COBRA and Medicare, Part II 

Posted by:  :  Category: Medicare

BITCH..beautiful individual that causes hardons .....item 1..Allen West calls Wasserman Schultz ‘vile’ and ‘not a lady’  (7/20/2011) ... by marsmet522[1] See, e.g., 42 CFR §423.56; also see CMS website at: http://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/index.html?redirect=/CreditableCoverage/. [2] See 29 USC §1162(2)(D)(ii). [3] See Treas Reg §54.4980B-7, Q&A 3, available at: http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=47126146b0c56fbbab9b6b6ebfb7db7d&rgn=div8&view=text&node=26:17.0.1.1.5.0.1.25&idno=26 [4] See Geissal v Moore Med. Corp. (1998) 524 US 74, 141 L Ed 2d 64, 118 S Ct 1869. [5] Note that for individuals who qualify for Medicare because of ESRD and are also entitled to health coverage under an employer plan, the group plan will be the primary payer for a 30-month coordination of benefits period. See 42 USC §1395y(b)(1)(C); 42 CFR §411.162.  This rule applies regardless of whether the individual is a current or former employee and regardless of whether the individual has coverage through COBRA.  Also note that if an individual enrolls in Medicare after electing COBRA coverage, the employer can elect to terminate the COBRA coverage.  [6]  Section 1882(s)(3)(B)(ii) of the Social Security Act; see also “Your Rights to Buy a Medigap Policy” at http://cahealthadvocates.org/medigap/guaranteed-issue.html (site visited May 31, 2012) [7] For a discussion of these plans, see  http://cahealthadvocates.org/medigap/overview.html (site visited May 31, 2012)
Source: medicareadvocacy.org

Video: Medicare Choices 2011

Why we can’t afford Medicare

calculates the amount of the transfer to an average retiree. An American man retiring in 2011 could expect to receive Medicare benefits worth $170,000 (in 2011 dollars). If he had worked from age 22 at the average U.S. wage each year, he would have paid Medicare taxes (plus interest) worth $60,000 (also in 2011 dollars). So the average male worker retiring in 2011 will receive benefits worth almost three times what he paid in. And the transfer to that retiree will be $110,000 from younger Americans, perhaps including his grandchildren.
Source: mbcalyn.com

Medicare Part B, Annual Wellness Visits, and Your Pocketbook

These stipulations could significantly impact transient patients – “snowbirds,” for example – who have a service performed by one physician and then travel to another region, where the same service is performed by a different doctor before the required time period has elapsed. While doctors don’t always share records, Medicare tracks these services. Redundant services will generate out-of-pocket expenditures for “noncompliant” patients.
Source: suite101.com

Medicare Open Enrollment: What are the Dates for Fall 2011?

Leaving the closing date to the last day of the year has caused problems in the past for some seniors who have waited until close to deadline to make changes. Bringing it forward should simply make it easier for the system to get up and running on January 1 2012 as it should. This also takes the Christmas holiday period out of the equation. Although some people do use the holidays to consider their options, others get diverted and have to make snap decisions at the last minute.
Source: suite101.com

Florida’s congressional Democrats talk Medicare

Democratic Reps. Alcee L. Hastings of Miramar, Debbie Wasserman Schultz of Weston, Kathy Castor of Tampa, Ted Deutch of Boca Raton, and Frederica Wilson of Miami met Thursday to talk about Medicare — without the Republicans in the Florida delegation. They haven’t met all together since early 2011.
Source: typepad.com

Regionally Tailored Primary Health Care Fund

Medicare Locals and the Australian Medicare Local Alliance will be directly funded to provide services under the Fund in the majority of circumstances. Individual grant processes that may be available to other organisations will contain detailed guidance on the specific requirements for that process, and will be consistent with the Fund Guidelines.  Medicare Locals will work in close collaboration with their communities to identify primary health care gaps and service needs, set priorities, and address areas of unmet need. These processes will be reflected in their strategic plans, needs assessments, and annual planning and reporting requirements. Local priority setting will be also be complemented by state/territory and Commonwealth level health and ageing policies and priorities.  Funding allocations will be monitored throughout the year, with potential underspends identified and allocated to activities identified as being the most appropriate method of meeting the Fund objective and priorities.
Source: com.au

Gordon Marketing Awarded Number One Anthem Medicare National FMO 2011

Gordon Marketing has become a leader in the Medicare Supplement Insurance industry as well as Medicare Advantage plans and in Medicare Part D. This is part of Gordon’s commitment to seniors and in support of all of their agents that market these products. Continuing education seminars and telephone training classes is a hallmark of their company. Train, train, train is what Gordon Marketing does best. They don’t just ask for more business, they show HOW to make more business! Gordon Marketing was founded in 1980 by Dick and Margaret Gordon and has made a national name from humble beginnings. Gordon Marketing is an independent, family-owned and operated brokerage company located in the heart of Indiana. Gordon Marketing specializes in Senior, Health, Life & Annuity products for independent agents across the nation. President, Sylvia Gordon and Vice President, Rebecca Gordon work together with their brother Frank, sister Theresa and a wonderful staff of 45 to service agents in 49 states. Gordon Marketing has grown over 127% in the last 3 years in the areas of senior, life, health and annuity insurance products. Gordon Marketing will be moving into their new Corporate Office at 20236 Hague Road in Noblesville, IN on June 1st 2012. This facility incorporates a state of the art training center, and will serve to take the company to a much higher level of service to their clients and agents. In 2009 and 2010 Gordon Marketing was named the Small Business of the Year. In 2011 Gordon Marketing also received the Small Business of The Year Award by the City of Noblesville Mayor Distlear. Dick Gordon, founder of Gordon Marketing is also the founder of the Riverview Hospital Gordon “Brick Layer” Club. Gordon Marketing also supports various charities throughout the year in giving back to the local community. Gordon Marketing now has 75 full-time employees and is projected to build another Corporate Building within the next 5 years to house an additional 30 employees. Gordon Marketing not only markets to agents, but is using their current facilities to operate their retail and consumer based program. These agents sell life, annuities, senior and health insurance products. For more information about Gordon Marketing, their services and products, please visit http://www.gordonmarketing.com.
Source: sbwire.com

How Nearly Half a Million People with Medicare Saved $724 on Prescription Drugs

Under the new health care law – the Affordable Care Act — seniors and people with disabilities in Medicare have saved a total of $3.5 billion on prescription drugs in the Medicare drug benefit coverage gap or “donut hole” from the enactment of the law in March 2010 through April of 2012. The Centers for Medicare & Medicaid Services (CMS) released data today showing that, in the first four months of 2012 alone, more than 416,000 people saved an average of $724 on the prescription drugs they purchased after they hit the prescription drug coverage gap or “donut hole,” for a total of $301.5 million in savings. These savings build on the law’s success in 2010 and 2011, when more than 5.1 million people with Medicare saved over $3.2 billion on prescription drugs.
Source: emaxhealth.com

President Obama’s Medicare Fantasies

With savings that small, the ad might as well have featured Obama searching his couch cushions for change to shore up the program’s finances. Never mind that estimates suggest that health fraud in government programs exceeds $60 billion a year, or that the Government Accountability Office found that the program wastes $48 billion annually on “improper payments” to Medicare providers. Forget that the administration has already put on hold at least one component of its anti-fraud initiative after complaints from health providers. The scale of the program is so huge—within a decade Medicare spending is expected to cost over $1 trillion each year—that even the billion dollar savings Obama touts are essentially meaningless. This is like a field commander bragging about a new way to defend against mosquito bites while his troops are taking mortar fire.
Source: reason.com

Medicare Board of Trustees Report Trust Exhaustion in 2024

The report also offers the Board’s long-range predictions, including an increase in Parts B and D outlays. Part B outlays are expected to increase from 1.5% of GDP in 2011 to 2.5 or 4.5% by 2086. Part D outlays are expected to increase from 0.4% of GDP in 2011 to 1.5% by 2086. The Board projects that, under current law, expenditures will increase at a faster pace than aggregate workers’ earnings or the economy, with estimated increases in expenditures from 3.7% of GDP in 2011 to 6.7% by 2086. However, according to the Board, if Congress continues to override statutory decreases in physician fees, and if reduced fee increases for other Medicare services are not sustained, then Medicare spending will increase to approximately 10.4% of GDP by 2086.
Source: vonbriesenhealth.com

 Health Care Insights

Posted by:  :  Category: Medicare

AARP * Aetna Inc * Alabama Insurance Department * American Specialty Health * Amerigroup Corporation * Ameri-Plus Select Services * Arcadian Health Plan & Management Services * Arnold & Porter * Balboa Nephrology Medical Group * Barclays Capital * BCBS of Minnesota * Blue Cross Blue Shield of Tennessee * Boehringer Ingelheim * California Association of Physicians Group * Capital District Physicians Health Plan * Care 1st Health Plan * Care N Care Health Plan * Caremore * Clarian Health Plans * DCA Solutions * DCIPA * Deft Research * Dendreon Corporation * Dial America * DMW Direct * Dynamic Healthcare Systems * Endo Pharmaceuticals * Essence Health Care * Essex Woodland * Express Scripts Inc * Family Health Plans * Firstsource * Forest Laboratories Inc * Fresenius Medical Care * Geisinger Health Systems * GemCare Health Plan * Gorman Health Group * Group Health Cooperative * Health Alliance Medical Plans * Health Data Essentials * Healthcare Partners * HealthMetrix Research Inc * HealthNet Government Programs * HealthPlan CRM * HealthSpring * Healthways Inc * Henry Ford Health System * HMS Permedion * Humana * Independence Blue Cross * Inspiris * Inter Valley Health Plan * Kaiser Foundation Health Plan of Colorado * Kaiser Permanente * Leprechaun * Marketing Direct Inc * Matrix Medical Network * Medagate Corporation * MedAssurant * MVP Health Care * North Texas Specialty Physicians * Old Surety Life Insurance Company * Oliver Wyman Actuarial Consulting * Peak Health Solutions * PopHealthMan * Preferred Care Partners * Quest Diagnostics * SCAN Health Plan Arizona * Sharp Health Plan * Silverlink Communications * South Shore * Sterling Life Insurance Company * Texas HealthSpring * The Bright Sight Group * The Harry Walker Agency * The Kaiser Family Foundation * The National Advisory Board on Improving Health Care Services for Seniors and People with Sisabilities* The Permanente Federation * Thoroughbred Research Group * TMG Health * TriZetto Group * Tucson Medical Centre * UMWA Health & Retirement Funds * United American * United Community Health Plans * United Health Care * Univita Health * UPMC Health Plan Inc * Varis * Visiting Nurse Service of New York * VNS Choice Medicare * Wilen Direct
Source: blogspot.com

Video: VNSExtras.flv

Associate Director, VNS CHOICE Quality Management

NY-Manhattan, Associate Director, VNS CHOICE Quality Management Visiting Nurse Service of New York, the nation’s largest not-for-profit home health care organization, provides expert home- and community-based health care services in all five boroughs of New York City and in Nassau and Westchester Counties.  Each day, over 14,000 VNSNY nurses, rehabilitation therapists, social workers, and allied professionals a
Source: nonprofitjobwire.com

Medical Assistant Sentenced to 36 Months in Prison for His Role in a Fraudulent Home Health Scheme : FERS

Ross, 51, pleaded guilty in July 2010 to one count of conspiracy to commit health care fraud.  According to court documents, Ross received kickbacks from the owners and/or operators of two Detroit-area home health agencies, Patient Choice Home Healthcare Inc. and All American Home Care Inc., in exchange for referring home health patients to those entities.   Ross admitted to receiving $500 per patient, paid either by check or in cash, in exchange for providing co-conspirator Mohammed Shahab with Medicare beneficiary information for various patients he recruited.    After paying the kickbacks to Ross, Shahab, an owner of Patient Choice and All-American, billed Medicare for home health visits purportedly made to the beneficiaries recruited by Ross.   Ross referred 21 patients to Patient Choice and All American.   During the time Ross participated in the scheme, Patient Choice and All American submitted claims for $172,573 in improper benefits.  Shahab pleaded guilty in February 2010 to health care fraud charges in connection with this case.
Source: dehaanbusse.com

VNS for Depression “New”? No, But Don’t Tell Wired

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues — as well as the intersection of technology and human behavior — since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine. Like this author? Catch up on other posts by John M. Grohol, PsyD (or subscribe to their feed).
Source: psychcentral.com

COBRA and Medicare, Part II 

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SS[1] See, e.g., 42 CFR §423.56; also see CMS website at: http://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/index.html?redirect=/CreditableCoverage/. [2] See 29 USC §1162(2)(D)(ii). [3] See Treas Reg §54.4980B-7, Q&A 3, available at: http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=47126146b0c56fbbab9b6b6ebfb7db7d&rgn=div8&view=text&node=26:17.0.1.1.5.0.1.25&idno=26 [4] See Geissal v Moore Med. Corp. (1998) 524 US 74, 141 L Ed 2d 64, 118 S Ct 1869. [5] Note that for individuals who qualify for Medicare because of ESRD and are also entitled to health coverage under an employer plan, the group plan will be the primary payer for a 30-month coordination of benefits period. See 42 USC §1395y(b)(1)(C); 42 CFR §411.162.  This rule applies regardless of whether the individual is a current or former employee and regardless of whether the individual has coverage through COBRA.  Also note that if an individual enrolls in Medicare after electing COBRA coverage, the employer can elect to terminate the COBRA coverage.  [6]  Section 1882(s)(3)(B)(ii) of the Social Security Act; see also “Your Rights to Buy a Medigap Policy” at http://cahealthadvocates.org/medigap/guaranteed-issue.html (site visited May 31, 2012) [7] For a discussion of these plans, see  http://cahealthadvocates.org/medigap/overview.html (site visited May 31, 2012)
Source: medicareadvocacy.org

Video: Medicare and You – Resources for Open Enrollment

Lesson Five: Carefree Caregiver Short Course to Peace of Mind

Hi! My name is Tammy I. Glenn and my journey began when I was eight years old, and my mother had a tragic accident that changed our lives forever. My mother became disabled and eventually, totally bedbound • In the 17 years that followed, my dad and I cared for my mom, pioneering a lot of everyday solutions from scratch • My mother died in 1992 and at that time, I vowed to use my family’s experience to help others in a similar situation • Please join me and a community of individuals who—just like you!—are dealing with a homebound situation.
Source: homeboundresources.com

HealthPlan Services Launches “benefit crossroads”

About HealthPlan Services HealthPlan Services (HPS) is the largest independent provider of service and technology solutions to the insurance and managed care industry. Since 1970, HPS has offered customized administration and distribution services to insurers of individual, small group, voluntary and association plans, as well as valuable solutions to thousands of brokers and agents. HPS’ proprietary, scalable technology provides innovative consumer-facing solutions that are turnkey self-service tools for insurance carriers and distribution partners. HPS offers an ever-expanding array of services to a diverse and growing client base, and administers products that include medical (PPO, HMO, indemnity, consumer-driven), dental, vision, life, disability, cancer, critical illness, accident, long term care, limited medical, as well as various other ancillary insurance. HPS is committed to providing extraordinary service to its customers. HPS is a company of Water Street Healthcare Partners, a strategic private equity firm focused exclusively on healthcare. For more information about HPS, visit www.healthplan.com.
Source: madduxpress.com

Compare Medicare plans and rates #168412

Save Money – Compare Affordable Coverage Plans Search for a wide range of benefits and pricing and find more of what YOU want with Me dicare! – Find out if Me dicare can provide the support and flexibility you’re looking for! – Compare plans from a variety of providers and get a better idea of value – Explore details, perks, supplemental insurance, and more! Compare Plans http://ircbloggin.com/2154020n98y2609914 to leave: http://ircbloggin.com/?e=****@bubble.ro or post: Account management options are available here. Cancellations are handled promptly. Or Write Us: 11400 W. Olympic Blvd. Suite 200 Los Angeles, CA 90064 US.
Source: bubble.ro

What Is Medicare Part C And What Does It Cover

Second, make a note of the rules the plan specifies such as the time when you can join or opt out of the plan, the rights you have under the plan and the services covered by the plan. Pay special attention to the conditions regarding visiting a specialist doctor and receiving authorization for particular procedures or you may find out too late that you have to bear these expenses on your own.
Source: blog-millionaire-articles.com

2008 Medicare Rx Plan Changes: Many Low

Open Enrollment begins each November 15 and continues through December 31. On January 1, all selections are locked in for 2008. Changes can only be made during Open Enrollment now and take effect on January 1 of the next year. In the past, Medicare allowed beneficiaries to make changes several times during the year, but as of 2007, these changes are only allowed during the Open Enrollment period.
Source: suite101.com

Welcome to Medicare Exam vs Annual Wellness Visit

Posted by:  :  Category: Medicare

New Online Rx System Makes UM Student 'Top Entrepreneur' Finalist by University of Maryland Press Releases50% 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: The Medicare Learning Network (MLN): Official CMS Information for Fee-For-Service Providers

Mutual of Omaha Medicare Supplement Rates and Plans in Arizona

Mutual of Omaha Medicare Supplement Plans and rates in Arizona are being talked about quite often these days.  If you are comparing companies, rates and plans, you will want to include Mutual of Omaha in the group of companies you are looking at.  Depending on your zip code, you may be surprised how competitive the Mutual of Omaha rates are in the different areas of Arizona.  From Phoenix down to Tucson back to Mesa and Scottsdale then up to Prescott and Flagstaff, Mutual of Omaha has you covered for your Medicare Supplement needs.
Source: johnconner.com

Durable Medical Equipment Provider License For Sale in Broward County Florida

More Businesses For Sale • Businesses For Sale in Broward County Florida • Franchises For Sale in Broward County Florida • Durable Medical Equipment Provider License For Sale in Broward County Florida Businesses For Sale by Category • Restaurants For Sale in Broward County Florida • Car Washes For Sale in Broward County Florida • Broward County Florida Laundromats For Sale • Liquor Stores For Sale in Broward County Florida • Broward County Florida Gas Stations For Sale • Convenience Stores For Sale in Broward County Florida • Internet Business For Sale in Broward County Florida • Broward County Florida Nightclubs & Bars For Sale • Automotive Businesses For Sale in Broward County Florida • Broward County Florida Routes For Sale • Broward County Florida Pet Businesses For Sale • Wholesale & Distribution Businesses For Sale in Broward County Florida • Manufacturing Businesses For Sale in Broward County Florida • Marinas For Sale in Broward County Florida Buying a Business Resources • Buying a Business in Broward County Florida • The Advantages of Buying An Existing Business in Broward County Florida • Forget The Asking Price of A Business For Sale • Getting Into Business: Durable Medical Equipment Provider License • How To Value A Durable Medical Equipment Provider License
Source: businessmart.com

President Obama’s Medicare Fantasies

With savings that small, the ad might as well have featured Obama searching his couch cushions for change to shore up the program’s finances. Never mind that estimates suggest that health fraud in government programs exceeds $60 billion a year, or that the Government Accountability Office found that the program wastes $48 billion annually on “improper payments” to Medicare providers. Forget that the administration has already put on hold at least one component of its anti-fraud initiative after complaints from health providers. The scale of the program is so huge—within a decade Medicare spending is expected to cost over $1 trillion each year—that even the billion dollar savings Obama touts are essentially meaningless. This is like a field commander bragging about a new way to defend against mosquito bites while his troops are taking mortar fire.
Source: reason.com

Partnering with Rehabilitation Services is a “Win

Accountable care organizations and the concept of managed care will have a huge impact as hospitals begin to launch efforts toward avoiding costly readmission penalties by discharging patients to trusted partners with proven outcomes. Having an on-site rehabilitation clinic in an assisted living community can help improve not just a senior living provider’s partnership profile, but can also be useful in marketing to prospective residents.
Source: seniorlivinginfo.com

How Do You Choose Your Healthcare Provider?

Fill out governmental hospital surveys In addition to doing your research and considering the source, my final hope is that you remember your voice and fill out hospital surveys that come from the government. Medicare distributes a survey called Hospital Consumer Assessment of Healthcare Providers and Systems, also termed “H-CAPS,” to a random sample of patients discharged from U.S. hospitals. Results are posted on Ohio Hospital Compare. Soon, hospital payments will be partly based on these surveys. Therefore, hospitals are paying very close attention to these reviews.
Source: summaflourish.org

CMS announces Provider Screening Innovator Challenge

1. Reduced processing and transaction time for submitting and receiving queries to authoritative data sources regarding provider credentials and sanctions. 2. Reductions in time needed by providers to submit information and resolve discrepancies. 3. Administrative/infrastructure savings from a multi-tenant provider screening solution. 4. Improved availability of key provider data relevant for program participation and oversight. 5. Improved timeliness and accuracy in provider participation, oversight, and enrollment decisions. 6. Improved ability to implement sections of the Social Security Act, as amended by the Patient Protection and Affordable Care Act. 7. Assist in better driving alignment of the Medicaid Information Technology Architecture (MITA) 3.0 framework to the Information and Technology Architecture levels.
Source: ehrintelligence.com

Medicare That Watches After You

Unfortunately, there are dishonest people out there, so it is up to you to watch out and be careful. When you detect any dubious particulars on your MSN, contact your medical provider immediately. Make an effort to call the attention of your health provider or doctor if you notice any amounts or items that shouldn’t be there. If this is just a mistake, your doctor or medical provider should be inclined to straighten out the issue. Nevertheless, if you do not get any feedback or help, you can report the concern to the Medicare fraud hotline. Pay close attention to the date, amount charged and particulars on your MSN.
Source: blogspot.com

Medicare This Week: National Provider Call on Registration and Attestation, New CMS Video Education on Youtube, Updates from the Medical Learning Network

From the MLN:Negative Pressure Wound Therapy Interpretive Guidelines MLN Matters ArticleReleased – MLN Matters Special Edition Article #SE1222, Negative Pressure Wound Therapy Interpretive Guidelines has been released and is now available in downloadable format. This article is designed to provide education on CMS-approved guidelines that accrediting organizations can use to accredit suppliers that provide Negative Pressure Wound Therapy (NPWT) equipment to Medicare beneficiaries. It includes a list of relevant local coverage determinations and standards to help DMEPOS suppliers comply with standards and guidelines for NPWT equipment.
Source: managemypractice.com

Jolta EMR/EHR Game for Android

An electronic health record (EHR) is an evolving concept which became necessity of today’s medical practice. The Jolta EHR is a Hand held device based EHR software in which you can keep practice, provider information. It allows you to keep record of demographics information of patient. You can schedule appointments for the patient. You can print out the report of appointment with respect to providers and appointment statuses.
Source: droidmill.com

Information Your Medicare Provider Needs

After weeks of procrastinating, now that you have finally mustered the will to visit your Medicare provider, ensure that you reach his office armed with all those bits of information that he will need to know. Regular visits to your Medicare provider is probably the only way to detect the early warning signs of grave medical problems and treat these before blow up into potentially debilitating diseases. Make the most of these visits by helping your Medicare provider with the information that he needs to know about you to examine and/or treat you.
Source: prime-medical.com

Wellness News at Weighing Success: Not Made in America

Current News, Resources and Events in Nutrition, Food, Health, Food Recalls, Safety, Lifestyle Skills, Disability Rights and Environmental Issues. Encourages awareness and inspires ideas for Journalists, Educators, Consumers and Health Professionals.
Source: blogspot.com

Have You Updated All of Your Addresses with Medicare The Consequences of Not Doing So Are Severe

Tag words:  Medicare, Medicare audits, Medicare site visits, termination of Medicare billing privileges, Centers for Medicare & Medicaid Services (CMS), corrective action plan (CAP), request for reconsideration, Medicare administrative hearing, administrative law judge(ALJ), physicians, medical groups, medical practices, clinic, pharmacies, durable medical equipment (DME) suppliers, home health agencies, nursing homes and other healthcare providers, Medicare Administrative Contractors (MAC), Zone Program Integrity Contractors (ZPIC), ZPIC site visit, ZPIC audit, fraud prevention, Medicare number revocation, Medicare termination, OIG special agents, Medicaid Fraud Control Unit (MFCU), investigators, Medicare Provider Enrollment Chain and Ownership System (PECOS), National Plan & Provider Enumeration System (NPPES), NPI Registry
Source: thehealthlawfirm.com

Doughnut Hole Rebate Checks Fuel Medicare Fraud & Insurance Scams

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SSMissouri Attorney General Chris Koster (also the name of the website) comments on the types of Medicare scams taking place across the nation. The article can be found in the Attorney General’s News Release titled, "Attorney General Koster Warns Seniors About Medicare Rebate Fraud Schemes" (June, 2010). According to the author (name not given), "[Koster] said a common scam related to the $250 donut hole checks was for individuals to convince seniors that the rebate check needed to be transferred to a third party or used to cover specific prescription drug payments."
Source: suite101.com

Video: DeafLink ASL Update – Show 1 – Medicare Part D Rebate Checks June 15, 2010.wmv

Senior Benefits Guide — New York

Every time the government enacts a Healthcare rebate there are crooks ready and eager to take advantage.  Remember the $250 Medicare rebate a few years back?  Hundreds of thousands of seniors were swindled by crooks calling them, pretending to represent Medicare.  These crooks asked for personal information, specifically, Medicare card details, so a $250 check could be issued to cover the gap in covered prescription charges. In fact, they wanted the info in order to commit identity theft
Source: seniorbenefitsguide.com

$250 Medicare Rebate Checks a ‘Drop in the Bucket’ Compared to Rising Drug Prices

–> Sometime in August, Patricia Holland will drop into Medicare’s dreaded doughnut hole. She is already bracing for that financial wallop. Holland, 67, of Centreville, Md., regularly takes seven prescription medications. One of them — Entocort — is especially expensive. It prevents severe attacks of her colitis, an inflammatory bowel disease. Right now, with full Medicare drug coverage — before the doughnut hole — Holland pays $195 a month for Entocort. That’s her co-pay, nowhere near the full price of the medication. When she enters the doughnut hole, though, her Entocort cost will go up exponentially, consuming, she says, her entire state retirement check. The doughnut hole is the coverage gap in the Medicare prescription drug benefit, called Part D. Seniors get initial coverage until their total drug expenses exceed $2,830. Then Medicare covers nothing until total spending reaches $6,440, when catastrophic coverage starts. The doughnut hole is the $3,610 space between the two amounts, when seniors pay all costs for their drugs.Health care reform legislation will shrink that hole in Medicare drug costs. This year, seniors who fall into the doughnut hole will get a rebate check for $250. Last week, the federal government mailed the first of those checks. Next year, Medicare recipients will get a 50% discount on brand-name drugs while in the doughnut hole. The coverage will improve annually until the hole disappears in 2020. The extra $250 doesn’t impress Holland. “A drop in the bucket,” she says. She spends hundreds of dollars a month on prescriptions even before she reaches the gap. When she arrives in the doughnut hole, the retail price of Entocort (three 3 mg pills a day) could reach $1,200 a month. For one drug. Fortunately, her position as a volunteer at a nearby Maryland hospital offers her a price break. Holland began volunteering there in 1997. Two years ago, when her drug costs spiked with Entocort, she started taking advantage of the hospital program offering medications at the same price that the hospital pays. When in the doughnut hole last year, Holland paid $680 for Entocort through the hospital. This year, she says, it will cost her $300 more a month in the doughnut hole. The hospital’s cost has climbed to $988, she says. The price difference stunned her. “My pharmacist told me that all drug prices have gone up,” Holland says. A recent AARP study found that average prices for brand-name drugs that are widely used by Medicare beneficiaries rose almost 10% over a 12-month period ending in March — higher than the rate of increase in the previous eight years. That compares with a general inflation rate of 0.3% over that same period. Meanwhile, the price of widely used generic prescriptions fell by an average of nearly 10% during that same period, the study found. AARP has been tracking drug price increases since the enactment of Medicare Part D and the doughnut hole. “It’s no surprise that prices have gone up,” says John Rother, AARP executive vice president. “The surprise is they’ve gone up faster than before — and gone up during an economic downturn.” Responding to the AARP data, the brand-name drug industry said prescription drugs help control health care spending by reducing unnecessary hospitalizations and helping manage chronic diseases. “Prescription medicines represent a small and decreasing share of growth in overall health care costs in the U.S,” said a statement from PhRMA, which represents the brand drug industry. Entocort is manufactured by AstraZeneca, which referred questions about pricing to the company that markets the drug, Prometheus Laboratories. A Prometheus spokesman declined to comment. The drug is expected to face generic competition in early 2012. As drugs near the end of their patent exclusivity, prices sometimes rise — probably so the manufacturer can maximize its revenue before the drug goes generic, AARP says. Holland takes generics when she can. She says her family income is too high for her to qualify for the manufacturer’s drug assistance program for Entocort. So the doughnut hole awaits — along with the $988 per month tab. “I know people in the doughnut hole who don’t take their prescriptions” because of the cost, Holland says, adding that it’s a good thing that health reform will eventually close the doughnut hole. Her overall assessment of the hole? “It stinks.” And the price increase for her medication? “There’s no rhyme or reason for that. It’s already high enough. ”
Source: dailyfinance.com

Have You Updated All of Your Addresses with Medicare The Consequences of Not Doing So Are Severe

Posted by:  :  Category: Medicare

No doctor shopping here, buddy by Newtown grafittiTag words:  Medicare, Medicare audits, Medicare site visits, termination of Medicare billing privileges, Centers for Medicare & Medicaid Services (CMS), corrective action plan (CAP), request for reconsideration, Medicare administrative hearing, administrative law judge(ALJ), physicians, medical groups, medical practices, clinic, pharmacies, durable medical equipment (DME) suppliers, home health agencies, nursing homes and other healthcare providers, Medicare Administrative Contractors (MAC), Zone Program Integrity Contractors (ZPIC), ZPIC site visit, ZPIC audit, fraud prevention, Medicare number revocation, Medicare termination, OIG special agents, Medicaid Fraud Control Unit (MFCU), investigators, Medicare Provider Enrollment Chain and Ownership System (PECOS), National Plan & Provider Enumeration System (NPPES), NPI Registry
Source: thehealthlawfirm.com

Video: Medicare Provider Enrollment 3.wmv

Medicare Patient PT Supervision is Confusing

Let’s start with a couple fundamentals:  first, medical practices that comply with the so called “group practice” exceptions (under both state and federal law) are permitted to provide PT to their own patients.  They are more accurately known as the “In Office Ancillary Services Exception,” but most refer to them as described above.  These exceptions dictate, for instance, the form of the practice and how much time each physician has to spend practicing through the group.  For instance, if the practice does not have at least two of the following, it does not meet the group practice requirements:  physician owner; physician W-2 employee.  Second, PT falls under both the state and the federal definitions of “designated health service” (DHS).  DHS are services that are regulated by the Stark Law and also (at the state level) by the Florida Patient Self Referral Act of 1992 (FPSRA).  They are very similar laws, but with some key differences.  Where many physicians go wrong is to ensure compliance with federal laws but not state or vice versa.
Source: wordpress.com

Women Jailed for U.S.$1.9 Million Medicare Fraud

Hassan and the co-owner of Jos Campau Physical Therapy sold the fictitious physical and occupational therapy files to multiple fraudulent therapy companies that had obtained Medicare provider numbers. Those companies billed the fictitious files created by Jos Campau Physical Therapy to Medicare and paid kickbacks to Jos Campau Physical Therapy based on these billings. Hassan and her co-owner split the profits from the sale of the falsified files.
Source: ptmanagerblog.com

Man Sentenced to 5 Years for Role in $1.5M Health Care Fraud Scheme

Brunswick Medical Supply was a fraudulent medical equipment provider that was opened in Brunswick in 2007. Associates of Tumanyan fraudulently obtained a Medicare provider number for this phony businesses, stole the identities of hundreds of Medicare beneficiaries, stole the identities of dozens of doctors, and used this stolen information to submit millions of dollars in phony claims for health care services that were never provided. Medicare paid approximately $1.5 million for these fraudulent claims before Brunswick Medical Supply was shut down. Tumanyan then took numerous steps to launder the money stolen from Medicare. Tumanyan opened at least four sham businesses in Los Angeles; opened multiple bank accounts in the names of these businesses; and used these bank accounts to launder the proceeds of the fraud at Brunswick Medical Supply. The evidence also showed that Tumanyan helped launder hundreds of thousands of dollars of other money stolen through various schemes to defraud, such as identity theft, check kiting, and other health care fraud schemes.
Source: loansafe.org

blog13: Qld: Lack of Medicare provider numbers make doctors see red

Qld: Lack of Medicare provider numbers make doctors see red Protesting junior doctors have said the federal government will face a backlash at the ballot box unless it changes laws on the Medicare provider numbers which restrict the numbers of general practitioners. Organisers of a protest in Brisbane yesterday — the Australian Medical Association of Queensland say public sympathy will grow in the lead-up to the federal election due by the end of this year. The AMAQ says another rally will be held in Townsville this week, and they hope that other states will continue with similar protests. AAP RTV rad/kb/rt KEYWORD: DOCTOR RALLY (BRISBANE) 2001 AAP Information Services Pty Limited (AAP) or its Licensors.
Source: blogspot.com

how would a physical therapist get out of being a medicare provider; can I get rid of my medicare number?

Question by : how would a physical therapist get out of being a medicare provider; can I get rid of my medicare number? I am in private practice and have a medicare number. I am going totally cash based clinic / we supply superbills so clients can bill on their own. Can I get out of medicare and can I then see patients that have medicare but can I just charge them our cash rate to collect cash instead of insurance money. ralph@missionhillspt.com thanks for your help , please!
Source: nptuner.com

Is Medicare and Medicaid Reimbursements fairer than Private Insurers: a Brief Comparison

The Committee on Ways and Means (US Congress) in its latest efforts in the health reforms regarding payments from private payers and its implementation in Medicare has started to explore how private payers are rewarding physicians who provide high quality and efficient care. The report released by the cites the Sustainable Growth Rate (SGR) formula in Medicare Fee-for-service (FFS) as lacking in recognizing the quality of care that is offered by the provider. A report by the U.S National Institute of Health clarifies that in 2004 31% of all outpatient physician income was derived from government sources and this number is set to rise as the reforms ensure health insurance for the remaining 32 million uninsured in the country. This essentially implies that even if Medicare and Medicaid pay a less amount per claim compared to private insurers, more than one-third of physician income is set to come from such government sources.
Source: ezinemark.com

SNFs: Its All About Quality Now

[…]  After sorting and sifting and balancing and restructuring, Medicare as a payment source is viewed by the post-acute industry as a really, really good payer and in all reality, one that should be mined.  SNFs focused on building therapy services and targeting certain patient types.  Home Health began doing the same.  SNF prices per bed paid during transactions were strong and growing, valuations the same and providers were investing in plant and equipment designed to take advantage of opportunities to attract Medicare patients.  Home Health agencies increased in number and the profit margins for home health driven by a high Medicare payer census pushed into the 20% area.  Hospice also grew in numbers and profitability, targeting terminally-ill Medicare beneficiaries, many residing in nursing facilities.  Hospitals came to the full realization that post-acute was fraught with regulatory and reimbursement land mines and this period began the earnest push among hospital systems to divest post-acute holdings.Source: rhislop3.com […]
Source: rhislop3.com

Major Improvements to Medicare Online Enrollment System

Posted by:  :  Category: Medicare

Over the last year, we have listened to your feedback about the Medicare online enrollment system, PECOS (“Provider Enrollment, Chain, and Ownership System”). As a result, we’ve made upgrades in order to reduce data entry time and increase access to information.
Source: hcafnews.com

Video: Medicare and You – Resources for Open Enrollment

How to choose a Medicare Advantage plan

• Total costs: Look at the plan’s entire pricing package, not just the premiums and deductibles. Compare the out-of-pocket maximums plus the copays and coinsurance charged for doctor office visits, hospital stays, diagnostic tests, visits to specialists, prescription drugs and other medical services. This is very important because if you choose an Advantage plan, you’re not allowed to purchase a Medigap supplement policy, which means you’ll be responsible for paying these expenses out of your own pocket.
Source: pomeradonews.com

Medicare providers urged to enroll in online system to fight fraud

Medicare issued $47 billion in improper payments in 2009, which accounted for about 43 percent of the $110 billion the government wrongfully disbursed that year, Daniel Werfel, controller for the Office of Management and Budget, told a Senate panel on Tuesday. Complicating matters for CMS, the stimulus package calls for the agency to start cutting bonus checks up to $44,000 over five years to Medicare health care providers that install an electronic health records system. CMS said it will rely on PECOS to verify Medicare eligibility.
Source: nextgov.com

Medicare Open Enrollment 2010: Review Coverage From November 15th

You may, for example, find new benefits that could save you extra money or give you better coverage. Or, you could get information on local plans that may work out to be more cost-effective than your existing coverage. According to Donald Berwick, M.D., CMS Administrator: "By shopping for next year’s coverage now, people with Medicare may find even greater savings or better coverage than they are getting this year.” More seniors, for example, may be eligible for help with prescription drug costs in the ‘donut hole.’
Source: suite101.com

Medicare This Week: 11 Stories About Balance Billing, eRX, PQRS, 5010, EHR, and Revalidation

Users can now complete and submit EFT Agreements electronically with the option to e-sign the document. If the provider/supplier submits the EFT agreement electronically and chooses not to e-sign, they shall include a hardcopy form of the completed and signed EFT agreement with its supporting documentation to the contractor. Providers/suppliers are still required to physically mail confirmation of account information on bank letterhead, or a voided check whether the EFT is submitted electronically or via the paper version.Along with the documentation, it is also important that the provider/supplier print and mail the enrollment submission confirmation page containing the web tracking ID. This will ensure that the supporting documents mailed to your MAC get associated with your electronic application submission.
Source: managemypractice.com

HealthPlan Services Launches “benefit crossroads”

About HealthPlan Services HealthPlan Services (HPS) is the largest independent provider of service and technology solutions to the insurance and managed care industry. Since 1970, HPS has offered customized administration and distribution services to insurers of individual, small group, voluntary and association plans, as well as valuable solutions to thousands of brokers and agents. HPS’ proprietary, scalable technology provides innovative consumer-facing solutions that are turnkey self-service tools for insurance carriers and distribution partners. HPS offers an ever-expanding array of services to a diverse and growing client base, and administers products that include medical (PPO, HMO, indemnity, consumer-driven), dental, vision, life, disability, cancer, critical illness, accident, long term care, limited medical, as well as various other ancillary insurance. HPS is committed to providing extraordinary service to its customers. HPS is a company of Water Street Healthcare Partners, a strategic private equity firm focused exclusively on healthcare. For more information about HPS, visit www.healthplan.com.
Source: madduxpress.com

Medicaid and Medicare Information

Crockett Resource Center for Independent Living (CRCIL) will be hosting a workshop about the Senior Medical Patrol Project (SMP) on Wednesday, June 20th at 1:00 p.m.  Presenter, Rick Rameriz, Texas SMP Project Coordinator, reports that there are many different ways Medicare is defrauded and each year, billions of dollars are stolen by scam artists and crooks.  The SMP presentation will educate seniors on how to protect, detect, and report fraud, waste, and abuse of the Medicare system.
Source: countylifeonline.com

Geographic Variation in Dual Eligible Enrollment

Over 9 million elderly Americans and younger persons with disabilities are jointly enrolled in the Medicaid and Medicare programs.  These “dual eligibles” receive coverage for most medical services from Medicare, and they also receive Medicaid assistance for Medicare premiums and cost-sharing and coverage of benefits not offered under Medicare (such as long-term care).  Dual eligibles are among the sickest and poorest individuals covered by Medicare and Medicaid and, as a group, account for a disproportionate share of spending in both programs.  For this reason, policymakers are focusing on dual eligible individuals in planning new initiatives to improve care coordination and quality, expand the use of managed care, or enhance current service delivery programs with the goal of achieving cost savings. States, which administer the Medicaid program jointly with the federal government, are playing an active role in the development of these proposals.
Source: medicareindex.com

Survive the Medicare Enrollment MazeMiss an enrollment deadline for Medicare,

Survive the Medicare Enrollment Maze Miss an enrollment deadline for Medicare, and you could end up with no medical coverage for months and a lifetime of penalties. Health Insurers Highlight Low-Income Medicare Advantage Enrollees Minority, rural, and low-income Medicare beneficiaries make up a significant portion of people using plans targeted for spending cuts, according to a report released by the health insurance industry Thursday.America s Health Insurance Plans, which issued the report, could use it to show Democrats that limits to Medigap policies would hit lower-income seniors.The report uses 2010 Medicare data to … Navigating Healthcare Costs In Retirement The ins and outs of planning for your healthcare costs well into retirement. Closed End Funds: The Too-Well-Kept Secret The advantages and disadvantages of closed end funds.
Source: medicare-news.com

Los Angeles County Medicare Supplement Rates

Posted by:  :  Category: Medicare

The 2012 Medicare Supplement Rates in Los Angeles County are not the lowest in California although with the continued growth in new customers turning age 65 in Los Angeles, my feeling is the L.A. area will continue to see consistent rates over the next several years.  Not the wide swinging ups and downs in other parts of the country.  Anthem Blue Cross is the carrier I think will continue to stay competitive in Los Angeles County, along with their Anthem Extras Dental & Vision packages, their Anthem Medicare PPO plan and their Medicare Part D Rx plans all continuing to stay very popular over the coming years.
Source: johnconner.com

Video: Is Freedom Blue PPO a Medicare Supplement?

Horizon Medicare Advantage Blue Value with Rx

With more than 25 years of health plan experience, Deanna brings to SCAN a solid background in Medicare Advantage sales management, sales operations and marketing. Immediately prior to joining SCAN she served as corporate director of Medicare marketing for Molina Healthcare where she was instrumental in optimizing marketing, sales and enrollment operations. She has held sales leadership positions at several other large healthcare companies including PacifiCare Health Systems/Secure Horizons and Aetna. Source: pepperdine.edu
Source: medicaresupplementalco.com

Dental Blue from Anthem Blue Cross Blue Shield of Colorado…

Based in beautiful Jackson Hole, Wyoming, we currently market health insurance in 18 different states from our website IndividualHealth.com. I have worked in the domestic and international markets for most of my adult life. Recently we launched a newly revamped website www.tetonmarketing.com which has a primary focus on music and Native American Flutes and hand crafted items made in Wyoming. Check it out! I want the Insurance Simplified Blog to be a place you can visit from time to time and read about real world issues that individuals and families face daily. Our parent website IndividualHealth.com we like to think of as a virtual brochure. But with the blog I want to talk about the topics behind the brochure. Also check out our blog www.JacksonHoleTim.com which is “All Things Wyoming, Everything Jackson Hole” . If you love the Yellowstone basin this is blog for you! Then when you are ready check out our new Social Network site Jacksonholetim.ning.com – this is a place you can connect with other who visit and live in Wyoming. And finally we have just launched another new blog. Jackson Hole Tim (www.jacksonholetim.com) is a new place to visit that talks about “All things Wyoming, Everything Jackson Hole”. I hope you find these blog helpful.
Source: wordpress.com

Flu clinic 12/28 noon until 4pm

(BINGHAMTON, NY) – The Broome County Health Department will be holding a flu clinic at their offices located at 225 Front Street, Binghamton, on Wednesday, December 28, 2011 from 12:00 p.m. to 4:00 p.m. Clinics are open to the county residents ages 3 and up.
Source: gobroomecounty.com

Blue Cross Medicare Supplement

The electronic module of the hybrid was refined to facilitate the different parts of the drivetrain which were made as tough as Volvo V40 parts. The hybrid version of the Mariner employs a four-cylinder Atkinson cycle engine, and a 70 kW electric motor to drive the SUV. To transfer the power from either the engine or the electric motor, the continuously variable automatic transmission is called upon. The effect of the refinement in the controller is a smoother transfer of power from engine to electric motor and vice versa. Gear changes are also made smoother thanks to the refinement. Another notable refinement in the Mariner is the use of electricity to power the rack-and-pinion steering system instead of the conventional hydraulic pump.Glady Reign is a 32 year old is a consultant for an automotive firm based in Detroit, Mi. she is a native of the motor city and grew up around cars hence her expertise in the automotive field. You can visitVolvo S40 partsfor more information.
Source: virginiamedicarepros.com

blue cross medical insurance 1099

Medical Insurance . insurance premiums are paid by CyberBest at 50%. We offer both Blue Cross . 1099 and W-2 contract employees are original: create a plate molds website banner exchange software gnc fish oil pills fox soccer channel streaming free
Source: posterous.com

California Medicare Insurance: Anthem Freedom Blue PPO for 2012

The Anthem Blue Cross Freedom Blue 2012 will be seeing some changes. It will now be called the Anthem Medicare Preferred Standard PPO. This plan  will be the only PPO Medicare Advantage plan in California. The Anthem Medicare Preferred is a Local PPO or LPPO available only in certain counties throughout the state and has a $300 annual deductible.. These counties include Los Angeles, Orange, San Francisco, Alameda, San Diego, Sacramento and Ventura just to name a few.Although the core benefits are similar there are some differences. One of the biggest changes for the Medicare Advantage LPPO for 2012 is that some counties are now charging a monthly premium. Los Angeles, San Diego and Ventura are the only ones where it is remaining a “No Cost” plan. The Anthem Medicare Preferred PPO also includes prescription drugs at no additional cost. It includes a standard 4 Tier Drug Formulary. This will allow you to have co-pays for your medications. In addition, you will have the option to add Dental, Vision and other benefits for an extra monthly cost. And lastly, the plan does include Silver Sneakers for those of you who like to stay active and go the gym. This coverage is at no additional cost. So to recap…you will have access to the Anthem PPO network, set co-pays, prescription drugs covered and great optional benefits! Now that is a value plan with an affordable cost to all Medicare beneficiaries in the available counties.
Source: blogspot.com

Blue Cross Blue Shield of Michigan Offers New Medicare Plans

HMO’s (health maintenance Organizations) let you select a primary care physician from the BCBS provider network and this PCP manages your overall care. He or she will refer you to a specialist or to a selected hospital for care should you need additional services beyond his scope of practice. Referring yourself to an outside provider will cause a forfeit of benefits and out-of-pocket costs. The four BCBSM HMO products, formerly known as Options 1, 2, and 3, will now be known as BCN Advantage Elements, Classic , and Prestige. The Blues Care Network will also continue to offer the BCN Advantage Basic Plan.
Source: emaxhealth.com

Broome County Health Department to Hold Seasonal Flu Clinic

Earlier clinics were cancelled due to shipment delays. “These delays make people anxious because they have legitimate concerns about their health. Right now we are seeing widespread 2009 H1N1 flu and no seasonal flu activity,” said Diane O’Hora, Supervising Public Health Educator for the Broome County Health Department. “There is still time to get vaccinated. It’s not too late.” In the Northern hemisphere, winter is the time for flu. The timing and duration of flu seasons vary. While flu outbreaks can happen as early as October, most of the time influenza activity peaks in January or later.  
Source: gobroomecounty.com

Polyclinique et Maternité D'Ilafy

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

Medicare Supplement Texas Medigap

Posted by:  :  Category: Medicare

Twenty percent. It is crucial to note that these Medicare supplement Texas plans will not cover long term care in a nursing home, and they often will not cover dental, vision, or other speciality areas of this nature.
Source: cuplessjoe.com

Video: Medicare Supplements in Texas: What to Look For When Choosing a Plan

Information On Medicare Part C And What All It Insures

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
Source: medicaresupplementalco.com

Global Telecommute, A Site for international telcommuters: Tx Medicare supplement Projects : Eligibility Procedures for folks Around 65 as well as Beneath 65.

This of which someone results in being eligible to Treatment is usually lost when using the age group that just one qualifies pertaining to Cultural Protection. You shouldn’t fooled — designed for trained men and women resorting get older 65, Medicare insurance frequently starts off within the earliest afternoon belonging to the thirty days by which you’re created. Those of you that own professional to get Medicare insurance smaller when compared with time 65, eligibility starts just after two years associated with obtaining sociable safety measures inability. Yet, think guidelines change that medicare health insurance health supplements they get access to. Eligibility to get a Colorado front range Medicare supplemental health insurance projects differs determined by how old you are.   FSA Eligible Expenses   Well before we all go into the exact protocols, you ought to be aware that any time a particular person very first triggers Portion M, there is always some sort of wide open sign up timeframe intended for getting a Medicare supplemental health insurance schedule when period anyone does not need to endure almost any well-being underwriting. They are really likely use of a policy for as much as six months above their particular Aspect H productive meeting. Most people becomes this particular unique eye-port to utilize, no matter age group where that they to start with receive Medicare insurance. From where the eligibility guidelines begin working happen to be about whichplans each one of the a pair of types includes having access to. Your strategies provided to those that underneath years 65 are usually constrained.   Here is the way in which eligibility regulations meant for numerous blueprints do the job throughout Florida, in accordance with your real age:   With regard to folks that are usually transforming 65 or simply more mature, legal issues will allow entry to every augment programs, cover anything from Approach Your via Schedule In. Additionally there is one particular high-deductible preference. Program Y is in all likelihood the most used as it contains almost all deductibles along with co-insurance you’d probably commonly fork out. Yet, Ideas He in addition to And also are increasing regular membership as a result of featuring just a bit reduce charges frequently for your very little cost-sharing against your area.   If anyone is with Medicare insurance with grow older 65 with The state of texas, some sort of caveat is available: many of these people deal with solely Method Any. Here i will discuss how come: every insurance company will be able to pick the complement options they would like to present thus to their loan applicants. Really the only medicare supplement method some people are necessary to give to be able to allbeneficiaries is actually Prepare A new. Seeing that coverage insurers realize that people today underneath 65 became Medicare health insurance from the beginning caused by a huge health, they will predict most of these person to utilize positive aspects with ease, which usually needless to say costs the particular company additional money. Due to this, the majority of insurance carriers provide you with primarily Prepare Any to help person’s sixty-four as well as young, considering that this plan of action features a smaller amount health benefits even more cost-sharing for any named beneficiary. They are able to moreover collection whatsoever high grade these people similar to pertaining to Method An important according to grow old, frequently all of us notice this treatment solution will probably be far more high priced to your youthful beneficiaries.   For certain, an agenda A new treatment supplementation nevertheless gives you benefits. Though it might not insure deductibles or even expert nurses co-insurance, it will take care of one of the critical breaks: the particular 20% co-insurance intended for Aspect H outpatient good care the fact that beneficiaries would likely or else have got to pay back. This really is massively crucial mainly because Portion T addresses around simply just health care provider goes to — in addition, it contains higher-ticket products which includes chemotherapy, the radiation together with dialysis. Not having additional insurance plan, therapy for your significant health could value a lot of money.   Since the standard medicare supplemental health insurance strategy enables any enrollee to view any specific medical professional which takes unique Medicare insurance, it indicates Method A new will always be the accommodate for many who wish entry to a range of medical professionals together with hostipal wards and might truly feel unpleasant having a network-based Advantages program. Nevertheless, considering most of augment blueprints get amount grows ever so often, it really is very difficult for that more youthful man or women for Treatment to help you keep these types of grows on the Schedule Any above several years. Regrettably, the diseases typically stop him or her as a result of having the capability to go underwriting so as to adjust into a lower-priced company.   The good thing is that after the actual successor extends to grow old 65, they can be handed a subsequent receptive registration windowpane and then change so that you can just about any complement on their alternative in that display. The laws pertaining to eligibility for you to numerous blueprints happen to be extremely difficult to your regular shopper to learn, consequently talking to a completely independent insurance broker designed for guide knowledge your current eligibility with your skills with regard to registration windows 7 could conserve enough time studying choices.   flexible spending account card
Source: telecommuteglobal.com

Texas Medicare Supplement Plan G

Plan G is also available in a money saving Medicare Select option. Basically, if you’re looking to save on premiums, you can receive the same benefits as the standard Plan G but for a reduced premium.  By agreeing to use Medicare Select hospitals and doctors, your monthly payment is reduced. Need emergency care? No problem, with Medicare Select, you can get treatment at any hospital for no extra charge. Plus, you can still choose your own doctor. Remember, to be eligible for Medicare Select Plan G, you must live within 30 miles of a Medicare Select participating hospital.
Source: medicareinsurancetexas.com

MASA Assist offered by Veteran Owned Business, Centaur Medicare Solutions that Helps Baby Boomers with Medigap

Centaur Medicare Solutions LLC., an independent insurance agency started by a retired Army veteran, has added MASA Assist into the arsenal of products it will be offering retiring Baby Boomers. MASA Assist is provided by the Medical Air Services Association, an international organization with over 500,000 members. “MASA Assist is a good fit for retiring Baby Boomers as they will be traveling more and often with grandchildren and pets in tow. It just makes sense to offer this lifesaving service which is much more robust than typical emergency travel insurance to our customers. Most seniors who travel will be very prone to wanting the peace of mind that this type of coverage brings,” says owner Joel Moyer. One of the great features of MASA Assist is that anyone can be covered. There are no health questions, age limits, and even pre-existing medical conditions are covered after 90 days. In addition to covering both air and ground Medical evacuation, MASA Assist has some unique features such as covering the return of minor children, pets, and even recreational vehicles should the policy holder have a medical crisis. A video and information about MASA Assist can be found on Centaur Medicare Solutions’ websites under the travel insurance tab. Centaur Medicare Solutions has expanded rapidly from offering Georgia Medicare supplemental insurance to now targeting 29 states including selling Medicare supplements in California, Florida, and Texas. As an independent agency, Centaur Medicare Solutions is better able to help people turning 65 and older find low-cost Medicare supplemental insurance by providing comparisons from all the leading insurance companies. About Centaur Medicare Solutions LLC Centaur Medicare Solutions LLC is a veteran-owned business, located south of Atlanta, Georgia and is on the internet at http://centaurmedicaresolutions.com and http://medicare-supplement.biz
Source: sbwire.com

House Republican Plan to Overhaul Medicare Opposed by Original Advocate

Posted by:  :  Category: Medicare

BANKRUPT! by SS&SSWhile 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

Video: Medicare Physician Feedback Program: Payment Standardization and RIsk Adjustment

How Medicare Risk Adjustment Program Is Used To Compensate Managed Care Plans

Now with the risk adjustment program, the payments from patients with multiple diseases are likely to increase, compared to what they were in the past. This program emphasizes that the providers of the Medicare Advantage Plan need to revise the list of customers they offer their services to on a regular basis. They also need to attract doctors and physicians who are capable of treating patients with different diseases effectively. Since many patients suffer from diabetes, chronological illness and heart disease, hospitals and medical facilities should design programs that address the needs of patients with these diseases as well.
Source: nationalsecuritydrone.com

Is Medicare and Medicaid Reimbursements fairer than Private Insurers: a Brief Comparison

The Committee on Ways and Means (US Congress) in its latest efforts in the health reforms regarding payments from private payers and its implementation in Medicare has started to explore how private payers are rewarding physicians who provide high quality and efficient care. The report released by the cites the Sustainable Growth Rate (SGR) formula in Medicare Fee-for-service (FFS) as lacking in recognizing the quality of care that is offered by the provider. A report by the U.S National Institute of Health clarifies that in 2004 31% of all outpatient physician income was derived from government sources and this number is set to rise as the reforms ensure health insurance for the remaining 32 million uninsured in the country. This essentially implies that even if Medicare and Medicaid pay a less amount per claim compared to private insurers, more than one-third of physician income is set to come from such government sources.
Source: ezinemark.com

All About Medicare Risk Adjustment

The Medicare Risk Adjustment program was launched in 2000 by the Centers for Medicare and Medicaid Services (CMS) to compensate managed care organizations. This program gathers information of treatment offered to patients in different facilities and on the basis of this information, Medicare determines how much to pay them. For this purpose, CMS uses ICD-9 codes to indicate different treatments and prepares a comprehensive report. The payment structure determined by using this system is more accurate and reliable compared to what it was earlier because the previous system relied only on geographic and demographic information to determine compensation of a facility.
Source: tow-truck-insurance.net

Senior Housing and Assisted Living

One of the most important factors within the area of risk adjustment analytics is being able to accurately estimate the costs of an individual by looking at their different factors, issues and other potential risks. One of the issues within the area of risk adjustment analytics is being able to create a type of software that will be capable of properly assessing the patients information and providing a qualified assessment of the potential risks and overall cost estimations. A number of different health care companies will provide a type of risk adjustment software to complete these calculations, however there are still much needed improvements to be made to ensure accuracy.
Source: infonex.us

Medicare Risk Adjustment – A Brief Input

Medicare Risk Adjustment is a term used to describe about the payment method authorized by Balanced Budget Act of 1997 & utilized by the Centers for Medicare & Medicaid Services (CMS) to make improvements in payment accuracy to Medicare Advantage Organizations.  However, to make such methodology be effectively possible, the ICD-9 coding plays the big part of the process.  ICD-9 coding determines the degree of severity of patient’s health condition through its numerical indexing of illness diagnosis, hospital procedures and other pertinent clinical data.  From such system, Medicare risk adjustment can analyze and provide the appropriate allowable funds that is to be reimbursed to physicians and amount that can be covered during hospitalization.
Source: ezinemark.com

GAO report on Medicare Advantage risk adjustment

We found that diagnostic coding differences exist between MA plans and Medicare FFS and that these differences had a substantial effect on payment to MA plans. We estimated that risk score growth due to coding differences over the previous 3 years was equivalent to $3.9 billion to $5.8 billion in payments to MA plans in 2010 before CMS’s adjustment for coding differences. Before CMS reduced 2010 MA beneficiary risk scores, we found that these scores were at least 4.8 percent, and perhaps as much as 7.1 percent, higher than the risk scores likely would have been as a result of diagnostic coding differences, that is, if the same beneficiaries had been continuously enrolled in FFS. Our estimates suggest that, after accounting for CMS’s 3.4 percent reduction to MA risk scores in 2010, MA risk scores were too high by at least 1.4 percent, and perhaps as much as 3.7 percent, equivalent to $1.2 billion and $3.1 billion in payments to MA plans.
Source: pnhp.org