COURT RULES THAT REIMBURSEMENT OF MEDICARE BENEFITS WAS NOT PROHIBITED BY THE NEW JERSEY COLLATERAL SOURCE STATUTE
The court recognized that the purposes of the NJCSS are: (1) to prevent double recovery by a tort plaintiff from both a collateral source of benefits (such as a health insurer) and a tort defendant; and (2) to shift the burden of medical costs related to tort injuries, wherever possible, from liability insurers to health insurers, to keep liability insurance premiums down. Neither the New Jersey Supreme Court nor the appellate courts have addressed the issue of whether the reimbursement of Medicare benefits was prohibited by the NJCSS. However, a New Jersey appellate court had previously found that the NJCSS did not apply to conditional Medicaid benefits that were subject to reimbursement. The court found that the New Jersey Supreme Court would likely hold, as it has in the Medicaid context, that the NJCSS does not apply to exclude conditional Medicare benefits from a tort settlement. Therefore, the court held that the reimbursement of Medicare benefits was authorized by the MSP Act and not prohibited by the NJCSS.
Source: themedicarespa.com
Video: How To Apply For Medicaid
Online Medicare Forms: Appeal, Payment, Disclosure, Application
Medicare insurance forms for parts A, B, C and D are accessible online for electronic filings and mail in. Online forms include an application for Medicare, claim forms for patients requesting payments and Medicare appeal forms. Older Americans can apply for Medicare even if not planning to retire, as long as the person is close to 65 years old. Even when a person has been denied Medicare, appeal forms can be submitted online requesting a hearing or case review.
Source: suite101.com
The American Spectator : Judges in Wonderland
The problem is that when you put the government in charge of your financial circumstances, you are no longer in charge of your own destiny. The Supreme Court ruled that Social Security was not guaranteed since it was NOT your money. Once the government confiscated the money from your paycheck, it was determined to be a tax. And what you received back was at the discretion of the government. Here is another example of your tax dollars at work: Medicaid takes up $10B of the New Jersey $33B budget. For one-third of our state revenues, we get a program that doctors will not accept. They net about thirteen dollars per one-hundred billed after fees and graft in the system and cost of care. So some doctors are already setting up free clinics and offer the poor charity care. For the $13 per one-hundred they forfeit, they gain in donations. And it takes them off the hook for liability lawsuits that typically cost $25K to settle even if there is no negligence. How many $13 office visits do you have to do to pay one settlement? (1,923 to be exact)
Source: spectator.org
Looking for APPLY FOR MEDICAID ONLINE? Here’s APPLY FOR MEDICAID ONLINE information for you!
To acquisition the acquaintance advice in your state, conduct a simple seek on the internet. The seek will acknowledgment with all the advice you will need. Anniversary accompaniment has its own point of contact, so be abiding to locate the appropriate accompaniment to admission the advice needed. You will be provided with a concrete address, a buzz amount and any links to websites that are available. You will aswell accept admission to downloadable appliance forms. Always yield the time to analysis the accommodation requirements afore bushing out an application. The accompaniment will accept austere guidelines and requirements that accept to be met for an alone to be advised for any of the allowances associated with Medicaid. To Apply For Medicaid Online you accept to aboriginal admission the PDF anatomy which may be downloaded through your accompaniment acquaintance website.
Source: www-averagecarinsurancerates.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
States Hold Off On Insurance Exchanges; Medicare ACOs Confront Challenges
Bloomberg: Health Insurer Tax Gives Nonprofits Advantage, Holtz-Eakin Says Fees that health insurers will be required to pay the U.S. government starting in 2014 will give nonprofits such as Kaiser Permanente a market advantage over corporate competitors, said economist Douglas Holtz-Eakin. The fees — starting at $8 billion and escalating each year based on the industry’s premium revenue — aren’t tax deductible. While nonprofits don’t have an income tax, companies such as UnitedHealth Group Inc. (UNH) would effectively be paying taxes on the fees they’re handing over to the government, said Holtz-Eakin, chief economist of the White House Council of Economic Advisers during the Republican Bush administration from 2001 to 2003 (Wayne, 6/8).
Source: kaiserhealthnews.org
Richard Charles for US Senator Nevada: Did Dean Heller Vote to Cut Medicare?
Okay Karen, you have added to my list of adjectives for Republican strategies (or “strateegery”?) with “diabolical fiendish”… Great post! It is hard for folks to recognize that the whole Grover Norquist affiliation and ongoing allegiance practically guarantees six figure money from Koch Brothers and big oil. Remember, Amodei received bucks from Koch, Exxon and big mining… Has anyone else noticed how the oil industry has started their campaign via TV ads painting themselves as warm and cuddly? Has anyone also noticed that as Washoe County has “battleground” fame now, OUR oil prices are a lot HIGHER than other areas? You see, high oil prices get blamed on a president (the president has the price stamper right there at his desk in the oval office) and the oil companies would add more PROFITS in a big big way with a Romney win. The oil companies humongous profits under Obama are just not enough… ah, greed – it’s alive and well across the fruited plain.
Source: blogspot.com
When To Apply For Medicare
There are a few misconceptions about when to apply for medicare benefits. So lets get rid of those misconceptions. The largest determining factor on when you should apply for medicare is age. If you are 65 years or older, you qualify for medicare benefits. Another determining factor in the US at least, is that you must be a US resident for at least 5 consecutive years. So if you were a citizen for 3 years and lost your status as a citizen, then regained it for 2 more years, you probably would not qualify.
Source: whentoapplyformedicare.com
Applying for Medicare Part B
So, even though my husband did everything right, he is being denied Medicare Part B because the people at Social Security couldn’t be bothered to process his application until after the deadline had passed. The phone representative called the office that received his application, and told my husband that someone from there should contact him. If no one contacts him, then he is to call Social Security back in 30 days. Meanwhile, he is going without the insurance coverage that he qualifies for.
Source: families.com
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
Fixing Medicare’s Double
P.S. Several readers noted an important qualification to my Social Security discussion in my earlier post. Many experts believe past Social Security surpluses have been used to finance deficits in the rest of the budget and, as a result, Social Security resources have been paying for higher spending or lower revenues elsewhere in government. I agree. My comments in these posts apply only to explicit budgeting decisions, like those in 2010′s health reform or today’s student loan legislation. In that context, Social Security savings cannot be legislatively used to pay for other programs. But they still might have indirect effects. For example, by reducing future unified budget deficits, Social Security savings might weaken future congressional efforts to reduce deficits outside Social Security.
Source: dmarron.com
For many people, using yellow, orange, and brown lenses is suggested by AMD.org to improve contrast vision and make it easier to see things like steps and curbs. The site, a macular degeneration partnership of the Discovery Eye network, recommends that people with specific types of color vision problems may benefit from wearing a green or blue lens as well. Eye care practitioners who specialize in low vision problems are excellent sources for finding the best style lenses for macular degeneration.
HHSC intends to submit transmittal number 12-022 to the Texas State Plan for Medical Assistance, which would exempt services provided by psychologists, psychiatrists, licensed clinical social workers, and specific services related to the transport of portable x-ray equipment and personnel from Medicare Equalization. See the Texas Register for details about both notices.
COLUMBUS — State officials are hoping to more easily grant uninsured pregnant women and children in Ohio access to health care services under Medicaid, if they are likely to qualify for the program that provides coverage to the poor and disabled. A pilot program slated to start next week would let certain health care providers in Ohio presume the patient’s eligible for Medicaid after an initial screening test. Children and expectant mothers would have to prove residency and provide other biographical details. The patients then could access the Medicaid-funded services immediately for 60 days while they apply for the program. Determining whether a person is eligible for the Medicaid program can take as long as 45 days, state officials said. Case workers must evaluate applicants against more than 150 separate categories to make eligibility determinations. The state wants to ease that enrollment time by allowing certain health care providers to presume Medicaid eligibility for children and pregnant women, the state’s Medicaid director said Tuesday. That way, patients will get the medical services they need faster and could be on a healthier path sooner. In general, potential beneficiaries do get served by some health care providers, but the delay in their Medicaid eligibility prevents them from getting prescriptions and any needed follow-up care, said Ohio Medicaid director John McCarthy. “What we’ve done is change that,” McCarthy told reporters at the news conference in Columbus. The state has been doing a limited version of presumptive eligibility for children, but that could only be granted at county job and family services offices, limiting the effectiveness for individuals with immediate medical needs. Under the pilot program, providers could perform an eligibility check and grant immediate medical assistance to both children and pregnant women where they receive their health care. A test run for the presumptive eligibility program will start at Nationwide Children’s Hospital in Columbus, MetroHealth System in Cleveland and the Community Action Committee of Pike County. The state hopes to expand the pilot program statewide by January. About 2.2 million Ohioans are enrolled in Medicaid. Roughly 1.2 million are children, and 30,000 are pregnant women, McCarthy said.