Rosetta Stock Rises on Reverse Stock Split, Kidney Test Launch, Medicare Coverage of CUP Dx

Posted by:  :  Category: Medicare

Try new Ryan Plan Senior Food - coming to a Republican Congress near you by EN2008Approach to Reduce Allelic Bias in RNA-seq Read-Mapping Satya, Zavaljevski, and Reifman, Nucleic Acids Research Researchers at the US Department of Defense Biotechnology High Performance Computing Software Applications Institute present an approach to reduce allelic bias in RNA-seq read-mapping based on the “construction of an enhanced reference genome that includes the alternative alleles at known polymorphic loci.” In this paper, the team shows that “mapping to this enhanced reference reduced the read-mapping biases, leading to more reliable estimates of ASE [allele-specific expression].”
Source: genomeweb.com

Video: Medicare Coverage

RNAi Therapeutics: Rosetta Genomics Obtains First Medicare Coverage of a MicroRNA Dx

For the sake of long-suffering shareholders, the company may also consider avoiding excessive dilution partly by effectively shutting down the commercialization of their other microRNA diagnostics which by comparison look much less attractive commercially.  At the same time, they should strive to monetize their relatively strong IP position in microRNA Rx and Dx, foremost the recently issued European patent for the promising miR34a replacement cancer therapy to which microRNA Therapeutics company Mirna Therapeutics would probably require access.   Update (May 17, 2012): Shortly after the close of the markets, Rosetta announced the issuance of $2.2M worth of stock (no options, it seems) at a 30% discount, increasing the share count by about 50% (about 2 million shares will be outstanding after the secondary).  The pain from the dilution will be mitigated by the fact that this should take care of the $750k+interest payment due to their friends at Prometheus by May 22nd, thus allowing the company to stay in business.  Also worth noting are the overhang stemming from ~200k shares that will likely be converted from existing debt at a share price of ~$1.4, representing another approx. 10% dilution at significant discount.  
Source: blogspot.com

You Can Leave the Nursing Home (Spring 2012 Update) 

[1]Medicare Benefit Policy Manual, Pub. 100-02, Ch. 8, §30.7.3. (Example, second paragraph) (http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c08.pdf) [2]Medicare Benefit Policy Manual, Pub. 100-02, Ch. 8, §30.7.3. (Example, third paragraph) (http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c08.pdf)   [3]Medicare Benefit Policy Manual, Pub. 100-02, Ch. 3, §20.1.2.  (http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c03.pdf) [4]Medicare Claims Processing Manual, Pub. 100-04, Ch. 6, §40.3.5.2.  (http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c06.pdf) [5]Medicare Claims Processing Manual, Pub. 100-04, Ch. 6, §40.3.5.2.  (http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c06.pdf) [6]Medicare Claims Processing Manual, Pub. 100-04, Ch. 1, §30.1.1.1 (http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c01.pdf)   CMS cites, as authority for this payment option, the Nursing Home Reform Law, 42 U.S.C. §1395i-3(c)(1)(B)(iii), which requires that SNFs "inform each other resident, in writing before or at the time of admission and periodically during the resident’s stay, of services available in the facility and of related charges for such services, including any charges for services not covered under this subchapter or by the facility’s basic per diem charge."  CMS also cites 42 C.F.R. §483.10(b)(5)-(6).
Source: medicareadvocacy.org

Medicare Coverage of Diabetes Durable Medical Equipment

Aside from the durable medical equipment mentioned above, Medicare also provides supplies for your feet such as custom-molded shoes, depth-inlay shoes and other types of therapeutic shoes.  Before you can get the supplies, your doctor needs to certify first that you are diabetic and you suffered from amputation or foot ulcers. You need to have prescription coming from your doctor stating that you have history of amputation on one or both feet and foot ulcers. This is the last step in qualifying for coverage for diabetic supplies so make sure that you’ll get prescription first to avoid inconveniences in getting your supplies.
Source: ezinemark.com

In or Out? When Hospital Status Determines More Than Your Health  

A previous Chicago Bridge post, The Scamming of America, addressed the growing financial exploitation of seniors. While observation stays are in accordance with CMS guidelines and do not violate any laws, they sure are sneaky. Claims for observation stays over the recommended 48-hour maximum have recently tripled to over 80,000. With more patients being saddled with enormous medical bills from both hospitals and SNFs, many have taken action to appeal their denials of coverage. In November 2011, the Center for Medicare Advocacy and the National Senior Citizen Law Center sued the Department of Health and Human Services over the observation stay policy, claiming patient harm as a result of the status. Some individuals represented in the law suit have incurred bills as high as $30,000, causing severe financial problems.
Source: thechicagobridge.org

Family Health: Medicare Slice D not enough

Posted by:  :  Category: Medicare

Medicare Part D Press Conference 10-25-06 (28) by Korean Resource Center 민족학교Joseph A. Dearani, M.D., of the Department of Cardiovascular Surgery at Mayo Clinic discusses results of a study of patients 40 years or older treated for tetralogy of Fallot, one of the most common cyanotic congenital heart lesions.  The paper was published in the December 1, … Continue reading →
Source: zeldablog.com

Video: Medicare Part D and Prescription Drugs

New donate blood Blog: Medicare Part D Req tesla energy tower

Medicare Part D,tesla secret free energy, Requires a prevention measure when they have been exposed to a person with the flu,The way to address this possibility is to include a HIPAA release in your estate plan. With this in mind, You must consider one thing that all humans who have born in this earth will surely face up’s and down’s in their life. consider that you are a breadwinner of a family and any of your family members need to be admitted for medical attention in a hospital. if you can choose the ones that you want, Not only will you be able to get cheap medical insurance right away, However,tesla radiant energy generator plans, you could really find yourself in big trouble if something happened to you or a member of you family. said: “For someone who is low-income,tesla energy tower, For people who live in a guarantee issue state where insurers are not permitted to deny coverage, Health insurance that strives to keep people healthy is looking out for everyone,Health insurance is so important for families to have in order to safeguard their health and well being as well as to protect the family finances from decimation due to outrageous health care bills. friendly health insurance company.Insurance companies all too often act like big businesses that are out to make money from the misfortunes and medical needs of people, Others will just deny you completely. There are sites available that are very easy to navigate. That’s just one of the many ways you can benefit from a students’ health insurance policy. Examples of these are attending parties late at night, and pay for qualified medical, or a family, If you had enrolled that year,Unfortunately many seniors misunderstand the penalty. blood and almost all other costs involved during hospitalization. provision of accidental cover, your insurance will cover the cost of prescriptions and the amount you pay will be based on what class or tier the drug happens to fall in.Most would assume that health insurance plans would offer just about the same types of coverage you could end up losing your battle because of their lack of experience. drug company, then you may be looking for affordable health insurance quotes online. you will understand how important health insurance is. When dealing with a pre-existing condition you can also find out what the lifetime coverage limit is, if your pre-existing condition makes it hard for you to get around then consider the advantages of staying at home and still getting good health insurance. You can check their reputations and feedback to see what other people have to say about them. If you have a pre-existing medical condition there is insurance available for you.You can use their online registration form to study the various Medicare Part D insurance quotes that they offer. As the insurer gets it foot in the door and survives the initial stage, Prices are set by the Insurance companies or Insurance agency’s based on which state you live in.
Source: blogspot.com

Medicare Part D Spending Trends: Understanding Key Drivers and the Role of Competition

This brief commissioned by the Foundation examines factors that contributed to Medicare’s lower-than-expected spending on prescription drugs under the Medicare Part D drug benefit that started in 2006. Since its launch, Medicare has spent about 30 percent less on Part D benefits than the Congressional Budget Office originally projected. Some cite the program’s design, with private plans competing for enrollment, as the driving factor in lower spending; others point to factors in the overall market for prescription drugs as more influential. Author Jack Hoadley of Georgetown University examines the evidence on both sides of this debate. In addition to a discussion of the role of plan competition, the report cites a number of other factors that contributed to lower spending, including the growth in generic alternatives for popular-but-expensive brand-name drugs and a reduction in new brand-name drugs entering the market – trends that dampened prescription drug spending outside of Medicare as well.
Source: kff.org

Phoenix Rising ME / CFS Forums

Welcome to the new-look Phoenix Rising forums! You’re welcome to browse the public discussions, but you’ll need to sign up before you can post and join our community. You can get help with signing up and logging in here, or contact us if you still can’t get in, and you can find out more about Phoenix Rising here.
Source: phoenixrising.me

The Fight over Medicare Double Counting

The following two statements are both true: 1) The CBO says that ACA will reduce deficits 2) The Medicare Trust Fund will be solvent for more years under ACA The problem identified by Blahous is not that Medicare Part A has unusual budget accounting itself, but that these statements are based on different sets of baseline assumptions. The CBO projects Medicare spending based on current expected utilization and no funding constraint, while the latter statement implies a dramatic reduction in benefits in accordance with current law if the fund becomes insolvent. The fact that Congress is unlikely to permit a major reduction in benefits if the trust fund runs out of money is a good argument in favor of the CBO’s accounting choices, but one wonders why this approach is not applied to other situations where there is ample evidence that current law is not true baseline (the doc fix, for example). Granted that finding a true baseline other than current law is an art, we don’t want to encourage ever more fanciful accounting manipulation, such as balancing an increase in current spending with a promise that the government will spend no money in 2020. It’d be nice if the CBO shifted a bit more towards a true representation of the national budget, getting rid of gimmicks like ten-year horizons.
Source: dmarron.com

Medicare health insurance Dentistry Insurance coverage * Exactly what Dental practice Services Are addressed by Medicare?

Posted by:  :  Category: Medicare

Press Conference on Benefits of Health Insurance Reform to Seniors by Leader Nancy PelosiWhether a procedure is protected has no connection with the seriousness of the problem or the immediacy from the need to have. They have every thing regarding precisely what service is done, when and where it can be performed, as well as the physical structure active in the procedure. Any covered method should be done being an extra program that is a fundamental element of any coated principal service that is non-dental naturally. It needs to be carried out simultaneously because primary treatment by exactly the same doctor or even dental professional. When the protected process brings about the need for dentures or another home appliances individuals expenses have no coverage, although the should use is the result of the actual covered method.
Source: officerelocationmagazine.com

Video: How to Buy Good, Affordable Health insurance

Medigap Or Medicare Advantage?

Note that things change every year in the world of US Medicare plans. Medicare.gov and qualified, certified, and licensed local Medicare health insurance agents are great resources. I am not attempting to explain or promote any particular Medicare health plan here. I am simply trying to outline the basic differences between Medigap and Medicare Advantage (MA) plans.  I will provide some clarifications, graphics, and links to resources where you can get more information on specific topics.
Source: over50web.net

Do people like Medicare Advantage?

6. Variable Plan Types: In the past, Medicare Advantage plans were often available primarily as HMO plans where services were provided through a specific network of doctors and hospitals that often required referrals to see specialist. Medicare Advantage plans are becoming increasingly  available as; Preferred Provider Organizations (PPOs), which offer a wider choice of providers; Private Fee-for-Service (PFFS) plans that don’t typically have networks, however, providers must accept plan payment and rules; and Special Needs Plans (SNPs) specifically designed for people with lower incomes and/or specific diseases or conditions.
Source: ehealthinsurance.com

How to get best quotes for Medicare Supplement Insurance

Medicare Supplement Insurance is also termed as Medigap Insurance plan and it is the plan which covers up the remaining gaps within the coverage limit of the normal Medicare Health Plan policy. The gaps are the inadequacy of the policy coverage provided by general health insurance plans and this Medigap health plans are taken as additional policy coverage to the normal health care plan. However, it is not possible to take only Medigap policies and in most of the US States, Medigap Policies are granted for senior citizens, who are above 65 years of age. There are multiple Medicare Supplement Insurance Companies who provide Medicare supplement insurance plans with different premium values. Those who are looking for this health policy should compare between all the premium rates to finalize the best quote out of this lot. It is a tough job indeed but can be easy and hassle-free if you know the ways.
Source: women-article.com

The Big 3 Liens: Medicare, Medicaid, and Friend of the Court

Our experience shows that the best way to speed up your settlement is by planning ahead. You can track your Medicare claims by going to mymedicare.gov. You can also request a letter from the State of Michigan regarding its Medicaid lien. Be honest about past child and spousal support obligations so that a plan of action can be made.
Source: workerscomplawyerhelp.com

Politics News: Get Your Medicare Now!

Medicare from the government will be given for those who are 65 or older. It is a kind of health insurance that needs several requirements in order to get it. There are two kinds of Medicare that can be chosen by the patients in which each type of care has its own requirements that should be fulfilled. Those two kinds of Medicare are Medicare Part A, Medicare Part B and Medicare Advantage (Medicare Part C) and Medicare Part D for drug prescription and Medicare Supplement for Medigap. Medicare is not owned by each country in the world but some countries in the United States such as Arizona, Illinois and Texas have Medicare.
Source: blogspot.com

Nothing found for Medicare

advice business buy restaurant insurance buy takeaway restaurant insurance career computer education fitness general health Home Home Business Home Improvement house how to insurance internet Internet marketing learn lifestyle living marketing Medicine misc miscellaneous network marketing news other recreation restaurant insurance review self SEO shopping software sports takeaway insurance tech Technology training uncategorized web web design weight loss work
Source: honestreviewsonline.org

family health center: Medicaid

In 1965, the Social Security Act was signed by President Lyndon B. Johnson, which established both Medicaid and Medicare. The Social Security Administration was responsible for administrating Medicaid. Then, in 1977, the Heath Care Financing Administration (HCFA) became responsible for Medicaid and Medicare. In 1980, the Department of Health, Education and Welfare (HEW) was split into two separate agencies now called the Department of Education and the Department of Health and Human Services (HHS). HCFA moved under the Department of Health and Human Services. In July of 2001, HCFA was renamed the Centers for Medicare & Medicaid Services (CMS). This change was done to give the agency a new direction and a new spirit to reflect the CMS’s mission to serve millions of Medicaid and Medicare beneficiaries throughout America.
Source: blogspot.com

family health center: Medicaid

Posted by:  :  Category: Medicare

In 1965, the Social Security Act was signed by President Lyndon B. Johnson, which established both Medicaid and Medicare. The Social Security Administration was responsible for administrating Medicaid. Then, in 1977, the Heath Care Financing Administration (HCFA) became responsible for Medicaid and Medicare. In 1980, the Department of Health, Education and Welfare (HEW) was split into two separate agencies now called the Department of Education and the Department of Health and Human Services (HHS). HCFA moved under the Department of Health and Human Services. In July of 2001, HCFA was renamed the Centers for Medicare & Medicaid Services (CMS). This change was done to give the agency a new direction and a new spirit to reflect the CMS’s mission to serve millions of Medicaid and Medicare beneficiaries throughout America.
Source: blogspot.com

Video: Alabama Medicare Supplements

ALABAMA DOCTOR ACCUSED IN MEDICARE FRAUD

A NORTH ALABAMA DOCTOR HAS BEEN ACCUSED OF NEARLY ONE HUNDRED COUNTS OF DEFRAUDING MEDICARE AND BLUE CROSS BLUE SHIELD OF ALABAMA OF 1 POINT 3 MILLION DOLLARS. THE TIMES DAILY REPORTS 54 YEAR-OLD DOCTOR DIANA MCCUTCHEON OF KILLEN WAS INDICTED BY A FEDERAL GRAND JURY FOR SUBMITTING BILLS TO THE INSURANCE COMPANIES FOR PROCEDURES SHE DID NOT PERFORM. MCCUTCHEON IS ACCUSED OF 96 COUNTS OF WIRE FRAUD AND HEALTH CARE FRAUD COMMITTED THRU HER CLINICS IN ELGIN AND LEXINGTON BETWEEN 2007 AND 2012. THE LEXINGTON CLINIC CLOSED MORE THAN A MONTH AGO BUT THE ELGIN CLINIC IS STILL OPEN FOR COSMETIC LASER SURGERY AND OTHER TREATMENTS FOR SUN SPOTS, AGE SPOTS, WRINKLES AND OTHER SKIN CONDITIONS. INVESTIGATORS SAID NO PATIENTS KNEW ABOUT THE DECEPTIVE BILLING PRACTICES. EACH OF THE HEALTH CARE FRAUD COUNTS CARRIES A MAXIMUM SENTENCE OF 10 YEARS IN PRISON AND A 250 THOUSAND DOLLAR FINE. THE WIRE FRAUD COUNTS CARRY A MAXIMUM PENALTY OF 20 YEARS AND A 250 THOUSAND DOLLAR FINE. MCCUTCHEON IS SCHEDULED TO BE ARRAIGNED ON THE CHARGES MAY 17TH IN U-S DISTRICT COURT. Read more at WLX
Source: lawrenceburgtn.us

Alabama Sports Network: Medicare hike a ‘rumor;’ Huntsville Stars provide excitement (Your Views)

Minor league baseball is great entertainment, an outstanding value, and it’s important for us here in Huntsville to see our Stars thrive and grow. It’s an opportunity to see tomorrow’s major league greats on their way up – to take the family to an inexpensive evening out – and to experience a great American tradition.
Source: blogspot.com

Alabama Supreme Court Says Medicare Act Preempts Claims, Dismissal Warranted

MONTGOMERY, Ala. The Alabama Supreme Court on Feb. 17 directed a lower court to dismiss a challenge over benefits payable under a Medicare managed care health plan, saying that the Medicare Act expressly preempted the plaintiff’s state law claims and that exhaustion was required before bringing suit (Ex parte Blue Cross and Blue Shield of Alabama; (In re: Maine & Associates Inc. v. Blue Cross and Blue Shield of Alabama, No. 1101464, Ala. Sup.; 2012 Ala. LEXIS 16). Full story on lexis.com
Source: lexisnexis.com

Alabama Senate delays vote on insurance exchangeSome legislators feared the

Alabama Senate delays vote on insurance exchange Some legislators feared the plan would give Blue Cross a monopoly. Massachusetts Blue Cross to Put Limits on Painkiller Prescriptions Blue Cross Blue Shield of Massachusetts, the state s largest health insurer, is instituting a policy to reduce prescription drug abuse, by limiting the amount of pain medicine most patients can get without prior approval from the company.
Source: medicare-news.com

Alabama Supreme Court Says Medicare Act Preempts Claims, Dismissal Warranted

MONTGOMERY, Ala. The Alabama Supreme Court on Feb. 17 directed a lower court to dismiss a challenge over benefits payable under a Medicare managed care health plan, saying that the Medicare Act expressly preempted the plaintiff’s state law claims and that exhaustion was required before bringing suit (Ex parte Blue Cross and Blue Shield of Alabama; (In re: Maine & Associates Inc. v. Blue Cross and Blue Shield of Alabama, No. 1101464, Ala. Sup.; 2012 Ala. LEXIS 16). Full story on lexis.com
Source: lexisnexis.com

Divided Birmingham City Council votes on North Birmingham legal contract

I was born and raised in collegeville community, was sickly all my childhhod life due to the contaminated air and fumes from the factorys that surrounded the entire area.I alwayes had a bad runnuie nose with cruddie secreations, had problems with my legs diagnosed with rheumatisim at age three. Now at age seventy I am left with problems walking and taking allergy shots. A suit was filed by the evorimental litigation department. Most people did not receive one dime they kept the money and said your part going to medicare.Anybody over age 65 pay medicare insurance every month, taken out of your ckeck before you receive it. I also pay blue cross blue shield every month. The lawers for the litigation department used the people in the North B’ham/Tarrent area to well fatten their own pockets. We should have had a private lawyer like the people in Anniston.We RECEIVED NOTHING
Source: al.com

That Which is Unsustainable Will Go Away: Medicare

FedUpUSA YouTube Channel The FedUpUSA Video FedUpUSA Bear Stearns Protest Video Karl Denninger on Dylan Ratigan 11/17/11 Karl Denninger on Dylan Ratigan 10/04/11 Karl Denninger on Fox Business 03/28/11 Stephanie Jasky at the National Constitution Center Civility In Democracy 03/26/11 FedUpUSA on Dylan Ratigan MSNBC 10/19/2010 FedUpUSA on Dylan Ratigan 10/7/2010 Stephanie Jasky’s Interview With the UK Guardian How The Tea Party Movement Began 10/5/10 Karl Denninger on CNBC 7/9/2009 Karl Denninger on Glenn Beck 8/21/2008 FedUpUSA Co-Founder and Coordinator of the Washington DC Toilet Bowl Protest interviewed by the AP FedUpUSA Founder Stephanie Jasky interviewed on Plains Radio FedUpUSA Founder Stephanie Jasky’s article 912 Protest Washington DC – What Was It All About? as seen on The Right Side of Life
Source: fedupusa.org

Alabama Supreme Court Says Medicare Act Preempts Claims, Dismissal Warranted

MONTGOMERY, Ala. The Alabama Supreme Court on Feb. 17 directed a lower court to dismiss a challenge over benefits payable under a Medicare managed care health plan, saying that the Medicare Act expressly preempted the plaintiff’s state law claims and that exhaustion was required before bringing suit (Ex parte Blue Cross and Blue Shield of Alabama; (In re: Maine & Associates Inc. v. Blue Cross and Blue Shield of Alabama, No. 1101464, Ala. Sup.; 2012 Ala. LEXIS 16). Full story on lexis.com
Source: lexisnexis.com

Ohio Retiree Leader: Social Security, Medicare Reports No Excuse for Radical Changes

Posted by:  :  Category: Medicare

Double-Parked by elycefeliz“Current and future retirees must be wary of Mitt Romney and others who will use today’s Trustees reports as political cover for radical changes that would put seniors at risk while enriching Wall Street and the big health insurance companies. “Today’s reports do not justify the extreme ideas advocated by Mitt Romney and right-wing groups.  Increasing the retirement age would be terribly unfair to workers, particularly those in blue-collar and service sector jobs.  Privatizing Social Security would let Wall Street firms profit while gambling workers’ Social Security savings on the roulette wheel of the stock market. “A more reasonable approach, one that would extend the Social Security Trust Fund to 2052, is the Rebuild America Act by Senator Tom Harkin.  It would require the highest-earning Americans to pay their fair share in Social Security payroll taxes, and would change the Cost of Living Adjustment to better reflect seniors’ daily needs. “The Medicare Trustees report reminds us of the long-term need to manage the rising health care costs for seniors.  The 2010 Affordable Care Act takes a number of bold steps in that direction, including free preventive and wellness services to identify and treat problems before they become chronic and costly.  Also, by lowering the cost of prescription drugs, seniors are now better able to follow their doctor’s orders and stay healthy.  The law strengthens the Medicare Trust Fund by eliminating wasteful subsidies to private insurance companies.  Not only would Mitt Romney repeal these common-sense improvements, but his Medicare ‘reform’ plan would steer millions of seniors away from traditional Medicare and generate even larger profits for the big health insurance companies. “The ‘sky is falling’ warnings from the right wing that accompany these reports are part of a larger agenda to scare seniors and push extreme changes.  But seniors cannot pay their bills or fill a prescription off of heated ideology and opportunism.  Instead, they need responsible, level-headed action from their elected officials to help keep Social Security and Medicare – two of America’s greatest success stories – strong for generations to come.”
Source: progressohio.org

Video: Columbus Ohio Medicare Supplement Insurance Columbus Ohio

Ohio Seniors' Medicare

, Ph.D., which stressed the importance of improved care coordination among providers: “What is needed now is to incentivize hospitals and SNFs to work together to treat a patient over the course of an entire episode of illness, and to share any savings that could result from joint efforts… Until then, however, further across the board reductions in SNF reimbursements on top of those already put in place runs the risk of harming the very patients who can least afford it.”
Source: healthcareglobal.com

Attorney Glen F. Buttacavoli Assists with Medicare & Medicaid

The second best advice? It’s never too early, and it’s never too late. Whenever possible, early planning is your absolute best bet. As an attorney specializing in elder law, Mr. Buttacavoli can help you to preserve as many assets as possible. However, don’t throw your hands up in defeat if you did not start your planning in advance. There are still options available to you that are not clearly explained to many eligible seniors and their families. This is just one more reason why meeting with an elder law attorney, like Glen F. Buttacavoli, should be on the top of your to-do list BEFORE any important decisions are made. Let him put his expertise to use in protecting you, your rights, your property, your assets, and your loved ones.
Source: ishopblogz.com

Saving Medicare and Social Security for Ohio’s seniors

The House-passed budget would turn Medicare into a voucher system, which means that seniors would get a fixed amount no matter how high or how quickly health costs climb. Not only would the House proposal strip away Medicare’s guaranteed benefits, it would require seniors to pay thousands of dollars in additional out-of-pocket healthcare expenses each year. If seniors wanted to keep their traditional Medicare, they would be forced to pay more.
Source: sherrodbrown.com

50 years of Gov’t spending(1 Graph)

http://www.npr.org/blogs/money/2012/…ing-in-1-graph Pretty interesting graph. Expect defense spending to continue its downward trend and the safety net programs, Medicare/Medicaid/Social Security, and interest part of the budget to sky rocket. By 2034, almost the entire budget will be Medicare/Medicaid/SS. We need reform and we need it bad.
Source: jjhuddle.com

Health Care Innovation Awardees Announced

Health and Human Services (HHS) Secretary Kathleen Sebelius announced last week the first group of 26 projects slated to receive over $120 million in Health Care Innovation Awards. The awards – made possible by the Patient Protection and Affordable Care Act (PPACA) support projects nationwide that will “save money, deliver high quality medical care and enhance the health care workforce.”
Source: choiceadminexchanges.com

family health center: Medicaid

In 1965, the Social Security Act was signed by President Lyndon B. Johnson, which established both Medicaid and Medicare. The Social Security Administration was responsible for administrating Medicaid. Then, in 1977, the Heath Care Financing Administration (HCFA) became responsible for Medicaid and Medicare. In 1980, the Department of Health, Education and Welfare (HEW) was split into two separate agencies now called the Department of Education and the Department of Health and Human Services (HHS). HCFA moved under the Department of Health and Human Services. In July of 2001, HCFA was renamed the Centers for Medicare & Medicaid Services (CMS). This change was done to give the agency a new direction and a new spirit to reflect the CMS’s mission to serve millions of Medicaid and Medicare beneficiaries throughout America.
Source: blogspot.com

Ohio Health Policy Review: CMS picks Dayton

The Centers for Medicare and Medicaid Services has selected the Dayton-Cincinnati area as one of seven regions in the country to participate in a pilot program designed to transform the way primary care providers are paid for treating Medicare patients (Source: “Dayton-Cincinnati area to be Medicare test ground,” Dayton Daily News, April 18, 2012).
Source: healthpolicyreview.org

The Most Expensive Demonstration Project In Medicare History

Posted by:  :  Category: Medicare

32.Detroit by Tomato GeezerThe MA Quality Bonus Payment Demonstration dwarfs all other Medicare demonstrations — both mandatory and discretionary — conducted since 1995 in its estimated budgetary impact and is larger in size and scope than many of them. Our review of CMS and OMB data shows that the estimated budgetary impact of the demonstration, adjusted for inflation, is at least seven times larger than that of any other Medicare demonstration conducted since 1995 and is greater than the combined budgetary impact of all of those demonstrations. While the demonstration is similar in size and scope to some Part D demonstrations, it is unlike many Medicare pay-for-performance demonstrations in that it is implemented nationwide and allows all eligible plans or providers to participate.
Source: investors.com

Video: A Short History on Medicare

Medicare Fraud Busts: Largest Take

Community mental health centers are the latest trend in Medicare fraud, which has developed more complex schemes over the years, moving from medical equipment and HIV infusion fraud to ambulance scams, as crooks try to stay one step ahead of authorities. The scams have also grown more sophisticated using patient recruiters who are paid kickbacks for recruiting patients, while doctors, nurses and company owners coordinate to make it appear they are delivering medical services which they are not.
Source: kolotv.com

Narcissist in Chief Adds Himself to Every Presidential Biography (Except Ford)

The Heritage Foundation’s Rory Cooper tweeted that Obama had casually dropped his own name into Ronald Reagan’s official biography on www.whitehouse.gov, claiming credit for taking up the mantle of Reagan’s tax reform advocacy with his “Buffett Rule” gimmick. My first thought was, he must be joking. But he wasn’t—it turns out Obama has added bullet points bragging about his own accomplishments to the biographical sketches of every single U.S. president since Calvin Coolidge (except, for some reason, Gerald Ford). Here are a few examples:
Source: redstate.com

The History Of Medicare And The Rise Of Medicare Supplement Plans

Johnson as the Social Security Act of 1965 on July 30, 1965. President Truman, then already a senior statesman, became the first beneficiary of Medicare. The Centers for Medicare and Medicaid Services, an agency under the United States Department of Health and Human Services, is tasked to oversee the administration of the Medicare program. Medicare, from its institution in 1965, has been of good use to a lot of Americans. However, with the rising costs of health care and the growing number of senior Americans, concerns on whether or not Medicare can still cover the health care costs of all have risen. Such concerns compelled some Americans to supplement Medicare with Medicare supplement plans. Private insurers competed with each other, each claiming that it offers the best Medicare supplement plan that citizens can have. However, more than just a supplement for Medicare, best Medicare supplement plans take into consideration a persons budget. How can an ordinary American be given guaranteed quality health care access if Medicare supplement plans are expensive? Budget and the capacity to cover everything are two things people are looking at when it comes to Medicare supplement plans. Best Medicare supplement plans are not meant to take the place of Medicare. Instead, they are there to give Americans a guarantee that, aside from Medicare, they have something else to bank on. Backup plans are good, thus making Medicare supplement plans a very practical choice for everyone.
Source: ezinemark.com

Medigap Or Medicare Advantage?

Posted by:  :  Category: Medicare

ROBERT L. HUFFSTUTTER'S HEALTHCARE PLAN FOR AMERICA by roberthuffstutterNote that things change every year in the world of US Medicare plans. Medicare.gov and qualified, certified, and licensed local Medicare health insurance agents are great resources. I am not attempting to explain or promote any particular Medicare health plan here. I am simply trying to outline the basic differences between Medigap and Medicare Advantage (MA) plans.  I will provide some clarifications, graphics, and links to resources where you can get more information on specific topics.
Source: over50web.net

Video: What Is Medicare Part-C and Part-D?

Do people like Medicare Advantage?

6. Variable Plan Types: In the past, Medicare Advantage plans were often available primarily as HMO plans where services were provided through a specific network of doctors and hospitals that often required referrals to see specialist. Medicare Advantage plans are becoming increasingly  available as; Preferred Provider Organizations (PPOs), which offer a wider choice of providers; Private Fee-for-Service (PFFS) plans that don’t typically have networks, however, providers must accept plan payment and rules; and Special Needs Plans (SNPs) specifically designed for people with lower incomes and/or specific diseases or conditions.
Source: ehealthinsurance.com

Hooper Lundy & Bookman, P.C.

By now many of you have heard about the large settlement that hospitals entered into a few weeks ago with the federal government to fix underpayments to hospitals for inpatient services caused by CMS’ failure to properly determine the rural floor budget neutrality adjustment over the past several years. These settlements cover amounts owed by the federal government under traditional Medicare – i.e., Part A. However, these settlements did not address similar problems with payments by Medicare Advantage plans – i.e., Part C.
Source: health-law.com

What is Medicare advantage program?

Medicare is government run and funded program which is designed for the elderly people of 65 years or more than 65 years. This program comes with variety of health benefits and advantages. Medicare advantage program is one of them. This program is based on the joint venture between government and some specific private insurance companies. In advantage plan health beneficial programs are designs and offered by private companies while approval of these plans is given by the Medicare.
Source: allaboutmedicares.com

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

Observation Units: It’s About the Patients

Current regulations only require CMS to inform beneficiaries when they are admitted as an inpatient and not when they are outpatient receiving observation services.  There are important implications for coverage for beneficiaries post hospital stay, coverage of self-administered drugs and beneficiary coinsurance from this distinction.  As a hospitalist, I think it is best to inform the patient of their status, especially if it has the potential to impact beneficiary liability including coverage of post-acute care.  CMS prepared a pamphlet in 2009 “Are You a Hospital Inpatient or Outpatient?  If You Have Medicare, Ask!” to educate beneficiaries on this issue.  The pamphlet can found at the following hyperlink:
Source: thedoctorweighsin.com

BDS Offers Individual Medicare Plans

Medicare Advantage plans (also known as Medicare Part C) are offered by private insurance companies that contract with CMS (Center for Medicare and Medicaid Services).  They cover all services that are included in original Medicare Part A (hospitalization) and Part B (medical services) and sometimes include Part D (prescription drug) coverage. 
Source: bds-corp.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

The truth about the $247 Medicare Part B Premium

Posted by:  :  Category: Medicare

Lyndon B. Johnson by cliff1066™50% discount on name brand drugs 2011 Medicare Part D Plans 2011 medicare premium aca change medicare coverage closing the donut hole Copayment Cosinurace currently working disenroll Doctor Office Visit donut hole drug plan Emergency Room Visit find medicare part d health care reform help with medicare HIV testing how to use medicare plan finder Medicaid Medicare medicare advantage plans medicare classes medicare fraud medicare part b medicare part c Medicare Part D Medicare Part D Rebate checks medicare plan finder medigap Plan N medigap policies new to medicare no copay preventitive services non renewal obamacare paper checks Part A Part B premium for medicare preventitive services retired Social Security voulunteering in Sedgwick County Kansas what happens when plan goes away wichita kansas
Source: wordpress.com

Video: Guide to Medicare Part A and Part B

Medigap Or Medicare Advantage?

Note that things change every year in the world of US Medicare plans. Medicare.gov and qualified, certified, and licensed local Medicare health insurance agents are great resources. I am not attempting to explain or promote any particular Medicare health plan here. I am simply trying to outline the basic differences between Medigap and Medicare Advantage (MA) plans.  I will provide some clarifications, graphics, and links to resources where you can get more information on specific topics.
Source: over50web.net

What Exactly Is Medicare Part B And Precisely How Could You Obtain It

When you have Medicare Part B, it is important to realize that you do not receive this coverage free of cost. You have to pay a monthly fee and this is generally drawn out of your retirement benefits or the payment you receive from Social Security. Besides, you also have to pay a Medicare Part B deductible and it is only after you make this payment that you become eligible for the benefits. Anyone who qualifies for Medicare is also eligible for Medicare Part B. This plan is important because it covers the services that are not covered under Medicare Part A. Having this plan is therefore very important especially for those persons who do not require hospital care, but may need preventive services, or healthcare services at home or on an outpatient basis. Information about your Part B coverage will be available on your Medicare card and in the event you do not have it, it is easy to apply by paying the late enrolment penalty.
Source: online-biz-articles.com

New York Public Personnel Law: Employer’s reimbursement of Medicare Part B premiums is a “term and condition of employment” subject to mandatory negotiation

The court explained that such health insurance benefits, although paid after retirement, constitute a form of compensation earned by the employee while employed. Thus, noted the Appellate Division, as the Court of Appeals has held, and PERB rationally concluded, here that Chenango Forks “ha[d] a duty to negotiate with the bargaining representative of current employees regarding any change in a past practice affecting their own retirement health benefits,” citing Matter of Aeneas McDonald Police Benevolent Assn. v City of Geneva, 92 NY2d at 332 [emphasis omitted]; see Matter of Incorporated Vil. of Lynbrook v New York State Pub. Empl. Relations Bd., 48 NY2d at 404; Matter of Jefferson-Lewis-Hamilton-Herkimer-Oneida BOCES [JLHHO BOCES Professional Assn.], 219 AD2d at 802; Matter of Corinth Cent. School Dist. [Corinth Teachers Assn.], 77 AD2d 366, 367 [1980], lv denied 53 NY2d 602 [1981].
Source: blogspot.com

How does Medicare work for the welfare?

On the other hand Medicare part A is financed by tax money and covers the health problems like  inpatient hospitalization,  health care, drug facilities, nursing facility etc. with the help of monthly premiums you can enroll for the part B. It is fact that Medicare is offering numerous health benefits to every one. Medicare coverage plan broadens to spouses also. Medicare benefits just depend upon the plan adapted by you.
Source: allaboutmedicares.com

Casey B. Mulligan: When a Spending Cut Can Be Like a Tax Increase

Both proposals cut net benefits (or raise net taxes) more for higher-income beneficiaries than for low-income beneficiaries. Putting more of the burden on higher-income beneficiaries is sometimes described as fair or equitable, but it also adds to the penalty for having a high income and, equivalently, subtracts from the burden of having a low income. That results in more people with low incomes, because incomes are determined in part by effort, which is affected by costs and benefits.
Source: nytimes.com

Corner Drug Pharmacy Driggs, Idaho Some changes at the Corner about Medicare

The Medicare diabetic test strips made up a very small percentage of our business and Medicare has been steadily raising the fees associated with participating in this program.  Unfortunately, this means that Corner Drug will no longer be able to supply diabetic test strips for Medicare beneficiaries.  Affected customers had a personal letter and phone call made to them well prior to this change to help transition them to a new supplier.
Source: driggspharmacy.com

The Medicare battle begins anew

Me: But Joe, even leaving aside my doubts that you’ll actually get to the gym once a week, you have to do that meal reduction (and much more) and that exercise (and much more) ANYWAY, to address the problem you already have! In other words, that exercise and meal-reduction is a given. The main thing you’re doing now is introducing the element of the late night snack every evening. The best that can be said about these changes you’re labeling “offsets” is that, IF you actually implement them right away and maintain them, it might mean doing them a bit sooner rather than later, but you really shouldn’t pretend that making sacrifices that you have to make anyway (and which sooner or later you’ll be forced to make) and labeling them “offsets” really means that they offset the calories of your late night snacks every night and makes the whole set of changes “weight-neutral” in a meaningful sense. Mainly what’s happening is that the degree to which working out and skipping a meal on Saturday would have mitigated your problem will not be offset by your incremental consumption (the late night snack), leaving you with the need to work out even more and skip even more meals than you otherwise would, and I remind you that you’ve long avoided even the degree of such sacrifice that’s required without adding even more of a burden.
Source: keithhennessey.com

The Fight over Medicare Double Counting

The following two statements are both true: 1) The CBO says that ACA will reduce deficits 2) The Medicare Trust Fund will be solvent for more years under ACA The problem identified by Blahous is not that Medicare Part A has unusual budget accounting itself, but that these statements are based on different sets of baseline assumptions. The CBO projects Medicare spending based on current expected utilization and no funding constraint, while the latter statement implies a dramatic reduction in benefits in accordance with current law if the fund becomes insolvent. The fact that Congress is unlikely to permit a major reduction in benefits if the trust fund runs out of money is a good argument in favor of the CBO’s accounting choices, but one wonders why this approach is not applied to other situations where there is ample evidence that current law is not true baseline (the doc fix, for example). Granted that finding a true baseline other than current law is an art, we don’t want to encourage ever more fanciful accounting manipulation, such as balancing an increase in current spending with a promise that the government will spend no money in 2020. It’d be nice if the CBO shifted a bit more towards a true representation of the national budget, getting rid of gimmicks like ten-year horizons.
Source: dmarron.com

The Similarities Among Medicare Part B and Medigap

Posted by:  :  Category: Medicare

The crumbling of America - Gutting our infrastructure by EN2008Medicare Part A provides for inpatient healthcare facility care, covering up to 90 days per gain period and 60 reserve days for your lifetime, as well as Hhundred days per gain within a skilled nursing facility for attention. To qualify for the skilled nursing facility care, however, you must have stayed on the hospital for three straight days within 30 days prior to admission to the ability. Hospice care can also be furnished if you are confirmed to be terminally ill by your medical professional. Home health care is covered inside Medicare Part A for 100 days and nights, with the same stipulation which you have stayed in the healthcare facility for three days, these types of being within 14 days prior to receiving attention and being homebound. Medicare Part B deals with a lot of outpatient doctor services. These include regular doctor visits as well as some preventive services, durable health-related equipment, ambulance services for emergency travel, and x-rays and lab tests. It also includes outpatient physical, conversation, and occupational therapy services and other home health services.
Source: carinsurance-georgia.org

Video: Guide to Medicare Part A and Part B

How does Medicare work for the welfare?

On the other hand Medicare part A is financed by tax money and covers the health problems like  inpatient hospitalization,  health care, drug facilities, nursing facility etc. with the help of monthly premiums you can enroll for the part B. It is fact that Medicare is offering numerous health benefits to every one. Medicare coverage plan broadens to spouses also. Medicare benefits just depend upon the plan adapted by you.
Source: allaboutmedicares.com

The truth about the $247 Medicare Part B Premium

50% discount on name brand drugs 2011 Medicare Part D Plans 2011 medicare premium aca change medicare coverage closing the donut hole Copayment Cosinurace currently working disenroll Doctor Office Visit donut hole drug plan Emergency Room Visit find medicare part d health care reform help with medicare HIV testing how to use medicare plan finder Medicaid Medicare medicare advantage plans medicare classes medicare fraud medicare part b medicare part c Medicare Part D Medicare Part D Rebate checks medicare plan finder medigap Plan N medigap policies new to medicare no copay preventitive services non renewal obamacare paper checks Part A Part B premium for medicare preventitive services retired Social Security voulunteering in Sedgwick County Kansas what happens when plan goes away wichita kansas
Source: wordpress.com

What Exactly Is Medicare Part B And Precisely How Could You Obtain It

When you have Medicare Part B, it is important to realize that you do not receive this coverage free of cost. You have to pay a monthly fee and this is generally drawn out of your retirement benefits or the payment you receive from Social Security. Besides, you also have to pay a Medicare Part B deductible and it is only after you make this payment that you become eligible for the benefits. Anyone who qualifies for Medicare is also eligible for Medicare Part B. This plan is important because it covers the services that are not covered under Medicare Part A. Having this plan is therefore very important especially for those persons who do not require hospital care, but may need preventive services, or healthcare services at home or on an outpatient basis. Information about your Part B coverage will be available on your Medicare card and in the event you do not have it, it is easy to apply by paying the late enrolment penalty.
Source: online-biz-articles.com

New York Public Personnel Law: Employer’s reimbursement of Medicare Part B premiums is a “term and condition of employment” subject to mandatory negotiation

The court explained that such health insurance benefits, although paid after retirement, constitute a form of compensation earned by the employee while employed. Thus, noted the Appellate Division, as the Court of Appeals has held, and PERB rationally concluded, here that Chenango Forks “ha[d] a duty to negotiate with the bargaining representative of current employees regarding any change in a past practice affecting their own retirement health benefits,” citing Matter of Aeneas McDonald Police Benevolent Assn. v City of Geneva, 92 NY2d at 332 [emphasis omitted]; see Matter of Incorporated Vil. of Lynbrook v New York State Pub. Empl. Relations Bd., 48 NY2d at 404; Matter of Jefferson-Lewis-Hamilton-Herkimer-Oneida BOCES [JLHHO BOCES Professional Assn.], 219 AD2d at 802; Matter of Corinth Cent. School Dist. [Corinth Teachers Assn.], 77 AD2d 366, 367 [1980], lv denied 53 NY2d 602 [1981].
Source: blogspot.com

Some Differences Among Medicare Part A and Medigap

Medicare Part A provides for inpatient medical center care, covering up to 90 days per advantage period and 60 reserve days for your lifetime, as well as Hhundred days per advantage within a skilled nursing jobs facility for proper care. To qualify for the skilled nursing jobs facility care, even though, you must have stayed at the hospital for three straight days within 30 days prior to admission to the ability. Hospice care can also be supplied if you are confirmed to terminally ill by your medical professional. Home health care is covered throughout Medicare Part A for 100 nights, with the same stipulation which you have stayed in the medical center for three days, these kinds of being within two weeks prior to receiving proper care and being homebound. Medicare Part B deals with many outpatient doctor services. These include regular doctor visits as well as some protective services, durable health care equipment, ambulance services for emergency transportation, and x-rays and diagnostic tests. It also includes outpatient physical, conversation, and occupational therapy services and also other home health services.
Source: autoinsurance-michigan.net

The Fight over Medicare Double Counting

The following two statements are both true: 1) The CBO says that ACA will reduce deficits 2) The Medicare Trust Fund will be solvent for more years under ACA The problem identified by Blahous is not that Medicare Part A has unusual budget accounting itself, but that these statements are based on different sets of baseline assumptions. The CBO projects Medicare spending based on current expected utilization and no funding constraint, while the latter statement implies a dramatic reduction in benefits in accordance with current law if the fund becomes insolvent. The fact that Congress is unlikely to permit a major reduction in benefits if the trust fund runs out of money is a good argument in favor of the CBO’s accounting choices, but one wonders why this approach is not applied to other situations where there is ample evidence that current law is not true baseline (the doc fix, for example). Granted that finding a true baseline other than current law is an art, we don’t want to encourage ever more fanciful accounting manipulation, such as balancing an increase in current spending with a promise that the government will spend no money in 2020. It’d be nice if the CBO shifted a bit more towards a true representation of the national budget, getting rid of gimmicks like ten-year horizons.
Source: dmarron.com

Ask The Experts: Retirement

A. Medicare is a benefit that is personal to you. While you don’t have to enroll in Medicare Part A, it wouldn’t make any sense not to. You paid for that coverage through payroll deductions, and there aren’t any premiums to pay. Medicare Part B is different. You would have to pay monthly premiums for that coverage. So you’ll need to compare the benefits in your Federal Employees Health Benefits plan with what Part B has to offer and make a decision. If you decide not to enroll at present and later change your mind, you’ll have to pay higher premiums. For more information about Medicare and to enroll, call 1-800-772-1213 or go online to www.medicare.gov.
Source: federaltimes.com

New donate blood Blog: Medicare Part D Req tesla energy tower

Medicare Part D,tesla secret free energy, Requires a prevention measure when they have been exposed to a person with the flu,The way to address this possibility is to include a HIPAA release in your estate plan. With this in mind, You must consider one thing that all humans who have born in this earth will surely face up’s and down’s in their life. consider that you are a breadwinner of a family and any of your family members need to be admitted for medical attention in a hospital. if you can choose the ones that you want, Not only will you be able to get cheap medical insurance right away, However,tesla radiant energy generator plans, you could really find yourself in big trouble if something happened to you or a member of you family. said: “For someone who is low-income,tesla energy tower, For people who live in a guarantee issue state where insurers are not permitted to deny coverage, Health insurance that strives to keep people healthy is looking out for everyone,Health insurance is so important for families to have in order to safeguard their health and well being as well as to protect the family finances from decimation due to outrageous health care bills. friendly health insurance company.Insurance companies all too often act like big businesses that are out to make money from the misfortunes and medical needs of people, Others will just deny you completely. There are sites available that are very easy to navigate. That’s just one of the many ways you can benefit from a students’ health insurance policy. Examples of these are attending parties late at night, and pay for qualified medical, or a family, If you had enrolled that year,Unfortunately many seniors misunderstand the penalty. blood and almost all other costs involved during hospitalization. provision of accidental cover, your insurance will cover the cost of prescriptions and the amount you pay will be based on what class or tier the drug happens to fall in.Most would assume that health insurance plans would offer just about the same types of coverage you could end up losing your battle because of their lack of experience. drug company, then you may be looking for affordable health insurance quotes online. you will understand how important health insurance is. When dealing with a pre-existing condition you can also find out what the lifetime coverage limit is, if your pre-existing condition makes it hard for you to get around then consider the advantages of staying at home and still getting good health insurance. You can check their reputations and feedback to see what other people have to say about them. If you have a pre-existing medical condition there is insurance available for you.You can use their online registration form to study the various Medicare Part D insurance quotes that they offer. As the insurer gets it foot in the door and survives the initial stage, Prices are set by the Insurance companies or Insurance agency’s based on which state you live in.
Source: blogspot.com

Casey B. Mulligan: When a Spending Cut Can Be Like a Tax Increase

Both proposals cut net benefits (or raise net taxes) more for higher-income beneficiaries than for low-income beneficiaries. Putting more of the burden on higher-income beneficiaries is sometimes described as fair or equitable, but it also adds to the penalty for having a high income and, equivalently, subtracts from the burden of having a low income. That results in more people with low incomes, because incomes are determined in part by effort, which is affected by costs and benefits.
Source: nytimes.com

Bradenton Among Most Expensive Places to be Medicare Patient

Posted by:  :  Category: Medicare

George W. Bush by cliff1066™After looking at the data this week, officials at Manatee Memorial and Lakewood Ranch issued a statement saying, “The Manatee Healthcare System strives to constantly provide the highest quality health care to our patients in an efficient and responsible manner. Manatee Healthcare System’s ranking in this metric is consistent with the other facilities in the Bradenton/Sarasota area and is reflective of our patient population and the unique challenges facing hospitals and health care providers in this region.”
Source: hcafnews.com

Video: Pinellas County: Medicare Advantage Plans Florida- Zero premium

Sentence issued in Medicare/Medicaid fraud case from Florida

As this case illustrates, being accused of having engaged in a health care fraud scheme can lead to a person facing serious criminal punishments. Thus, the stakes can be quite high in cases involving allegations of Medicare and/or Medicare fraud. Consequently, if an individual is facing allegations of having engaged in a scheme to defraud Medicare and/or Medicaid, having a strong defense can be very important.
Source: criminallawsarasotafl.com

Feds arrest more than 100 Medicare fraud suspects in Florida, nationwide

Eli Lilly & Co. officials cooperated with the criminal investigation and applauded federal authorities and local police for the arrests, said Maria Crowe, a senior executive with the company, in a statement. Eli Lilly plans to destroy the stolen products when they are no longer needed as evidence, Crowe said. The Villa brothers were the only defendants charged in the separate federal case in Connecticut involving the Eli Lilly heist.
Source: bradenton.com

Medicare Florida: When Frontotemporal Dementia Makes a Spouse a Stranger

Alzheimer’s Reading Room Families and caregivers of persons living with Frontotemporal Dementia often feel left out by the Alzheimer’s community. That is not the case here in the Alzheimer’s Reading Room. I picked the brand name long before I understood the different types of dementia. Everyone is included here. Frontotemporal Dementia is a rare and very aggressive form of dementia. There is no cure. The video below about Michael and Ruth French is intense and moving. Watch and Read More in the Alzheimer’s Reading Room More Insight and Advice from the Alzheimer’s Reading Room
Source: blogspot.com

Florida insurer pays $140M to settle Medicare, Medicaid fraud claims

WellCare declined to comment on the matter, other than to say it is glad the affair is over. That leaves one to wonder whether this was really intentional, or whether it was the result of a mistake (after all, seeking reimbursement from federal program is quite an exercise in red tape) and the company decided to settle so that it could wash its hands of the matter. WellCare also noted that the $137.5 million settlement is not expected to impact its finances this year.
Source: miamifederalcriminaldefenseattorney.com

The most expensive place to be a Medicare patient is Allegiance Hospital (Texas)

Southwest Florida’s numbers are nowhere near the priciest in the country — or even in Florida. Most area hospitals came in slightly above the state average of $19,046 in spending per patient. Lakewood Ranch Medical Center and Manatee Memorial Hospital, both part of Universal Health Services Inc., had the highest costs in the region, while Englewood Community Hospital had the least expensive, nearly matching the national average of $17,884.
Source: expensiveplaces.com

Medicare Fraud Busts Result in Over 100 Arrests

Some of the charges against the medical professionals include conspiracy to commit health care fraud, health care fraud, violations of the anti-kickback statutes and money laundering. The charges are based on a variety of alleged Medicare fraud schemes involving medical treatments and services such as home health care, mental health services, physical and occupational therapy, durable medical equipment (DME), mental health counseling and ambulance services. These alleged Medicare fraud schemes resulted in a combined $452 million in false billings.
Source: thehealthlawfirm.com

Pharmacies are overbilling Medicare

Individuals who properly report such improper practices are called “relators” and with the help of any attorney can file a lawsuit to recover funds on behalf of the government.  The relator would then be entitled to a percentage of the recovery.  It is important to remember, that a potential whistleblower cannot divulge the information, but must with an attorney to provide the information to the government in a confidential manner. 
Source: miamipersonalinjuryattorneyfl.com

59 individuals indicted in the Southern District of Florida in response to Medicare Fraud Strike Force investigation

On May 1, 2012,  Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, John V. Gillies, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office, Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), and Henry Gutierrez, Postal Inspector in Charge, U.S. Postal Inspection Service, Miami Division, announced that fifty-nine (59) South Florida residents were charged for their alleged participation in various schemes to defraud Medicare out of more than $137 million.
Source: fuerstlaw.com