud, GAO, GOP, Government Accountability Office, government health care, government lies, government program, government-run health care, government-run healthcare, health care issue, health care nightmare, health insurance, hoax, hospital, insurance, left-wing fraud, low income families, medical, medical treatment, Medicare, Medicare Advantage, Medicare fraud, medicine, minorities, Nancy Pelosi, Obama, Obama election, Obama fraud, Obama health care, Obama reelection, ObamaCare, old people, political lies, Pres. Obama, Pres. Obama lies, reelection, Republicans, retire, retiree, retirement, retirement age, scam, senior, senior citizens, seniors, socialized health care, socialized medicine, taxpayers, Team Obama, waivers
Source: frugal-cafe.com

Forced to Sit Still and Shut Up

I would like to say that last week was the week from hell.  But it could have been worse.  Mentally, I almost lost it,  but all through the week,  I had to keep my cool so as to keep my health and immunity, and not raise my blood pressure.  And of course, since I have auto-immune conditions — the worst of which are my allergies — my mental condition had to stay within control.  What happened was so out of my control that I had to give up any attempt to take control, and that meant I had to accept that the people involved are stupid, inept, non-caring, and nothing more than government drudges who are programmed like robots, to do and say certain things, regardless of the fact that they hold the fate of a human being in their hands.  As you read this, understand that I am a comparatively young, and very educated and intelligent person of pretty sound mind.  Also keep in mind that if this happened to me, it has to be happening to millions of other people, most of whom are older than I, and be not with as sharp a mind as I have.  Most of all, I could be your parent, grandparent, friend, any family member or loved one.  I don’t think anyone really appreciates the fatigue that goes along with a neuromuscular disease. I have Medicare, since I had to leave my job in late 2004, and collect Social Security Disability. Anticipating that I would need round-the-clock care, Eileen, the social worker at the ALS clinic at the time, referred me to an eldercare attorney, and I got into a pooled-income trust.  In order to get all that home care, you have to get on Medicaid.  The pooled-income trust takes everything except the under-$800 I am allowed to keep. The trust pays my monthly bills. with the money I send them, which is everything else. Without the trust,  I would have to go down to the Medicaid office every month and present my bills to have my Medicaid “turned on” and make sure there were no gaps, or I would have Medicaid “turned off” and would have to have it “turned on” again.  Instead — in my case — I just have to stay in the trust by re-certifying every year. Recertification:  Every year, I receive the appropriate form in the mail about 4-6 weeks before the due date.  This gives me time to gather about 50 documents that have to be attached, and which give me certain information that goes on the form.  Then, for my own protection, I never let anything leave this house without making copies.  My multi-function printer/scanner/copier is not all that fast, so it’s a tedious process. It’s also a fatiguing activity for me, especially since this damn new wheelchair has obnoxious footrests that don’t fold up like my old ones, and it’s tiring to keep reaching for files, because I can’t park the wheelchair close enough to the file cabinet.  It’s hard for anyone to help me, because it’s a lot faster for me to find the files and not have to talk to someone to give directions. On Sunday, April 15, I pulled my wheelchair up to my desk, and it gave a jump and and landed the right arm containing the joy stick, under the desk, and the control bent totally upward so I couldn’t move the wheelchair.  Sunday is TV night for me — my three favorites all in a row 8PM “The Amazing Race”, 9PM “The Good Wife” and 10PM “Mad Men”.  Well, the Race was about to start, and I couldn’t move, and my back was to the TV. G, my aide is not good in a crisis.  I was trying to tell her to put the wheels in manual and pull me back.  She never got me the iPad or writing board and the frustration was mounting and my voice went up two octaves. G. said she couldn’t deal with “this strange voice” and panicked even more.  I finally convinced her to get the doorman, who if you compare him to the sharpness of the knives in the drawer, he’s the butter knife.  It was like a scene from “Confused and Dumber”.  Finally, we called 9-1-1 and two cops came and shifted the wheels while lifting the desk a bit, and I was free.  Except that my joystick was forever bent because it was in that position for a full hour.  My “Amazing Race” was over, and “The Good Wife” was about to start, but the stress was there; you could cut it with a knife.  Not only was I stressed out that there had to be such drama, but now I knew there would be challenges driving the wheelchair until it was repaired.  The process of getting the repair approved through Medicare is a long and involved one.  If the wheelchair had been pulled back immediately after this happened, rather than almost an hour later, the damage wouldn’t have been as serious.  But I didn’t feel like arguing about fault, or about how “unsafe” it is, and certainly not about how the aide had to get the doorman as a “witness” so I wouldn’t get her in trouble or say that my voice change to a higher pitch was because she was abusing me.  The woman has been with me for five years, and I asked her one question: “So in a crisis, you are more concerned with how it looks for you, than helping  me?”  I knew the answer.  I just wanted to watch “The Good Wife” and “Mad Men” Back in February I called my case worker JP because I knew my recertification was coming up again, and I told him I would download the M11q doctor’s form and bring it to my clinic appointment.  He told me that the form was due like right now.  So of course I told him I would get an appointment at the ALS clinic as soon as possible and have the form signed.  He warned me that I’d better get it in soon, or my Medicaid will be cut off.  I went to clinic on March 2, and the next day sent my aide to UPS to fax it.  But first we have to call JP,  because even if I put the fax to his attention, it goes right to the Central Office and nobody gives it to him.  So he has to be at the fax when the fax comes in, or someone else will snatch it.  I’m not making this up.  So when my aide calls him, he says “Why are you sending this to me?  I’m not showing in my computer that it’s due.”  My aide reminds him that he threatened me with cutting off my Medicaid.  He says “I did?”    I call him and ask him about the recertification.  He says “Wait until you receive it and fill it out and send it in”. So the day after the wheelchair mishap, which is Monday, April 16,  I get a call from JP. He yells at me “Where is your recert?  You never sent it in?  The Central Office is cutting off your Medicaid!! Why didn’t you send me a copy?”  I reminded him that he told me to fill it out when I received it, and I never received it. He yelled “According to them, they sent it to you, and you never returned it!” “I don’t care what they say”, I told him.  “I never got anything” JP said “well, they don’t care what you say. They say they sent it.  I am coming to your house tomorrow. Have it ready for me to pick up!” I told him that, even if I had the form, there was no way I would be able to do it that fast.  He said he was out in the field but would fax it to me the next day- Tuesday, which he did,  and said he would be at my apartment on Thursday to pick it up at 10:00am and I should have it ready. Maybe if I could give it to him then, we could avoid the interruption of my Medicaid.  The next two days, I let my emails and everything else pile up.  I cancelled two appointments.  I had already gotten most of the documents together on Monday, because I had done this form 5-6 years in a row.   Unfortunately, my files are not as neat as I would like them to be, but I managed to clean out some files while I was digging for the documents I needed.  Now I had to put everything in order and make copies, with the aides’ help loading paper in the printer and stapling things together.  By Wednesday early evening, it was all together.  When JP came the next day, I would be able to hand it to him in perfect order and maybe he could expedite the process. So JP walks in on Thursday morning and sits in the chair.  He says “Feel free to ask me any questions”.  I said “I have no questions”.  I try to hand him the big brown envelope with everything he needs,  and came to pick up from me.  He doesn’t touch it.  Instead he says “I’m in the field today.  Tomorrow I will not be going into the office because I have a training.  I will have to hold this until Monday.  If you trust me, I will take it.  But I am not responsible if it gets lost or gets into the wrong hands.” WHAT????!!    Is this really happening?  He tells me “If I were you, I would take it into my office and give it to my supervisor LR”  His office is clear on the other end of Queens in Long Island City.  He turns to my aide and says “Why don’t you take it in today”.  He offers her driving directions, but she doesn’t drive.  And I want to go with her.  I can’t go on the subway because it’s not accessible.  JP doesn’t tell us the Queens Boulevard Bus [Q60] goes right there [the buses are accessible], so I tell him I will book Access-a-Ride for the next day. He calls LR and verifies she will be there in the morning and I tell JP I will be there in his office tomorrow.  He tells me he is retiring in July and says “By the way, your Medicaid will definitely be cut off on May 1, but not your home care.  But you should get it back in 4-6 weeks. I use Medicaid for my psychologist, and for dental and optical.  I was planning to get new eyeglasses for the first time in three years, and go to the dentist for the first time in two years. I guess both of those will need to wait a little longer.  “You and I won’t be seeing each other again, so good luck to you”,  JP says as he walks out the door.   Yeah, Mr. P, good luck to you too, and thanks for this mess-up as your swan song.  But why should you care? So the next morning we go to the CASA/Medicaid office and we are met by LR and she calls JP out of his cubicle.  I don’t miss a beat. I look at him as he escorts us into a conference room, and I set up my iPad so I can speak.  I remind him he told me he wasn’t coming to the office today. He says  “I have a training later”, and then he adds “I didn’t know you were coming here so early while I was still here” And he gives a nervous giggle……BUSTED….. “But Mr. P, you told me you weren’t coming here until Monday. Why couldn’t you bring in my papers?” ” I told you I wouldn’t be responsible and you CHOSE to come in here” “But that was because you said you weren’t coming here until Monday” Again, he repeated, “I thought you would arrive here after I went to my training”, and he ran out of the room.  So, in other words, you didn’t know you would be busted. LR comes into the conference room, opens up my envelope, sees that I have everything, including a set of papers I didn’t need to submit past the first year of the trust. She looks at me and says “I don’t understand why Mr. P couldn’t just bring this in. Why did he make you come in?”  She leaves to make copies of everything.  JP comes back in the room with her and she hands me the copies.  JP says “You see, Ms. Cohen.  It’s always a good idea to come in person”  Excuse me?  Did you ever tell me that was even an option all these years when I paid $20.00 at UPS to send this, rather than $4.50 for Access-a-Ride and the luxury of someone making the copies for me with the city’s paper and ink? Fast Forward to today.  I received official notice that my Medicaid is discontinued as of May 1, including my home care. BUT I can appeal by requesting a hearing,  and then I will continue to receive my service until a decision is made. So I requested a hearing online,  and I will have to go to Brooklyn at the date they give me, even though my papers have been submitted.  And this is all through no fault of my own.  JP is retiring, so he cares even less than he always has.  I’m thinking of writing to my city councilwoman or my state senator and/or assemblywoman, but let’s see how much energy I have.  First I want everyone to read it here, and know this is not just me.  Things like this are probably happening every day. All government agencies have people who are biding their time until retirement. And if they can do this to a smart and level-headed person like me, think about what they are probably doing to elderly patients or families with children.  You’re right, JP —- when you said “I am not responsible”, you really meant it.  
Source: blogspot.com

Horizon Medicare Advantage Blue Value with Rx

Posted by:  :  Category: Medicare

THE PEOPLES LEADER by SS&SSPlease 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

Video: Medicare and Medicaid, changes on the Horizon

The American Spectator : The Spectacle Blog : Fiscal Conservatism Would Be Fantastic

By the way, the entitlements numbers I cited earlier have a lot to do with why I take a dim view of describing George W. Bush as a “fantastic president.” Here are the projections for Medicare Part D, the prescription drug benefit passed by a Republican-controlled Congress (though the House had to be dragged along kicking and screaming) and signed into law by Mr. Fantastic: $6.8 trillion in unfunded liabilities over a 75-year horizon and $14.3 trillion over an infinite horizon. Those are bigger long-term deficits than for Medicare Part A, the hospital insurance program.
Source: spectator.org

2013 Tax Changes to Medicare

An increase in Medicare tax on certain wages. The amount of Medicare tax you pay on wages and self-employment income is scheduled to go up next year. When you’re single and your wages are greater than $200,000, your employer will withhold an additional .09% of Medicare tax from your paycheck. Are you self-employed? The tax applies when net self-employment income exceeds the threshold. The income threshold is $250,000 for married couples.
Source: rstaxes.com

Our Health Policy Matters: Is Medicare for All on the Horizon?

This year, these and other states are proposing disturbing cuts to safety net health services.  Florida is considering a proposal to turn most state health services over to counties .  The Governor of Maine wants to remove 65,000 adults from the Medicaid program.  Louisiana just announced a new round of cuts to local mental health providers.  And Connecticut has begun denying some Medicaid coverage to kids with disabilities.
Source: blogspot.com

Secure horizons medicare supplement

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Source: fluxfeatures.com

Ending ‘Obamacare’ Would Cause Huge Harm To Health Care System, Medicare, Says Program’s Trustee

There has never been any reasonable prospect of US health care expenditures continuing to rise on some extrapolated geometrically progressing curve.  There is the inherent limit that high monetary cost services always exact high human costs from the patients..  There are only so many people every year who need a liver transplant, or open-heart surgery.  Even if you posit a maximally ruthless, profit-driven system willing to go to any length to railroad people who don’t really need a liver transplant into getting one anyway, there’s only so many suckers out there whose minds won’t clear sufficiently to call a halt at the prospect of undergoing something with such enormous human costs unless the alternative is clearly worse.
Source: talkingpointsmemo.com

Heist – Who Stole the American Dream? – Movie Review

Heist goes beyond the crisis itself to explore the policies and decades of deregulation that led up to this crisis.  The oft-repeated mantra during the Regan era came to be “Government is the problem” and the policies enacted were aimed at rolling back the Government and introducing tax policies favoring mega corporations and the outrageously wealthy elites.  The film explores the historical background beginning with FDR’s handling of the economic crisis.  During the 1930s economic depression, President Roosevelt’s swift and bold action involved deep Government intervention, from which emerged a centralized, planned economy.  During the last four decades, FDR’s New Deal was largely dismantled, under the guidance of the infamous Powell Memo and the right wing Heritage Foundation’s Mandate for Leadership on government reform.  Both Republicans and Democrats, courted by the lobbyists, showed allegiance to big businesses and played a hand in drafting policies to minimize the role of the government.
Source: wordpress.com

Visions From The Horizon: Federal Programs Waste Tens of Billions of Dollars Every Year

during Tuesday’s hearing in the House Oversight and Government Relations Committee.   Some agencies are conducting their own security evaluations for federal buildings, even though the Federal Protective Service uses $236 million annually to perform the same work. Moreover, 13 agencies fund 209 different math, science, engineering, and technology education programs, 173 of which overlap one or more other programs. Further yet, the government has at least 15 financial literacy programs in place, including three new ones added by the Consumer Protection Act and the Dodd-Frank financial reform law.   Sen. Tom Coburn (R-Okla.) projected that taxpayers dish out $100 billion per year in government waste through duplication and overlapping federal programs. “Not one corner of our daily life remains untouched by a government program or federal effort,” said Coburn, a witness at Tuesday’s hearing. “From what we eat and drink, to where we live, work, and socialize, nearly every aspect of human behavior and American society are addressed by multiple government programs.”   The Oklahoma Senator mentioned a host of duplicative programs in last year’s GAO report: 17 disaster response programs; 18 food assistance programs; 20 homelessness prevention programs; 47 job training programs; 82 teacher quality assessment programs; 88 economic development programs; and more than 100 surface transportation programs. In nutritional programs alone, Coburn noted, duplication vacuumed up $62.5 billion in taxpayer dollars in 2008 — for items as small as potato chips. Mr. Coburn continued:   While many of these programs, such as the Supplemental Nutrition Assistance Program (SNAP) allow federal funds to purchase potato chips, dozens of other government-wide initiatives, are aimed at keeping Americans healthy, specifically suggesting food like potato chips should be limited in intake, and perhaps even taken out of public schools all together.   At the same time, just this year the Department of Agriculture announced a nearly $50,000 federal grant was being doled out to a private potato chip company in New York. According the proposal, this money would be used to overhaul their media strategy and raise brand awareness and consumer knowledge — essentially encouraging people to buy and consume potato chips. In the report, the GAO recommended 18 cost-saving measures that would reportedly save billions in taxpayer dollars, including consolidating government offices, selling off excess uranium at the Energy Department, substituting the $1 bill with a $1 coin, and slashing erroneous Medicare and Medicaid payments, which cost approximately $65 billion in fiscal year 2011.   Government housing programs desperately need reform, Mr. Dodaro indicated, as the Treasury and Federal Reserve invested nearly $1.7 trillion in Fannie Mae and Freddie Mac in 2010. The GAO also pinpointed “20 different entities that administer 160 programs, tax expenditures and other tools” intended to prop up home ownership and rental housing while another “39 programs, tax expenditures, and other tools” provided assistance in buying, selling, or financing homes.   Dodaro also suggested that differences in coding practices between Medicare and Medicare Advantage should be eliminated. Diagnostic coding for Medicare Advantage, the Comptroller General noted, computes a 3.4 percent higher risk score for beneficiaries, equating to $2.7 billion in higher payments. This is because Medicare Advantage providers are compensated based on the diagnostic code, while payments for traditional Medicare providers are determined by the services delivered.   “We estimated that a revised methodology that addressed these shortcomings could have saved Medicare between $1.2 billion and $3.1 billion in 2010 in addition to the $2.7 billion in savings that CMS’s 3.41 percent adjustment produced,” Dodaro cited.   Despite its keen interest in the GAO’s recommendations, Citizens Against Government Waste (CAGW)
Source: blogspot.com

Progressives Say Trustees’ Report Shows More Health Reform Needed to Solve Rising Medicare Costs, Not Cuts to Benefits

Posted by:  :  Category: Medicare

Try new Ryan Plan Senior Food - coming to a Republican Congress near you by EN2008The problem isn’t that Medicare is a government program: The problem is the power of insurance companies and drug companies. For-profit hospital and other medical providers have increased their hold over the U.S. healthcare system. Our system for reimbursing doctors encourages overtreatment. We refuse to allow our government to negotiate with pharmaceutical companies. And for-profit health insurance companies fail to manage costs, which makes it increasingly difficult to rein in that portion of the health economy that Medicare supports.
Source: enewspf.com

Video: What Does Medicare Cost?

Few Seniors Support GOP Plan To Restructure Medicare

For example, when the survey told those initially opposed to changing Medicare that a voucher system would help reduce the deficit and let seniors choose plans based on cost and quality, support rose from 46 percent to 54 percent. Conversely, when initial supporters of a voucher system were told changing Medicare would put private insurers in charge of their benefits and cause seniors to pay more or get fewer benefits, preference for keeping Medicare rose from 50 percent to 68 percent.
Source: kaiserhealthnews.org

AARP Medicare Supplement Plans (2012 Rates, Summaries and Application) « Insurance News from Crowe & Associates

Plan K supplement- Plan K was brought into the market overpriced but is now worth taking a look at after 2 years of rate reductions.   This plan offers a much lower premium but leaves much more potential for out of pocket cost vs. Plan F and N.   Those seriously considering a plan K would likely be better suited to choose the Anthem BlueCross BlueShield Plan F High Deductible Supplement with a monthly premium of about $35.00 a month at this point
Source: croweandassociates.com

Progressive Leader: Trustees Report Points To More, Not Less, Health Reform

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Source: thedemocraticdaily.com

Medicare Supplement Insurance Still Worth The Cost

Even if you supplement Medicare with a Medicare Part D Prescription Drug plan, you may also enroll in one of the ten Medigap plans. During a six-month period that begins on the first day of the month in which you become 65 and you are enrolled in Part B, your application for a Medigap plan is guaranteed to be accepted regardless of your health problems. You may switch to a different plan during this time, and guaranteed acceptance also applies to the application for the other plan.
Source: online-business-expert.com

GAO Calls Test Project by Medicare Costly Waste

The panel denounced Medicare’s “overly broad use of demonstration authority” and said “limited Medicare dollars should go to truly high-performing plans.” It said “the extension of quality bonuses to the vast majority of plans is likely to result in far greater program costs than the reward system enacted” by Congress, and that by spreading the rewards so broadly, “the demonstration lessens the incentive to achieve the highest level of performance.”
Source: ibytes.net

Ducking the Medicare Crisis

To properly address the competing needs of the Affordable Care Act and Medicare, let’s start with more transparency. The government should act like a company that provides investors with separate profit and loss data for different divisions — without double-counting. Next we need a better plan for financing the health care law, which will be challenging because actually paying for federal programs (that is, increasing taxes) has become a no-go zone in Washington.
Source: stevenrattner.com

Medicare Hospital Trust Fund Still Expected To Be Insolvent in 2024

However, expenses for Part B likely will be higher than the report predicts because the report factors in a more than 30% cut to physician reimbursement rates scheduled for 2013 under the sustainable growth rate formula. Congress since 2002 has passed a series of so-called “doc fixes” to offset the cuts scheduled under the SGR and is expected to continue to do so (
Source: californiahealthline.org

Medicare Costs Too Much and They Better Not Cut It

Working off CBO projections, my colleague David Rosnick calculated that the Ryan plan would increase the cost of buying Medicare equivalent policies by $34 trillion (in 2011 dollars) over the program’s 75-year planning horizon. In short, if people are worried that IPAB is going to make some procedures unaffordable for some people, then they should want to run as far as possible from Representative Ryan and his fellow Republicans. Their plan will leave beneficiaries far less able to afford care than anything that the IPAB might do.
Source: cepr.net

The 2012 contenders fiddle while Medicare burns

Follow @ftcomment Comment: To comment, please register with FT.com for free and read our comments policy. Please include your institutional affiliation and title in comments, if relevant. Schedule: We post at least one entry each weekday, in the morning in London. Time: UK time is shown on our posts. Follow us: Links to our Twitter and RSS feeds are at the top of the site.
Source: ft.com

President Obama’s healthcare reform law will save Medicare $200 billion by 2016

Photographs from other sources sometimes appear on TPC for humorous or illustrative purposes. As it is not our intention to use these images in any inappropriate manner or to infringe upon any rights held by others, anyone holding legal rights in the use of these images who wishes to have them taken down please contact us immediately requesting such removal, with which we will comply promptly.
Source: thepoliticalcarnival.net

Why do liberals whine for UHC when over 40 states are creating programs to prove low income health insurance?

Posted by:  :  Category: Medicare

about affordable article benefits Best business california Care Cheap cost Costs Coverage exchange family find Free from Getting good guide Health Healthcare home Individual insurance life Management maryland Medical Medicare money National Need online Plan Plans policy Private quotes rates Reform save Small state Virginia
Source: 123homesolution.com

Video: Ten Key Things About Medicare — UHC TV

UHC Announces Changes to its Medicare Advantage Audits

UHC will no longer use MedAssurrant, the contractor that previously conducted its payment integrity audits. UHC will also make changes in the way that it conducts its Risk Adjustment Date Validation (RADV) audits. These audit request letters will be more clear about the reason for the audit and provide consistent information on follow-up medical record review, audit requests, and post-audit claim payment determinations. UHC will also update its payment integrity and recovery practices. Currently, UHC asks physicians to refund the full amount paid on the original claim and then resubmit the claim using the recommended coding. In the first quarter of 2012 physicians will only need to resubmit the claim with the recommended coding and refund only the difference between the amount UHC originally paid and the amount that should have been paid using the new coding. Physicians who disagree with UHC’s recommended coding should appeal the claims.
Source: wordpress.com

Trying to Sell a Medicare Book

I have a book of business with UHC. I recently switched to an FMO, but I was direct to UHC when these clients were written. The book currently produced about $ 1600.00 / month. 75% is MA the other 25% is supps and PDP. Renewals will kick up some in 2013 because of business that was sold in 2011, but not yet in renewal. I need to sell the book or get a loan against future receivables because I need immediate cash. I have tried Oakstreet Funding, Access Capital and TWG. Does anyone have any other suggestions? I would appreciate some opinions concerning the value of the book. It will produce $ 14000.00 in income before the end of this year. At 50% renewal, it will produce about 16000.00 next year (considering the 2011 sales not currently in renewal.) Thanks for the help.
Source: insurance-forums.net

President Obama’s Medicare slush fund

ACH12-Distribution ACH19-ValueforMoney AHC13-PovertyandHealth Entitlement Reform International Comparisons NN11-Personal-News NN12-Job-Listings NN18-Conferences-Meetings NN19-Books NN20-Articles-Papers NN21-Grey-Literature NN25-Videocasts NN27-Blogs PPACA-Constutionality PPACA-EssentialBenefits PPACA-HealthExchanges PPACA-Impact-Access PPACA-Impact-Consumers PPACA-Impact-Costs PPACA-Impact-Employers PPACA-Impact-HealthInsurers PPACA-Impact-HealthProfessionals PPACA-Impact-States PPACA-Medicaid PPACA-Medicare PPACA-PublicOpinion PPACA-Repeal Regulation-FDA Regulation-HealthFacilities UHC12-2012
Source: wordpress.com

Uhcmedicaresolutions.com UnitedHealthcare Medicare Solutions

Uhcmedicaresolutions.com has 3 years old, it is ranked #372,428 in the world, a low rank means that this website gets lots of visitors. This site is worth $35,728 USD and advertising revenue is $20 USD per day. The average pages load time is 1.203 seconds, it is very good. This site has a very good Pagernk(4/10), it has 1,008 visitors and 5,342 pageviews per day. Currently, this site needs more than 651.97 MB bandwidth per day, this month will needs more than 19.10 GB bandwidth. Its seo score is 55.5%. IP address is 149.111.129.3, and its server is hosted at Cypress, United States. Last updated on Sat, 14 Apr 2012 00:28:17 GMT.
Source: statscrop.com

Richard Yadon + Medicaid in the News

Mr. Kunemund said that United Healthcare already has been working with Alabama Medicaid with the dual eligible seniors.  Dual eligibles are poor seniors that receive Medicare and Medicaid.  Alabama Medicaid pays most of the deductibles and copayments Medicare does not pay as well as the $99.40 a month Medicare Part B premium for the poor seniors.  Vice President Kunemond said that United Healthcare works with the physicians and the Medicaid clients to achieve the best outcomes for the clients.  Kunemond said that UHC has a large doctor’s network and clients would have access to a nurse 24 hours a day when ever needed.  UHC will also provide extra benefits that Medicaid does not offer like transportation to doctors.  Kunemond said that savings would be generated by promoting and improving the overall health and wellness of the Medicaid clients.
Source: managedmedicaidservices.com

UnitedHealthcare’s Online Health and Entertainment Network UHC.TV Delivers Original Programming from National Personalities and General Consumers

UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, and contracts directly with more than 650,000 physicians and care professionals and 5,000 hospitals nationwide. UnitedHealthcare serves more than 38 million people and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.
Source: virtual-strategy.com

Toomey to force vote on Ryan budget

Posted by:  :  Category: Medicare

OOPS I THINK THE SHINE IS OFF THE PEACH ...........IT'S ABOUT TIME by SS&SSThe Republican Party of Pennsylvania is dedicated to providing privacy on the Internet. In addition to developing our privacy policy, we have provided you the opportunity to opt out of future ad serving cookies. In order to identify you as someone who has elected to opt out of receiving future cookies from ad serving companies, we will place an opt out cookie on your machine. If you would like to opt out of ad serving cookies or read additional information about these cookies, go to www.optout-choices.com.
Source: pagop.org

Video: State Takeover of Harrisburg, Medicare/Medicaid Funding [Pennsylvania Newsmakers]

Faster Workers Compensation Settlements In Pennsylvania Involving Medicare

Workers’ compensation settlements across the United States, including Pennsylvania, have been either prevented or delayed because of long approval delays from Medicare. A potential solution to this problem might be on the way though. In the majority of cases, if the workers’ compensation settlement compromises either past or future medical treatment liabilities, then Medicare has to give approval to the settlement before it can even be presented to a Workers’ Compensation Judge for potential approval with a Petition for Compromise and Release.
Source: workercompensationsettlements.com

PA Republicans Vote to End Medicare As We Know It. Again.

“Today, all but one Republican in our congressional delegation reaffirmed their support to end Medicare as we know it while providing tax breaks to wealthy special interests,” said Pennsylvania Democratic Party Chairman Jim Burn. “Rep. Paul Ryan and his plan will attack Medicare while providing tax breaks for millionaires, billionaires and corporate special interests. It is the wrong vision for Pennsylvania. Once again, Pennsylvania Republicans picked wealthy special interests over Pennsylvania seniors.”
Source: eriedems.com

The American Spectator : Obama's Latest Plan to Snooker Seniors

Except, genius, among the reasons you have a banana lodged where it must be strangling the oxygen to your brain, you are equating constitutional providing for the common defence, with unconstitutional domestic spending, unless you friggin try the liberal gambit that social security is constitutionally promoting the general welfare, in which case, how, exactly, is the general welfare promoted, exactly, by a general welfare promotion that is already actually unfunded in ponzi scheme actuality by more than $100 trillion, which means is actually unfunded in ponzi scheme actuality by more than $1 million for each and every single taxpayer already, actually, which actually unconstitutionally unsecures not only the blessings of liberty to ourselves, but unsecures the blessings of liberty to our posterity created equal that is actually endowed with actual birth, not to mention the unsecured blessings of liberty to our posterity created equal that is not actually endowed with actual birth, insanely, much less unconstitutionally forming a less perfect union, unconstitutionally unestablishing justice, and unconstitutionally uninsuring domestic tranquility, in exactly insane liberal progressive socialist tyrannical insane order, insanely.
Source: spectator.org

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

Research Roundup: Doctors Still Take Medicare

Headache: The Journal of Head and Face Pain: Direct Costs of Preventive Headache Treatments: Comparison of Behavioral and Pharmacologic Approaches – The authors examined treatments for migraine headaches by tracking the total cost of prescription medicines and a number of behavioral treatments, such as biofeedback and relaxation techniques. They found that through the first year, “inexpensive” preventive medications “(such as generically available beta-blocker or tricyclic antidepressant medications) and behavioral interventions … are the least costly of the empirically validated interventions. This analysis suggests that, relative to pharmacologic options, limited format behavioral interventions are cost-competitive in the early phases of treatment and become more cost-efficient as the years of treatment accrue.” According to a press release from The University of Mississippi, one of the participating institutions, “the researchers didn’t compare the effectiveness of methods, nor did they calculate the costs over time of individual drugs, since dosages and prices vary widely. Rather, they figured the per-day costs of each method based on fees of physicians and psychologists” (Schafer et al., June 2011).
Source: kaiserhealthnews.org

MSPRC Website: Liability Medicare Set

Posted by:  :  Category: Medicare

Running Amok Again by elycefelizThis Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.
Source: wordpress.com

Video: Structured Medicare Set Aside

Miami Personal Injury Attorneys Blog

We established this blog to share stories and information about topics relevant to our practice. Our intent is to highlight local stories, as well as national subject matter, that we think you will find interesting. We will regularly update this blog and encourage you to share your thoughts on these posts.
Source: neufeldlawfirm.com

Medicare Set Aside Personal Injury

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Source: fluxfeatures.com

The New Frontier of Liability Medicare Set Asides: Part 3

A large problem with today’s MSP compliance hysteria is that defense attorneys and insurers are routinely including “kitchen sink” language in their releases to address Medicare. This language frequently shifts all of the responsibility of creating a Medicare set aside to the injury victim while identifying an arbitrary amount to be set aside. This practice is dangerous because those releases typically have the injury victim acknowledge a responsibility to set funds aside while picking an arbitrary, usually small, amount to be set aside. This is a bad practice and exposes the injury victim as well as plaintiff counsel since if CMS ever refused to pay for Medicare covered services related to the injury there would be no way to justify the amount of the set aside. A better practice is to actually do an MSA analysis, which may or may not include getting a formal MSA allocation done. There are certain instances where an MSA may be unnecessary based upon factors present in the case such as a private primary health insurance policy, Workers’ Compensation coverage for future medical or where there is no future Medicare covered expenses related to the injury. These should be identified and the release language specifically tailored to that exception but with an indication that Medicare’s future interests where considered with nothing needing be set aside. If the case requires the full-blown MSA analysis, it should be done and the cost of doing so passed along as a client cost. Most MSA allocation reports cost between two thousand and three thousand dollars, which is a small price to pay for the proper analysis of the client’s future Medicare covered services. The allocation gives all parties the proper amount to be set aside, arguably subject to a reduction formula.
Source: injuryboard.com

Medicare and Medicare Set Asides, a Personal Injury Attorney’s Perspective

Although there have been rumblings from Medicare for the past several years that Medicare will begin demanding the same or similar evaluation of whether Medicare Set- Asides are required in bodily injury liability cases, we have not yet received any definitive statement from Medicare on this issue.  Some attorneys have taken Medicare’s failure to establish rules and regulations for Medicare Set-Asides as an indication that Medicare will continue to pay for future accident related treatment without requiring a Medicare Set-Aside, and have consequently not addressed the issue with their clients.  Unfortunately, this may expose the attorney to significant legal liability down the road.  It is always possible that Medicare will start withholding Medicare benefits for accident related treatment if a Set-Aside has not been established, which could in turn lead to a lot of angry clients knocking on attorneys’ doors looking for explanations.  While this scenario may never come to pass, prudence dictates that attorneys should at the very least discuss with their clients the potential need for a Medicare Set-Aside.  If the client refuses to establish a Set-Aside, the attorney should obtain a written acknowledgment that failure to establish a Set-Aside may affect future Medicare benefits for accident related treatment.  If you would like to discuss these matters further, please do not hesitate to call me at 386-258-1622 or email me at steve@sandswhitesands.com.
Source: wordpress.com

The Official Medicare Set Aside Blog And Information Resource: Top 10 MSP

With regard to the reasons against, it is important to understand a few basic facts about the MSP to understand why reliance upon CMS memos was shaky at best. First, the CMS policy memoranda are merely agency interpretations of the governing statutes and regulations and do not carry the force or effect of law. While generally granted deference by the courts, CMS policy is not infallible nor is it the only means by which to comply with the underlying legal obligations. It is simply the agency’s recommendation in light of what it believes it can do to pursue recovery under the MSP. The WCMSA review program is not governed specifically by any law or regulations and is voluntary, a fact finally openly admitted by CMS itself in its May 2011 memo. Those who have followed the issue since the beginning will recall CMS’ liberal use of the word “must” in the early memos, and the idea that an MSA must be approved by CMS when the settlement meets the established thresholds continues to erroneously linger today. The reason we have not had any detailed memos for liability is that tort law is not as uniform as workers’ compensation, thus it would be impossible to render unilateral policies across all jurisdictions as was possible for workers’ compensation which is fundamentally the same throughout the country. I am not saying that all states are exactly the same, only that the differences are more the exception, whereas in liability, the only common thread is generally the common law elements of negligence. Pretty much everything after that will be determined on a case by case basis due to a unique limiting feature specific to state law or governed by an insurance contract. To even expect such policies to be issued by CMS is unreasonable in and of itself, but to rely upon the absence as a means to avoid a statutory obligation borders upon negligence.
Source: medicaresetasideblog.com