On April 25, 2012, NCMS president Robert Monteiro, MD, and senior NCMS staff met with Melanie Combs-Dyer, Deputy Director, Provider Compliance Group at the Centers for Medicare and Medicaid Services (CMS) to discuss programs aimed at reducing improper payments in the Medicare program. While there are five categories of contractors, each fulfilling different roles in improper payment mitigation for CMS, the majority of this meeting focused on the Recovery Audit Program (RAC) and Zone Program Integrity Contractors (ZPIC). Information about all of these programs can be reviewed here.
Video: North Carolina Medicare Enrollment.wmv
Critical Information on Medigap Insurance Policies and Medicare
Medicare is a type of wellness insurance available for those over 65 or those beneath the age of 65 with certain disabilities, this kind of as Finish-Stage Renal Illness, which benefits in long term kidney failure that calls for both a kidney transplant or dialysis. If you have Medicare Element A or Element B, you are eligible to also buy Medigap insurance. Medicare Element A is Hospital Insurance coverage, and helps to cover inpatient care in hospitals as well as skilled nursing facilities, hospice, or residence wellness care. Element B is medical insurance, and helps cover doctors’ and other wellness care providers’ services, outpatient care from hospitals, and preventative services to aid preserve your wellness or to stop certain illnesses from acquiring worse. There are also Element C and Element D coverage. Element C is typically acknowledged as Medicare Advantage Plans, and they cover prescription drugs and other benefits. Element D is the Medicare Prescription Drug Coverage, which helps to cover the charges of prescription drugs and may aid lower prescription drug charges and aid shield against larger charges. These Element D plans are run by Medicare-accepted private insurance companies.
Volunteers continue to be essential for SHIIP’s operation
In addition to the program’s professionally-operated call center, SHIIP has a volunteer base of 124 county coordinators and 753 volunteers assisting Medicare beneficiaries in all 100 N.C. counties. They must successfully complete a computerized training course to become certified to better help people with Medicare. They are required to attend quarterly follow-up trainings, and they must provide 40 hours of counseling services annually to maintain their certification. Without these volunteers, SHIIP could not reach out to all the people using Medicare across the state.
ACOs Multiply As Medicare Announces 27 New Ones
Accountable Care Coalition of Caldwell County, LLC Lenoir, NC 5,000 Accountable Care Coalition of Coastal Georgia Ormond, FL (Serving beneficiaries in GA and SC) 8,000 Accountable Care Coalition of Eastern North Carolina, LLC New Bern, NC 10,000 Accountable Care Coalition of Greater Athens Georgia Athens, GA 8,500 Accountable Care Coalition of Mount Kisco, LLC Mount Kisco, NY N/A Accountable Care Coalition of the Mississippi Gulf Coast, LLC Clearwater, FL (Serving beneficiaries in the Mississippi Gulf Coast area) 7,000 Accountable Care Coalition of the North Country, LLC Canton, NY 5,300 Accountable Care Coalition of Southeast Wisconsin, LLC Milwaukee, WI 10,000 Accountable Care Coalition of Texas, Inc. Houston, TX 70,000 AHS ACO, LLC Morristown, NJ (Serving beneficiaries in NJ and PA) 50,000 AppleCare Medical ACO, LLC Buena Park, CA 8,000 Arizona Connected Care, LLC Tucson, AZ 7,500 Chinese Community Accountable Care Organization New York, NY 12,000 CIPA Western New York IPA, doing business as Catholic Medical Partners Buffalo, NY 31,000 Coastal Carolina Quality Care, Inc. New Bern, NC 11,000 Crystal Run Healthcare ACO, LLC Middletown, NY (Serving beneficiaries in NY and PA) 10,000 Florida Physicians Trust, LLC Winter Park, FL 16,500 Hackensack Physician-Hospital Alliance ACO, LLC Hackensack, NJ (Serving beneficiaries in NJ and NY) 11,000 Jackson Purchase Medical Associates, PSC Paducah, KY 6,000 Jordan Community ACO Plymouth, MA 6,000 North Country ACO Littleton, NH (Serving beneficiaries in NH and VT) 6,000 Optimus Healthcare Partners, LLC Summit, NJ 29,000 Physicians of Cape Cod ACO Description of Organization Hyannis, MA 5,000 Premier ACO Physician Network Lakewood, CA 12,500 Primary Partners, LLC Clermont, FL 7,500 RGV ACO Health Providers, LLC Donna, TX 6,000 West Florida ACO, LLC Trinity, FL 10,000
North Carolina Medicare Part D Plans
After you have narrowed your list of plans to criteria which you find to be important, i.e. premium, deductible, gap coverage, etc. , you should visit plan websites to review the formulary. The formulary will also indicate which tier specific drugs are listed in. This will have have an impact on your out-of-pocket costs as you use your plan. Drugs may be placed in different tiers by different companies.
Medicare releases states’ catheter infection rates; NC in middle
Central-line infections are introduced into the body when hospital staff do not properly clean and administer a catheter. Because a central-line infection is a hospital-induced infection, it is a clear result of medical malpractice. Yet even though the development of these infections can clearly indicate negligence on the part of a doctor or his staff, central-line infections are not uncommon — according to the study, one in six hospitals nationally suffers from high rates of the infection.
North Carolina Medicare Leads
A common list among Medicare supplement and Medicare Advantage insurance agents you could purchase from Affordablemedicareleads would focus in on individuals who are approaching the age of 65. By focusing on this demographic you are certain to find those that are new to Medicare and are looking for either a Medicare supplement or Medicare Advantage plan that you are offer. The downside to focusing on individuals turning 65 is that these individuals are new to Medicare and be quite confused. They are getting bombarded by a number of different agents, not to mention their mail box is being flooded by numerous different insurance carriers. Affordablemedicareleads can provide another list that is commonly used by Medicare insurance agents. That would simply be individuals that are in the age range of 67-78. By calling or mailing this age demographic what you are going to find this that #1; their agent the initially enrolled them in their plan is long gone by now. #2; they have been on Medicare for at least a couple of years an have most likely to have had at least one premium increase. They should understand that by now Plan F is Plan F and if you can offer them the same plan at a lower rate, you may just be able to gain a client. By not going over the age of 78 will help you focus in on the more healthy individuals.
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Patsy Keever vows to protect Medicare at senior citizen roundtables
If passed in 2010, Republican Congressman Paul Ryan’s budget plan, which every Republican member of the U.S. House supported, would have replaced Medicare with a voucher system. Seniors would have had to shop for their own insurance and hope they could find coverage that was affordable. Though seventy percent of voters want to keep Medicare as it is today, according to a recent Kaiser Family Foundation poll, Republicans in Congress still seem determined to raise seniors’ health care costs while giving more tax breaks to millionaires and Big Oil companies.