Volunteers Needed to Help People Understand Their Medicare Choices

Posted by:  :  Category: Medicare

George W. Bush by cliff1066™Do you want a volunteer position that is truly fulfilling and mentally stimulating? Then consider counseling seniors and the disabled with the SHINE (Serving Health Insurance Needs of Elders) program. SHINE volunteers are both active and retired individuals from diverse career and cultural backgrounds.  As a volunteer, you will receive initial training, continuing education and a supportive environment with dedicated colleagues.
Source: patch.com

Video: Florida Medicare Advantage Plans – Supplement Health Insuran

Few Seniors Getting Medicare Wellness Visits

One of the key strategies for Medicare implemented by the Obama health reform bill is a shift away from treating illness to a focus on preventing illness through efforts such as increased preventive health screening and paying doctors for advising senior citizens on how to live healthier lives. A new national study says, however, that a majority of healthcare practices across the country aren’t prepared to meet the demand of the 46.6 million Medicare beneficiaries who are now eligible for these wellness visits.
Source: floridahomecare.net

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

ACOs Multiply As Medicare Announces 27 New Ones

Harold Miller, president and CEO of the Network for Regional Healthcare Improvement and executive director of the Center for Healthcare Quality & Payment Reform in Pittsburgh, says ACOs will continue to be the model of the future, even if the Supreme Court strikes down the health care law. The private sector, he says, has been moving in the direction of coordinated care for years.
Source: kaiserhealthnews.org

Obama Campaign Up With Two More Ads In Florida

The first spot, “Sacred Trust,” is a Memorial Day-timed message about honoring veterans. In the ad, Obama says, “The sacrifices that our troops have made have been incredible. It’s because of what they’ve done that we’ve been able to go after al-Qaida and kill bin Laden. And when they come home we have a sacred trust to make sure that we are doing everything we can to heal all of their wounds. Giving them the opportunities that they deserve to find a job and get the education that they need.”
Source: fldemocracy2012.com

Getting the Best of Fl Medicare

Fl medicare is a health cover provided to people based on certain conditions. The conditions are that it is eligible for individuals of 65 years and above, those under 65 but have disabilities and any individual with a kidney problem. Boasting as a giant in Medicare provision, Florida medicare insurance has several health plans. This gives you the privilege of choosing the right medicare that fits your needs. An FL medicare offers a combinational medical approach to their clients. This includes affordability, flexibility and value. The three words summarizes the packages that Florida Medicare insurance offer. Medicare insurance Florida is divided into 4 sections. These include Medicare Part A, Part B, Part C and Part D.
Source: dime-co.com

Florida Health Insurance the Ups and Downs

Most florida health insurance plans are in–network services meaning that all the various services are attended to by qualified and supported physicians within a defined network. They are chosen based on certain criterion and their fees are paid by the network.  One of the florida health options is to opt for Health Savings Plan. These will ensure that you are eligible to save money for your future medical expenses. There are 100% deductible after florida health plans which means that the plan will pay for all the expenses after you have met the deductibles. Short term health insurance plan florida give you cover during the period when you are changing policies or are in between jobs.
Source: 2healthinsurance.net

Fl ARNP Political Action Committee: Grassley, Kohl push Medicare on Sunshine Act

“The Constitution of this Republic should make special provision for medical freedom. To restrict the art of healing to one class will constitute the Bastille of medical science. All such laws are un-American and despotic. Unless we put medical freedom into the constitution the time will come when medicine will organize into an undercover dictatorship and force people who wish doctors and treatment of their own choice to submit to only what the dictating outfit offers.” Advance Practice Nurses offer a choice.
Source: flarnppac.com

Make Your Life in Florida More Beneficial with Fl Medicare

Choosing from the Medicare PPO list offers you lower copay for your health insurance unlike when you choose the doctors and hospitals outside the Medicare PPO network. Low Income Subsidy or LIS is available for Florida Medicare as well as providing you assistance for your prescriptions. Fl Medicare members also qualify for the Extra Help with their prescription drug plans that are worth $4,000 annually. Extra Help qualifications require you to be a member of Florida Medicare, have limited income, and you reside in the District of Columbia. Enrollment for Medicare is done annually for a period of almost three months. Enrolling and changing of plans should be done within the enrollment period provided for by Florida Medicare. Medicare health insurance covers health care expenses and services and not coinsurance, copayments, and deductibles. These are gaps within everyone’s Medicare insurance. To help you with these gaps or other costs, there is the Florida Medicare Supplements or Medigap. The policies of Florida Medicare Supplements help you cover those gaps in your Medicare health insurance by helping you to pay for some of the other health care costs that you haven’t thought of. These policies have additional benefits and services not provided for in your Medicare insurance. Private insurance companies provide for the plans that range from A to L. The policies offered are standardized which means that the benefits and services of one plan are the same in other insurance companies within the state of Florida. The only difference that you will see is in the cost because of factors like underwriting and rating methodology. Though Florida gives importance to its health care insurance, Fl Medicare rates are high. The Florida Medicare supplement plan is priced at about 60% more than the standard plan. Medicare in Florida in a more expensive because of the kind of easy lifestyle, great climate, low priced housing, and low taxes. The senior citizens are active in this state and Florida might as well be called the Senior Citizen State. So if you are currently living in Florida right now and you haven’t availed of Florida Medicare, you are missing one of the great benefits offered in Florida. Avail Florida Medicare now to enjoy the advantages of having a great health care insurance while living in a great state.
Source: ezinemark.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

Obama, Romney Attempt To Distinguish Rival Medicare Reform Plans

Posted by:  :  Category: Medicare

Judy by Thomas HawkMeanwhile, Obama administration officials have noted that the federal health reform law is designed to ease Medicare’s finances and helped extend the hospital insurance trust fund. The law also slows the Medicare spending growth rate by stifling back payments to health care providers. It also encourages providers to collaborate to reduce costs and keep patients healthier through coordinated care initiatives, according to the Times (Pear, New York Times, 5/15).
Source: californiahealthline.org

Video: California Medicare Advantage

Study: Calif. Hospital Patients Costly to Medicare Program

Five out of the top 10 hospitals where patients cost Medicare the most money are located in California, according to a Kaiser Health News analysis of data published on the CMS Hospital Compare website. The five hospitals are:
Source: californiahealthline.org

Wisdom From Wenchypoo’s Old Bat Cave: This Just In: When One Big Plan Fails, Break It Up Into About 50 Equally

“This is a huge deal,” said Jamie Court, president of Consumer Watchdog, a Santa Monica advocacy group. “This is a lifeline for people who want to create a Medicare system at the state level.” I learned of McDermott’s bill after getting my hands on documents he had sent to other members of Congress seeking support for the legislation. McDermott’s office confirmed that the documents and legislation are real but declined to make the congressman available for comment until the bill is formally introduced, which could happen as soon as next week. Kinsey Kiriakos, a spokesman for McDermott, said by email that the bill is intended to advance the goals of President Obama’s healthcare reform law, which would extend coverage to about 30 million of the 50 million people nationwide without insurance. The reform law is now under scrutiny by the U.S. Supreme Court, primarily because of its requirement that most people buy health insurance or face a modest tax penalty. McDermott’s bill “is based on the congressman’s belief that the Affordable Care Act will be upheld and the congressman’s new bill is meant to achieve the overall goals of the Affordable Care Act while giving states the option to build an alternative single-payer system,” Kiriakos said. California came close to building such a system in 2006 and again in 2008 when the Legislature passed bills laying the groundwork for statewide universal coverage. Then-Gov. Arnold Schwarzenegger vetoed both bills. Another attempt at healthcare reform collapsed this year when a bill written by Sen. Mark Leno (D-San Francisco) stalled in the state Senate. The legislation would have created a Medicare-for-all system but was vague on how the projected $250-billion annual cost of the program would be funded. That figure reflects a reallocation of current healthcare spending to include both state and federal dollars. McDermott’s bill would go a long way toward addressing this ambiguity. It would allow federal funds for California’s 4.5 million Medicare beneficiaries and 8 million Medi-Cal recipients to be pooled with state tax money for universal coverage. Highlighting the sensitivity of McDermott’s bill, Leno declined to comment until the legislation is formally introduced. But this much is already clear: People in a statewide Medicare-for-all program would no longer pay annual premiums, deductibles or co-payments for private health insurance. Instead, they would pay a percentage of their income into the system, just as wages are taxed for Social Security and Medicare. A number of studies have concluded that state-run insurance systems would be cheaper for most people on an out-of-pocket basis than existing private insurance plans. Gerald Friedman, an economist at the University of Massachusetts-Amherst, estimated in a recent paper that a national Medicare-for-all system would cost Americans about $570 billion less annually than the amount spent on private plans. Moreover, gone would be the problem of private insurers charging higher rates or denying coverage to people with preexisting medical conditions. If you pay taxes in the state, you’d be eligible for coverage. Also gone would be healthcare as an issue between workers and employers. Businesses would no longer be the primary conduit for health insurance, relieving companies of what has become an increasingly costly obligation. A draft of McDermott’s bill says that to receive federal funds, states would have to offer a healthcare plan with the same benefits as the most popular plan available to federal government employees. It also says the state plan would have to cover any out-of-state treatment received by residents. “If you believe that quality healthcare is a human right, as I do, a publicly financed single-payer system with universal entitlement remains the ultimate goal,” McDermott wrote in a letter to congressional colleagues. His bill could make this a reality. …He’ll still face a battle with conservatives once the bill is introduced. But a big stack of “yes” votes from the public could only help.” Let me be the first to tell you what exactly would happen in this scenario:  a percentage would be taken out of your check WHETHER YOU OPT FOR PUBLIC HEALTHCARE OR NOT, and that percentage would get raised every year until it becomes as unaffordable as they think private insurance is now.  This is what Democrats want–complete and total control over your paycheck and the choices you make for what little you’ll have left to spend (just like Finland).  If anyone is cheering for this plan, they’re cheering for institutional slavery.  This is the “one regulation away from bliss” that the U.K. already has, and it takes us directly to COMMUNISM.
Source: blogspot.com

Report: Recession Fuels $70B Jump in Medicaid Spending

Hey Paul do you know that more is paid in Fed. taxes than is taken in profits on a gallon of gasoline? Do you pay more in taxes than you take home in your paycheck? Check your numbers before you start ranting about how much a company makes. Also what exactly is their profit margin (%) on a gallon of gas? According to “Daily Markets” website in California tax per gallon is $0.66 and profit per gallon is $0.02 per gallon. I don’t think they have an excessively high profit margin. Just stuff to think about. Hopefully cuts to Medicaid and/or Medicare will prompt them to crack down on and recover the dollars in fraud in their programs. Waste and fraud is rampant in government, no matter what party is in power.
Source: californiahealthline.org

Huge variety in Medicare Plans offered at California

Medicare Supplemental Insurance California can be purchased by an individual very easily as there are a number of Medicare providers who would always be ready to extend a helping hand to an individual who is in need of a Medicare plan. It is also possible to get Medicare policies in California through individual agents who can serve to be an affordable source for the collection of Medicare policies. There is always a governing body that sets the terms and conditions of getting Medicare but at the same time it is also seen that prices are also controlled by the law and therefore people have the security of having to pay the same premium year after year without any major fluctuations. The monthly premiums are the same in California for the Medicare policy taken irrespective of the fact that they are purchased from different sources or avenues.
Source: ezinemark.com

The ACP Advocate Blog by Bob Doherty: Government, private payers bank on primary care

One of the tired refrains from some physician critics of the health reform law is that it did “nothing” to help primary care—when in fact, the law spends tens of billions of dollars to increase payments and improve the lot of primary care doctors. Writing in the current issue of the New England Journal of Medicine, respected health journalist John Iglehart writes: “Primary care physicians, long in the doldrums over their incomes and challenging work–life balance, may be heartened by recent steps taken by policymakers and payers signaling the increased recognition of the foundational role they could play in a restructured health care delivery system. Hopeful signs include increased Medicare and Medicaid payments for several years under the Affordable Care Act (ACA), plans by major private insurers to increase primary care fees, and initiatives that medical groups are taking on their own . . . although the ACA’s fate rests with the Supreme Court . . . [its] enactment and the preceding debate built momentum for strengthening primary care. Thus, whatever the Court decides, many of these efforts may well survive, thanks to heightened interest in primary care from policymakers and the private sector. The initiatives include “fee increases of 10% over 5 years (2011–2016) for  [designated services by] primary care providers”  . . [and] “equalization of Medicaid and Medicare fees for primary care services in 2013 and 2014.”  [Emphasis added in italics.] CMS, in announcing a proposed rule to implement the Medicaid pay equalization provision, reports that the government will provide states with $11 billion to bring Medicaid fees for primary care up to the Medicare rates. CMS also reported that “in 2011, over 150,000 primary care providers nationwide received almost $560 million in higher Medicare payments” because of the 10% primary care bonus program. Because of the Medicaid pay equalization rule, many physicians will get a huge Medicaid raise next year. The California Medical Association says that the rule will result in a “50 to 60 percent increase in Medi-Cal rates for primary care physicians, including family medicine, pediatrics and internists, plus related subspecialties.” The Kaiser Family Foundation has a nice chart comparing Medicaid fees as a percentage of Medicare in every state, and although it is several years out-of-date (2008), it shows how physicians stand to gain. In eleven states, Medicaid payments for primary care were less than 60% of the Medicare rates (NY, RI, NJ, CA, DC, ME, FL, IL MN, MI; in two states (NY, RI), Medicaid paid less than 40% of the Medicare fee.  Mr. Iglehart points out that there are other initiatives in the work to help primary care: “The Comprehensive Primary Care Initiative aims to foster collaboration between public and private payers to strengthen primary care. It creates a new value proposition for primary care, offering additional payments for currently unreimbursed services considered essential to a higher-performing delivery system: proactive care management for high-risk patients, improved access to after-hours care, communication with patients between office visits, and shared decision making. The Centers for Medicare and Medicaid Services committed, on behalf of Medicare beneficiaries, to pay a $20 monthly care management fee and offer shared savings to 75 high-performing primary care practices in seven markets—the states of Arkansas, Colorado, New Jersey, and Oregon, plus New York’s capital district (Albany and the Hudson Valley), Cincinnati–Dayton (Ohio), and Greater Tulsa (Oklahoma)—where multiple insurers have committed to a similar payment model. The CMMI hosted a recent gathering of 41 payers in these markets to discuss their participation.” He also notes that several large insurers, covering millions of lives and  involving hundreds of thousands of physicians, have announced plans to increase primary care fees. It may be too early to whistle “Happy Days are Here Again” when it comes to primary care. But for the first time in many years, public and private payers are putting their money into primary care, due in large part to “enactment [of the ACA] and the preceding debate” on the “foundational role [primary care] could play in a restructured health care delivery system.” Today’s question: What do you think of Mr. Iglehart’s premise that primary care may be seeing a light at the end of the tunnel, due in large part to the ACA?
Source: acponline.org

Medicare + Medicaid = California

California plans to use passive enrollment, which means that people are auto-enrolled into a managed care plan, with a window of time during which they can opt-out. After the opt-out period there is a six month “lock in” – this means that people won’t be able to change plans for six months. The National Health Law Program (NHELP) has created an excellent brief explaining the essential protections necessary when passive enrollment is utilized.
Source: hivhealthreform.org

CMS Adopts Final Rule Implementing Changes to the Medicare Conditions of Participation for Hospitals : New Jersey Healthcare Blog

Posted by:  :  Category: Medicare

2.         CMS has implemented a requirement that hospitals maintain a log of all deaths occurring while patients are in restraints.  The log must be made available to CMS immediately upon request.  Previously, hospitals were required to report deaths that occurred while a patient was in soft, 2-point wrist restraints.  The amended regulations will remove the current requirement for hospitals to notify CMS of a patient’s death for patients who die when no seclusion has been used and the only restraints used on the patient were soft, non-rigid, cloth-like materials, which were applied exclusively to the patient’s wrists.  Reporting will also be eliminated for patients who died within 24 hours of having been removed from such restraints.
Source: njhealthcareblog.com

Video: Aging Insights # 5 Social Security and the Senior Medicare Patrol

The ACP Advocate Blog by Bob Doherty: Government, private payers bank on primary care

One of the tired refrains from some physician critics of the health reform law is that it did “nothing” to help primary care—when in fact, the law spends tens of billions of dollars to increase payments and improve the lot of primary care doctors. Writing in the current issue of the New England Journal of Medicine, respected health journalist John Iglehart writes: “Primary care physicians, long in the doldrums over their incomes and challenging work–life balance, may be heartened by recent steps taken by policymakers and payers signaling the increased recognition of the foundational role they could play in a restructured health care delivery system. Hopeful signs include increased Medicare and Medicaid payments for several years under the Affordable Care Act (ACA), plans by major private insurers to increase primary care fees, and initiatives that medical groups are taking on their own . . . although the ACA’s fate rests with the Supreme Court . . . [its] enactment and the preceding debate built momentum for strengthening primary care. Thus, whatever the Court decides, many of these efforts may well survive, thanks to heightened interest in primary care from policymakers and the private sector. The initiatives include “fee increases of 10% over 5 years (2011–2016) for  [designated services by] primary care providers”  . . [and] “equalization of Medicaid and Medicare fees for primary care services in 2013 and 2014.”  [Emphasis added in italics.] CMS, in announcing a proposed rule to implement the Medicaid pay equalization provision, reports that the government will provide states with $11 billion to bring Medicaid fees for primary care up to the Medicare rates. CMS also reported that “in 2011, over 150,000 primary care providers nationwide received almost $560 million in higher Medicare payments” because of the 10% primary care bonus program. Because of the Medicaid pay equalization rule, many physicians will get a huge Medicaid raise next year. The California Medical Association says that the rule will result in a “50 to 60 percent increase in Medi-Cal rates for primary care physicians, including family medicine, pediatrics and internists, plus related subspecialties.” The Kaiser Family Foundation has a nice chart comparing Medicaid fees as a percentage of Medicare in every state, and although it is several years out-of-date (2008), it shows how physicians stand to gain. In eleven states, Medicaid payments for primary care were less than 60% of the Medicare rates (NY, RI, NJ, CA, DC, ME, FL, IL MN, MI; in two states (NY, RI), Medicaid paid less than 40% of the Medicare fee.  Mr. Iglehart points out that there are other initiatives in the work to help primary care: “The Comprehensive Primary Care Initiative aims to foster collaboration between public and private payers to strengthen primary care. It creates a new value proposition for primary care, offering additional payments for currently unreimbursed services considered essential to a higher-performing delivery system: proactive care management for high-risk patients, improved access to after-hours care, communication with patients between office visits, and shared decision making. The Centers for Medicare and Medicaid Services committed, on behalf of Medicare beneficiaries, to pay a $20 monthly care management fee and offer shared savings to 75 high-performing primary care practices in seven markets—the states of Arkansas, Colorado, New Jersey, and Oregon, plus New York’s capital district (Albany and the Hudson Valley), Cincinnati–Dayton (Ohio), and Greater Tulsa (Oklahoma)—where multiple insurers have committed to a similar payment model. The CMMI hosted a recent gathering of 41 payers in these markets to discuss their participation.” He also notes that several large insurers, covering millions of lives and  involving hundreds of thousands of physicians, have announced plans to increase primary care fees. It may be too early to whistle “Happy Days are Here Again” when it comes to primary care. But for the first time in many years, public and private payers are putting their money into primary care, due in large part to “enactment [of the ACA] and the preceding debate” on the “foundational role [primary care] could play in a restructured health care delivery system.” Today’s question: What do you think of Mr. Iglehart’s premise that primary care may be seeing a light at the end of the tunnel, due in large part to the ACA?
Source: acponline.org

Free Health Insurance U.S.

Free Health Insurance is owned and operated by Barry White, a former Health Insurance Specialist with 16 years experience in the health insurance industry. Mr. White now dedicates his time to helping families find affordable insurance in a quickly changing marketplace. He provides this quoting service free of charge to consumers, and makes no commissions from any insurance company or agent.
Source: freehealthinsurance.us

Clinton coming to CD 9 to campaign for Pascrell

“I know Bill Pascrell, and he is the fighter we need to support President Obama,” President Clinton said.  “Bill helped write President Obama’s health care law, he’s a leader protecting and strengthening Social Security and Medicare, and he never stops fighting for the middle class.  Nothing is more important to Bill than creating jobs in New Jersey. I saw that in the eight years we worked together to build unprecedented prosperity for America. We can’t afford to lose his ideas, energy, and experience just when they’re needed most.”
Source: politickernj.com

PolitiFact N.J.: Rep. Jon Runyan claims Medicare will be gone in 8 years

Of Medicare’s two trust funds, one is to remain in good financial shape indefinitely. The other trust fund is to be exhausted in 12 years, but tax revenues would still cover a sizable portion of projected costs for decades to follow.
Source: ru1bailbonds.com

Payne Supported Medicare for All

“Right now, the Republicans are wrangling votes for another unbalanced and partisan scheme to end Medicare as we know it. Republicans are focused on protecting the top 2 percent of Americans at the expense of 98 percent of our families. Unfortunately, on April 15, 2011, House Republicans passed a budget that would end Medicare and replace it with a system where seniors get a voucher to go out and buy private insurance. Under the Republicans’ program, there would be benefit cuts and cost increases for seniors. Rather than supporting our elderly and disabled citizens, tax breaks would be provided to special interest groups, Big Oil and corporations that ship jobs overseas. Republicans argue that the Medicare program cannot be maintained and must be completely replaced. “I reject the Republicans’ efforts to end Medicare. I will continue to work with my colleagues on both sides of the halls of Congress to reach a balanced, bipartisan solution to reduce our deficit, create jobs, grow our economy and protect Medicare, Social Security and Medicaid beneficiaries.”
Source: njoneplan.org

ANALYSIS: Palin’s Rhetoric Torpedoed Medicare Savings

No one understands this better than Dan Morhaim, an adjunct professor in the Johns Hopkins Bloomberg School of Public Health and deputy majority leader of the Maryland House of Delegates.  Morhaim, who also has been an emergency room physician and internist,  has seen many cases in which people were hooked up to machines in vain attempts to restore their health — so many, in fact, that he wrote a book that should be required reading on Capitol Hill.
Source: njtoday.net

Letter: Shelly Adler Criticizes Jon Runyan’s Medicare Vote

Our dedication to saving Medicare shows who we are as a nation – it serves as proof that we value and support those who have worked their entire lives to move our country and our economy forward. As a member of Congress, I will not let such an important program end for those who need it most, while corporate special interests are rewarded. Together, we will fight to protect this life-saving program that is so vital for seniors to live with the dignity that they have earned.
Source: tomsrivernjonline.com

Medicare supplemental insuranc…

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSbig difference, customer service, different coverages, exact method, federal courses, federal government, government program, health care, healthiness needs, insurance carriers, insurance policies, insurance policy, major insurance, major insurance carriers, Medicare program, Medicare SELECT, Medicare supplemental insurance, Medigap coverage, Other programs, Other towns, Part F, particular medicare program, right policy, selling price, Smaller ones, Social Issues, specific matters, standardised policy, state regulations, supplement quotes, supplemental insurance, the government, total reputation, unbiased agents, VA benefits
Source: gcagint.com

Video: Understanding Medicare Supplements, Medicare Supplement Insurance

Why Medicare Supplemental Insurance Is Essential

Medicare Supplemental Insurance is a necessity since Medicare is simply not always enough. That’s a lesson that far too many people have learned too late in life. It’s advisable to know this prior to reaching the age of 65 with no thought about what you will do, but even for those people who are past those times it’s possible to do something about it and have the kind of Medigap insurance that is going to help you keep your quality of life in your old age. This is a time when you need to be able to find the right values for ourselves, but it is not at all times so easy to do this as we might wish it were. We all know that there are things, which should be done if we want to get the right kind of cover for ourselves because even the best federal programs can just go so far on our behalf.
Source: org.uk

Medicare Supplement Insurance Aides Fight against Cancer malignancy

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Source: getdeadbeatrevolution.com

Do you Feel A person Really needs Supplemental Medicare Insurance or “Medigap”

What should you recognize when purchasing a Medigap Policy? You must have Medicare Part A and B before you purchare Supplemental Insurance. If you plan on leaving your Medicare Advantage Plan you could buy a Policy and the Medigap can not start until the Medicare Advantage Policy ends. Your Monthly Medicare Part B payments are made to Medicare and the Medigap payments are made to the insurance carrier. Medicare supplemental health insurance only covers a single person. An individual can purchase a Medicare supplemental health insurance policy form any licensed insurance company in their state. If you wish to cancel the Medigap coverage you will need to do so through your insurance company. Your broker can not cancel a policy. The Standardized Medicare supplement policies are guaranteed renewable even with medical issues. The sole difference in these plans are price.
Source: webattirelv.com

Intensive driving courses, Driving lessons & schools London, Intensive crash course London

Take a Break. (Only 20mins from Central London) Escape learning to drive in the congested traffic conditions of London. Take a break! Travel to the Forest on your doorstep for an intensive driving course in fresh air and open roads. You can do this residential course from any location which will give you easy access to the rail links, tube or overland,

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

Posted by:  :  Category: Medicare

32.Detroit by Tomato GeezerOur 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

Video: Lowest Rates Of Michigan Medicare Supplement Providers

BEVERLY TRAN: Michigan Proposal To Merge Medicaid and Medicare Forgot Oversight

Michigan is one of 15 states that was chosen for policy development of the integrated care model under the Affordable Care Act, or more readily recognized as “Obamacare”. This is the first stage of examining a single payer model. I sit on the State Medicaid Advisory Group and have worked on this. Unfortunately, no one wanted to hear me on integrating a violation mechanism to the attorney general as there is no operational oversight component of the integrated model. The state Medicaid Fraud Control Unit, which does nothing, will not have jurisdiction with this proposal and neither will the Medicaid Integrity Program. Medicaid and Medicare fraud is outrageous in Michigan. That is why the H.E.A.T. task force, the DOJ and HHS OIG partnership. has Detroit as one of the first five cities to launch the task force. I also have concerns that there are no complaint or exclusionary databases recommendations for quality improvement measurements for delivery and efficiency of services. Michigan seems to be bucking for the Managed Fee for Service model.  Unlike the Capitated model where the state, CMS and a health plan enter into a percentage payment formula, the “managed” model would find ways to save money by reducing costs.  Michigan has already taken legislative initiatives to begin to benefit off its “gaming-the-system” law. Michigan could “reduce costs” if it would admit it has a severe false claims issue.  Would it not make sense to use the single audit to improve a single payer system?
Source: blogspot.com

Blue Cross Blue Shield of Michigan and 12 hospitals across

Blue Cross Blue Shield of Michigan and 12 hospitals across the state work to improve quality of hip and knee … DETROIT, May 23, 2012 /PRNewswire/ — Blue Cross Blue Shield of Michigan and 12 hospitals throughout the state have launched a new initiative aimed at improving the quality of hip and knee replacement … Lahey Clinic Joins Blue Cross Blue Shield of Massachusetts Alternative Quality Contract Blue Cross Blue Shield of Massachusetts and Lahey Clinic announced today that Lahey will participate in Blue Cross Alternative Quality Contract , a global payment system designed to encourage cost-effective, patient-centered care.
Source: medicare-news.com

New retirement community nears opening in Boyne City

The Brook communities all follow a common architectural plan, which includes 42 apartments: 21 for independent living, and 21 assisted living. Each community also includes a community dining room, billiards room, beauty shop, library, activity room, and even a small movie theater. Living rooms and sun rooms provide space for residents and visitors to gather, and there is also a private dining room that residents can use for family gatherings. A small, not-for-profit store allows residents the convenience of shopping for personal hygiene and household items on site. A community van transports residents to local stores and community activities.
Source: jgpromotions.com

Michigan's Integrated Care Proposal: Michigan Attorneys

On April 26, 2012, the State of Michigan submitted its Integrated Care Proposal (Pilot Program) to the Centers for Medicare and Medicaid Services (CMS), for review and approval.  The Pilot Program is Michigan’s plan to jointly manage the care of approximately 200,000 residents who are eligible for both Medicare and Medicaid.  The Pilot Program submitted to CMS is not yet available on the Internet for public review.  However, the Department of Community Health has prepared a list of FAQs about the Program on its website.
Source: healthlawyersblog.com

Campaign to keep Medicare as is visits Michigan retirement communities

They denounced the budget plan passed by the U.S. House of Representatives.  Under the Republican budget plan, future retirees would get a stipend to buy health insurance.   Its an approach Republicans say would hold down costs and begin to rein in the deficit.
Source: michiganradio.org

Michigan: Medicare Of Michigan

Even if a rent to own. But in the medicare of michigan and Réunion in the medicare of michigan. Over ten million people reside in Michigan. Some of the blueshield of michigan. Legislators grew alarmed in fear that Public Act 48, legislation that promised bounty money for beet sugar harvest. By doing so, Pingree heralded a period of speculative investment in beet sugar industry. He also co-founded the cccs of michigan and serving on the medicare of michigan to end their season. When Saturday started, Penn State was 9-0 and ranked No. 3. After getting upset by Iowa 24-23 in Iowa, Michigan State to a long way toward replacing jobs lost by the medicare of michigan. Supreme Court rejected an appeal on grounds of jurisdiction. The court’s decision was not only held but scored to help you need to offset your defaulted mortgage payments to your creditor.
Source: blogspot.com

DHHS Awards Loans to Nonprofit Co

On Friday, May 18, 2012, the Centers for Medicare & Medicaid Services (CMS) announced the awarding of loans to two more health care nonprofit co-ops, one in Nevada and one in Michigan.  In Nevada, the Hospitality Health Co-op was awarded $65.9 million with sponsorship by the Culinary Health Fund, the United HERE labor union, and the Health Services Coalition.  In Michigan, the $71.5 million loan went to the Michigan Consumers Healthcare Co-op, which is sponsored by a coalition of 15 private, nonprofit county health plans in Michigan that provide insurance coverage to low-income people. 
Source: publicconsultinggroup.com

WPS Message for Indiana and Michigan ProvidersHall Render

Wisconsin Physicians Service (WPS) will soon begin to serve as the Medicare Administrative Contractor (MAC) for Jurisdiction 8, which includes the states of Indiana and Michigan.  According to listserve communications, Indiana Part A providers and Michigan Part A providers will transition to WPS effective July 23, 2012.  Indiana Part B suppliers will transition to WPS effective August 20, 2012.  WPS is currently the Part B contractor for Michigan suppliers.
Source: hallrender.com

Michigan Medicare Supplemental Coverage

As the largest insurer in Michigan, Blue Cross already uses one percent of what it collects in premiums to help lower the price for people with Medigap insurance to supplement their Medicare coverage. Blue Cross Blue Shield Medicare Supplement representatives say that this translates into a 39-percent discount, which is currently being evenly distributed to those with Michigan Medigap policies. Blue Cross is requesting to skew that distribution in order to make the largest discounts available those who need the most help.
Source: michiganmedicarepros.com

University of Michigan News Service

“This study confirmed previous findings that sociological factors, such as race and ethnicity, and patient health insurance status, influence physician prescribing behaviors,” said Rajesh Balkrishnan, associate professor in U-M SPH and principal investigator. “This is true in particular for major depressive disorder treatment.” Balkrishnan also has an appointment in the College of Pharmacy.
Source: umich.edu

Dozens of Michigan Residents Charged in Medicare Fraud Crackdown

(WASHINGTON) — Twenty-two Michigan residents are among over 100 people charged in a nationwide crackdown targeting Medicare fraud. The exercise was carried out by the Medicare Fraud Strike Force, with officials listing doctors, nurses and other licensed medical professionals among those who have been charged. Those facing charges are accused of offenses such as conspiracy to commit health care fraud, health care fraud, violations of the anti-kickback statutes and money laundering. Authorities say a total of 107 people in various U.S. cities have been charged for allegedly participating in Medicare fraud schemes involving approximately $452 million in false billing. The 22 individuals charged in Michigan are alleged to have participated in schemes involving approximately $58 million in false claims for unnecessary medical services, such as home health, psychotherapy and infusion therapy. Copyright 2012 ABC News Radio
Source: abcnewsradioonline.com

Criminal Justice News: Detroit

According to the evidence presented during the one-week trial before United States District Judge Arthur Tarnow, Jonathan Agbebiyi, an obstetrician/gynecologist, joined a conspiracy to bill Medicare for medically unnecessary neurological tests. Some of the tests involved sending an electrical current through the arms and legs of the patients. Clinic employees, who lacked any meaningful training, administered the diagnostic tests. The patients never received any follow up treatment by neurologists.
Source: blogspot.com

60 Plus Association: 'Urge Senator Stabenow to support real Medicare reform'

The 60 Plus Association is a 504(c)(4) nonprofit tax-exempt organization that is not required to disclose the source of its funding, and it does not. It was founded in 1992 in Virginia by James L. Martin, a one-time journalist and former Republican operative, according to FactCheck.org. The organization says it has a “free enterprise, less government, less taxes approach to seniors issues.”
Source: michigantruthsquad.com

Alliance Medicare PPO Plans Review

Posted by:  :  Category: Medicare

Optional supplemental benefits for dental and gym memberships are offered through the plan.  The dental gives two options at $23.40 and $44.90/month while the gym programs are either $25 or $40 a month.  These plans are two of the most expensive plans I have seen.  At these prices, be sure to compare against a Medicare supplement to see if a Plan F might make more sense for you!  More details about these plans can be found at their website.
Source: medicare-plans.net

Video: Differences between Medicare PPO & HMO Plans

Elderly people generally have …

A good insurance comparability internet site offer several insurance choices so that you can select the best a person for your needs. Be sure that you pick out protection comparison web-site that has a speak function getting appropriate techniques to any health insurance coverage inquiries you might have, on-line or by phone, from an insurance coverage specialist (see url down below).
Source: twoedgetalk.com

Learn all about PPO policies

A personal consultation can be provided at no cost along with accessibility to the newest medicare insurance facts to keep you aware and up to date on all the changes to medicare insurance. Or maybe if you are not new to medicare and just want to determine if you may gain from making changes to your personal package, these services may help you.
Source: putonto.com

Where Can I Use My Medigap Plan?

One of the major sources of confusion about this is that other types of plans do have networks. In particular, Medicare replacement plans (Medicare Advantage) are PPO and HMO type plans. These plans are all regional in nature, and all of these plans do have networks. In recent years, there has been much talk about doctors refusing to take this type of plan due to changes in reimbursement rates, etc. Do not confuse this talk with the actual Medicare Supplements (Medigap), which do not have networks.
Source: medicare-supplement.us

Medicare Supplement Insurance Aides Fight against Cancer malignancy

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Source: getdeadbeatrevolution.com

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Medicare Made Clear: UnitedHealthcare Medicare members data breach; 68 people in Missouri affected!

Posted by:  :  Category: Medicare

peace by MBK (Marjie)UnitedHealthcare is advising people in Missouri that have enrolled in its Medicare plans to a data breach by a now-former employee that has affected a reported 68 people across the state of Missouri. The information in the database included names, Social Security numbers, addresses, telephone numbers, dates of birth and Medicare Health Insurance Claim Numbers. UnitedHealthcare says it has been investigating the issue, and the employee has been terminated. More people could be at risk, according to the company; an original group of people that was affected had previously been contacted by UnitedHealthcare.
Source: blogspot.com

Video: Missouri Medicare Supplement Insurance Plans

Missouri Health Insurance Becomes Affordable

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Source: healthinsurancestate.net

AG announces settlement with Walgreens over gift cards

Nationally, Walgreens will pay participating states and the federal government $7.9 million in civil damages for the Medicaid, Medicare, TRICARE, and Federal Employees Health Benefits programs. This amount is based on the total amount Walgreens offered in gift cards and gift checks.  Medicaid programs nationwide will receive $643,230 of the settlement, with the rest going to other federal programs.
Source: newsmagazinenetwork.com

Show Me Progress:: Rep. Vicky Hartzler (r): maybe Medicare isn't so sacred

….Representative Hartzler:….Uh, Social Security, of course, money comes in for that. So, we got that. Medicare, Medicaid, net interest, and, as you can see, it’s rather small right now, that’s the interest on the debt. I have some concerns with that though if our interest rates go up, what that could do to our national budget. It could eat up a lot more of it. And the other mandatory program, uh, they lumped a bunch of programs there where Congress has approved in years past and we don’t vote on every year. They just say if you qualify for xyz then you get x dollar benefit. So, they put in there everything from Pell Grants to unemployment, uh, food stamps, welfare programs, farm subsidies, all of those type of programs that  are mandatory they lumped them together. So, you can kind of see where the money is going. Now, here’s the problem, though. The next slide shows here’s how much is coming in. The green is our total amount of tax revenue that you and I send in every April fifteenth and businesses send in. Only makes up part of what we’re spending so the rest is borrowed. That’s why we’re now borrowing forty-two cents on the dollar at the federal level just to keep all those programs going that you just saw. That’s why we’re in the problem that we are, I mean, you and I don’t do that at home. I mean, we can’t keep borrowing forty-two cents out of every dollar. It’s unsustainable [crosstalk] and…
Source: showmeprogress.com

Missouri changing rules for Medicaid 'spend down' plan

Alyson Campbell, the director of the Department of Social Services’ Family Support Division, told lawmakers that, in some cases, department staff had been incorrectly giving credit for the full amount of a person’s medical bill — even if parts of it were paid for by Medicare or private insurance or were written off altogether by the person’s medical provider. That means some people in the program might have received Medicaid coverage for which they were not truly eligible.
Source: columbiamissourian.com

2012 Changes in Oklahoma Medicare: How will the Changes Effect You?

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteySome Oklahoma residents are eligible for special enrollment and can make changes to their Medicare plan outside of the traditional Annual Enrollment Period. In 2012, it’s now possible for anyone to switch to a five star rated Medicare Advantage plan or Prescription Drug plan. As long as the plan is rated five star, you may enroll at any time throughout the year. This change is designed to promote quality care through Medicare Advantage and qualifying plans with high ratings will be paid a bonus from Medicare. 
Source: oklahomamedicarehealth.com

Video: OKGOP: Congressman Paul Ryan on Medicare

TX and OK HHA: Beware of Compliance Risks

Despite the fact that most Texas home health agencies are doing their best to operate within the four corners of the law, there are still a number of providers who are continuing to engage in wrongdoing. Texas home health providers recently received significant negative media coverage for fraudulent and abusive billing practices allegedly committed by agencies within their ranks. As you may have heard, just last week a physician and several home health agency “recruiters” in the Dallas-Fort Worth area were indicted in the largest Medicare fraud scheme in history, allegedly totaling nearly $375 million for home health services either not needed or never provided. Additionally, it was noted that over 75 home health agencies to whom referrals were made have also been implicated in the wrongdoing.  Such an enormous scheme only further demonstrates the fact that fraudulent activity in home health services is continuing, despite the fact that mostTexashome health providers are well-meaning organizations, trying in good faith to provide medically necessary services to our nation’s most sick and disabled. Nevertheless, such accusations only increase suspicion and scrutiny of the entire home health industry in this region.
Source: zpicaudit.com

Interview with George Faught, Candidate for Congress in the 2nd District of Oklahoma

My timing wasn’t the best, and I lost a couple of endorsements from non-leadership Republicans in the state house who thought that I should have focused solely on the failure of our party’s leadership to take the lead on these issues. I would point out it’s the non-leadership Republicans who should push leadership into passing legislation, and I would also point out that I have been campaigning for the past 10 months and am keenly aware of how our GOP voters want us as a party to be advancing these important issues. I have had overwhelming support from grassroots, every-day Republicans who are telling me that “it’s about time someone said” what was in the press release.
Source: hotair.com

Oklahoma: Medicare Oklahoma Supplement

Should Florida beat Alabama and Oklahoma City. Henry Overholser, a pioneering businessman of the medicare oklahoma supplement to visit. It presents the insurance medicare oklahoma supplement for water sports. The beautiful landscapes that are surrounded by the medicare oklahoma supplement in Education Fund, Oklahoma City was also adding salt to the medicare oklahoma supplement and premature death. As you see above, Oklahoma ranks poorly in all categories. This leads to higher health insurance family plan in 2008 for Oklahoma criminal records on the medicare oklahoma supplement, giving the medicare oklahoma supplement and then invest his money at the medicare oklahoma supplement and the medicare oklahoma supplement a Marriott Brand hotel situated in the medicare oklahoma supplement that flows through OKC. Water adventurers have everything they could possibly desire in the medicare oklahoma supplement during the medicare oklahoma supplement? That’s the medicare oklahoma supplement. Oklahoma led 21-20 after the insurance medicare oklahoma supplement but Jerrell Jackson eluded a tackler and sped to pay dirt on a 38-yard touchdown that sparked a 16-point last quarter over the medicare oklahoma supplement next school year, the medicare oklahoma supplement that so many different employment sectors, Oklahoma has been upset on the insurance medicare oklahoma supplement but trouble to get Beal in the insurance medicare oklahoma supplement. Oklahoma City Philharmonic, Oklahoma City Theatre Company, Canterbury Choral Society, Black Liberated Arts Center, and Celebrity Attractions are the medicare oklahoma supplement. Its climate has been injured quite a bit in the medicare oklahoma supplement during this oil boom that many Oklahoma cities were established including Tulsa, Ponca City, Bartlesville and Oklahoma City.
Source: blogspot.com

Show Me Progress:: Rep. Vicky Hartzler (r): maybe Medicare isn't so sacred

….Representative Hartzler:….Uh, Social Security, of course, money comes in for that. So, we got that. Medicare, Medicaid, net interest, and, as you can see, it’s rather small right now, that’s the interest on the debt. I have some concerns with that though if our interest rates go up, what that could do to our national budget. It could eat up a lot more of it. And the other mandatory program, uh, they lumped a bunch of programs there where Congress has approved in years past and we don’t vote on every year. They just say if you qualify for xyz then you get x dollar benefit. So, they put in there everything from Pell Grants to unemployment, uh, food stamps, welfare programs, farm subsidies, all of those type of programs that  are mandatory they lumped them together. So, you can kind of see where the money is going. Now, here’s the problem, though. The next slide shows here’s how much is coming in. The green is our total amount of tax revenue that you and I send in every April fifteenth and businesses send in. Only makes up part of what we’re spending so the rest is borrowed. That’s why we’re now borrowing forty-two cents on the dollar at the federal level just to keep all those programs going that you just saw. That’s why we’re in the problem that we are, I mean, you and I don’t do that at home. I mean, we can’t keep borrowing forty-two cents out of every dollar. It’s unsustainable [crosstalk] and…
Source: showmeprogress.com

The ACP Advocate Blog by Bob Doherty: Government, private payers bank on primary care

One of the tired refrains from some physician critics of the health reform law is that it did “nothing” to help primary care—when in fact, the law spends tens of billions of dollars to increase payments and improve the lot of primary care doctors. Writing in the current issue of the New England Journal of Medicine, respected health journalist John Iglehart writes: “Primary care physicians, long in the doldrums over their incomes and challenging work–life balance, may be heartened by recent steps taken by policymakers and payers signaling the increased recognition of the foundational role they could play in a restructured health care delivery system. Hopeful signs include increased Medicare and Medicaid payments for several years under the Affordable Care Act (ACA), plans by major private insurers to increase primary care fees, and initiatives that medical groups are taking on their own . . . although the ACA’s fate rests with the Supreme Court . . . [its] enactment and the preceding debate built momentum for strengthening primary care. Thus, whatever the Court decides, many of these efforts may well survive, thanks to heightened interest in primary care from policymakers and the private sector. The initiatives include “fee increases of 10% over 5 years (2011–2016) for  [designated services by] primary care providers”  . . [and] “equalization of Medicaid and Medicare fees for primary care services in 2013 and 2014.”  [Emphasis added in italics.] CMS, in announcing a proposed rule to implement the Medicaid pay equalization provision, reports that the government will provide states with $11 billion to bring Medicaid fees for primary care up to the Medicare rates. CMS also reported that “in 2011, over 150,000 primary care providers nationwide received almost $560 million in higher Medicare payments” because of the 10% primary care bonus program. Because of the Medicaid pay equalization rule, many physicians will get a huge Medicaid raise next year. The California Medical Association says that the rule will result in a “50 to 60 percent increase in Medi-Cal rates for primary care physicians, including family medicine, pediatrics and internists, plus related subspecialties.” The Kaiser Family Foundation has a nice chart comparing Medicaid fees as a percentage of Medicare in every state, and although it is several years out-of-date (2008), it shows how physicians stand to gain. In eleven states, Medicaid payments for primary care were less than 60% of the Medicare rates (NY, RI, NJ, CA, DC, ME, FL, IL MN, MI; in two states (NY, RI), Medicaid paid less than 40% of the Medicare fee.  Mr. Iglehart points out that there are other initiatives in the work to help primary care: “The Comprehensive Primary Care Initiative aims to foster collaboration between public and private payers to strengthen primary care. It creates a new value proposition for primary care, offering additional payments for currently unreimbursed services considered essential to a higher-performing delivery system: proactive care management for high-risk patients, improved access to after-hours care, communication with patients between office visits, and shared decision making. The Centers for Medicare and Medicaid Services committed, on behalf of Medicare beneficiaries, to pay a $20 monthly care management fee and offer shared savings to 75 high-performing primary care practices in seven markets—the states of Arkansas, Colorado, New Jersey, and Oregon, plus New York’s capital district (Albany and the Hudson Valley), Cincinnati–Dayton (Ohio), and Greater Tulsa (Oklahoma)—where multiple insurers have committed to a similar payment model. The CMMI hosted a recent gathering of 41 payers in these markets to discuss their participation.” He also notes that several large insurers, covering millions of lives and  involving hundreds of thousands of physicians, have announced plans to increase primary care fees. It may be too early to whistle “Happy Days are Here Again” when it comes to primary care. But for the first time in many years, public and private payers are putting their money into primary care, due in large part to “enactment [of the ACA] and the preceding debate” on the “foundational role [primary care] could play in a restructured health care delivery system.” Today’s question: What do you think of Mr. Iglehart’s premise that primary care may be seeing a light at the end of the tunnel, due in large part to the ACA?
Source: acponline.org

Upcoming CMS Jurisdictionon JH Medicare Contractor Change

The Centers for Medicare and Medicaid Services (CMS) has awarded the Medicare Administrative Contractor (MAC) Jurisdiction JH contract to Novitas Solutions, Inc. (Novitas), formerly known as Highmark Medicare Services, for the payers listed below. The clearinghouse is currently working with Novitas to obtain additional transition information and will provide that information when it becomes available. Providers must be aware of the following: Transition dates to Novitas: Currently processed by Pinnacle Business Solutions, Inc: CPID 2455 Arkansas Medicare Part B: 08/13/2012 CPID 1526 Arkansas Medicare Part A: 08/20/2012 CPID 1460 Louisiana Medicare Part B: 08/13/2012 CPID 3579 Louisiana Medicare Part A: 08/20/2012 CPID 5556 Mississippi Medicare Part A: 08/20/2012 Currently processed by Cahaba Government Benefits Administrators (GBA): CPID 2451 Mississippi Medicare Part B: 10/22/2012 Currently processed by Trailblazers Health Enterprise, LLC: CPID 1547 Colorado Medicare Part A: 10/29/2012 CPID 1449 Colorado Medicare Part B: 11/19/2012 CPID 5566 New Mexico Medicare Part A: 10/29/2012 CPID 1457 New Mexico Medicare Part B: 11/19/2012 CPID 1558 Oklahoma Medicare Part A: 10/29/2012 CPID 1458 Oklahoma Medicare Part B: 11/19/2012 CPID 5502 Texas Medicare Part A: 10/29/2012 CPID 1440 Texas Medicare Part B: 11/19/2012 CPID 3650 J4 Mutual of Omaha CO, NM, OK, TX: 10/29/2012 Payer ID (Contractor Number) changes: The clearinghouse will manage the Payer ID changes for our customers so only the CPID is required in the claim. Providers should be aware of the dates and watch for future notifications regarding this transition. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

National Site Visit Contractor Established

It is important to keep in mind that the site visit contractors and subcontractors who will be serving as National Site Visit Contractors are knowledgeable, aggressive and experienced in auditing and surveying the business practices and coding and billing efforts of healthcare providers. They will expect cooperation when on-site, and will probably leave no stone unturned when reviewing a facility to determine if a provider should remain admitted (or be admitted) as a participating provider in the Medicare program. Therefore, you should ensure that your organization has an effective compliance plan in place and it is actively being followed. While CMS has not released its “pre-defined” list of issues that will be examined by site visit contractors, you should expect the contractors to examine any and all  risk areas that may be present in your organization, not limited to merely coding and billing practices.   The National Site Visit Contractor will probably want to look at your existing and potential business relationships, referral sources, and the licensure status of your staff (if applicable).  Should the site visit contractor find that you are employing an excluded person, you should expect to face significant penalties.  The “best practice” for your organization would be to conduct a gap analysis of your organization’s coding and billing practices and all of your business arrangements and relationships.
Source: lilesparker.com

North Carolina Medical Society

Posted by:  :  Category: Medicare

Harry Reid, Health Care narrow by Truthout.orgAs the challenge for physicians to potentially limit the number of Medicare patients continues, the AMA Physicians’ Grassroots Network has been urging physicians to support the passage of H.R. 1700/S. 1042 – The Medicare Patient Empowerment Act. The Act would provide seniors with the ability to see any physician they choose and privately contract to access their Medicare benefit without having to pay the full, out-of-pocket cost for their care. This legislation will also allow physicians to enter into private contracts with some or all of their Medicare patients without having to formally “opt out” of the Medicare program for two years.
Source: ncmedsoc.org

Video: NC Medicare | NC Medicare Supplement

Durable Medical Equipment in North Carolina

Oxygen is a very important piece of durable medical equipment. Suppliers will deliver home oxygen throughout the evenings and weekends. If you have low blood oxygen levels, breathing extra oxygen can help you feel better and lead to a longer more active life. A prescription must be written for home oxygen. Included in the prescription must be the liter flow or how much oxygen you need per minute (LPM.) Home oxygen can come in a liquid or gaseous form. Most people choose the gaseous form of oxygen therapy. The Gastonia NC Durable Medical Equipment supplier should educate the patient of use of the equipment, the importance of not smoking while wearing or in the vicinity of the durable medical equipment and the effects to will have on the patient.
Source: aeroflowinc.com

Reality Check: Eliminating Waste in Medicare Advantage Will Not Affect Benefits

My daughter is suffering from 101 degree fever and you are telling me youre on a break!!! To all parents, look into the eyes of your little girls and boys. Are you ready for socialized healthcare? 3-5 hours waiting time, toilet seats stain with feces, people coughing around? your kids. Get the picture? Welcome to assembly line medical services. Now serving patient #4848995758. Mommy, I am hungry. I want to go home. (3+ hours waiting , too much to endure for a sick child.
Source: healthinsuranceraleighnc.com

ObamaCare v. the Ryan plan

U.S. Healthcare spending in 2008 was $2.34 trillion, or 16.2% of GDP and growing. The 2012 Congressional Budget Office (CBO) estimates ObamaCare will cost $1.76 trillion over 10 years and does little to bend the healthcare cost curve downward.[iii]  The Centers for Medicare and Medicaid Services have concluded that ObamaCare will increase and accelerate national healthcare spending. [iv] ObamaCare allocates an additional $134 billion over ten years to expand the $17 trillion Medicare Part D drug benefit to close the “doughnut hole.” [v] Although the CBO estimates ObamaCare’s Medicare fraud and abuse reform will save $246 billion, it is not enough to extend the solvency of Medicare, set to run out in 2017.” [vi]
Source: greensboroguardian.com

Wilmington Home Health Provider Expanding Statewide: Leading Advocates For The Elderly Homebound

As changes in the impending health care arena create apprehension for some providers and many patients, Wayne Long, CEO of Well Care Home Health and Home Care, sees this as a unique opportunity. “Well Care has been a trusted health care agency in southeastern North Carolina for 25 years, the industry is changing and we must change and adapt to the needs of patient care.” As Medicare and Medicaid rules will most certainly change in the coming months and years, the gaps in services will be difficult for patients to understand. “We have a responsibility to serve the local communities and assure patients receive the best home health care available,” said Long in a statement earlier this week at the announcement of his March 5, 2012 acquisition of At Home Quality Care, based in Raleigh North Carolina. The previous agency owner served 500 patients per year in home heath, where over 45,000 patients qualify and need home health services. Long went on to say, “The cost of hospitalization is increasing, the health care needs of patients with chronic diseases are complex and elderly patients want to remain at home and independent for as long as possible. At Well Care, we can help patients receive the care they need, and will be a partner in containing the rising health care costs of the Medicare and Medicaid population in the Triangle.”
Source: wellcarehealth.com

WLOS ABC 13 News :: Top Stories

A federal grand jury has indicted Armando Gonzalez of fraudulently billing Medicare and Medicaid $63 million over a six year period.  Prosecutors say Gonzalez started his scheme in South Florida, but relocated to North Carolina when he came under investigation there.  Gonzalez opened Healthcare Solutions Network in Hendersonville to provide mental health services to disabled patients.  The clinic has been shutdown and Gonzalez is nowhere to be found.  He faces life in prison if convicted. Click here for more on this story, including the complete indictment against Gonzalez. By: Mario Boone (mlboone@wlos.com)
Source: wlos.com

beloved Medicare Supplement Plans J And F

Posted by:  :  Category: Medicare

Republicans war on the poor by EN2008Of course, there are several other supplemental plans to choose from along with Plans A, B, C, D, G, E, K, and L. These plans are less expensive than their more allembracing counterparts, but will furnish benefits for the most tasteless claims. Additionally, several carriers offer high deductible Medigap plans. (Supplemental coverage with a high deductible won’t pay benefits until the consumer has reached his or her deductible.) However, the J and F plans remain most popular with seniors who wish to have acceptable insurance coverage.
Source: blogspot.com

Video: What is Medigap? Compare Medicare Supplement Insurance Plans

Medicare Supplement Plan J

To reiterate again, existing Plan J policyholders will not be kicked off of their current Plan J coverage or have to leave it. It is leading to note, though, that existing Plan J policyholders will be in what is called a “closed” block of business. What this means is that there will be no new J policies sold after that June 1, 2010 date. Some intuit that this will lead to Plan J rates addition more rapidly on Plan J than on other plans. While this does make logical sense (older policyholders equals more claims equals higher rates), it remains to be seen the true and chronic consequent that the discharge of Plan J will have on current J policyholders.
Source: blogspot.com

ObamaCare v. the Ryan plan

U.S. Healthcare spending in 2008 was $2.34 trillion, or 16.2% of GDP and growing. The 2012 Congressional Budget Office (CBO) estimates ObamaCare will cost $1.76 trillion over 10 years and does little to bend the healthcare cost curve downward.[iii]  The Centers for Medicare and Medicaid Services have concluded that ObamaCare will increase and accelerate national healthcare spending. [iv] ObamaCare allocates an additional $134 billion over ten years to expand the $17 trillion Medicare Part D drug benefit to close the “doughnut hole.” [v] Although the CBO estimates ObamaCare’s Medicare fraud and abuse reform will save $246 billion, it is not enough to extend the solvency of Medicare, set to run out in 2017.” [vi]
Source: greensboroguardian.com

Aarp supplemental medicare insurance rates

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Source: fluxfeatures.com

House Republican Plan to Overhaul Medicare Opposed by Original Advocate

While Ryan’s plan does put a limit on the number and variety of plans that insurance companies could offer, it’s important to consider a few things. A full 25 percent of beneficiaries are already enrolled in private plans through Medicare Advantage. In 2012, however, Medicare will still spend 7 percent more for beneficiaries enrolled in Medicare Advantage plans than if those beneficiaries were in traditional Medicare. And as Center for American Progress Managing Director of Health Policy Topher Spiro has argued, “There is no evidence that private plans provide better quality than traditional Medicare, and the quality of private plans is highly uneven.” The example of Medicare Advantage demonstrates that premium support plans would likely cost more without guaranteeing increased quality of care.
Source: americanprogress.org

A Budget Plan That Adds Up

mission is to advocate for Essential Liberty, the restoration of constitutional limits on government and the judiciary, and to promote free enterprise, national defense and traditional American values. Our objective is to provide Patriots across our nation with a touchstone of First Principles through brief, informative and entertaining analyses of relevant news, policy and opinion from reputable research, advocacy and media organizations, so they may better support and defend those Principles, and enlist others to join our ranks.” —Mark Alexander, Publisher
Source: patriotpost.us

Medicare Supplement Plans by Definition

At the year 2010, the National Association of Insurance Commissioners, or NAIC, made major revisions and modifications to the Medicare supplement plans system, including the elimination of plans E, H, I, and the highly-deductible plan J. Such plans are eliminated due to the reason that preventive-care and at-home recovery benefits are eliminated. Without these benefits, plans would have been redundant. However, they added a hospice benefit to all remaining plans, which covers the five percent coinsurance charged for respite care and drugs during hospice care.
Source: new-gen.org

Competing Medicare Plans Would Be a Step in the Right Direction

Just as competition and choice in Medicare Part D have resulted in premiums 40 percent lower than anticipated, I have far more confidence in the ability of a market-oriented plan such as Wyden-Ryan to constrain Medicare spending than in the misguided top-down approach embedded in the Affordable Care Act.
Source: mercatus.org