Medicare Shared Savings Program Gets 27 New ACO Participants

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KNOW WHO YOUR CZARS ARE --ENOUGH TO MAKE YOU SICK ---ONLY OBAMA COULD CREATE POSITIONS FOR THESE INCOMPENTENT COMMUNISTS AND SOCIALISTS by SS&SSTwenty-seven new Accountable Care Organizations (ACOs) in 18 states have entered into voluntary agreements with the Centers for Medicare & Medicaid Services (CMS) under the new Medicare Shared Savings Program (MSSP).  Under the MSSP, as previously discussed, these selected ACOs have agreed to take responsibility for improving the health and care experience of individuals in the traditional Medicare fee-for-service population while reducing the rate of growth in health care spending. The 27 ACOs, which include more than 10,000 physicians, 10 hospitals, and 13 smaller physician-driven organizations in both urban and rural areas, will serve an estimated 375,000 Medicare beneficiaries.
Source: wolterskluwerlb.com

Video: President Harry S.Truman gets Medicare

Social security’s financial forecast gets darker; Medicare’s outlook unchanged

Health and Human Services Secretary Kathleen Sebelius, speaking at the news conference about the trustees’ report, countered that even with the demonstration project, the administration has cut overpayments to Medicare Advantage by half. And she said the bonus system has helped reduce the premiums charged by such plans, increase the number of plans being offered and draw more seniors toward high-quality plans. “I think it’s a basic win-win-win,” she said.
Source: cfed.org

Bret Baier Gets NPR’s Mara Liasson to Admit Medicare ‘Ends As We Know It’ Without Ryan Plan

We have a system now where it incentivizes overuse by doctors with tests and procedures and everything. It guarantees they’re going to spend much more than they need to. And that’s the idea of the premium support plan proposed by Paul Ryan. Alice Rivlin has her version of it. You have the Senator from Oregon who’s joined in, Ron Wyden, and others. It’s out there. And to have Geithner to denounce it, I mean this guy’s the Treasury Secretary, for heaven’s sake, adopt some in his announcement today adopt some political line I think is really shameful.
Source: abouttruth.net

Panel Urges Crackdown On Medicare’s Use Of Imaging

While a 1989 law prohibited physicians from referring patients to testing centers in which they had a financial interest, it did not stop them from performing imaging and other tests in their offices. In 2008, the Center for Studying Health System Change surveyed doctors and found that 29 percent owned or leased equipment to conduct testing such as echocardiograms and nuclear medicine studies, 25 percent had clinical lab testing equipment, 23 percent had X-ray machines, and 17 percent had MRI or computed tomography machines.
Source: kaiserhealthnews.org

Clinical Support Services, Inc. Software Boosts Medicare Star Ratings

Posted by:  :  Category: Medicare

About CSS: Founded in 1999 by pharmacists and technologists, CSS is staffed by experienced clinicians, software developers and processes personnel. The hub is Medication PathfinderTM built in S-O-A-P (Subjective-Objective-Assessment-Plan) Note structure to help you pharmacists take appropriate steps swiftly through complex patient Medication Therapy Management (MTM) assessment procedures. Structured data storage is a main differentiating feature in the MTMPath system. Additional CSS programs include iDeal TherapyTM and TMR BoosterTM. Currently, over 20 percent in the 5-star Medicare MA-PDP plans are CSS clients CSS for MTM program support/documentation.
Source: hugohosting.com

Video: Jed Weissberg, MD, Talks About Medicare Advantage Health Plans and the Special Enrollment Period

Medicare Star Ratings for Medicare Advantage Programs

In terms of measuring the quality of the Medicare Advantage plans alone, Medicare has created five different categories for quality measurements and spread out within these categories is 36 different and specific topics and areas of measurement. When it comes to calculating the quality of the Medicare prescription drug services, commonly referred to as the Medicare Part D plan, there are four different categories and 17 different areas or topics that are measured. By using information that is collected through member surveys, the providers of the care as well as a number of other sources, Medicare analyzes information by topic in order to create an overall rating. These ratings are accessed each year in order to have a database that is updated and accurate for members to be able to make their decisions. Five star ratings are hard to come by and the majority of plans are rated between one and four stars.
Source: cerecons.com

Medicare Star Ratings Program

There are a number of people who believe that there are flaws within the current Medicare Five Star Rating Program. While they do a good job at measuring the hard evidence as seen in health inspections, they fail to look past the numbers and at the overall happiness of the patients and their families. Some administrators believe that there should be additional factors taken into consideration when grading nursing homes including family and patient satisfaction. Currently there is no way to grade how well the staff interacts or cares about their patients, something that many find to be an important factor when choosing a nursing home.
Source: nationalsecuritydrone.com

Medicare Star Ratings Program

There are a number of people who believe that there are flaws within the current Medicare Five Star Rating Program. While they do a good job at measuring the hard evidence as seen in health inspections, they fail to look past the numbers and at the overall happiness of the patients and their families. Some administrators believe that there should be additional factors taken into consideration when grading nursing homes including family and patient satisfaction. Currently there is no way to grade how well the staff interacts or cares about their patients, something that many find to be an important factor when choosing a nursing home.
Source: cghaircolorspa.info

Medicare Star Ratings Program

In this program, medical facilities are ranked from 1 to 5. For each rank a star is assigned to a facility that denotes the quality of services offered there. On the rating scale, 1 means that a facility has failed to satisfy its patients, while 5 indicates high-end services offered to patients. Typically the rating assigned to a facility is based on the following three factors: 1. The percentage of patients that visit a facility and the number of staff present to treat them 2. Health inspection scores 3. Quality of services
Source: financialdata.com

Medicare Star Ratings Program

The Medicare Star Ratings Program assigns 1 to 5 star ratings to different medical facilities. In this rating system, 1 is given to a facility that has failed to satisfy its customers. On the other hand, a 5-star rating is given the one who has successfully attracted a large number of patients due to its superior services. Basically, the program evaluates a facility on the basis of the following three factors: 1. The percentage of patients to the staff present at a facility 2. Ratings of health inspection 3. Quality of services as reported by the patients
Source: financial-information.org

Rewarding Mediocrity: GAO Report Concerning Medicare Advantage “Bonus” Payments  

[1] "Quality Bonus Payment Demonstration Undermined by High Estimated Costs and Design Shortcomings" General Accounting Office (April 23, 2012), summary available at: http://www.gao.gov/products/GAO-12-409R; report available at: http://www.gao.gov/assets/590/589473.pdf [2] Note that according to GAO, even with these payment reforms, MA plan payment (including bonuses) is still about 7 percent higher than what the government would pay for similar beneficiaries in traditional Medicare.  [3] "GAO Calls Test Project by Medicare Costly Waste" by Robert Pear, New York Times,(4/22/12), available at: http://www.nytimes.com/2012/04/23/health/policy/gao-says-medicare-test-project-is-wasting-8-billion.html?_r=1&emc=tnt&tntemail0=y
Source: medicareadvocacy.org

Clinical Support Services, Inc. Software Boosts Medicare Star Ratings

About CSS: Founded in 1999 by pharmacists and technologists, CSS is staffed by experienced clinicians, software developers and operations personnel. At the heart is Medication PathfinderTM built in S-O-A-P (Subjective-Objective-Assessment-Plan) Note structure to help pharmacists move quickly through complex patient Medication Therapy Management (MTM) assessment procedures. Structured data storage is a main differentiating feature of the MTMPath system. Additional CSS software solutions include iDeal TherapyTM and TMR BoosterTM. Currently, more than 20 percent of the 5-star Medicare MA-PDP plans are CSS clients CSS for MTM program support/documentation.
Source: cssrzr.com

Medicare and the Star Ratings Program

There are a number of people who believe that there are flaws within the current Medicare Five Star Rating Program. While they do a good job at measuring the hard evidence as seen in health inspections, they fail to look past the numbers and at the overall happiness of the patients and their families. Some administrators believe that there should be additional factors taken into consideration when grading nursing homes including family and patient satisfaction. Currently there is no way to grade how well the staff interacts or cares about their patients, something that many find to be an important factor when choosing a nursing home.
Source: typepad.com

Medicare Star Ratings Program

The Medicare Star Ratings Program assigns 1 to 5 star ratings to different medical facilities. In this rating system, 1 is given to a facility that has failed to satisfy its customers. On the other hand, a 5-star rating is given the one who has successfully attracted a large number of patients due to its superior services. Basically, the program evaluates a facility on the basis of the following three factors: 1. The percentage of patients to the staff present at a facility 2. Ratings of health inspection 3. Quality of services as reported by the patients
Source: hostgator.com

Benefits of Implementing the Medicare Advantage Program

Posted by:  :  Category: Medicare

San Diego, CA by Oggie DogBeneficiaries 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

Video: EHR: Medicare and Medicaid Incentive Program Registration Webinar for Eligible Hospitals

Registration for CMS EHR Incentive Programs

On your mark: Determining your eligibility Before you register, you need to determine if you are eligible. Eligibility differs for eligible hospitals and professionals — criteria that you should review as soon as possible. Those who’d prefer a more interactive experience can use CMS’s Eligibility Wizard to reveal what program(s) they qualify for. It’s crucial to know that EPs qualifying for both Medicare and Medicaid Incentive Programs have to choose one or the other prior to registration. (Hospitals can receive payments from both.) Moreover, EPs can only change programs once before 2015 after receiving their first incentive payment. The major difference between the programs is money, nearly $20,000 (Medicare’s 44,000 to Medicaid’s $63,750), but there are plenty more. Choose your own adventure.
Source: ehrintelligence.com

Register now for 2012 Medicare EHR program

Before attempting to achieve compliance with the EHR utilization standards during a reporting period, practitioners should check to ensure they have properly installed a complete EHR system certified for use in the incentive program, have an active e-prescribing solution, and understand the required meaningful use criteria they will have to meet.
Source: newsfromaoa.org

Medicare drug plan changes Time to shop around R : asics news

The bottom line as seniors: the plan you bought surrounded 2010 may never suit you well within 2011. It’s more important than ever apt?apt be sure your pills are covered,www.longchamp.com, and along reasonable total price But the reshaping of plans as 2011 doesn��t mean seniors won��t be competent apt find solid coverage; amid many cases,karen millen dresses outlet, the changes reflect efforts by the analgesic plans apt streamline their formularies��the list of covered narcotics and the rules below which they are provided.
Source: enterprisebusinessexperts.biz

Medicare Leaves Me Scratching My Head

Before you even get started on the whole Medicare process, make sure you start researching early. Most of us are eligible to start receiving these benefits at age 65. When you sign-up to receive Social Security benefits, you are essentially also registering for Medicare and will automatically start getting Part A and Part B on the first day of the month that you turn 65. That’s why you want to take care of the process BEFORE you turn 65. Three months before you turn 65, you should contact Social Security even if you are still employed.
Source: pittsburghhealthcarereport.com

Poor, Sick And Expensive: Colorado’s Scaled

Posted by:  :  Category: Medicare

The state is one of just a few that is expanding Medicaid in advance of the major expansion called for in 2014 by the federal health law. Starting in mid-May, Colorado will begin offering Medicaid to adults like Miller who make less than $1,080 per year (that’s 10 percent of the federal poverty line, or $90 per month) – but there’s a catch. Though the state estimates that there are 50,000 people who meet the income bar, Colorado will only be able to offer the health coverage to 10,000 people. Those people will be chosen by a lottery method in each county, designed to distribute the benefits fairly across the state.
Source: kaiserhealthnews.org

Video: Exploding Medicaid Costs in Colorado

House Approves Bill Aimed At Overhauling Colorado’s Medicaid System

Medicaid spending increased more than 70 percent in Colorado over the last six years. The current payment system is fee-for-service, which means doctors are compensated based on how many tests they order or how many office visits they get.
Source: cbslocal.com

Colorado Expands Its Medicaid Program

Colorado has decided to extend its Medicaid program to cover that group. There is a provision in the Affordable Care Act that extends the federal dollar-for-dollar match to cover adults who do not have children. Colorado hospitals volunteered to pay a new fee to the state Medicaid program. That money pulls in the federal matching funds. This allows Colorado to cover more people with Medicaid. Colorado is one of only seven states to take advantage of this program.
Source: families.com

Colorado Medicaid Expansion

Starting on April 1, 2012, adults who do not have dependent children receiving Medicaid, and who are at or below 10% of the Federal Poverty Level (FPL), may apply for Medicaid. Enrollment in the Adults without Dependent Children (AwDC) expansion will be limited to 10,000 people due to limited funding.
Source: biacolorado.org

Bill Strengthens State’s Medicaid Fraud Prosecution

“No. That’s the point.  There are some people who say it’s rampant.  And yet last fall when I was trying to get a handle on this, nobody could give me accurate numbers. HCPF has data for what they cover but it’s not the state agency’s responsibility to pursue it on the recipient side. The Attorney General’s office has a Medicaid fraud control unit which has several million dollars a year that they recover.  But that is only providers, not recipient fraud.  What happens at the county level, because often the dollars involved are much smaller, there’s not really a strong pursuit of going after Medicaid fraud because it takes more time and personnel  than they think they will actually recover.  The way the statute currently reads is that even if a county were to recover Medicaid fraud proceeds, they have to turn it over to the state (the state being Health Care Policy and Financing) so there’s no incentive for the counties to really pursue it because they have to help pay for the District Attorney to actually prosecute.  If they recover any money, they don’t even get the cost of prosecution.”
Source: advocacydenver.org

Gerou’s Medicaid Pilot Program progresses

Under HB 1281, providers of Medicaid care will submit program proposals aimed at improving the payment process for the state’s Medicaid program to the Department of Health Care Policy and Financing. The DHCPF will instate trial periods for programs that show potential in streamlining and simplifying the administrative structure for managing contracts relating to Medicaid managed care.
Source: coloradohousegop.com

Colorado Medicaid expansion to add 10,000, but many more out of luck

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Source: us-society.com

Colorado’s Hickenlooper Rejects Calls for Medicaid Waiver

Access Andrew Cuomo Avik Roy Barack Obama Block Grant Bob McDonnell Cato Institute CHIP Costs Cutbacks Dental Care Eligibility Enrollment Final Notice: Medicaid Crisis Flexibility GAO Gary Alexander Grace-Marie Turner Haley Barbour HHS Innovative Ideas Jagadeesh Gokhale John Barrasso John Graham John Kitzhaber Kaiser Family Foundation Legislation Medicaid Ghetto Michael Cannon MISEA National Center for Policy Analysis Obamacare Opt Out PPACA Richard Burr Richard Foster Rick Perry Saxby Chambliss SCHIP Solutions Studies Texas Texas Public Policy Foundation Tom Coburn Waste Fraud and Abuse
Source: reformmedicaid.org

Primary care barriers for Medicaid patients

Faculty at the University of Colorado School of Medicine work to advance science and improve care. These faculty members include physicians, educators and scientists at University of Colorado Hospital, Children’s Hospital Colorado, Denver Health, National Jewish Health, and the Denver Veterans Affairs Medical Center. The school is located on the Anschutz Medical Campus, one of four campuses in the University of Colorado system. To learn more about the medical school’s care, education, research and community engagement, please visit its web site. For additional news and information, please visit the University of Colorado Denver newsroom.
Source: ucdenver.edu

Tuesday, May 8, 2012: Bipartisanship, priest abuse allegations and student loans — Opinion — Bangor Daily News — BDN Maine

Posted by:  :  Category: Medicare

Letters to the Editor, by their nature, are mostly opinion. But stating falsehoods as if they are fact is beyond misleading; it is damaging and irresponsible and must be corrected. Bishop Malone is not keeping secret a list of priests who are credibly accused of sexual abuse as stated in a recent Letter to the Editor. On the contrary, every claim is reported to law enforcement and all substantiated claims are made public (example: Bishop Names Accused Priests, BDN, Jan. 29, 2007). Cases where priests are removed from ministry pending investigations of claims are also made public by the diocese, even if the reports ultimately are not substantiated (see Two Maine priests accused of sex abuse, Portland Press Herald, March 18, 2010).
Source: bangordailynews.com

Video: Medicare Part B_1.wmv

Mike Corthell: Caring for God

The significant financial demands which result from a catastrophic injury require that all financial resources be pursued.  In addition to social services at the hospital and/or rehabilitation facility, it may be necessary to consult with legal professionals to help brain injury survivors in the areas of Social Security Law, Medicare, Medicaid, competency, guardianship, estate planning, and power of attorney. Insurance and legal claims may need to be brought as a result of the incident that caused the injury (such as motor vehicle collisions, work related injuries, falls, defective automobiles, killer roadways, defective sports and recreational vehicles). It is important that an experienced attorney be brought in early in the process to make sure that the legal rights are protected by preserving evidence, conducting an investigation and interviewing witnesses. The lawyer can analyze all benefits available under an individual’s insurance policies and through public benefits, and determine whether there are deadlines to meet to make sure that your rights to bring a claim is protected.
Source: blogspot.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

Higher Medicare Part B premiums in 2012

The Social Security Administration (SSA) uses tax figures from two years ago to determine the Part B premiums. So the MAGI reported on a taxpayer’s 2010 tax return determines if the taxpayer must pay a higher monthly Part B premium in 2012. For example, a single filer with a MAGI of $150,000 in 2010 will have to pay a monthly Medicare Part B premium of $199.80 in 2012.
Source: businessmanagementdaily.com

THE ASTUTE BLOGGERS: BY THE NUMBERS: HOW OBAMACARE SCREWS SENIORS AND MEDICARE

THIS IS MAKING THE ROUNDS: MEDICARE  Look clearly at the 2014 rate compared to the 2013 rate. For those of you who are on Medicare, read the following. It’s short, but important and you probably haven’t heard about it in the Mainstream   News:  “The per person Medicare Insurance Premium will increase from the present Monthly Fee of $96.40, rising to:  $104.20 in 2012 $120.20 in 2013 And $247.00 in 2014.”  THAT MEANS THEY ARE MORE THAN DOUBLING.  These are Provisions incorporated in the Obamacare Legislation, purposely delayed so as not to confuse the 2012 Re-Election Campaigns.  Send this to all Seniors that you know, so they will know who’s throwing them under the bus. 
Source: blogspot.com

Medicare will cut Social Security’s “raise” in : asics news

High-income seniors actually were hit among two ways: never only did they pay higher premiums,merely likewise the rate increases were greater than they would have been lacking the ��hold harmless�� provision. Under the decree Medicare enrollees cover 25 percent of projected Part B program costs; amid 2010 and 2011,nike air jordan 5, that projected spent was borne onward a much more narrow-minded base of beneficiaries �C and forward Medicaid, which likewise was stuck with chapter of the additional tab.
Source: enterprisebusinessexperts.biz

Medicare: A Brief Tutorial

Part A: Medicare’s equivalent of private health insurance catastrophic coverage and associated medical procedures for hospital and skilled nursing inpatient care; hospice, home healthcare. With critical limitations, Part A covers inpatient hospital care on an “admitted” status only and inpatient skilled nursing care for 20 days, $0 co-pay up to a 100 day limit per “spell of illness” and only if admission to the skilled-nursing facility follows a three-day/three-night inpatient hospital stay within 30 days of that hospital stay. Sign up for enrollment premium free.
Source: livinoutloudmag.com

The Myth of the $247 Medicare Part B Premium

The amount of the Part B premium is calculated each year based on health care costs from the previous year. For most individuals, the government pays 75 percent of this calculated premium, while beneficiaries are responsible for 25 percent. The aforementioned email suggests that the ACA universally and dramatically increases premiums for all Medicare beneficiaries, an indisputably false claim. In fact, one of the potential effects of the ACA, which does not alter the long-established formula used to calculate Part B premiums, may be to slow the growth rate of these premiums over time. Health reform intends to decrease fraud, waste and abuse, and drive down health care costs through delivery system reforms, such as preventing unnecessary hospital readmissions. Because the Part B premium is calculated based on health care costs, a decrease in the growth rate of these overall expenses will result in a similar slower growth rate for Part B premium costs.
Source: wordpress.com

2012 Medicare Premiums, Deductibles and Co

Enrollees in Medicare Part D prescription drug plans pay premiums that vary from plan to plan.  Beginning in 2011, Part D enrollees whose incomes exceed the same thresholds that apply to higher income Part B enrollees must also pay a monthly adjustment amount. The regular plan premium will be paid to their Part D plan, and the income-related adjustment will be paid to Medicare.  The amounts by income level are below.
Source: medicareadvocacy.org

The Importance of Comparing Medicare Supplemental Insurance Plans

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98Many Medigap customers think that comparing Medicare supplement insurance is a highly complicated process and that only insurance agents will know how to compare these supplement to Medicare policies. If you too are holding the same view about Medicare supplemental insurance, then you will be surprised to learn that comparing your Medigap plan options need not be a complicated or tedious process anymore. Today, the internet has empowered the customers so much that they can accomplish a lot of time consuming tasks in a matter of just few clicks. This applies to Medicare supplemental insurance price comparison too. You will be able to compare your Medicare supplement plans easily online. You will not have to visit several websites or spend several hours anymore to compare the various policies. You just need to find a reliable Medicare supplemental insurance website such as Lowcostmedigap.com that will allow you to compare Medigap plans online. Using such online services you will be able to make well-informed choices on your Medicare supplement. You will be able to save not only a lot of money but also a lot of time by comparing your Medicare supplement plans online.
Source: medicarequotefinderblog.com

Video: Medicare Advantage Plan Comparison Tool – PlanPrescriber

Medicare Advantage plans are a vital source of coverage for low

3rd Party Studies ACOs Admin Costs Cadillac Tax cbo Cost-Shift Dual Eligibles Employers Essential Benefits Exchanges GRP HAIs Health Plan Satisfaction House hearings House legislation KI MA Makena McCarran-Ferguson Medical Prices Medical Tests medicare medigap MedMal MLR Morning Headlines MT Patient Safety PCR premiums Premium Tax Profits Provider Consolidation PWC Quality Rate Review Readmissions Reform RZ Senate hearings Senate legislation Small Business The Link Vilification Waste Fraud and Abuse
Source: ahipcoverage.com

Best Medicare Supplement Plan

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Source: medicare-supplement-comparison.com

Polyclinique et Maternité D'Ilafy

Medicare is a federal health insurance plan for people over 65 years old and some disabled people. It is the primary insurance carrier for old people and the disabled. On the other hand, blue cross is the secondary insurer that covers most of what the primary insurer fails to pay (BlueCross BlueShield Association, 2009). In its design, Medicare does not cover all health care costs which mean clients covered by Medicare are responsible for a high percentage of their health care costs. Medicare patients have to dig deep into their pockets in order to repay for some of healthcare cost.  It has been established that doctors often charge more for the services they deliver than what Medicare will pay and patients are left with a deficit to cover for medical services.  Comparing the medical cost between Medicare and Blue Cross, it is evident that in Blue cross, one pays 2 a month while in Medicare you pay ,156.80 per year.
Source: polyclinique-ilafy.com

Best Comparison Of Medicare Supplemental With Other Plans

A Medigap policy refers to Medicare supplement insurance. It is a private health insurance offered by the private insurance company with many benefits of health insurance plans. It is very good plan used to fill the gaps between supplemental original Medicare. Therefore, it is the most supportive option for keeping you safe and secure, and then you have to pay some of the health care costs that are not covered by original Medicare. Well, if you want to secure your life for long term, then you have to take it from private health insurance company.
Source: ezinemark.com

Medicare Supplement Plans Comparison – Some questions to make the process easier

Choosing a plan is the first thing that one should do. Price comparison is the second job that one must keep at the priority list. After having a right plan in hand, price comparison can be done without worrying for the coverage or features. Medicare supplement insurance is one of the best types of insurance policies that one can buy for the family. It is also essential to create a checklist of to –do things before getting involved in buying an insurance policy. What kind of services you want? What type of treatments or medications you could require in the coming years? If you have good understanding of all such things, it will be easy for you to decide upon a right policy.
Source: ezinemark.com

Research Roundup: Medicare Vs. Private Plans

Archives Of Internal Medicine: Obesity Treatment For Socioeconomically Disadvantaged Patients In Primary Care Practice – Low-income patients are underrepresented in clinical trials and are disproportionately prone to obesity and the related problems of high blood pressure and heart disease. Researchers conducted a 24-month trial of more than 300 low-income, obese patients from various Boston community health centers, randomizing participants “to usual care or a behavioral intervention that promoted weight loss and hypertension self-management using eHealth components. The intervention included tailored behavior change goals, self-monitoring, and skills training, available via a website or interactive voice response.” The intervention resulted in “modest weight losses, improved blood pressure control and slowed systolic blood pressure” (Bennett et al., 4/9). Kaiser Family Foundation: How Does The Benefit Value Of Medicare Compare To The Benefit Of Typical Large Employer Plans? A 2012 Update — This study, updated from 2008, found that “Medicare remains less generous on average than typical large employer health plans, even after recent improvements in the program’s drug coverage. Overall, Medicare would cover $11,930 on average of the $14,890 in estimated annual spending for an individual age 65 and older, less than would be covered under either the federal employee plan ($12,260) or the typical PPO comparison plan ($12,800) for an individual age 65 and older. The gap was narrower in 2011 than it was in 2007, largely due to provisions in the Affordable Care Act that provide discounts on brand-name drugs purchased in the Medicare drug benefit’s coverage gap, or “doughnut hole” (McArdle, Levinson, Stark and Neuman, 4/4). The Heritage Foundation: Saving The American Dream: Comparing Medicare Reform Plans – The Heritage Foundation has proposed a premium support plan for Medicare as part of a comprehensive defict reduction package. This backgrounder looks at that proposal and five other plans that offer such supports. In a plan with a premium support, sometimes called a voucher, the government makes a fixed payment to Medicare beneficiaries, who then can shop for appropriate health insurance.  The author writes that, while details vary, each requires “traditional Medicare to compete with private plans, using competitive bidding to determine market-based payments to health plans, requiring upper-income retirees to pay more for their benefits, providing extra assistance to lower-income enrollees, and adding a risk-adjustment mechanism to guarantee market stability and security for older and sicker retirees. The breadth of the consensus on key policy components could be the basis for a strong bipartisan agreement” (Moffit, 4/4).
Source: kaiserhealthnews.org

Medicare Supplement insurance Plans Comparison

Another thing to remember is that the Medicare supplement packages are the same. Anything plan you select will be the same, whoever you buy it from. Your first order of business, therefore, is to understand what is included in the plans and to select the one that is right for you. If you select a more unabridged plan, such as Plan J, is will naturally cost more than Plan B, for instance, but even so, one guarnatee enterprise may payment more or less for it than another. guarnatee associates are not bound by law to payment the same excellent for the same policy.
Source: blogspot.com

Medicare Supplement insurance Plans

Icep – introductory Coverage determination Period. This is duration when you first go on Medicare, in which you can “elect” a Medicare benefit plan. This duration is three months before you go on Medicare Part B and three months after you go on Medicare Part B (for a total of 6 months). Aep – This is the every year determination Period. This is the one most people know about – the one you see the Tv advertisements for. This occurs in the middle of November 15 and December 31 each year. You can make changes to your benefit plan while this time. Oep – This is the Open Enrollment Period. This occurs from January 1 to March 31 each year. You can only make one convert while this time duration each year, and as a part of that change, you can neither add nor drop Part D coverage. In other words, if you have a plan that includes Part D now, you cannot switch into a plan that does not comprise Part D while the Oep.
Source: blogspot.com

Even average Medicare plans get government bonuses

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Source: retirementrevised.com

Don McCanne, MD: Why we need an improved 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.
Source: californiaonecare.org

Medicare Advantage plans are a vital source of coverage for low

Posted by:  :  Category: Medicare

Receiving Thanks from Seniors by ct senatedems3rd Party Studies ACOs Admin Costs Cadillac Tax cbo Cost-Shift Dual Eligibles Employers Essential Benefits Exchanges GRP HAIs Health Plan Satisfaction House hearings House legislation KI MA Makena McCarran-Ferguson Medical Prices Medical Tests medicare medigap MedMal MLR Morning Headlines MT Patient Safety PCR premiums Premium Tax Profits Provider Consolidation PWC Quality Rate Review Readmissions Reform RZ Senate hearings Senate legislation Small Business The Link Vilification Waste Fraud and Abuse
Source: ahipcoverage.com

Video: Understanding Medicare Advantage Plans

the walden pond blog: An Introduction to Medicare Advantage Plans

Shopping for an appropriate and cost-effective insurance plan can be a daunting experience. There are many choices but not all options are suitable for everyone. Medicare Advantage Plans have been popularly used since the programs were first introduced in 1997.
Source: blogspot.com

Types Of Standard Medicare Supplemental Insurance

Medigap policy operates just like any other supplement health insurance but is sold after being qualified by Medicare. The different policies offered offer basic health coverage with slight differences being noted throughout the plans that range from A-L. Notable differences can also be spotted among plans purchased from different companies especially about the issue of premiums. However, regardless of recognise the business supplies the plans, the 12 plans should be covered inside a standard manner and there should not be any any notable major variations in the typical covers. A couple of key gaps which can be present in medicare supplement plans will also be included in Medigap policy which includes coinsurance, deductibles, co-payments, emergency travel insurance and also short-term healthcare facilities. Every one of these may possibly not for sale in a single plan. Rates charged on additional insurance plans suffer from several factors especially on the issue of Medicare funding. Such funding tends to either increase or reduce premiums payable about the coverage. Other plans like medicare plan D usually do not provide coverage for various medical issues including private nurses, opticians and dental costs which patients must buy from other sources.
Source: officerelocationmagazine.com

AHIP: Many Medicare Advantage Enrollees Have Low Incomes

Medicare Advantage plans give enrollees incentives to use in-network providers. To reward enrollees for accepting limits on provider access, the plans typically charge low or no premiums and may offer much lower out-of-pocket costs than traditional Medicare plans. The private plans also may offer extra features, such as free memberships in exercise programs or free hearing tests.
Source: lifehealthpro.com

Medicare, “Medigap” and Medicare Advantage Plans

Yes. Another example: Citing language in the ACA, the Department of Health and Human Services has exempted Medicare Supplement carriers from so-called “rate review rules.” This means that Supplement carriers will be free to increase the rates and premiums they charge for the coverage without HHS oversight. This exemption will become important in a few years, when the ACA’s “guaranteed issue” standards are fully implemented. At that point, people will probably be paying more for Medicare Supplement coverage, even though the plans will likely cover less.
Source: online-health-insurance.com

Even average Medicare plans get government bonuses

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Source: retirementrevised.com

An introduction to the Humana Medicare advantage plans

Humana Medicare advantage plans have other additional benefits such as low-cost health and wellness services. Most of the plans also cater for gym memberships. This is very encouraging especially to people who are planning on loosing weight. Other benefits of this plan include; one has the option of choosing his/her desired health care provider, the policy holder can switch to the original Medicare plan and most of the prescription drugs issued are catered for. However, those who opt for doctors who do not participate in Medicare pay more for such services.
Source: moeec.com

Medicare Advantage Premiums To Fall 4% Next Year

The plans were targeted by Democrats who complained that the government pays more per capita for beneficiaries in the private plans than it spends on those in traditional Medicare. The billions of dollars cut from the plans were used to help the Obama administration pay for the cost of expanding coverage to 32 million Americans through expanded Medicaid eligibility and subsidies for people buying coverage in new insurance exchanges starting in 2014.
Source: kaiserhealthnews.org

CVS Agrees To Pay $5M To Settle Medicare Drug False Advertising Claims

Posted by:  :  Category: Medicare

"I'm George Washington and I approve this message." by eyewashdesign: A. GoldenBloomberg: CVS Caremark To Pay $5 Million To Settle FTC  Probe Of Medicare Drug Prices  The FTC said it decided to close its investigation “after a thorough and comprehensive review of the other consumer protection and competition issues in this matter,” and won’t take any further action “at this time,” according to a letter addressed to CVS Caremark’s lawyer. The FTC began investigating the business practices of the company in 2009 after CVS bought Caremark for $27.2 billion, the largest acquisition ever by a drugstore (Forden, 1/12).
Source: kaiserhealthnews.org

Video: Changes to Medicare Supplements – Plans M and N

Bateria para ASUS U56J Series : lan

The Patient Protection and Affordable Care Act was created by the Obama administration to improve the health care system in the United States. More specifically, it aims to reduce the number of people going without any form of health care coverage.Bateria para ASUS 4INR18/65 One of the controversial mandates of the new health care reform law is the Medical Loss Ratio (MLR). What Is The Medical Loss Ratio All About? Medical loss ratio is the percentage of premium dollars spent on medical care and healthcare quality improvements versus administrative costs. Under the medical loss ratio mandate of the health care reform law, starting 2011, all insurance companies are required to maintain a MLR of 80 percent for small group and individual health insurance plans and 85 percent for large group plans.Bateria para ASUS 4INR18/65-2 The remaining percentage should be spent on administrative costs. If an insurance company could not comply with this mandate, they would be required to issue rebates to their plan holders by 2012. Texas Filed A Waiver For The Implementation Of The MLR States are allowed to file a waiver to the secretary of Health and Human Services (HHS) Kathleen Sebelius if they think the MLR requirements would pose a risk of destabilizing their insurance market. It would be the decision of the secretary Bateria para ASUS A32-U46of HHS if she would grant the state a waiver or not. Since the passage of the health care reform law, the HHS has received 15 requests for exemption from the MLR mandate. Texas was one of the states who submitted a request regarding the medical loss ratio requirements for the individual and small group Texas health insurance plans.Bateria para ASUS A41-U46 Texas Department of Insurance believes that the mandate will disrupt their state’s individual and small group insurance plans. Currently, out of the 15 states who filed waiver requests, only one was fully approved. Five requests were granted limited approval and six were rejected right then and there. As for Texas and two other states, their fate still lies in the hand of HHS because they are waiting for the decision. How Will The MLR Mandate Affect According to Spencer Harris,Bateria para ASUS A42-U46 Texas health care policy analyst, the MLR mandate can be damaging because it interferes with the way insurance companies run their business. Instead of the main purpose of lowering premiums so people can afford getting healthcare, it might have the opposite effect. The medical loss ratio mandate might even raise Texas health insurance premiums. This would force a lot of insurers to stop doing business or leave the state. If this happens, competition among insurers will be limited driving up the prices of healthcare coverage. While waiting to see the changes to Texas health insurance, why not take a closer look at your health care spending? There are plenty of things that you can do to lower your health insurance premiums without compromising the quality of healthcare that you receive. You can get a high-deductible to get lower premiums. You may also consider pairing it up with an HSA to enjoy tax-free benefits.Bateria para ASUS U46 Series From the Medicare Modernization Act in 2003, the Medicare Advantage program that we know today was born. These types of plans allow seniors and people eligible for Medicare due to disability to get health coverage from private health insurance companies. Private insurance companies offering Medicare Advantage (MA) plans are required to offer the same benefits offered by Medicare Parts A and B. Part A covers hospital insurance while Part B covers medical insurance. Aside from coverage on both in-patient and out-patient services, Advantage plans typically cover some prescription drugs as well.Bateria para ASUS U46E Series That is why these plans are sometimes referred as Medicare Part C. They combine Medicare Part A, B and often Part D coverage. Since MA plans have been available, they have become a popular alternative to Original Medicare. In 2010 alone, approximately 25 percent of all Medicare beneficiaries were enrolled in Medicare Advantage plans. From an initial enrollment of 5.3 million, the enrollees have more than doubled and the numbers are still increasing every year. Medicare Advantage plans have paved the way for beneficiaries to expand on traditional Medicare benefits.Bateria para ASUS U46J Series Ever since the beginning of the program, the success that MA plans have had among seniors has been a subject of debate. Recently, data was released regarding the quality of care that MA enrollees receive. Medicare Advantage Plans Offer Higher Quality Of Care According to a study by Niall Brennan (Acting Director of the Office of Policy at the Centers for Medicare and Medicaid Services), and Mark Shepard (Ph.D. candidate in economics at Harvard University),Bateria para ASUS U46JC Series MA plans offer higher quality of care compared to Medicare fee-for-service plans for hospital utilization and delivery of care using widely-accepted measurements of quality. Back in 2006 when the first data on became available, Brennan and Shepard used 11 measurements to look at the underuse of effective care. Out of the 11 measurements, MA plans noticeably performed better than fee-for-service plans in 9 fee-for-service plans. Fee-for-service plans only outperformed Medicare Advantage plans on a couple of measurements, which were not that significant to overall care. A similar study was conducted by America’s Health Insurance Plans (AHIP) utilizing HEDIS (Healthcare Effectiveness Data and Information Set) measurements. The study shows quality improvements in health care for MA policyholders with diabetes and heart disease. Bateria para ASUS U46S SeriesThe findings reveal that compared to fee-for-service plans, diabetic MA policyholders have fewer hospital readmissions and shorter hospital stays. As for heart disease patients, the trend was the same. was also an option for coverage. Medicare Advantage plans have done a better job of preventing unneeded hospital admissions by increasing the use of doctor visits and outpatient health care services. Readmissions are also down due to superior and well-planned discharge procedures and coordination of medical care. According to Kathryn Nix,Bateria para ASUS U46SD Series a policy analyst at the Heritage Foundation, a lot of comparative studies have continually shown that Medicare Advantage plans offer above average medical services to their policyholders and result in better health outcomes for patients. The superior services offered by this program have contributed to the popularity of MA plans.In the past, having a job meant having health care coverage. But, times have changed. With the current economic crisis that we are facing today, people are struggling to get health insurance because premiums are on the rise. Having a job is no longer a guarantee that you will get health coverage from your employer. According to a recent report released by the UCLA Center for Health Policy Research,Bateria para ASUS U46SV Series hundreds of thousands of Californians lost their employer-provided health insurance plans. They were laid off from work because of the recession or employers just stopped offering health benefits to their employees because of financial hardship. However, the most alarming finding of the report resulting from the recession is the number of Californians facing healthcare debt significantly increased. Increase In Medical Debt Noted As stated in the new Bateria para ASUS U56 Series”State of Health Insurance in California” report, it showed from 2007 until 2009 there was an increase of 400,000 non-elderly Californians who faced some form of medical debt. The report also showed that medical debt was highest among those without consistent California health insurance. For those uninsured all of the year, 18.4 percent experienced healthcare debt. Among those uninsured for part of the year, 23.2 percent faced medical debt. Bateria para ASUS U56E SeriesThe report also added that even those with employer-provided California health insurance plans (9.1 percent) had their share of medical debt. Shana Alex Lavarreda, lead author of the report and director of health insurance studies at the UCLA Center for Health Policy Research, said that “No Californian should have to take on debt to pay medical bills or go without access to health care just because they lost their job.” What Are The Other Findings Of The Report Regarding ? Aside from the awareness that there is a rise in the number of Californians facing debt, the report also revealed that about half of those who have medical debt reported the amount to be less than $2,000.Bateria para ASUS U56J Series Based on this finding, Lavarreda said that Californians are living on a very “thin margin” since they don’t even have $2,000 to pay their medical bill. Among Medi-Cal enrollees, 18.2 percent had medical debt. This is really alarming because Medi-Cal is a program intended to provide comprehensive healthcare for low income individuals. For Lavarreda, this indicates that the program may not be covering all healthcare needs of the enrollee. Bateria para ASUS U56JC SeriesThe medical debt might have arisen from certain exclusions in coverage or the doctors accepting Medi-Cal are decreasing. Although there are people who rely on high-deductible to get lower premiums than co-pay plans, these plans are really risky because you need to pay off that high deductible before your he.
Source: lematin.ch

Seniors Not Taking Heart Medication in Part D Donut Hole

Medicare Part D Plan: Signing up for a Medicare Part D plan is important because enrollment in Medicare Part D will not only help you avoid a late enrollment fee, but it can also offer coverage for your prescription drugs. Every Medicare Part D plan has a different drug formulary and regulations around drug coverage. Given that each individual takes different amounts and combination of prescription drugs, it is important to select a Medicare Part D plan with the most drug coverage and lowest out-of-pocket costs for you and the unique combination of prescription drugs you take. You can compare Medicare Part D plans based on your individual medication needs by visiting the PlanPrescriber Medicare Part D plan comparison tool.
Source: ehealthinsurance.com

Medicare Part D Claims Preempted By Medicare Act, California Court Says

SAN FRANCISCO – The First District California Court of Appeal, Division Two, on April 24 affirmed a trial court ruling sustaining defendant Health Net Inc.’s demurrers in a Medicare Part D, prescription drug benefit, denial of benefits cause of action. The appeals court agreed with the lower court that the negligence claims against the insurance company are subject to administrative exhaustion and that the state fraud and unfair trade practices claims are preempted by the federal Medicare Act (Jordan Rosenberg v. Health Net Inc., No. A131756, Calif. App., 1st Dist., Div. 2; 2012 Cal. App. Unpub. LEXIS 3087). Full story on lexis.com
Source: lexisnexis.com

Richton Park man charged with $1M in Medicare fraud scheme

The indictment alleges that between January 2008 and June 2009 Day submitted fraudulent claims to Medicare totaling $1,078,733, and caused Medicare to pay approximately $438,852. Day allegedly submitted claims for individual psychotherapy services purportedly performed by Doctor A, knowing that Doctor A did not provide the services claimed. In addition, the claims included services that were purportedly provided at times when Doctor A was not present at Charm and not licensed by the state of Illinois. The claims also included services that were purportedly provided by Doctor A after Doctor A was no longer employed by Charm, and Day allegedly submitted Medicare claims for services purportedly rendered by Doctor A in excess of 24 hours a day.
Source: typepad.com

the walden pond blog: Medicare Health Care Plans at Affordable Prices

In order to offer top-notch Medicare health care services to the elderly people, the United States government announced Medicare health care plans for people aged 65 years and above. The government has been offering Medicare benefits to all the American citizens at very low rates. Various kinds of Medicare health plans are Medicare Supplement, Medicare Advantage and Part D Plans.
Source: blogspot.com

medicare supplement leads

Posted by:  :  Category: Medicare

"Every citizen should be a soldier. This was the case with the Greeks and Romans, and must be that of every free state." ` Thomas Jefferson. by eyewashdesign: A. GoldenThe Add Links To is a social network for news and interesting articles, shared by users registered with the site. Sign in to post legal articles, comment, or vote for the articles, or just read the news at will!. In Add Links To, you can submit your news articles, submit url of articles about tv, can submit site url of hot news, submit to here the news coolest, and more. To submit news or to add link of hot news, simply add a url, and after, you send a text resume. After this, you send your links to promote on twitter, share in facebook and add to other social media. Copyright © 2010-2012 Add Links To…
Source: addlinksto.com

Video: Free Insurance Leads…Your “Where Do I Sign?” Leads for Insurance?

A way to remain tension free – medicare supplement leads

All the above types have their own sets of limitations that can get exhausted anytime. And hence can not be fully relied upon. In this regard, you need the help of Medicare supplement leads. They will help you cover those areas that Medicare couldn’t. All the extra funds needed by you would be kept ready by these supplement needs. So having these supplement leads along with the general insurance cover will assure you that you will never fall short of any funds during your stay in the hospital and during your entire treatment days. These leads can be your perfect gift to your parents or grand parents so as to enable them to spend their last years peacefully and not worry unnecessary about the mounting medical expenses. It is thus very important to have them irrespective of your age group and your present condition. These leads can render your life stress free and you can relax and spend quality time with your near and dear ones.
Source: women-article.com

UroMed Expands Nationwide Insurance Network Coverage For Urological Supply Customers

Posted by:  :  Category: Medicare

About UroMed Catheters Headquartered in Suwanee, GA [a suburb of Atlanta], UroMed is one of the nation’s leading providers of single-use catheters, urological and disposable medical supplies, including intermittent catheters, closed system catheters, condom catheters, pediatric catheters and continence care products. UroMed is nationally accredited for Medicare reimbursement and most state Medicaid plans, and partners with private health insurance providers and health plans to provide patients with single-use catheters, catheter kits and incontinence products. UroMed also has seven staffed regional offices located in Boston, MA; Columbia, SC; Jacksonville, FL; Dallas, TX; Carlsbad, CA; Knoxville, TN; Richmond, VA; and Baton Rouge, LA; enabling next-day delivery after a customer’s initial medical supply order. For more information, please visit http://www.uromed.com or call 1-800-841-1233.
Source: wordpress.com

Video: UroMed Catheter Commercial 1: English

The CareGiver Partnership: Tax

Lynn Wilson founded The CareGiver Partnership based on her experience in caring for loved ones as well as providing the highest level of customer service. She takes pride in offering personalized service that helps her customers find the best solutions for their individual needs. Now that her children are grown, Lynn enjoys spending time with her granddaughter while also helping to care for her mom. To find out how The CareGiver Partnership can serve you, call 1-800-985-1353 M-F 9-4 CST.
Source: caregiverpartnership.com

Medicare Incontinence Supplies

Urinary incontinence and unexpected bowel problems are no longer whispered about subjects among medical professionals, patients and caregivers. However, these conditions are still private matters for many people. Increasing life span averages and progressive medical advances allow patients to use simple solutions such as Diapers for Adults, disposable garments such as Depends Adults Diapers and Adult Cloth Diaper products rather than complicated, expensive and embarrassing waste bags and catheter tubing. The demand for convenience, and the increased medical necessity for these products has dramatically increased the market for privately purchased disposable protection and billed Medicare incontinence supplies requested by hospitals, nursing homes and assisted living facilities. Individual consumers and facility purchasing managers will not only find product use to be easier, but purchase and delivery methods are streamlined when buying online.
Source: forincontinence.com

Cheap Catheters and Urological Supplies, Find Medicare Covered Leg Drain Bags, Foley and External Catheter Suppliers Online

Many seniors have incontinence problems or conditions which make require the use of incontinence supplies. If you are searching for a way to find cheap indwelling silicone foley catheters, you might consider any number of online suppliers. However, it will be important to make certain that these suppliers are authorized to bill Medicare Part B, to help keep the price affordable for you, whatever french size foley catheter you need. Generally, Medicare will only cover the use of foley catheters and urinary leg or night bags if you have been diagnosed with condition of permanent incontinence or permanent problems of urinary retention. Once a senior has this diagnosis, their doctor can write a prescription for the need incontinence supplies.  Present this presciption to the authorized supplier for the foley catheter or leg bag, then expect to pay 20% of the approved Medicare amount. Medicare will pay the final 80 percent of the approved amount for the urological supplies.
Source: seniornewscoverage.com

How to Use Samples to Notice the Right Incontinence Product for Your Wants

• Decide what you really would like-The fact is that not all incontinence is that the same. Some folks solely expertise light-weight symptoms while others could have a whole loss of bladder or bowel control. One in every of the foremost necessary steps in managing your incontinence is finding the incontinence undergarment that works best for your needs. Each kind of incontinence underwear contains a totally different absorbency level and even purpose. Many individuals who are only experiencing light incontinence may be ready to merely use an incontinence pad either in incontinence underwear or worn in traditional underwear. For those people with heavier symptoms they may want to use an adult diaper. You must conjointly keep in mind that the time of the day might play a half in what type of incontinence product you use. You will be ready to use a lighter incontinence product throughout the day however need a heavier one (like an adult diaper), at night. Visit for more info on Adult diapers.
Source: what-is-medicare.net

Medicare and Durable Medical Equipment

There are also apparatuses outside this basic definition and are known as DMEPOS.  This means aside from DME’s there are also prosthetics, orthotics, and other supplies related. Prosthetics is an artificial device extension that replaces missing or defective body parts.  Under this device category are other familiar devices such as hearing aids, gastric bands, and dentures.  On the other hand, orthotics is an orthopaedic device made to support or correct the function of a limb or torso.  This group of apparatuses can also assist movements, speed up the rehabilitation of a patient with fractures after cast, and also reduce pain caused by a certain bone or joint condition.
Source: ezinemark.com