Poll: Florida bingo set will go for safest net

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SS(This is the third article to run as part of American Mosaic, a yearlong Reuters/Ipsos polling and reporting project that focuses on the diverse groups and competing views at play in the 2012 presidential race. The data is drawn primarily from online surveys using sampling methods developed in consultation with outside experts. By Election Day the survey will have reached 150,000 people, mixing respondents recruited from the Internet with individuals screened by Ipsos. Their responses are weighted based on demographic information and refined using a monthly telephone poll. With this method, accuracy is measured using a statistical calculation called a credibility interval. To see all the data from this survey and other polls in the series, go to www.reuters.com/politics/american-mosaic.)
Source: expatnewsletter.net

Video: Sonora Resident Fights Blue Cross, Medicare

Choose Blue Cross Medicare Insurance Plan To Get Complete Coverage

Also known as the Blue Shield plan or Blue Cross Blue Shield Arizona (BCBSAZ), this is actually a supplemental insurance plan that takes care of all medical expenses that have not been covered by Medicare or Medicare Advantage. So, the individual has to subscribe to the BCBSAZ plan apart from the Medicare Part A and Medicare Part B plans. By subscribing to this plan, the person will be able to fill out the gap in coverage created by Medicare. But it will not work for the Medicare Advantage or the Part C plans. Blue Cross Medicare insurance also does not work with any other healthcare insurance plan which is usually a part of the retirement benefits. Various Senior Security Plans Of Blue Cross Medicare Insurance There are two such plans that are mentioned below: The BCBSAZ Senior Security Plan: Here, there are four Medicare supplemental health insurance plans that the person can choose from. The individual could choose from any of the several providers under this. The four plans are as follows: * BCBSAZ Senior Security Plan A. * BCBSAZ Senior Security Plan C. * BCBSAZ Senior Security Plan F. * BCBSAZ Senior Security Plan N. The BCBSAZ Senior Preferred Plan: Here, there are two supplemental options to choose from. In both these options, the care offered is of the standardized level, but the monthly rates are lower than the BCBSAZ Senior Security plan. There are more than 14,000 providers anybody could select from within the coverage area. The two plans are as follows: * BCBSAZ Senior Preferred Plan C. * BCBSAZ Senior Preferred Plan N. There are other good plans too for those who are interested in Blue Cross Medicare insurance such as the CIGNA Medicare plans. CIGNA has offered the Medicare Advantage HMO plan for years. They are introducing the CIGNA Medicare Select plus Rx plan for those in the state of Arizona; this will start in 2011. It will cover inpatient hospitalization, skilled nursing facility care, preventive care, emergency room care, and visit to the doctor’s clinic, prescription drugs, durable medical equipment, diagnostic tests, and much more.
Source: ezinemark.com

We Can Tame the Debt Without Breaking Medicare, Medicaid and Social Security

It’s conventional wisdom among everyone from Republicans (and too many Democrats) in congress to the Washington Post editorial page to members of blue-ribbon committees (cf Bowles/Simpson) that thanks to our huge and all-devouring national debt we can no longer afford Medicaid Medicare Social Security
Source: getallmusic.com

Blue Anthem Cross Medicare Plans: Anthem Shield Advantage, Medicare Part D & Supplemetal BCBS Plans

Anthem Shield Advantage HMO – in this plan, beneficiaries are provided with a network of health care providers within which they must find the care they need. In addition, beneficiaries must choose a primary care physician. Those enrolled don’t have to have seek referrals for specialist care; additionally, those enrolled automatically receive Part D prescription drug coverage;
Source: suite101.com

Blue cross blue shield medicare advantage

advantage Benefit coinsurance com Complement cost cowl firm health information insurance medical health insurance Medicare medicare beneficiaries medicare benefit medicare drug plan medicare insurance medicare part c medicare part d medicare plan medicare protection medicare supplement medicare supplemental insurance medicare supplement insurance medicare supplement plan medicare supplements Medigap medigap plans number person personal insurance coverage plan premium prescription prescription drug coverage private insurance companies Protection provider Safety sixty Social social security administration state supplement website
Source: fluxfeatures.com

Blue Dogma: Deconstructing Myths About ConservaDems

This entry was posted in 1984 elections, 1992 elections, 1994 midterms, 2008 elections, 2010 midterms, 2012 elections, Arizona, Artur Davis, Barack Obama, Ben Nelson, Bill Clinton, Bill Daley, bipartisanship, Brian Schweitzer, budget deficit, Buffet Rule, campaign finance reform, centrists, Chellie Pingree, Christine O’Donnell, climate change, Clinton presidency, Colorado, conservaDems, Dan Boren, Democratic coalition, Democratic Party, DLC, economic recovery, economic security, EFCA, Elizabeth Warren, environment, Evan Bayh, financial regulation, financial transactions tax, Florida, Harold Ford Jr., health care, HI-Sen, Hubert Humphrey, Illinois, Independents, Iowa, Iraq, jobs first, Joe Lieberman, John Yarmuth, labor unions, MA-Sen, Matt Cartwright, Mazie Hirono, Medicare, Michigan, Midwest, Minnesota, Mitch McConnell, Nevada, New Mexico, New South, NM-Sen, North Carolina, OH-Sen, Ohio, PA-12, PA-17, PA-AG, Patrick Murphy, Paul Wellstone, Pennsylvania, Populist Caucus, Progressive Caucus, progressive coalition, progressive populism, public opinion, Rahm Emanuel, Recovery Act, reproductive rights, Republican Party, Richard Shelby, Sherrod Brown, Social Security, Southwest, Steve Cohen, Tammy Baldwin, tax rates, Ted Strickland, Terry Sanford, Texas, Third Way, Tom Harkin, trade, Virginia, Wall Street, WI-Sen, Wisconsin, Zell Miller. Bookmark the permalink.
Source: wordpress.com

Daily Kos: Republicans softening on taxes? Only if Social Security and Medicare are cut

I’d restructure the entire tax code so that it raises taxes on EVERYBODY back to something close to the EFFECTIVE tax rates of the Clinton years.  I’d do it in a Simpson Bowles method of reducing tax expenditures and lowering rates — so that people at the same income levels paid roughly the same amounts, rather than the wild swings we have now based on deductions/exemptions.  I think that’s much fairer than a situation where one family making $500,000 pays an effective tax rate of 15%, while another pays an effective tax rate of 30%.  I’d basically be willing to look at eliminating virtually all tax expenditures except the charitable deduction in exchange for a reform in rates that meant that everybody at the same income level paid roughly the same EFFECTIVE tax rates.  (The AMT kind of does that, making sure that people at certain income levels pay an EFFECTIVE tax rate of 26% – 28%.)
Source: dailykos.com

Daily Kos: Why Walker won in Wisconsin

We need to do it better, keep reorganizing adaptively as needed, and start with a better alternative candidate than Walker.  (Assuming he survives John Doe investigation.)  If we would have had a Feingold commit to running, that might have helped. We should be trying to get someone credible committed to run by end of this year.  Having national Dems rowing with us for more than a few days would have helped.  DKos members did so much to help, but losing to Walker has to be seen as a wake up call to national Dems that they have to be focused on rebuilding the Dem brand from the local level on up, and it’s not just about Obama winning…we need Dems winning in state and local elections or states will continue to ignore or work against whatever Obama is trying to do.  At this point, it feels like we’re just the loose aggregate of diverse people who are not Republicans and mostly want Obama for 2nd term.  We won’t win broad party consensus and loyalty by clinging to the negative definition of being “not Republicans.”
Source: dailykos.com

Physical Therapy Practice Management Software and Billing Systems: Medicare Reimbursements at Risk

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CareAccording to Medicare, any practice that they have targeted should receive a letter notifying the practice that this revalidation is required.  The practice has 60 days from the post-mark date of the letter to submit a complete credentialing application.  If this application is not submitted within this time frame, then Medicare will revoke your billing privileges and stop all reimbursements.
Source: blogspot.com

Video: Update on Medicare Reimbursement

Osiris Receives Medicare Reimbursement Codes for Grafix®

This press release contains forward-looking statements. Forward-looking statements include statements about our expectations, beliefs, plans, objectives, intentions, assumptions and other statements that are not historical facts. Words or phrases such as “anticipate,” “believe,” “continue,” “ongoing,” “estimate,” “expect,” “intend,” “may,” “plan,” “potential,” “predict,” “project” or similar words or phrases, or the negatives of those words or phrases, may identify forward-looking statements, but the absence of these words does not necessarily mean that a statement is not forward-looking. Examples of forward-looking statements include, but are not limited to, statements regarding the following: our product development efforts; our clinical trials and anticipated regulatory requirements and the ability to successfully navigate these requirements; the success of our product candidates in development; status of the regulatory process for our biologic drug candidates; implementation of our corporate strategy; our financial performance; our product research and development activities and projected expenditures, including our anticipated timeline and clinical strategy for Prochymal, Chondrogen and our other MSC and biologic drug candidates; our cash needs; patents and proprietary rights; the safety and ability of our potential products to treat disease and the results of our scientific research; our plans for sales and marketing; our plans regarding our facilities; types of regulatory frameworks we expect will be applicable to our potential products; and results of our scientific research. Forward-looking statements are subject to known and unknown risks and uncertainties and are based on potentially inaccurate assumptions that could cause actual results to differ materially from those expected or implied by the forward-looking statements. Our actual results could differ materially from those anticipated in forward-looking statements for many reasons, including the factors described in the section entitled “Risk Factors” in our Annual Report on Form 10-K and other Periodic Reports filed on Form 10-Q, with the
Source: seekingalpha.com

How Medicare’s Payment System Discourages Quality and Innovation

Patient experience, convenience and quality of care do not effect, or at least significantly effect, clinical reimbursement in the standard, traditional fee-for-service Medicare program. There is therefore no incentive to find ways to create new value in the system.  By law, a physician or hospital cannot charge premium pricing for a Medicare-reimbursed service or procedure. I first notice this while treating patient maybe 15 years ago. A first- or second-year physician, I was treating a patient with a serious lung impairment caused by a blood clot in his pulmonary artery. I was transferring this patient from a poorly run suburban hospital, soon to close,  to arguably the world’s expert on these types of clots at the Brigham and Women’s, which is consistently rated as one of the nation’s ten finest facilities. Medicare was paying both physicians the same fee and both hospitals the same fee.
Source: reason.com

Osiris (OSIR) Receives Medicare Reimbursement Codes for Grafix®

The product has been assigned pass-through status under Medicare’s outpatient prospective payment system (“OPPS”), effective 7/1/12. These codes will assist in facilitating reimbursement when Grafix products are used to treat Medicare patients with acute and chronic wounds in the hospital outpatient department and ambulatory surgical center settings. CMS also issued a preliminary positive decision for the assignment of permanent Healthcare Common Procedure Coding System (HCPCS) Q-codes for Grafix. If the decision is made permanent, it is anticipated that the Q-codes would be available starting in 1/13. The assignment of unique Q-codes will assist in facilitating reimbursement in the physician office setting, offering additional access for Medicare patients.
Source: proactiveinvestors.com

CONVERSABLE ECONOMIST: Why Official Medicare Costs are Understated

When the Medicare trustees deliver their official forecasts for the Medicare system in their annual report, the actuaries who draft the report are required by law to assume that the law will be followed as written. For example, the current Medicare law says that physician payments will be cut 31% by 2013. For most other categories of Medicare services, 2009 hearth care reform legislation also specifies that the payment rates will be reduced each year by a rate equal to the economy-wide increase in multifactor productivity, which is projected at 1.1% per year.  However, to their great credit, the Medicare actuaries also produce an annual background which explains why these assumed cost reductions are so implausible. This year’s version was published on May 18 under the dry-as-dust title: ” Projected Medicare Expenditures under Illustrative Scenarios with Alternative Payment Updates to Medicare Providers.” Here are a couple of figures projecting how Medicare reimbursement would compare with reimbursement from private health insurance. The first figure shows what current law projects for Medicare reimbursements for physician services, with comparisons to reimbursement from the Medicaid program and from private health insurance. Notice the 31% drop that is supposed to happen immediately, followed by an additional decline. In short, Medicare reimbursement of physicians is now about 80% of private health insurance, but under current law it is supposed to fall immediately to less than 60% of private insurance, and then over time to about 25% of private insurance.
Source: blogspot.com

Key Developments and Strategies for Medicare Reimbursement

In a session at the Becker’s Hospital Review Annual Meeting in Chicago on May 18, Ken Perez, senior vice president of marketing and director of healthcare policy at MedeAnalytics, discussed key developments in Medicare reimbursement and strategies to deal with pending changes. Mr. Perez began the discussion by referring to the Titanic. “2012 is the 100th anniversary of the maiden voyage and sinking of the Titanic. For many years, many people have asked why the Titanic sank wanting to know what really occurred,” Mr. Perez said. “A recent article in the Smithsonian showed that the night the Titanic sank there was an optical phenomenon. The phenomenon prevented the Titanic’s commander from seeing the iceberg because the iceberg was basically invisible to the naked eye. The inability to clearly see what lay ahead, doomed the Titanic.” Mr. Perez spent time on this metaphor because the healthcare industry, payment models and Medicare reimbursements are similar to the Titanic. They are big, complex and have relatively low nimbleness. “It takes years for healthcare to move and shift, much like it took hours for the Titanic,” said Mr. Perez. With that comparison in mind, Mr. Perez discussed the societal, legislative and market context for Medicare reimbursement. The U.S. federal debt is $15 trillion, which is equal to 100 percent of the U.S. annual gross domestic product. Annual national health expenditures are around $2.7 trillion or 18 percent of GDP. “Healthcare reform is a tapeworm in America — one that cuts our competitiveness far more than taxes do.” There are also 48 million Medicare beneficiaries, and total gross Medicare spending in fiscal year 2011 was $555 billion. “That is 14 percent of the federal budget, 20 percent of total national health expenditures and 4 percent of the gross domestic product,” said Mr. Perez. Additionally, more than 7 million Medicare beneficiaries experienced more than 12.4 million inpatient hospitalizations in 2009, and Medicare finances four out of 10 hospital visits. Medicare beneficiaries are using healthcare services frequently, but 61 percent of hospitals are losing money on Medicare. Mr. Perez recommended hospitals focus on six strategies to improve their Medicare margins and delivery of care. 1. Form a financial-clinical partnership. Recognizing the need for more cost-effective care delivery, hospital CFOs should initiate meetings with CMOs and others on the clinical leadership team to forge or reinforce a financial-clinical partnership. Key agenda items in these meetings should include a candid assessment of the current financial condition of the hospital; an explanation and discussion of the impending increased financial pressures and their likely impact; and a solicitation of support and assistance from the clinical leadership team. 2. Perform detailed margin analysis. Hospitals should analyze the MS-DRGs or service line margins down to the physician and patient level, with attention on the five service lines with the highest volume, the highest profitability and the greatest losses. Mr. Perez said this margin analysis should be ongoing with review by service line managers, physicians and the hospital’s senior management team. 3. Engage with service line managers and physicians. Hospitals must create a performance improvement action team, analyze the reason for Medicare clinical denial and create a clinical documentation improvement program. 4. Revamp care coordination. Hospital management teams should then evaluate and improve care coordination policies, reduce costly avoidable readmissions by improving the discharge process and establish a regional health information exchange. 5. Ensure efficient operating room utilization. Hospitals can achieve efficiencies by improving scheduling and aligning surgeons and surgeries. A standardization of processes and operational reporting can decrease gaps and delays, reduce costs and enhance care delivery, Mr. Perez said. 6. Improve emergency room operations. Hospitals must make sure that space and staffing challenges faced by the ER are well-documented. In addition, conduct a thorough data analysis and review of the ER’s supply and drug utilization, ancillary testing and inappropriate usage.
Source: beckersasc.com

Medicare, Reagancare and Obamacare: A Brief History of Healthcare Reform

In 1986 Republicans controlled the Presidency and Senate, but Democrats controlled the House of Representatives. President Reagan expanded socialized medicine through the “Emergency Medical Treatment and Active Labor Act” (part of the better-known COBRA). The “group mandate” of EMTALA required healthcare providers to give away their products and services for free.  It did this by requiring healthcare providers to treat anyone who walks into the Emergency Room. As a result, government statistics show that over half of all emergency room care in the U.S. now goes unreimbursed. Imagine if Ford and General Motors were required by federal law to give away half of the cars they produce for free.  Reagancare, through its “group mandate,” was an expansion of socialized medicine.
Source: seeitmarket.com

We Stand FIRM: Freakonomics on Surgeons’ Fees

The 6/6/2012 Freakonomics blog has an interesting post, “What Surgeons Get Paid, and What Patients Think Surgeons Get Paid”. They discuss a paper written by an orthopedic surgeon on public perception of surgeons’ fees. Here’s the money quote (both literally and figuratively): On average, patients thought that surgeons should receive $18,501 for total hip replacements, and $16,822 for total knee replacements. Patients estimated actual Medicare reimbursement to be $11,151 for total hip replacements and $8,902 for total knee replacements. Seventy per cent of patients stated that Medicare reimbursement was “much lower” than what it should be, and only 1% felt that it was higher than it should be. In reality, surgeons get paid on average $1,378 for a total hip and $1,430 for a total knee. Thus patients were off by an order of magnitude in their estimates! The disconnect in public knowledge seems extreme. In short, patients — the most important part of all of health care policy decisions — have absolutely no clue how much doctors get paid. They think we get paid (or, at least, deserve to) about 10 times more than we actually do! Of course, when a patient gets an artificial hip, he or she also has to pay the hospital for the OR time, the nursing care, and for the cost of the artificial hip itself. The surgeon’s fee is thus a fairly small part of the total bill. In fact, the $1,400 fee is comparable to the charge for labor (not including parts) for replacing the transmission in your automobile! (Freakonomics link via Kelly Valenzuela.)
Source: westandfirm.org

CMS Settles Medicare Reimbursement Dispute With Hospitals

Modern Healthcare: CMS’ Hospital Settlements Seen Costing At Least $3 Billion Ongoing CMS settlement negotiations with about 2,200 hospitals are expected to cost the federal government at least $3 billion, according to parties involved in the deal. The payments to hospitals will settle several similar years-long federal lawsuits in which those providers alleged CMS officials erred in calculating pay rate cuts needed to offset an increase for rural hospitals required by a 15-year-old law. The settlement process began when a federal appeals court struck down a lower court ruling that sided with the CMS (Daly, 4/12).
Source: kaiserhealthnews.org

Emerson Consulting on Medicare reimbursement?

Hello, I work with a soci t? mat? riel m? dical and? looking for health insurance and other insurance reimbursements ing? United States. Contact? J? done with Emerson Consulting, Corcoran Consulting, want to ask? Does anyone know the company of others who sp? cialisent in service companies with Medicare and other insurance reimbursements ing? A big thank you.
Source: tunglionsh.com

Medicare’s Messed Up Payment System

Medicare’s resource based relative value scale (RBRVS) is basically a socialist payment system. It pays physicians based on the predetermined “work values” of various activities and procedures. The idea is to equalize payments in such a way that physicians never have a financial incentive to perform some procedures more than others: One procedure that takes about an hour of a physician’s time should pay roughly as much as any other procedure that takes an hour out of their day. A procedure that takes two hours should pay roughly twice as much, and so forth. Stress and skill level calculations also factor in, but the overriding idea is to avoid giving physicians an incentive to focus on certain higher-paying procedures at the expense of others.
Source: reason.com

Comment on: Medicare and Medicaid Programs; Electronic Health Record Incentive Program

Posted by:  :  Category: Medicare

NYC TO WALL ST.: BUSH / CHENEY: DROP DEAD. by eyewashdesign: A. GoldenDescription: Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); two H influenza type B (HiB); three hepatitis B (HepB); one chicken pox (VZV); four pneumococcal conjugate (PCV); two hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday. The measure calculates a rate for each vaccine and nine separate combination rates.
Source: nychepbc.org

Video: New York Medicare Advantage Plans

35 New APIs: Medicare, NYC 311 and Mobile Contact Syncing

BMBets API: BMBets.com helps bettors to find the best betting odds on their bets by processing and comparing odds from the most popular bookmakers. BMBets.com also provides users with the tools that help punters bet with data from Sure Bets or Value Bets. BMBets provides sport betting odds compilation and analysis services using the Oddsmaker engine, which simulates the probabilistic model of a sport event, assess probabilities and turn them into the betting odds. The engine supports offline and real-time (live odds) betting odds generation and analysis. The API uses SOAP protocol and responses are formatted in XML.
Source: programmableweb.com

Lowest Cost Medicare Supplement In New York « Insurance News from Crowe & Associates

Anyone currently in a Medicare Supplement plan should review the benefits and price point of  a high deductible F plan to see if it would be advantageous for them to change to one.  The High F plan is not often understood by the medicare eligible population and is not always popular with the companies offering them due to the low premium revenue they generate.
Source: croweandassociates.com

How Should I Choose A Medicaid Or Medicare Fraud Defense Lawyer in New York?

Both beneficiaries and providers can be prosecuted for Medicaid and Medicare fraud in federal courts, although for practical purposes, beneficiaries who commit this type of fraud (generally by lying on their applications about their income and resources) are rarely prosecuted in federal courts in New York. In other states, federal prosecutors are more likely to make it a “federal case” out of this situation, while in New York practically all cases involving recipient fraud are prosecuted in state courts.
Source: jpdefense.com

SCAMRAIDERS News, Views & Exposes: KENNETH V GOMEZ ESQ ROBS MEDICARE FOR MORE THAN $230,000.00 IN CONCERT WITH GEORGE PAVIA ESQ, DR JOHN SIEBERT THE DISGRACED SEX PERVERT, JOSEPH M BURKE ESQ. MEDICARE IS ON TO STALKER GOMEZ WHO HAS COMMITTED PERJURY, BRIBERY AND FRAUD IN CARRYING OUT THE MEDICARE THEFTS

KENNETH V GOMEZ ESQ ROBS MEDICARE FOR MORE THAN $230,000.00 IN CONCERT WITH GEORGE PAVIA ESQ, DR JOHN SIEBERT THE DISGRACED SEX PERVERT, JOSEPH M BURKE ESQ. MEDICARE IS ON TO STALKER GOMEZ WHO HAS COMMITTED PERJURY, BRIBERY AND FRAUD IN CARRYING OUT THE MEDICARE THEFTS—STAY TUNED
Source: blogspot.com

State Roundup: Big NYC Hospital Merger; Colo. To Fight Exapnding Waistlines?

WBUR’s CommonHealth blog: Longtime Mass. Planned Parenthood Leader Stepping Down Dianne Luby, who has led the [Planned Parhenood] league for 13 years, has told the board that she’ll step down at the end of this year. … The Planned Parenthood press release says that Ms. Luby worked to “change the public conversations around sexual health” (Goldberg, 6/6).North Carolina Health News: Some Experts Restored To State Panels In a meeting on state boards and commissions slated for reduction or elimination, several boards that advise health care policy-makers were restored.  After more than 15 proposed amendments, several health-related boards that had been slated for elimination were restored (Hoban, 6/6).
Source: kaiserhealthnews.org

Medicare Stops Cognitive Therapy for Patients with Alzheimer’s Disease

In his article, “From Anti-Alzheimer’s ‘Magic Bullets’ to True Brain Health,” Dr. Peter Whitehouse writes that if one followed the headlines surrounding the National Alzheimer’s Plan (NAPA), “you’d probably conclude that the likely solution to maintain lifelong brain health is simple: simply wait until 2025 for a ‘magic bullet’ to be discovered, to cure (or end or prevent) Alzheimer’s disease and aging associated cognitive decline. These kinds of beliefs, often reinforced by doctors and advertising, may explain the billions spent today by pharma companies on discovering new compounds….” (SharpBrains, May 31, 2012)
Source: wiredprnews.com

Daily Kos: Republican Medicare plan tanks in new poll

Posted by:  :  Category: Medicare

Cassandra Q. Butts by Center for American ProgressAsked what Medicare should look like in the future, just 26 percent said it “should be changed to a system where the government provides seniors with a fixed sum of money they could use either to purchase private health insurance or to pay the cost of remaining in the current Medicare program.” Fully 64 percent said “Medicare should continue as it is today, with the government … paying doctors and hospitals directly for the services they provide to seniors.” Here’s the kicker: “Even a solid 56 percent to 30 percent majority of Republicans preferred the current system.”
Source: dailykos.com

Video: Learn About Medigap Plans

BCBCS Illinois Plans Have Many Advantages

Blue Cross Blue Shield is one of the oldest and most trusted names in the health insurance industry. When founded in 1939 Blue Cross was strictly intended for hospital coverage. It quickly became apparent that people wanted more from their health plans and in 1949 Blue Shield was added to encompass doctor’s office services.  With more than 100 million members in America BCBS offers one of the biggest provider networks which guarantees that no matter where it’s BCBS  Medicare members are located they is a doctor near them or hospital near them. Do you have any questions about BCBS? Just give us a call.
Source: abchealthplans.com

Medicare Quality Ratings Questioned

Earlier this year, the U.S. Government Accountability Office (GAO) issued a report stating that the Medicare Advantage Quality Bonus Payment Demonstration will spend over $8 billion over the next ten years. Given the scale of the bonus payment program and the fact that bonus payments do not consistently offer better incentives (plans with 4, 4.5, and 5 stars all receive the same percent bonus) to achieve higher ratings, the GAO recommended the Medicare Advantage quality bonus payments be canceled and instead, allow a bonus payment system more aligned with what was originally created by the Patient Protect and Affordable Act (PPACA) to take effect.
Source: ehealthinsurance.com

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

Poll: Florida bingo set will go for safest net

(This is the third article to run as part of American Mosaic, a yearlong Reuters/Ipsos polling and reporting project that focuses on the diverse groups and competing views at play in the 2012 presidential race. The data is drawn primarily from online surveys using sampling methods developed in consultation with outside experts. By Election Day the survey will have reached 150,000 people, mixing respondents recruited from the Internet with individuals screened by Ipsos. Their responses are weighted based on demographic information and refined using a monthly telephone poll. With this method, accuracy is measured using a statistical calculation called a credibility interval. To see all the data from this survey and other polls in the series, go to www.reuters.com/politics/american-mosaic.)
Source: expatnewsletter.net

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: millionaire-business-articles.com

View and Compare Medicare Supplement Insurance Online

When it comes to taking the leap into gap insurance online advisors will guide you through what is available and help shop the Medigap market to find the best premiums that you qualify for. As rates change each year you will want to contact your online Medicare Supplement Insurance provider to get updates on lower rates from other Medigap Insurance providers. An online advisor is helpful in helping determine exactly what gap insurance program you should enroll in according to prior history and current lifestyle.
Source: internet-millionaire-articles.com

A Democrat Reaches Across the Aisle on Medicare

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

Waiting For Ohio Medicare Benefits To Begin

Posted by:  :  Category: Medicare

If you feel you are unable to medically qualify for a new health insurance plan, you should definitely keep your current contract in effect until you reach age 65. This may mean that you must continue on COBRA or a HIPAA plan. Although expensive, these two federally-backed options will continue to provide benefits for the specific conditions that keep you from obtaining private medical coverage. And if you develop new health issues, they will not be excluded from your current health care policy.
Source: ohioquotes.com

Video: What Are The Ohio Medicaid Eligibility Guidelines

Bachmann Calls For Federal Audit Of Minnesota Medicaid Program

Minnesota Public Radio: Bachmann Wants Independent Audit Of State’s Medicaid Program Michele Bachmann is stepping up her campaign for federal officials to take a deeper look at how Minnesota’s Medicaid managed care plans operate. Later today, the Minnesota Republican congresswoman will send a letter to Marilyn Tavenner, the head of the Center for Medicare and Medicaid Services, asking that the federal government conduct an independent, third-party audit of Minnesota’s management of the federal-state health care program for the poor. Bachmann’s request comes after a House hearing in April that paid particular attention to Minnesota’s contracts with nonprofit managed care organizations and UCare’s $30 million payment to the state in 2011 (Neely, 6/7).
Source: kaiserhealthnews.org

Josh Mandel is Wrong for Ohio’s Working Families

Susan: We’re careful with the money we earn. Pat: So when we heart that Josh Mandel missed 14 meetings of the board that invests our tax dollars – we got worried. Susan: Now Josh Mandel is running for Senate – with plans to make deep cuts in Social Security and Medicare. Pat: That will hurt families like ours. Susan: But Mandel would protect tax breaks for millionaires. Pat: We need a Senator who will fight for the middle class – and that’s not Josh Mandel. NARRATOR: SEIU-COPE is responsible for the content of this advertising.
Source: seiu.org

The Health Care Reform Debate Blog

cleveland.com An independent payment advisory board created by the health care reform law “can ration care and deny certain Medicare treatments.” Pat Boone makes this claim as the front man for an ad from the 60 Plus Association that aired this spring and targets five Democratic senators, including Ohio’s Sherrod Brown. The law creates a 15-member Independent Payment Advisory Board to suggest ways to limit Medicare’s spending growth, but the board may be overruled by Congress, and it makes no decisions about individual care. It is specifically forbidden from making any recommendations that would ration care, reduce benefits, raise premiums or cost-sharing or alter eligibility for Medicare. The 60 Plus Association was spending $720,000 on a campaign in Ohio aimed at Brown when PolitiFact Ohio ran the claim through the Truth-O-Meter and called it Pants On Fire. The national health care reform is “a government takeover of health care.” We’ve heard it before — so often that PolitiFact national named it the 2010 Lie of the Year — and we’ll surely hear it again. It has come recently from third-party advocacy ads. While the law gives the federal government a larger role in the health insurance industry, it relies overwhelmingly on the private market. In fact, the reform is projected to increase the number of citizens with private health insurance. PolitiFact has noted that the claim has been proven wrong over and over again. The rating: Pants On Fire. The Affordable Care Act contains “a series of slush funds, set up to stay on the books automatically, with little or no oversight.” So said House Speaker John Boehner in a news release and video, and again during debate on college student loan rates. PolitiFact Ohio found that the health care bill provides several pools of money that the secretary of health and human services can disburse for purposes designated by the legislation. But slush funds? Merriam-Webster defines a “slush fund” as “an unregulated fund often used for illicit purposes.” The money in question is designated for programs specifically defined by the law. Congress also has the power to oversee the bill’s implementation. The rating: Pants On Fire. The health care law “slapped Ohio small businesses with a $500 billion tax increase.” This statement came from the National Republican Senatorial Committee. PolitiFact Ohio found that the $500 billion figure was a fair number for total revenue raised nationally by the 2010 health care law, as estimated by the Congressional Budget Office at the time of the December 2009 vote on it. But the number for just taxes is lower, probably between $400 billion and $465 billion. The rest was for various other fees and revenue enhancements, and for all new revenue nationwide — not just for the share to be paid in taxes by small businesses in Ohio. To pick a national number and apply it to one segment of one state is not accurate, simply ridiculous and gets a rating of Pants on Fire. “Preventive care . . . saves money for families, for businesses, for government, for everybody.” Ad claims in support of the health care law have been exponentially fewer than attacks, but this sweeping claim came from President Obama. Is preventive care a good idea? It can often save lives and keep patients healthier, and certain preventive measures may save money as well. But the findings of the Congressional Budget Office and physicians who have studied the medical literature say otherwise, including a Feb. 14, 2008, article in the New England Journal of Medicine that noted that “the vast majority” of preventive health measures that were “reviewed in the health economics literature do not” save money. The rating: False. “Obamacare . . . will kill jobs across America.” The U.S. Chamber of Commerce made this claim in ads that targeted Brown and other Democrats, and “job-killing” is the standard epithet applied to the health care law by opponents. PolitiFact looked at the best projections available when the claim was raised, based on how the law is actually written, and found that they do not suggest that the law will “kill” jobs. PolitiFact also looked at evidence provided by the Chamber to support its claim, including a brief from the Heritage Foundation, a conservative think tank that has been critical of the law. When the authors were asked whether their brief supported the claim, they responded that “our paper does not provide evidence that the [health care law] would cause job loss.” The rating: False. The health care law “will cut $500 billion from Medicare.” This claim from candidates and advocacy groups has been examined numerous times by PolitiFact national, PolitiFact Ohio and other PolitiFact state operations. The important point there is that $500 billion is not taken out of the current Medicare budget and that nowhere in the bill are benefits eliminated. The $500 billion represents the projected saving by slowing the projected growth in Medicare spending over 10 years. Medicare spending will still increase. The rating: Mostly False.
Source: blogspot.com

Very affordable Wellness Insurance coverage In Ohio

If you are one in the lots of Ohio citizens on Medicare, or are a loved ones member or friend of an Ohio resident on Medicare, check out OSHIIP. You might study additional about this reasonably priced health insurance in Ohio, too as how to continue conserving funds on the price of wellness insurance coverage in Ohio. Get in touch with the Ohio Division of Insurance coverage for much more facts about OSHIIP; or, in the event you reside near an Ohio state well being department, give them a call or generate down for a take a look at for informational pamphlets and brochures about OSHIIP also regarding setup an appointment having an OSHIIP volunteer.
Source: apostoliccm.com

Daily Kos: Old Waitress says, “Don’t Raise Medicare Eligibility Age!”

ginabroom, Ed in Montana, Joe Bob, pundit, tmo, Paleo, Laura Clawson, Jackson L Haveck, Bendygirl, Nina Katarina, Outsourcing Is Treason, Emerson, Debby, Shockwave, SanJoseLady, Stein, rhubarb, polecat, HootieMcBoob, elfling, SallyCat, Matilda, opinionated, Zinman, wonkydonkey, annrose, DaleA, bluesteel, boadicea, roses, someRaven, Clues, bwren, jalbert, Major Tom, splashy, antirove, revsue, NMRed, tidalwave1, scorpiorising, dejavu, figbash, 2laneIA, draghnfly, lcrp, MagentaMN, alizard, bwintx, Diana in NoVa, VerbalMedia, zerelda, ybruti, WV Democrat, solesse413, Josiah Bartlett, murrayewv, Gowrie Gal, sb, libnewsie, Treg, TexasTom, el dorado gal, elsaf, lilypew, newfie, Independent Musings, chimene, PBen, offred, Blue Jean, dewtx, dancerat, Brooke In Seattle, YucatanMan, madmommy, Dem Beans, where4art, ladybug53, Burned, rlochow, Bob B, Arsenic, huttotex, mightymouse, kathny, splashoil, third Party please, Nance, BlueInARedState, Themistoclea, Dvalkure, sleipner, dougymi, blueoasis, triv33, global citizen, gooderservice, Preston S, AmBushed, fiddlingnero, Stripe, ms badger, theark, Thinking Fella, seabos84, pale cold, One Pissed Off Liberal, Cronesense, redheadgeek, grelinda, ColoTim, Positronicus, FishOutofWater, terabytes, NoMoJoe, artisan, millwood, gchaucer2, RudiB, fallina7, Neon Mama, MKinTN, KLS, Amor Y Risa, also mom of 5, poligirl, elwior, lineatus, monkeybrainpolitics, Calamity Jean, tofumagoo, davekro, envwq, mofembot, temptxan, SmileySam, CitizenJoe, KrazyKitten, aigeanta, DixieDishrag, MizC, priceman, rodentrancher, David Futurama, GrannyOPhilly, vmdairy, legendmn, prettygirlxoxoxo, bluemoonfever, Florene, ImABlondOK, Lura, lostinamerica, Pariah Dog, lapidarygal, bamjack, CamillesDad1, zaka1, TheOpinionGuy, kevinpdx, sfarkash, porchdog1961, cassandraX, Amber6541, smileycreek, rb137, p gorden lippy, flitedocnm, ColoradAnne, melpomene1, manyamile, pixxer, ItsSimpleSimon, beverlywoods, Oh Mary Oh, cany, not4morewars, dot farmer, Mike08, allenjo, mama jo, msazdem, La Gitane, Boris49, yakimagrama, Arkieboy, pbgv23, deeproots, ciaomama, muddy boots, Coastrange, evilgalblues, seattlebarb, LSmith, Grandma Susie, chira2, PhilJD, Sunspots, stlsophos, Regina in a Sears Kit House, Mathazar, DawnN, SuWho, jacey, jeopardydd, MNGrandma, Kiterea, Cordyc, Heart n Mind, anodnhajo, oblios arrow, Williston Barrett, Jakkalbessie, wordfiddler, Eric Nelson, oldcrow, orangecurtainlib, swampyankee, FloridaSNMOM, Horace Boothroyd III, Mr Robert, deweyrose, hotheadCA, oldflowerchild, Arahahex, BusyinCA, MartyM, burnt out, doroma, Grabber by the Heel, miningcityguy, NCPSSM, GAladybug, Spirit of Life, George3, DarkLadyNyara, Sue B, allensl, Metta, Dancun74
Source: dailykos.com

Ohio Launches Initiative to Expand and Improve Medicaid Presumptive Eligibility for Pregnant Women and Children

“Nationwide Children’s Hospital is honored to be a test site for enhanced Medicaid presumptive eligibility for children and adolescents,” said Kelly J. Kelleher, MD, vice president for health services research at Nationwide Children’s Hospital. “This program will allow preventive and treatment services to begin immediately for children and adolescents who might otherwise delay prescriptions or other therapies after an initial visit without insurance. It will also provide greater choices for a family that is seeking a medical home for their child or teen by offering immediate coverage. We look forward to working with the state of Ohio and other partners to increase access, improve outcomes and reduce health-care costs for Ohio’s children through this program.”
Source: asiainc-ohio.org

Current Law Provides Unrealistically Low Medicare Spending Projections

The Trustees acknowledge in their own report that their projections are based on current law and that “future costs are highly uncertain and likely to exceed those shown by current law projections.”  This has happened in the past.  For instance, the 2012 actual expenditures are currently estimated to be $246.9 billion which is $26.4 billion or 12 percent higher than last year’s projection by the Medicare Trustees.  Much of this increase is attributable to Congress overriding the 29 percent reduction in physician reimbursement which was included in the Trustee’s projection, but did not actually occur.
Source: wolterskluwerlb.com

Ehealthmedicare.com Estimated Value $16,236.00 USD

The data contained in GoDaddy.com, LLC’s WhoIs database, while believed by the company to be reliable, is provided “as is” with no guarantee or warranties regarding its accuracy. This information is provided for the sole purpose of assisting you in obtaining information about domain name registration records. Any use of this data for any other purpose is expressly forbidden without the prior written permission of GoDaddy.com, LLC. By submitting an inquiry, you agree to these terms of usage and limitations of warranty. In particular, you agree not to use this data to allow, enable, or otherwise make possible, dissemination or collection of this data, in part or in its entirety, for any purpose, such as the transmission of unsolicited advertising and and solicitations of any kind, including spam. You further agree not to use this data to enable high volume, automated or robotic electronic processes designed to collect or compile this data for any purpose, including mining this data for your own personal or commercial purposes. Please note: the registrant of the domain name is specified in the “registrant” field. In most cases, GoDaddy.com, LLC is not the registrant of domain names listed in this database. Registrant: eHealthInsurance Services, Inc eHealthInsurance Services, Inc Registered through: GoDaddy.com, LLC (http://www.godaddy.com) Domain Name: EHEALTHMEDICARE.COM Domain servers in listed order: PDNS1.ULTRADNS.NET PDNS2.ULTRADNS.NET PDNS3.ULTRADNS.ORG PDNS4.ULTRADNS.ORG For complete domain details go to: http://who.godaddy.com/whoischeck.aspx?domain=EHEALTHMEDICARE.COM
Source: widestat.com

Very affordable Wellness Insurance coverage In Ohio

If we have been the single in the lots of Ohio adults upon Medicare, or have been the desired ones part of or crony of an Ohio proprietor upon Medicare, check out OSHIIP. You have been starting to investigate one some-more about this pretty labelled illness word in Ohio, as great as how to go upon conserving supports upon the cost of wellness word coverage in Ohio. Get in hold with the Ohio Division of Insurance coverage for most some-more contribution about OSHIIP; or, in the eventuality we reside nearby an Ohio state great being department, give them the call or beget down for the take the demeanour during for informational pamphlets as great as brochures about OSHIIP additionally per setup an appointment carrying an OSHIIP volunteer.
Source: xikv.com

Masterpiece Transformers Rolling Out in Force

Posted by:  :  Category: Medicare

And of course there are still the upcoming releases of the newly molded Starscream, Sideswipe and Red Alert builds, as well as a Soundwave that’s sure to impress. No word on stateside releases of those figures yet, but this stretch of never-before-released Masterpiece characters should add a lot of depth to the line and create some fresh excitement. I can’t wait.
Source: about.com

Video: TEDxTokyo – Gunter Pauli – 5/22/09

Californians enjoy the best Medicare policies

Medical insurances are provided to the patients who need a lot of financial support. People now suffer from many kinds of threats and medication is important to fight against threat. First of all, Original Medicare came up to support the life of the people from all kinds of threats. It was fine and good till the time Medigap insurance came into existence. Medigap plans are those policies which fill up the necessary gaps of the Original Medicare insurance. They are also known as Medicare supplemental insurance as the word “supplement” refers to “extra” or “addition”. Original Medicare plans do not include the whole package of the treatment and some points were always to be left over. So, clients use to feel uneasy and tensed all the time in regards to – pints of blood, choice of physicians, expenses of medicine need in an urgent moment.
Source: articlelib.org

Sun Health Senior Living: Masterpiece Living Achieves Major Milestone

     In the fall of 1999, a small group of determined individuals set out on a journey to improve the lives and aging experience of all older adults.  That group included, among others, Drs. Robert Kahn and Toni Antonucci from the University of Michigan’s Institute for Social Research, my brother Larry and me.  Masterpiece Living (MPL) is the result of that group’s work, and MPL’s partnerships with now 60 communities has demonstrated clearly that its lifestyle and cultural approach to successful aging is effective.  Recently, however, MPL took a major step towards achieving its core goal of improving the lives of all older adults.      The University of Michigan, in partnership with Masterpiece Living, was awarded one of five MacArthur Foundation grants as part of the Foundation’s How Housing Matters initiatives intended to support research projects which seek to address how affordable housing for older adults can achieve improved health and well-being outcomes, while lowering overall health-care costs.  Toni Antonucci, PhD, Principal Investigator and Robert L. Kahn, PhD, Co-Principal Investigator will lead the study in which The University of Michigan, Masterpiece Living and American Baptist Homes of the West (ABHOW) will collaborate.      “The ABHOW Affordable Housing Team is thrilled to be part of this initiative.” Ancel Romero, Senior Vice President of ABHOW, said. “Our residents and team members are of greatest importance to us and this grant allows us the opportunity to further enhance their well-being.”   The Study will involve three ABHOW affordable housing communities in the Redlands, California area and last two years.      “Our goal is to develop a blueprint that can be widely used to improve the quality of life for all older adults, of every income level,” Principal Investigator, Toni Antonucci said. “We hope the results of this field experiment will also result in Medicare and Medicaid savings and contribute to efforts to reform current models of service provision to older Americans.”      The outcomes of the project will be presented to the House and Senate, The Administration on Aging, the Department of Housing and Urban Development, the Center for State Innovation and the Surgeon General;   a potential major step in influencing public policy on aging in America.      Larry Landry, Chairman of Masterpiece Living summed up the feelings of the entire MPL Team.  “We are both humbled and exhilarated by this project.  We thank all of our partners for their commitment to successful aging.  Without their hard work, we would not have this opportunity.”
Source: sunhealthseniorliving.org

Daily Kos: POTUS Unveils 2012 Re

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Source: dailykos.com

Universal’s Comp Plan for 2010 in Ga.

This Compensation Schedule pertains to all Representatives of the FMO, for Enrollments effective for the period starting January 1, 2010 thru December 1, 2010, specifically for those individuals who become Medicare eligible during this period. Representatives understand that this document is for your information only and the actual terms and conditions for any Compensation or other duties is as more fully set forth in the FMO Agreement between UHC and the FMO. UHC agrees to compensate Representatives for Enrollments accepted by CMS as follows: 1. Commission Payments for Tier 1 Counties (see details at Schedule A herein). For each individual who is newly enrolled in one of the following UHC Medicare Advantage products: Medicare Masterpiece HMO, PPO, POS and SNP Plans, Universal HMO of Texas, and Any, Any, Any PFFS Plans, UHC will pay an Initial Rate of $403.00 in all states excluding Pennsylvania, which is $454.00, and a "Renewal Rate" of $202.00 in all states excluding Pennsylvania, which is $227.00 based upon applications accepted by CMS. Beginning in January, 2010, commission payments will be paid to the FMO as outlined in Section 3 herein. 2. Commission Payments for Tier 2 Counties (see details at Schedule A herein). For each individual who is newly enrolled in one of the following UHC Medicare Advantage products: Medicare Masterpiece HMO, PPO, POS and SNP Plans, Universal HMO of Texas, and Any, Any, Any PFFS Plans, UHC will pay an Initial Rate of $200.00 (all states) and a "Renewal Rate" of $100.00 (all states) based upon applications accepted by CMS. Beginning in January, 2010, commission payments will be paid to the FMO as outlined in Section 3 herein. 3. Payment Terms. Beginning January 8, 2010, commissions will be paid out twice a month. For those individuals who were newly entitled or enrolled from traditional Medicare, as determined by CMS, FMO will be paid at the Initial Rate. Compensation is earned in months four (4) through twelve (12) of the enrollment year as long as the member is active with the plan. If an enrollee leaves the plan prior to month four (4), no compensation is earned. If enrollee leaves the plan after month three (3), compensation is paid on a pro-rated basis for the months in which the enrollee actually was a member of the plan. 4. Renewal Payments for Tier 1 Counties. Representative will receive renewal compensation in the amount of $16.66 per member per month in all states excluding Pennsylvania, which is $18.91, for the five (5) year renewal period (year’s two through six) as long as the member remains enrolled in the plan or enrolled by FMO in a like replacement plan with UHC. Compensation is earned in months four (4) through twelve (12) of the enrollment year as long as the member is active with the plan. If an enrollee leaves the plan prior to month four (4), no compensation is earned. If enrollee leaves the plan after month three (3), compensation is paid on a pro-rated basis for the months in which the enrollee actually was a member of the plan. 5. Renewal Payments for Tier 2 Counties. Representative will receive renewal compensation in the amount of $8.33 per member per month in all states for the five (5) year renewal period (year’s two through six) as long as the member remains enrolled in the plan or enrolled by FMO in a like replacement plan with UHC. Compensation is earned in months four (4) through twelve (12) of the enrollment year as long as the member is active with the plan. If an enrollee leaves the plan prior to month four (4), no compensation is earned. If enrollee leaves the plan after month three (3), compensation is paid on a pro-rated basis for the months in which the enrollee actually was a member of the plan.
Source: insurance-forums.net

Universal Health Care Group Adds Dr. Keith Singer as Medical Director

About Universal Health Care Universal Health Care Group is the parent company of Universal Health Care, Inc., a managed care company that has been providing Medicare Advantage Health Plans to Medicare eligible beneficiaries since 2003 – most notably the “Medicare Masterpiece® Plan” and “Medicare Masterpiece® PPO,” as well as Florida Medicaid benefits through its “Universal U-First®” Plans. The Group is also parent to Universal Health Care Insurance Company, Inc., which offers the popular Medicare Advantage “ANY ANY ANY® Plan.” Currently, the Group is serving over 95,000 individuals located in eleven states (Florida, Arizona, Georgia, Louisiana, Maryland, Mississippi, Nevada, Pennsylvania, South Carolina, Texas, and Utah). For more in-depth information about the Company and the services we offer, please visit our website at www.univhc.com.
Source: madduxpress.com

Aikane Leo: Business, Florida style

ST. PETERSBURG – Dr. Akshay Desai of St. Petersburg prides himself on his versatility. A physician turned entrepreneur, the 48-year-old Indian native is also a major Republican donor and frequent appointee to state boards, most recently named by Gov. Charlie Crist to the body that oversees Florida’s schools. “Making policy is a tremendous enjoyment for me,” Desai said. “I do it instead of golf.” But many members of Desai’s fast-growing Medicare plan provider, Universal Health Care in St. Petersburg, wish he’d pay more attention to his business. Universal was co-founded in 2002 by Desai and Dr. Zachariah P. Zachariah, another prominent Republican fundraiser from Fort Lauderdale. As it has grown to become the state’s fourth-largest Medicare HMO, Universal has also attracted a disproportionate share of customer complaints for aggressive marketing, false advertising, denied medical treatments and poor customer service. [….] Though 20 percent of Universal’s members switched to another insurer for 2007, the company still netted 75,000 new enrollees for the year. The reasons: expansion of Universal’s Medicare HMO, Medicare Masterpiece, into eight new Florida counties plus the introduction of a new Medicare Private Fee for Service (PFFS) plan in Florida and seven other states. PFFS plans allow members to go to any health care provider that accepts Medicare as long as the provider is willing to bill the insurer, instead of the government. Universal gets about $800 a month from Medicare for each HMO member. The PFFS plans are even more lucrative, paying the insurer about 19 percent more than original Medicare.
Source: blogspot.com

Medicare Part D Proves That Competition Lowers Health Care Spending

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CareFew patients switching plans. Another critique of competition is that a general reluctance to switch plans “reflects the large number of plan choices available combined with the costs in terms of time and energy of doing research and of actually making a switch.” This claim, taken from behavioral economics, does not negate a person’s price sensitivity. Experience with the Federal Employees Health Benefits Plan (FEHBP) shows that about 5 percent of patients switch plans each year. This reluctance to switch reflects well-documented satisfaction with plan choices. This only proves that people make decisions based on many factors, including how much they like their plans.
Source: heritage.org

Video: Medicare and the Federal Employees Health Benefits (FEHB) Program

Medicare, Reagancare and Obamacare: A Brief History of Healthcare Reform

In 1986 Republicans controlled the Presidency and Senate, but Democrats controlled the House of Representatives. President Reagan expanded socialized medicine through the “Emergency Medical Treatment and Active Labor Act” (part of the better-known COBRA). The “group mandate” of EMTALA required healthcare providers to give away their products and services for free.  It did this by requiring healthcare providers to treat anyone who walks into the Emergency Room. As a result, government statistics show that over half of all emergency room care in the U.S. now goes unreimbursed. Imagine if Ford and General Motors were required by federal law to give away half of the cars they produce for free.  Reagancare, through its “group mandate,” was an expansion of socialized medicine.
Source: seeitmarket.com

Measuring Healthcare Quality for Persons Dually Eligible for Medicare and Medicaid: Measures Are Not Yet Available

Accessibility Adolescents Adults Aging Assistive Technology Bladder Dysfunction Bowel Dysfunction CDC Cerebral Palsy Children Communication Community Community Integration Depression Developmental Disabilities Diabetes Education Elderly Emergency Preparedness Environmental Toxins Exercise Health Care Health Care Professionals Health Disparities Health Promotion Hearing Impairments Intellectual Disabilities Learning Disabilities Mental Health Mental Illness Mentoring Minority Mobility Multiple Sclerosis Native Americans Nutrition Obesity Paralysis Parents and Caregivers Physical Activity Physical Disabilities Post-Traumatic Stress Disorder Program Evaluation Psychiatric Disabilities Public Policy Sexuality Smoking Cessation Social Determinants of Health Social Participation Spina Bifida Spinal Cord Injuries Substance Abuse Training Traumatic Brain Injuries Veterans Violence Visual Disabilities Women Young Adults Youth
Source: aahd.us

Health care court ruling could paralyze Medicare

Last year, 3.6 million seniors hit the gap and saved a collective $2.1 billion due to the health care law, according to the U.S. Department of Health and Human Services. In the first four months of 2012, more than 416,000 people saved an average of $724 on prescription drugs bought after they hit the cap, for a total of $301.5 million. Last year, 3.6 million seniors entered the gap and saved $2.1 billion, the health department says.
Source: msn.com

Health insurance cost growth; Medicare, Medicaid, and commercial

Another data point – Massachusetts. As we noted a few weeks back, commercial insurance rate increases have dropped dramatically over the last year, driven by payers and providers working together to better manage cost and quality. Small group insurance premiums were up just over one percent last quarter, the second quarter in a row where rates have gone up less than 2 percent. Moreover, two large health plans filed for rate decreases…
Source: joepaduda.com

Consider a House Call Position for Medicare Patients

In Portland, Ore., Housecall Providers Inc. is one of 16 agencies nationwide participating in the federal program – and the only one west of Texas. The nonprofit employs four physicians, three physician assistants and almost 20 nurse practitioners. Two registered nurses were hired as transition advocates for the Independence at Home patients. They work with patients’ families and caregivers to educate them about health changes that would warrant a phone call for help.
Source: allhealthcarejobs.com

News briefs: Illinois ranks high in excessive Medicare billing

Illinois ranks seventh in the number of doctors who may be excessively billing Medicare for intensive evaluation and management of patients, services that are vulnerable to fraud and abuse, according to a report by the inspector general of the U.S. Department of Health and Human Services. The inspector general identified 1,669 physicians nationwide in 2010 that consistently billed more to assess patients’ health, claiming that the services were more complex than usual. Illinois accounted for 3.5 percent of the doctors charging higher fees, but that’s lower than the 4.3 percent of Illinois physicians that bill for such services, the report said. The problem may be more severe in other states. For example, California had the most high-billing doctors, at 17 percent, but just 8 percent of the doctors who provided such services, according to the report, released in May, which did not try to determine the propriety of the bills.
Source: chicagobusiness.com

Medicare Is Already In Fiscal Trouble; Let us Prevent The Fraud

Almost all healthcare vendors are honest as well as reputable. However, as with everything else a few are not. Medicare is especially a good target for deceitful activity. Many Government agencies are working with Medicare to stop these fraudulent activities. How does fraud normally happen? Its basically easy to do and just requires that the Healthcare provider bills Medicare for products and services that have not been given. Naturally many of us have no clue exactly what services were completed anyway. This costs Medicare an enormous amount of cash and as we all know Medicare is under a lot of financial stress. The fraud ultimately ends up costing the Medicare receiver more money in premiums.
Source: preteristnews.com

Wyoming offers free medical informatics systems to Medicare providers

"Initially, we had a limited EHR adoption rate in Wyoming because many of our physicians come from small to mid-sized practices and were unable to find a cost effective and efficient EHR solution that wouldn’t disrupt workflow," James Bush, medical director of the Wyoming Department of Health, said in a statement. "Many of our physicians also believed that there was no point in having an EHR if it didn’t connect with a health information exchange (HIE), hospitals, labs, pharmacies and/or other physician specialists."
Source: uic.edu

Inculpatory evidence, Medicare, and voter suppression | MyFDL

Posted by:  :  Category: Medicare

Wall Street by elycefelizAnd I have a question: How widespread is this problem? Are there other counties where voter histories are strategically eroding? I have spoken with both Democratic and Republican election integrity enthusiasts, and one of my frustrations is that the Democrats count on their VAN system and the Republicans count on their VOTER VAULT system to keep them up to date on voter list data. Neither of these systems is the real, working data. It should be possible to detect alterations like this in other counties, but since purges are performed using the actual county database, skip the VAN and VOTER VAULT: Examine the actual lists. As we see in Shelby County, there is no reason to believe that the raw data matches VAN or VOTER VAULT. The raw data is getting altered from time to time.
Source: firedoglake.com

Video: Medicare Part A Benefit Periods

Designing a Long Term Care Insurance Policy

At the end of that period, you’ll start spending down your own resources, and those of your family. When those are exhausted, except for some exempt assets such as a limited amount of home equity and a bare minimum for a spouse, you will become a Medicaid patient. After you pass on, the state’s Medicaid Estate Recovery Program will seize your assets until the taxpayer has been reimbursed for any benefits paid on your behalf. To protect your assets, you may want to investigate your state’s Long Term Care Partnership Program. Generally, if you buy long term care benefits at least equal to your assets, the state will allow you to keep that amount of assets and still let you qualify for Medicaid once your long term care insurance benefits are exhausted. If you have a house or other assets you want to pass on to your children, this can be a key element in your overall estate plan.
Source: longtermcareinsuranceinfo.com

Medicare Explained: The Skilled Benefit Period

As an example, my father, who did get his qualifying hospital stay at Christmas time, was placed in a skilled nursing facility for rehabilitation.  He received Physical Therapy, Occupational Therapy and Speech Therapy for about 6 weeks.  At that point, though he had not used 100 days of his benefit period, he no longer was receiving services that qualified him under Medicare.  My mother was notified by the facility before the Medicare benefits ended.  He continues to stay in this facility as a resident but now pays privately for his care.  Due to the nature of his needs, he will also qualify to access his long-term care benefits after reaching the 100 day exclusion period.
Source: wordpress.com

Medicare Costs and Financial Retirement Planning: Preserve Retirement Savings with Medicare Education and Planning

It should be noted that private insurance policies under Medicare Advantage plans are sometime called "Medicare Part C." Though regulated by the federal government, these are not under Medicare but are the private insurance options for services typically covered under Medical Part A and B. Medicare benefits under Medicare Part A or Part B are no longer available if private medical insurance is secured by an otherwise eligible beneficiary. Additionally, Medigap is a term used to describe supplemental private medical insurance to cover "gap" services not covered by Part A, Part B, or Part D.
Source: suite101.com

Medicare Nursing Home Coverage Explained

The unfortunate fact is that most people cannot pay for long term care or cannot pay for the full term of care and also have not purchased a long term care policy. When this happens, the only choice is to qualify for Medicaid. To qualify, the amount of assets you are able to retain is severely limited. And contrary to popular belief, you cannot merely sell assets or transfer them to someone else. Doing  so and trying to qualify for Medicaid under false pretenses constitutes Medicaid fraud. Not good!
Source: affordablemedicareplan.com

What does Medicare REALLY cover?

Deductibles are tied to benefit periods: It’s also important to know that Parts A and B have different deductibles. Most health insurance policies only have one deductible. Your Part A deductible is not tied to a calendar year like it is with traditional health insurance. Instead, it’s tied to a benefit period that starts when you go in to a hospital or nursing facility, and ends when you haven’t received hospital care for 60 days in a row.
Source: ehealthinsurance.com

Medicare Changes for 2012

Tags: Medicare Part B, Medicare Standardized Plans, Medigap Plans, Missouri Medicare, Missouri Medicare News, Missouri Medicare Supplement Quote, Missouri Medigap, Missouri Medigap Quotes, Skilled Nursing Care, Standardized Medicare Supplement Plans Posted in Medicare Benefits, Medicare News, Medicare Part D
Source: missourimedicaresupplementinsurance.com

Medicare Terms and Definitions

Affordable Care Act annuities annuity Archer Weiss business lines Commercial insurance coverage DIabetes employee benefits employer group insurance financial planning guaranteed income health health care health care reform health insurance insurance investment IRA Los Angeles LPPO Marc Weiss medical medical insurance Medicare Medicare Advantage Medicare Supplement Momentous Momentous Insurance open enrollment personal lines PPO Prescription Drug press release prevention preventive care retirement retirement planning Roth IRA San Fernando savings Social Security stock market women’s health Woodland Hills
Source: archerweiss.com

Marci’s Medicare Answers, www.MedicareRights.org

Many states coordinate their drug assistance programs with Medicare’s drug benefit (Part D). If you do not have Part D, but qualify for your state’s SPAP, you will have the chance to sign up for Part D, and you may be required to enroll in a Part D plan. If a drug is covered by both your SPAP and your Part D plan, both what you pay for your prescriptions plus what the SPAP pays will count towards the out-of-pocket maximum you must reach before your Medicare drug costs go down significantly. Your SPAP may also help pay for your Part D plan’s:
Source: homeboundresources.com

Medicare prepayment review comes to eye care

Posted by:  :  Category: Medicare

The Pfelons of Pfizer: Too Crooked to Fail and Don't Go to Jail (g1a2d0052c1) by watchingfrogsboilIn April, the medical review department for Palmetto GBA, the Medicare administrative carrier (MAC) for North Carolina, South Carolina, Virginia, and West Virginia, announced it will perform a service-specific pre-pay “probe” review of outpatient ophthalmic claims, focusing on 13 common ophthalmic codes found to be used with high frequency.
Source: newsfromaoa.org

Video: “Confederate ancestors” weigh in on SC Medicare battle

Governor Haley Proclaims June as Obesity Awareness Month

Eat Smart, Move More South Carolina is a statewide partnership coordinating obesity prevention efforts in South Carolina and aims to make the healthy choice, the easy choice. It is comprised of representatives from community-based organizations, health care systems, voluntary health organizations, academic institutions, state agencies, professional organizations, government and policy makers, and the media. For more information, visit www.eatsmartmovemoresc.org. 
Source: eatsmartmovemoresc.org

Daily Kos: Republican senators want to sell seniors on Medicare privatization

These poor Republicans are so busy and working so hard for the American people.  They really don’t take enough time for themselves and their families.  They must be exhausted after their battles with birth control rights and the rights of women to choose while writing laws that make absolutely no sense.  Yet they still have time to try and bring down the elderly and disabled.  Your tax dollars working hard for you.  I’m sure they still have other overworked Republicans working hard on further bringing down the poor while they now work on Medicare.  And they probably worried about not having enough time to work on taking away Veteran’s benefits and making them pay for their own benefits as Michelle Bachmann suggested.  Our Republicans caring for the American people and doing their jobs as representatives for all Americans.
Source: dailykos.com

South Carolina man charged in alleged online Medicare scheme

Although no cases of identity theft have been reported, South Carolina Governor Nikki Haley has made it clear that she wishes “an example” to be made out of this man. She has requested that the State Law Enforcement Division “slam him to the wall.” He is currently charged with violating the confidentiality of medical indigents and with disclosing confidential information. The man faces up to 10 years in prison if he is convicted on all charges.
Source: columbiasccriminaldefenseblog.com

GOP senator: Let the state take over Medicare, or risk the displeasure of Confederate ghosts (VIDEO)

This legislation which supposedly has our dead Confederate forefathers so up in arms is called the Interstate Healthcare Compact, which would allow South Carolina “to suspend the operation of all federal laws, rules, regulations, and orders regarding health care that are inconsistent with the laws, rules, regulations, and orders adopted by the member state pursuant to this compact.”
Source: palmettopublicrecord.org

car accident / workers comp vs. medicare

Why is this an issue? Medicare has always had the right to get reimbursed for any accident related treatment costs it has covered once when someone gets an insurance settlement. So if Medicare has covered $5,000 of treatment bills related to your car accident, and you then get a settlement from the insurance company for the at-fault driver, Medicare has always had the right to get reimbursed for accident-related costs it paid. About ten years ago, Medicare got much more aggressive in the worker compensation field in trying to also protect its right to have future treatment costs that were incurred after a case was settled paid by the worker compensation insurance company. If someone was disabled as a result of a work injury, they typically would also be approved for Social Security Disability benefits, which would allow them to get Medicare coverage. What often happened with the settlement of the worker compensation claim is that the worker’s compensation insurance company would pay a little more money than the value of the disability claim to completely close the case up out, use their Medicare coverage for future treatment needs. As the Medicare system has become more financially stressed, Medicare has had to become much more aggressive in keeping the worker’s compensation insurance company, responsible for future treatment costs. Now, Medicare is starting to get involved in monitoring settlements related to car accident claims. That’s what this article addresses. It is very important that you are at least aware of this issue so that you don’t do something that could possibly jeopardize your Medicare coverage.
Source: south-carolina-attorneys.net

South Carolina Nursing Home Abuse and Neglect Attorney Applauds Medicare Initiative Against Misuse of Antipsychotic Drugs

The Louthian Law Firm, P.A., of Columbia, S.C., has been obtaining fair compensation for personal injury victims since 1959. The firm was founded by Herbert Louthian, who has more than 50 years of trial experience and is licensed to practice in all courts in South Carolina. In addition to claims involving nursing home abuse, the Louthian Law Firm also handles whistleblower claims, sexual harassment, personal injury cases involving medical malpractice; car, truck and motorcycle accidents; and other serious and catastrophic injuries throughout South Carolina. For a free, confidential case evaluation, contact the firm by phone at (866) 410-5656 or through its online contact form.
Source: louthianlaw.com

Opportunity for Public Comment on Integrating Care for Dually Eligible Individuals

Supported by a grant from the Centers for Medicare and Medicaid Services (CMS), SC DHHS is exploring development of a service delivery model for integration of care for individuals receiving both Medicare and Medicaid services. SCDuE aims to expand access to needed care but eliminate duplication of services and lower costs. South Carolina is one of fifteen states participating in the state demonstration projects through CMS. Download a copy of the draft proposal here.
Source: imph.org

Using Data and Technology to Drive Process Improvement in Medicaid and CHIP: Lessons From South Carolina

South Carolina provides a case study example of how states can utilize data and technology to improve Medicaid processes and increase enrollment for children and low-income families. In 2011, South Carolina initiated a data-driven decision making process to identify potential simplifications to its Medicaid enrollment process. This effort was in response to administrative and legislative directives to better utilize technology to reduce bureaucratic waste and improve customer service in Medicaid by eliminating unnecessary “hassle factors”. Using data analysis, the state identified significant churn in its Medicaid program—each year, about 140,000 children were losing coverage, with 90,000 returning within the year, 60,000 of whom were returning within one month. This repeated movement into and out of coverage was creating burdens for families, administrative staff, and providers.
Source: kff.org

Who Is Eligible For Medicare Part B

Posted by:  :  Category: Medicare

For those who do not have Part A: Even individuals who do not have Part A coverage may select Medicare Part B as long as they satisfy a few Medicare eligibility requirements. For starters, they should be citizens of the USA. Even non-citizens are eligible, provided they have been admitted following all the specified legal requirements and have resided in the US for five years or more. Secondly, people who are aged 65 years and above are eligible for Medicare Part B. Even if you do not have Part A, you can qualify for the Part B by filling out the necessary paperwork and remitting the monthly premium specified by the insurance provider.
Source: internet-millionaire-articles.com

Video: EHR: Medicare Incentive Program Attestation Webinar for Eligible Professionals

Notification of a policy change in the 2012 AAAHC Handbook and Guidelines for Medicare deem status survey

Because an ASC seeking a Medicare Deemed status survey must be open and operational, CMS has advised AAAHC to revise its policies regarding the Early Option Survey/Initial Medicare Deemed Status Survey. These policy changes will apply to ASCs that submit an application for an Early Option Survey/Initial Medicare Deemed Status Survey on or after July 1, 2012.
Source: nicole-brown.com

Medicare Health Insurance

A kind of Medicare, health insurance for pre-existing conditions is still new in the United States, and that’s why people are still researching how to comply with all of its requirements. Insurance costs can also be a problem and the benefits one may get from application of the insurance coverage. Together with most of its eligibility requirements it can be hard to apply for and acceptance is therefore not guaranteed. These health insurance pre-existing conditions plans are supported with the law – The Affordable Care Act that makes it a law of the land that everyone has to follow, so be assured that all benefits indicated by the insurance coverage are for you to enjoy. By the end of it all, after successfully complying with all requirements, you will definitely be able to enjoy the benefits listed below: primary and specialty care benefits, reduced hospital care cost, and discounts on prescribe medications.
Source: co.uk

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

COBRA and Medicare, Part II 

[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

CMS to revise, simplify Medicare enrollment form for physicians: support for AMA proposals.(Practice Trends): An article from: Family Practice News

This digital document is an article from Family Practice News, published by International Medical News Group on October 15, 2003. The length of the article is 702 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.
Source: healthinsuranceandmedicareupdate.com

MHA’s Executive Briefing: CMS may expand medical home demonstration under Medicare

The Centers for Medicare & Medicaid Services is evaluating whether the Multi-Payer Advanced Primary Care Practice demonstration should be expanded to other states under Medicare, according to a notice the agency published May 31. Eight states are participating in the three-year demonstration, which will evaluate the effectiveness of the patient-centered medical home model for Medicare, Medicaid and privately insured patients: Maine, Michigan, Minnesota, New York, North Carolina, Pennsylvania, Rhode Island and Vermont.
Source: typepad.com

Medical Insurance Australia

In some cases (such as visiting a doctor) you must anticipate service cost and then claim it back from the insurance company. Be careful: refunds are calculated on standard rates. This means that if you pay more than expected for a service, you will only get Australian Government standard refund for that care. Australian insurance do not cover extra territories: if you travel abroad, in New Zealand for example, you’ll need another health insurance.
Source: com.au