Find Out Your Healthcare Benefits Through Medicare.gov

Posted by:  :  Category: Medicare

When you visit medicare.gov you can have a comparison of drug and health plans. In the United States, there is a wide range of health plans offered by various insurance companies. Every insurance company will give you free, easy to search, and quick online quotes. So if you’re looking for an individual health insurance plan here’s what you can do to help. Go online and look for insurance website. You fill up a short online form and then ask for free quotes. You can compare the quotes and the think about the health insurance that appeals to you. Next is you go to their website for more information and then proceed for the best health plan that best for you and works on your budget. Health Insurance in the USA gives you plenty of options to choose from the best affordable health plans. Such insurance programs will give you the maximum health coverage that goes easy on your pocket. The plans administered by every State Health Insurance Program includes Health Savings Accounts (HSAs), High deductible Health Plans (HDHps), Health Reimbursement Plans (HRAs), Flexible Spending Accounts (FSAs), and Medical Savings Accounts (MSAs) The HMO health care plans are the initial priority when looking out for that cheapest Health Insurance in your area, kind of like guaranteed issue health insurance plans. It gives you you a broad medical coverage at cheaper rates with a remarkably high amount of coverage. HMO health plan is a kind of health insurance in which the insured member visits the hospital, doctor falling in the HMO group. This group of HMO involves a set of doctors and hospitals connected with respective insurance companies for giving health care to the insured members. At Atlanta, vast majority are drifting towards the HSA health insurance plan because of its cheap rates as well as the tax savings that it tends to offer. It has got the advantage of lower premiums (monthly) when compared to the older health insurance plans. Prior to buying any kind of health insurance plan you should possess the fundamental knowledge of the plans that are offered by many insurance companies in most state. Understand the things that seriously matter in a good health insurance plan like monthly premiums, deductibles and above all, medical coverage. Why there’s need to get medical coverage in the form ‘health insurance’. A single visit of a doctor or hospital burns up a hole in your pocket. Getting insured will lessen your burden created by medical expenditures that you meet often. Medicare.gov is a comprehensive site, which could give you the information you need in terms of your health care needs. This site can help you compare Medigap insurance policies and also find one in your area. Insurance should be a priority for you and your family. Not only sick people but healthy ones too can catch an illness, meet a medical emergency anytime. Don’t forget, accidents happen without any forewarning and then for people that have a pre-existing condition it will be quite more complicated and expensive to buy health insurance. It will be wise to get one today.
Source: articleseer.com

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

MBTC offers Medicare EHR Incentive Program training

PracticePro includes MTBC’s EHR system, EHR 5.0, and a host of other services such as revenue management and Web and mobile patient appointment scheduling. What many providers may find particularly appealing, though, is the “meaningful use coaching team” that works with the providers one-on-one to educate them on the EHR Incentive Program. From creating an EHR roadmap, to training and implementation, this team’s goal is to ensure you’re hitting all of your checkpoints for meaningful use.
Source: ehrintelligence.com

Www.Medicare.gov/Coverage/Home.asp

At the official U.S. Government Medicare site, you will be able to login to your Medicare Account online. You can also find out about your Medicare Coverage.  Find out the conditions that you have to meet in order for the services and supplies to be covered. You can also find out how much you have to pay and who can get in touch with if you have any problems or even questions.
Source: snipsly.com

PHP Bloopers: User Login Mess Up!

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Source: wealllovemoney.com

A Tool For the Elderly for Home Health Care

Now about the Tool. The Tool referenced above “Home Health Compare” is designed for the elderly and their families, for other consumers, and also for the home health care agencies themselves, compare the quality of care provided to their customers. “Home Health Compare” is a compilation of all the Medicare Certified Home Health Agencies in the United States. The information is arranged by State and by location or city. It is an important Tool to help users compare quality of care provided for different quality measures. Experts within the Medicare/Medicaid program and professionals within the industry always stress that Home Health Compare is only one tool, and it should not be used as the only tool or the only means that people use for their decision making or selection of a home health agency.
Source: selfgrowth.com

Understand Your Medical Benefits Through Medicare.gov

The HMO health care plans are the first priority when looking out for the most affordable Health Insurance in your city, a lot like guaranteed issue health insurance plans. It offers you a wide medical coverage at cheaper rates having a surprisingly high amount of coverage. HMO health plan is a type of health insurance where the insured member visits the hospital, doctor falling in the HMO group. This group of HMO involves a group of doctors and hospitals linked with respective insurance companies for giving medical care to the insured members. At Atlanta, majority are moving towards the HSA health insurance plan owing to its inexpensive rates and also the tax savings it tends to offer. It has the benefit of lower premiums (monthly) as compared to the older health insurance plans.
Source: superarticledirectory.com

MBTC offers Medicare EHR Incentive Program training

Posted by:  :  Category: Medicare

Healthcare in America: Who's Paying Who? And Who's Getting What? (g1a2d0014c1) by watchingfrogsboilPracticePro includes MTBC’s EHR system, EHR 5.0, and a host of other services such as revenue management and Web and mobile patient appointment scheduling. What many providers may find particularly appealing, though, is the “meaningful use coaching team” that works with the providers one-on-one to educate them on the EHR Incentive Program. From creating an EHR roadmap, to training and implementation, this team’s goal is to ensure you’re hitting all of your checkpoints for meaningful use.
Source: ehrintelligence.com

Video: Medicare Provider Enrollment 3.wmv

Fraud Costs Pretty much all Of Us When Talking About Medicare insurance

Most healthcare vendors are honest and reputable. Nevertheless, as with anything else some are not. Medicare is definitely a large government organization that it becomes a simple target for fraud. A number of government agencies are fighting against Medicare deception. Exactly what are these folks doing to pull the fraud off? Its actually very easy to do and only requires that the Healthcare provider charges Medicare for services that have not been supplied. After all most of us have no idea precisely what services were completed anyway. This costs Medicare an incredible amount of cash and as everyone knows Medicare is under a lots of monetary burden. The fraud ends up costing the Medicare recipient more money in premiums.
Source: bwiainfosources.com

Medicare health insurance Is Actually In Financial Trouble; Let’s Eliminate The Fraudulence activity

The majority of healthcare companies are honest and also reputable. Unfortunately, you will find those that are not sincere! Medicare is particularly a good target for deceitful activity. A number of government agencies are fighting against Medicare deception. Precisely what are these people doing to pull the particular fraud off? Its really super easy to do and just requires that the Healthcare provider charges Medicare for services which have never been given. Of course many of us have no clue what services were executed anyway. Naturally with Medicare being backed by tax payers along with the Medicare system is in jeopardy of survival because of a shortage of money. The scams leads to higher premiums for all of us.
Source: webattirelv.com

Durable Medical Equipment Provider License For Sale in Broward County Florida

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Source: businessmart.com

Update All of Your Addresses with Medicare Immediately!

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

CMS pays $5.58B in EHR incentives to date

A snapshot from 2011 meaningful use data is beginning to emerge. “It does appear that those coming in at the end were performing significantly lower in a way from those who came in the beginning. We’re unsure whether that means that once you’re a meaningful user, you’re a meaningful user, or whether these are the folks in 2011 who were most situated to come in and incorporate it in the workflow. We’ll want to look at whether the folks who came in 2012 differ in any significant way,” Anthony said.
Source: oneclickmed.com

Halt Fraud As A Medicare Consumer And Watchdog

Nearly all Healthcare vendors are trustworthy and honest. Even so, as with other things a few are not. Medicare is especially a great target for deceitful activity. Many Government agencies work with Medicare to halt these fraudulent activities. How does fraud normally happen? Its actually super easy to do and only requires that the Healthcare provider charges Medicare for products and services that have never been given. Naturally many of us have no clue exactly what services were completed anyway. Naturally with Medicare being financed by tax payers along with the Medicare system is in jeopardy of survival caused by a shortage of funds. The scams leads to higher monthly premiums for everyone.
Source: muratabenov.com

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

Posted by:  :  Category: Medicare

Under this latter scenario taxes go up and spending is restrained compared to the other one.  Some of the assumptions involved — like we allow Medicare payments to doctors to fall sharply or all the Bush tax cuts do in fact permanently expire next January — are unrealistic.  More likely, were we to follow the broad outlines of this path, we’d have higher budget deficits for a few more years as the economy recovers.  But if we then make the necessary tax and spending changes, we could then rejoin the virtuous path.
Source: rollingstone.com

Video: How to Save Medicare $30 billion: www.UpgradeThe Card.org

Romney Medicare Plan Draws a Stark Contrast

ACTION ALERT On Tuesday, March 6th at 10:00 a.m., the House Ways and Means Health Subcommittee will hold a hearing on the Independent Payment Advisory Board (IPAB).  Tell Congress to support H.R. 452 and repeal IPAB
Source: protectingmedicare.org

Do Florida residents deserve affordable Medicare insurance?

These are all in one fl medicare advantage plans offered through health insurance carriers across the nation. Original Medicare pays these insurance companies a monthly fee for administering your Medicare benefits as a third-party administrator. This is why a lot of the Medicare advantage plans can be sold for a zero premium or even a small premium such as $50 a month, when a comparable Medicare supplemental policy plus a part D prescription drug card would cost around $200-$250 a month.
Source: rotaryarequipa.org

KaiserEDU.org Tutorial on Medicare/Medicaid Dual Eligibles

In this KaiserEDU.org tutorial, MaryBeth Musumeci, senior health policy analyst for the Kaiser Commission on Medicaid and the Uninsured, focuses on the 9 million low income seniors and people with disabilities who receive coverage through both Medicare and Medicaid — a population with complex needs and very high health and long-term care expenses.  This tutorial provides a closer look at the characteristics of dual eligibles, the types of services and coverage they receive from each program, and how program spending for this population is allocated.  Lastly, Musumeci discuss challenges with coordinating care across the two very different programs and reviews the Affordable Care Act provisions that address these issues.
Source: kff.org

Covering hospital finances: Challenges & opportunities : BusinessJournalism.org Reynolds Center for Business Journalism

Karl Stark is currently the health & science editor at the Philadelphia Inquirer. He has worked as The Inquirer’s pharmaceuticals reporter, national/foreign editor, deputy editor of science and medicine, and covered health care extensively as a business reporter. He has won many awards for his investigative work, including the National Press Club’s Consumer Story of the Year. His work on a Pennsylvania-based health system triggered a criminal probe that resulted in plea bargains by top managers for misusing restricted medical endowment funds. He is the vice president of the Association of Health Care Journalists and was one of four authors of the group’s “Covering the Quality of Health Care – A Resource Guide for Journalists.”
Source: businessjournalism.org

House Republican Plan to Overhaul Medicare Opposed by Original Advocate

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

Medicare Open Enrollment: Get Help From MyMedicareMatters.org

Prescription Drugs: Those without an existing Medicare Part D plan will be taken through a simple process to help them understand their options. Those with coverage can learn more about whether switching plans will be worthwhile. This area of the site also contains useful information on getting extra help with costs and a link to the Prescription Drug Plan Finder on Medicare.gov.
Source: suite101.com

We Stand FIRM: More Doctors Declining Medicaid and Medicare

This does not bode well for government-run medicine: “Survey: More doctors report they cannot afford to take new Medicaid, Medicare patients”. These patients may have theoretical “coverage”. But they won’t be able to receive actual medical care.
Source: westandfirm.org

Medicare issuing separate 10% EHR bonuses to HPSA practitioners

“Many optometrists practice in health profession shortage areas, and the 10 percent HPSA bonus represents another good reason for them to implement EHRs and take part in the incentive program as soon as possible,” said Philip Gross, O.D., chair of the AOA Health Information Technology Subcommittee. “The additional 10 percent bonus means HPSA practitioners, who enter the EHR Incentive Program during the first two years (2011, 2012) while the maximum bonuses are available, stand to receive payments totaling $19,800.”
Source: newsfromaoa.org

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

Posted by:  :  Category: Medicare

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

Video: Medicare Age-In

MLN updates education product, info series

MLN Guided Pathways (Basic, A, and B) Provider-Specific Resource Booklets (Revised) — The revised MLN Guided Pathways curriculum is designed to allow learners to easily identify and select resources on topics of interest. The curriculum begins with basic knowledge for all providers and then branches from information for either those enrolling on the 855B, I, and S forms or on the 855A form (or Internet-based PECOS equivalents) to a provider-specific resource booklet. The provider-specific booklet provides various specialties of health care professionals, (physicians, chiropractors, optometrists, podiatrists), nurses (APN, RNCNS, NP, Midwife) physician assistants, social workers, psychologists, therapists (OT, PT, SLP), dietitians, nutritionists, suppliers (ambulance, ASC, DMEPOS, FQHC, RHC, labs, mammography, radiation therapy, portable x-ray), and providers (CMHC, CORF, ESRD, HHA, hospice, OPT, pathology and SNF) with resources specific to their specialty including Internet-Only Manuals (IOMs), Medicare Learning Network publications, CMS web pages, and more.
Source: newsfromaoa.org

4 Programs that Can Help You Pay Your Medical Expenses

Extra Help If you have limited income and resources, you may qualify for Extra Help paying your Medicare drug costs. The amount of Extra Help you get is based on your income and resources. If you qualify for Medicaid, one of the Medicare Savings Programs, or SSI, you automatically qualify for Extra Help paying the costs of Medicare prescription drug coverage. The income and resources level may change each year. The only way to know for sure if you qualify is to apply with your State Medical Assistance (Medicaid) office. For more information about Extra Help, visit www.medicare.gov/publications to view the booklet “Your Guide to Medicare Prescription Drug Coverage.” For More Information
Source: inhomeassistedcare.com

Medigap Or Medicare Advantage?

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

Medicare Insurance Information www.medicarebenefitsdirect.com

I hope you have new knowledge about . Where you’ll be able to offer use in your daily life. And just remember. View Related articles associated with Medicare Supplement . I Roll below. I even have suggested my friends to assist share the Facebook Twitter Like Tweet. Can you share Medicare Insurance Information www.medicarebenefitsdirect.com.
Source: blogspot.com

Supplement Basic Medicare Coverage Parts A & B: How to Analyze Medigap Supplemental Insurance Options

Medigap comes in 12 different plan options labeled A through L. While an insurance company is not required to sell all 12 plans, the insurance coverages offered for each policy must meet the government standards. Therefore, a Level A Medigap insurance policy purchased from the ABC insurance company will offer the exact same coverages as a Level A policy purchased from the XYZ insurance company.
Source: suite101.com

Board on Aging publishes Health Care Choices booklet for seniors

The primary purpose of the governor-appointed Minnesota Board on Aging is to ensure that older Minnesotans and their families are effectively served by state and local policies and programs in order to age well and live well. Partnering with area agencies on aging and others, the MBA administers and oversees the use of the Older Americans Act funds as well as state funds to support older Minnesotans. In addition, the MBA provides objective information and data to the Minnesota Legislature, the governor and state agencies to shape policies that reflect the needs and interests of older Minnesotans.
Source: echopress.com

UCSF HR/Benefits Open Enrollment 2010: Oops

You should know, there is inaccurate information about Medicare on page 4 of the hard copy of your Open Enrollment Booklet. The information indicates that employees/and or family members that become Medicare eligible must enroll in Medicare and in a Medicare coordinated plan. This is absolutely wrong! If you continue working at UC past age 65, you are not required to sign up for Medicare Part B. In fact, you may delay enrollment, without penalty and the University does not even provide a Medicare coordinated plan option for employees that have not yet retired. For more information, see the Medicare Factsheet [PDF] and/or contact Social Security at 800-772-1213. A corrected version of the Open Enrollment booklet is available online.
Source: blogspot.com

CMS Posts Medicare Learning Network Enrollment Fact Sheet to Help Educate Ordering Physicians

Posted by:  :  Category: Medicare

The Centers for Medicare & Medicaid Services has issued new educational materials for physicians and other ordering and referring practitioners. This fact sheet provides education on the enrollment requirements for eligible ordering/referring providers. In the fact sheet CMS spells out who the requirements apply to as follows:
Source: hcafnews.com

Video: Medicare Provider Enrollment 3.wmv

Medicare providers urged to enroll in online system to fight fraud

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

Update All of Your Addresses with Medicare Immediately!

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

CMS Announces Data and Information Initiative

This wealth of data is critical to decision making for CMS and other stakeholders in the nation’s health care system. CMS must leverage this data to inform internal decisions and has a public responsibility to provide appropriate access to data (while ensuring beneficiary privacy) to external stakeholders in order to facilitate healthcare innovation. At the same time, CMS recognizes the critical role of analytics in transforming data resources into information and insight.  Through the creation of OIPDA, CMS is focusing resources to improve data access and dissemination, and enabling the development of new products and analysis tools designed to harness its data resources to better highlight relevant and actionable information for internal and external policy and decision makers.  In all of these activities, CMS will ensure that all data release and dissemination processes follow privacy laws and regulations and that the release of beneficiary identifiable data is limited to cases permitted by statute and regulations. OIPDA will also focus on creating new and innovative mechanisms, such as virtual data centers that allow data users remote and secure access to the data, to improve appropriate access to beneficiary identifiable data for research and analysis, while simultaneously increasing data security.
Source: nebraskaruralhealth.org

Find Aetna Medicare, Illinois Plans Affordably

Medicare is a health insurance plan specifically created by the United States government to help our seniors, aged 65 and over pay for needed medical care. Unfortunately times change and the Original Medicare plans are no longer enough for most of our seniors. In particular the rising cost of prescription medications has made it almost impossible for many people to afford the care that they need. In the late 1980s Medicare changed and a new Part was added to the mix specifically to meet this growing need. This article will help you understand a little about Part D and how to choose the best Medicare drug plan from a company you can trust like Aetna Medicare, Illinois.
Source: abchealthplans.com

Free Health Insurance U.S.

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

Doctor’s Orders: Cerner Corp. (CERN) Could Deliver

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

Obamacare Hits Seniors Hard 

Higher taxes. In 2013, two new Obamacare taxes go into effect that will likely impact seniors: the 2.3 percent excise tax on medical devices and the 3.8 percent tax on unearned of investment income. Not only do seniors rely heavily on medical devices, but, as Heritage expert Bob Moffit points out, “older people have larger investments than younger people, and thus high income older persons will be more heavily impacted by the new 3.8 percent Medicare tax imposed on unearned or investment income (effective 2013).”
Source: usdailyreview.com

InsureBlog: Medicare Equal Access Options Act

That is much more stringent than any private disability plan. In addition to the above, you must have been totally and permanently disabled for 5 consecutive months before you can even apply for Medicare benefits. Evem if you qualify for SSDI, you have to wait 29 months (5 month elimination + 24 months of SSDI eligibility) before you can qualify for Medicare. There are exceptions, such as those with ESRD or ALS. People (including children) who have not accumulated enough work credits do not qualify for SSDI which will also disqualify them from Medicare benefits. So what does Sen. Kerry want to do to make Medicare more accessible and affordable? Nothing actually. His proposal outlined here is to change the law with regard to access to Medicare supplement plans and Medicare Advantage plans. Kerry-Heinz believes those who live long enough to qualify for SSDI are discriminated against by Medicare supplement carriers because of their health status. If Kerry-Heinz get’s his way those on SSDI and Medicare will see the following changes.
Source: blogspot.com

CMS Finalizes Changes in Medicare/Medicaid Provider and Supplier Enrollment, Ordering, Documentation Requirements : Health Industry Washington Watch

Mandates document retention and provision requirements for certain providers and suppliers that order and certify items and services for Medicare beneficiaries. The provision specifically applies to durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), laboratory, imaging, and home health services – importantly, CMS has dropped an earlier reference to “specialist services” being subject to these requirements. The final rule also clarifies that the documentation requirement is not the responsibility of the physicians interpreting imaging studies — only the technical component entity has to meet these requirements. Under the final rule, necessary documentation must be retained for 7 years from the date of service (rather than the date of the order or certification as provided under the interim final rule). A provider or supplier that does not meet the documentation retention requirements is subject to revocation for not more than 1 year for each act of noncompliance. 
Source: healthindustrywashingtonwatch.com

New Obama Ads Focus on Medicare and Veterans

Posted by:  :  Category: Medicare

Old people read alone... by Ed Yourdonavid Bronner, the C.E.O. of Dr. Bronner’s Magic Soaps, locked himself in a cage across the street from the White House during a protest calling for hemp harvesting to be made legal in the United States. Police tried to talk him out, but eventually cut the cage open with a chainsaw and arrested Mr. Bronner.
Source: nytimes.com

Video: Medicare Cuts Cost GOP New York’s 26th District

Navigating Health Care in New York: Researching Insurance, Medicare, Medicaid, and Providers

Whether one’s health care provider must be chosen from a health maintenance organization or insurer, may provide health care as part of Medicare or Medicaid, or is recommended by family or friends, it is always wise to find out more about the health care provider. If your doctor practices in New York State, s/he is licensed by the New York State Department of Health and a good deal of basic and supplemental information is available about him or her in their New York State Physician Profile. In order to search the Physician Profile, it is necessary to have the proper spelling of the physician’s name which should be available from either your health insurance provider or from the office of the doctor. This site provides such basic information as whether this physician is licensed by the State of New York, whether the doctor went to an accredited medical school in the United States, where s/he did a residency or internship (a period of from one to several years of training after medical school but before receipt of a medical license) and whether s/he is "Board Certified" in the field. That is, after finishing formal medical training, s/he received post graduate training and supervision that indicates additional training in a specific medical field such as orthopedics or psychiatry. It should also indicate where his or her medical office is, what hospitals licensed in the State of New York s/he can practice in, whether s/he has published research papers in his medical field or has been teaching medicine or providing community service.
Source: nypl.org

Simon Johnson: How the Banks Endangered Medicare

The economic mechanism through which a bank-led financial crisis has a broader adverse fiscal impact is straightforward. The recession that deepened sharply in 2008 implied a deep loss of tax revenue, mostly because people lost their jobs. Lower revenue means larger government deficits, particularly when the government also provides unemployment insurance, so spending also goes up. (In comparison, the Bush stimulus of 2008 and the Obama stimulus of 2009 added relatively little to the cumulative additional total debt, according to the Congressional Budget Office.)
Source: nytimes.com

Entitlement Reform For the Entitled

But graduated eligibility also accounts for the fact that the rich live longer than the poor, and that the longevity gap is increasing. In 2007, the Social Security Administration did a study of mortality and income. Among 65-year-old men born in 1922, those with income in the top half lived an average of 2.2 years longer than those in the bottom half. But among 65-year-old men born in 1941, those with income in the top half were projected to live an average of 5.3 years longer. Thus, requiring wealthier Americans to wait five more years to claim Social Security and Medicare has the effect of giving an average rich and an average poor person nearly the same number of years of benefits.
Source: nytimes.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

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

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

The Impact of Proposed Medicare Cuts on New York’s Teaching Hospitals

The American Association of Medical Colleges estimates  a national deficit of at least 90,000 physicians by 2020, and 125,000 by 2025. Here is why.  Currently, there are only about 700,000 active physicians in the United States — for a population of over 310 million — and nearly one-third of our doctors will retire in the next decade. Meanwhile, the U.S. Census Bureau projects a 36 percent growth in the number of Americans over age 65 in the next 10 years. Older patients are sicker and have multiple chronic conditions that require more medical care. Add to that the estimated 32 million Americans who will gain access to medical insurance as a result of recent health care reforms.
Source: thirteen.org

New Medicare Reporting Requirements for the New Year

Of course, these requirements only apply if the employee is a Medicare beneficiary.  Medicare beneficiaries include persons 65 or older and persons of any age who (a) have end stage renal disease (kidney disease/dialysis patients), and (b) apply or will potentially apply for Social Security Disability Insurance (“SSDI”).  Employees who receive, or will potentially apply for, SSDI may include worker’s compensation claimants who are permanently and totally disabled.
Source: sglawoffice.com

CMS Raises Questions About N.H. Medicaid Reimbursement; Other Medicaid News

Posted by:  :  Category: Medicare

THE NATURAL by SS&SSCalifornia Healthline: State Health Officials Intrigued By New Medi-Cal Data Last week, the California HealthCare Foundation, which publishes California Healthline, released a survey of the attitudes and concerns of Medi-Cal beneficiaries. It has been a relatively long time since a similar survey was completed in 2000, so state health care officials were extremely pleased to get updated information, (Len Finocchio, director of the Department of Health Care Services) said. … One of the main general findings in the current survey is that beneficiaries are pretty happy with Medi-Cal. According to survey results, about 90 percent of the Medi-Cal insured have a positive view of the program and 78 percent said the program covers the care people need (Gorn, 6/5).
Source: kaiserhealthnews.org

Video: Chris Discusses Medicare Reimbursement Rates with Dr. F. Scott Gray in Danbury

Lower Medicare Reimbursement Rates Can’t Stall Nursing Home Profits But Could Lead To Staff Cuts

For over 15 years I’ve represented victims of accidents and negligence. Protecting my clients and their families in their times of need is the reason I practice law. I have not and will not represent insurance companies, unlike some of the top law firms of Chicago. As a local Chicago injury compensation lawyer, I have dedicated my legal practice to helping the residents of the Northern Illinois areas with their personal injury claims. My No Recovery, No Fee approach means that your satisfaction with your settlement is my utmost focus. If you have questions about your legal situation, or that of a loved one, please contact us today for your free initial consultation – 312-263-1080.
Source: chicagonursinghomelawyerblawg.com

This Week in Orange County June 10 2012

A committee comprised of County officials and County legislators interviewed the four companies that submitted proposals for the purchase of Valley View. All companies agreed to retain the beds and care in Orange County and committed to owning the facility for a minimum of five years, factors that were of concern to many Orange County residents. Recommendations regarding the potential buyers were made to the Legislature’s Health and Mental Health Committee. Now, the final decision regarding sale of Valley View and its potential new owner is in the hands of the Orange County Legislature. I, like many concerned residents throughout Orange County, anxiously wait to see what their next steps will be so that the residents of Valley View and their families know what their future holds and can plan and transition accordingly. Rest assured that no one will be kicked to the curb, left homeless, or without care.
Source: hvinsider.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

Entitlement Spending, Insufficient Revenue To Drive Up Debt, CBO Says

It also notes that health care spending as a percentage of GDP has risen from 4.7% in 1960 to 16.8% in 2010, the most recent year for which such data is available. Although the report estimates that spending growth in Medicare, Medicaid and the private sector will slow even without changes in federal law — because of “reactions to cost pressures” that will result in providers using “cost-reducing technologies” and increasing efficiency — it also estimates that such spending in relation to GDP will continue to grow.
Source: californiahealthline.org

More Private Insurers Using Medicare Rates for Out

“Health insurance premiums are continuing to rise, even though Obamacare was supposed save us from that. This payment rate shift is how markets are supposed to respond to increasing costs—by taking steps that will guide patients to lower the cost of care, in this case in-network providers,” Cannon said. “Insurers are looking for ways to control premium increases. And they really want patients staying in the negotiated network of providers.  Adopting a Medicare-plus reimbursement will accomplish both goals.”
Source: consumerinsuranceguide.com

VPR News: Medicare Rates May Cause Rutland Rehab Unit To Close

And while Rutland area nursing homes provide sub-acute rehabilitation services – she said the level of care was not the same. "It’s not as intense," Trapeni said. "They don’t have a rehab doctor on staff. They don’t have the other medical doctors on staff. And they are not required by Medicare to have three hours of therapy a day. So they get significantly less therapy."
Source: vpr.net

Medicare on Main Street: Beneficiaries Should Expect Additional Access Challenges

Another story in the Bellingham Herald just this week drives home the message.  The story points out that of approximately 150 primary care physicians in Whatcom County, WA for 32,000 Medicare beneficiaries, less than 25 percent accept fee-for-service Medicare.  “For patients with Medicare,” the story explains, “finding a doctor means calling a list of providers to learn who is accepting new Medicare patients and which Medicare plans they accept.  It can also mean putting your name on a waiting list until space becomes available.”   Whitney Jagich, a counselor at Whatcom Alliance for Healthcare Access observes, “‘[seniors] need encouragement to keep trying to find a primary care practitioner, because they’re definitely encountering barriers to receiving the care they need.’”  The story describes this challenge ultimately as a question of dollars and cents.  “‘Whatcom physicians want to be able to treat these patients but economically they can only see a certain number before they can no longer sustain their businesses,’” says Christopher Key, executive director of the Whatcom County Medical Society.  “‘A fairly limited number of physicians and groups accept [Medicare] to start with…Some don’t want to deal with it at all and won’t accept Medicare under any conditions.’”  Many of the calls to the Whatcom Medical Society are from people who have seen their family doctor for years.  “Then, when they turn 65 and find themselves on Medicare, they learn that their relationship with their physician is severed because they can’t or won’t accept Medicare.”
Source: gop.gov

The Impact of Healthcare Reform on My Private Practice

Insurance premiums and costs to patients are increasing at record rates. Patients who visit our practice are faced with ever-rising deductibles and copayments. Medications on their formularies are almost entirely restricted to generic medications. Most diagnostic imaging tests and procedures require prior authorization by the insurance company. The cost of providing the services to our patients is ever increasing. Once the patient leaves the office, our employees are faced with the task of getting approval for tests and procedures, calling the insurance company to beg for prior authorization of branded medications that are needed because the generic medications are not helpful. An average time for getting a medication authorized with the insurance company can exceed 30 minutes per medication. While the employee waits on the phone and goes through the never-ending number of choices with the automated systems, patient wait times increase and patient satisfaction decreases. Employees become irritated and they become more and more dissatisfied with their job.
Source: physicianspractice.com

We Stand FIRM: More Doctors Declining Medicaid and Medicare

Posted by:  :  Category: Medicare

"Every citizen should be a soldier. This was the case with the Greeks and Romans, and must be that of every free state." ` Thomas Jefferson. by eyewashdesign: A. GoldenThis does not bode well for government-run medicine: “Survey: More doctors report they cannot afford to take new Medicaid, Medicare patients”. These patients may have theoretical “coverage”. But they won’t be able to receive actual medical care.
Source: westandfirm.org

Video: Medicare Covered Power Chair – Do You Qualify? – Toll Free Phone Hotline

top secret surgeons – one of the best protection Taker In London

secret docs are on mammoth necessity in London lately by using the standard of provision that they provide. in order for you Medicare or therapeutic aid then it is a quite private doctor london  demanding labor to receive the right expert. The medical professional that you have demanded may be familiar practitioners who delivers exclusive provider for the reason that according to your priorities and can glimmer par above the whole thing your hopes. The walk in doctors london charge arrangement as accepted by the community body for private medics is quite a smaller amount and this is the very justification that medical professionals want so as to choose out of the system and focus of non-public therapies at the same time. the govt. should private doctors london reimbursement lavish sum of money so as to such docs so that you can supply highest quality of assistance in order to the individuals. because of this very explanation why, breakthrough a physician who will watch over your Medicare or Medicaid patients is by no means a straightforward duty. This looks very simple because you may comfortably open the phone book index and create a cellphone communicate each time you simply like. However, for picking the right dr you should investigate the whole thing the available medical doctors in the variability and walk in order for the most efficient one. step in medical doctors London is known in order for the quality of labor that they offer. They are well prestigious for improving patients smooth in negative states. in simple terms detail is that when you simply bring to mind such docs you must make a prior pre-stay at and then possible stage in order to their sanatoriums so that you can ingredient your medicinal requests. you will find experts open of the necessary website that can take care of you just in the most effective it is easy to tactic and can accomplish the whole thing your Medicare specifications. you should center around authorities who can provide your cause in a well and qualified form. cases like these are excellent from individual’s perception. machinist doctors are on mammoth required just because they can supply the sufferer in the best possible process. this is why of the reason that they are having intensity technology in the individual specialty and they can study sufferer’s an issue comfortably and can unravel them in a very less time span.
Source: yoursfree.biz

Choosing a Trustworthy Medigap Quote Comparison Service

Frequent policy changes in the Medicare supplemental insurance industry and the technical issues make things difficult for consumers to understand. Using reliable online resources will make the selection process fast and easy. However, if you are not cautious in choosing trustworthy services, you may end up making financially poor choices on your Medicare supplemental insurance plan. Look for companies that also offer telephone support so that you can talk to someone real to have all your questions answered. There are such reliable services in the industry and you just need to know where to find them. At Lowcostmedigap.com we offer our users with a dependable online Medicare supplemental plan quote comparison service and free phone consultations.
Source: medicarequotefinderblog.com

Help with Medicare open enrollment?free phone f

Health Care Stamps. The efficiency of markets vis-à-vis centralized control is well documented wherever centralized control has been tried. But how do we transition from the current centrally controlled Medicare system to individual control. Perhaps we can learn something from how the food industry is treated. Supermarkets contain thousands of individual products all with prices attached. Since food consumption is a necessity, just as health care, how do we insure that food is available to all? Rather than having Foodcare, we subsidize low income individuals by selling them “dollar value food stamps” at discounted prices. These stamps are real money to the grocery stores and to the recipients. Since individuals consume more than their food stamp limit, on the margin they are spending a dollar for a dollar. However, if they choose to buy pricey steak instead of hamburger using food stamps dollars, they will have less to spend on other products. Source: healthworkscollective.com
Source: medicaresupplementalco.com

Research Roundup: Savings From Electronic Health Records?

Health Affairs: Despite ‘Welcome To Medicare’ Benefit, One In Eight Enrollees Delay First Use Of Part B Services For At Least Two Years — Medicare’s Part B covers non-hospital medical services, and it includes a ‘Welcome to Medicare” check-up visit at no cost to the patient. This analysis of national survey data found that about one in eight people did not use Part B services in the first two years. Researchers noted that “this delay reflected patterns of use before enrollment … Men had a lower probability of using Part B services early than women; blacks and members of other minority groups were less likely to use services early than whites.” They concluded that underuse of preventive care “may lead to more expensive care and a higher cost burden on Medicare in later years” (Sloan, Acquah, Lee and Sangvai, 6/5). Annals of Internal Medicine: Effect Of The Medicare Part D Coverage Gap On Medication Use Among Patients With Hypertension and Hyperlipidemia — Medicare Part D was introduced in 2006 to increase access to prescription medicines, but a gap in coverage known as the “doughnut hole” left seniors with 100 percent of cost between $2250 and $5100. Researchers looked at claims before and after Part D was implemented to see if the gap affected beneficiaries’ use of drugs for high blood pressure and high cholesterol. They concluded: “The Part D coverage gap was associated with decreased use of medications for hypertension and hyperlipidemia in patients with no gap coverage and generic-only gap coverage. The proposed phasing out of the gap by 2020 will benefit such patients; however, use of low-value medications may also increase” (Li et al., 6/5). Health Affairs: Six Features Of Medicare Coordinated Care Demonstration Programs That Cut Hospital Admissions Of High-Risk Patients — Coordinated care for seniors with chronic disease and frequent hospitalizations has the potential to improve health and reduce Medicare spending. The authors picked out six key practices from demonstration projects, which include “supplementing telephone calls to patients with frequent in-person meetings; occasionally meeting in person with providers; acting as a communications hub for providers; delivering evidence-based education to patients; providing strong medication management; and providing timely and comprehensive transitional care after hospitalizations.” These techniques did not reduce spending (Brown et al., 6/5).
Source: kaiserhealthnews.org

View and Compare Medicare Supplement Insurance Online ~ Ex web blog

Online Medicare Supplement Insurance help is never farther than a click or phone call away. Thankfully it is easier than ever to maneuver through the maze of Medicare Part A and Part B as well as the many Medigap plans used to fill in the holes. The first step when taking the leap into the world of Medicare is to find out as much as you can about what is covered and what is not by Medicare Part A and Part B. 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. An over view to Medicare Supplement Insurance plans will give clients the most basic look into the different plans available. A sample of the Supplement Insurance Plans Medicare has to offer is listed below. You can see just from glancing below how vary different the coverage is and why it is important to determine which plan is best on an individual basis. Medicare Supplement Plan F Medigap Plan F is the most comprehensive supplement plan available for 2012. 100% of the gaps left by Medicare Part A and Part B are covered under Plan F. Individuals are free to see any doctor or specialist, who accepts Medicare, without needing a referral. This plan allows individuals to pay nothing out of pocket for any Medicare approved expense. Plan F is the most widely used plan for Medicare participants. Medicare Supplement Plan G Medigap Plan G is often compared directly to Plan F; the main difference being that individuals pay the Medicare Part B deductible out of pocket as it is not covered by Plan G. Another popular option in Medicare Supplement Insurance plans to enroll in. Once the Medicare Part B deductible is covered, 100% of the Medicare Part A and Part B gaps are covered with Medigap Plan G. Lower premiums than Plan F. Medicare Supplement Plan N Similar to the above plans, Medicare Supplement Plan N offers the convenience of being able to be seen by any doctor that accepts Medicare without being part of a network. Lower monthly premiums than Supplement Plan F and Plan G. Cost-sharing option for emergency room visit co-pays, doctor visits co-pays up to $20 each visit after the Medicare Part B deductible has been met. When entering into the Medicare Supplement maze it is best to find a source for information that is reliable and up to date. Online Medicare Supplement Insurance advisors will help individuals find the best plan for your needs while offering the ability to compare rates from the hundreds of private insurance companies offering Medicare Supplement Insurance for sale. —————————————————- Senior Heath Direct offers individuals a chance to view and compare Medicare Supplement Insurance Plans Online. Visit http://www.seniorhealthdirect.com today to determine which Medigap plan best suits your lifestyle and explore rates from several Medicare Supplement Insurance providers. EasyPublish this article: http://submityourarticle.com/articles/easypublish.php?art_id=272415
Source: blogspot.com

For an Impartial Broker which …

There are currently 10 standard Medicare Supplemental Insurance Options. Approach A, Approach W, Approach Chemical, Program D, Strategy P oker, Strategy Gary, System Okay, Program L, Strategy Michael and Program Deborah. The results in each one of these strategies are licensed by the Centre for Medicare health insurance and Medicaid Companies (Content management system). All insurers who present Medicare Supplement Insurance Policies need to abide by the approved advantages for your health supplement strategies which they provide.
Source: cohamagazine.com

Types of Health Insurance Offered by State Farm

Medicare Options There are choices available to you when choosing Medicare health benefit options. There is the original Medicare or you can select from a variety of other Medicare Advantage health plans that include prescription drug coverage and other benefits that may better fit your health care or financial needs. Medicare Supplement Insurance is for those 65 and older enrolled in Medicare Parts A & B.  This supplemental insurance helps cover some of the health care costs, like deductibles, coinsurance or copayment amounts, not covered by the Medicare plan.  Some of the supplemental plans can cover certain hospital or medical services not covered by Medicare.  
Source: adupit.com

#Masshealth Dental Providers

Posted by:  :  Category: Medicare

Community or Government Dental and vision Care – I have seen ads for dental clinics, ad even mobile dental care vans, at local society centers. Many church or society sponsored centers will have information on reduced fee clinics for seniors, disabled people, or others with low income. The federal government, state, or county may also run reduced fee clinics in some areas. Your local health and human resources offices should have information. There is help out there for older people, but it can take some digging to find it.
Source: blogspot.com

Video: Boston: Medicare Fraud Summit Providers Panel

Texas Medicaid Dental Claims Under Scrutiny

Although the practice of using a statistically relevant sample to estimate the number of times something may be present in the universe of items has been around since the advent of higher mathematics, the application of this methodology to estimate the number of improper claims paid over a specific period of time is relatively new.  The application of statistical sampling to health care claims for this purpose dates back about twenty years to a decision by the U.S. Secretary of Health and Human Services (HHS) to authorize the use of statistical sampling in lieu of engaging in onerous claim-by-claim reviews. In Chaves County Home Health Services v. Sullivan, 931 F.2d 914 (D.C. Cir. 1991), the Federal District Court upheld extrapolation as being within the Secretary’s discretion.  The use of statistical sampling has spread over the years.  Federal agencies (such as HHS-OIG, CMS-contracted auditors, etc.), State agencies (such as HHSC-OIG) and even private insurance payors now capitalize on the use of this damages-estimating tool, usually to the detriment of the targeted health care provider.  To be clear, everyone recognizes that an “extrapolation” is merely a substitute for conducting a claim-by-claim review of every claim submitted by thee provider and paid by a payor during the period in question.  Nevertheless, the methodology is here to stay, regardless of the adverse impact it can have on a provider’s ability to remain in business.
Source: lilesparker.com

HOT NEWS & ENTERTAINMENT

“This investigate confirms with tangible paid Medicaid claims information that entrance to dental services for Medicaid-eligible children has increasing 16 percent nationally between 2002 and 2007, even nonetheless no state has nonetheless reached even 50 percent access,” pronounced investigate co-author Dr. Allen Conan Davis, an associate highbrow during a University of Alabama during Birmingham School of Dentistry and former arch dental officer for a Centers for Medicare and Medicaid Services (CMS).
Source: svthanhha.vn

Springfield Vermont News: VT making progress on national dental crisis

Speaking here in Springfield at the site of a soon-to-open dental clinic, Sen. Bernie Sanders (I-Vt.) said Friday that Vermont is making progress on access to affordable dental care, but more must be done in Vermont and the nation to address the national crisis. More than 130 million Americans do not have dental insurance, according to a report prepared for a Senate subcommittee that Sanders chairs. One quarter of U.S. adults ages 65 or older have lost all of their teeth. About 17 million low-income children do not see a dentist each year. Only 45 percent of Americans age 2 and older saw a dental provider in the past 12 months. Although most oral health conditions are preventable, 60 percent of kids age 5 to 17 have cavities. Tooth decay, is five times more common among children than asthma, according to the report. While oral health problems can affect anyone, low-income people, racial or ethnic minorities, pregnant women, older adults, and people who live in rural areas have the hardest time getting to see a dentist. Unless the situation is addressed it is likely to get worse. At a time when there are nearly 10,000 too few dental providers in the United States, dental schools are graduating fewer new dentists than the number who retire each year. In Vermont, Sanders said, there has been significant progress. Over the last six years, six new dental clinics have opened at Federally Qualified Health Centers (FQHCs). Within the last year, a new facility at Ludlow, Vt. was opened by the Springfield Medical Care Systems and another clinic will open in Springfield in the future.  Altogether, 10 dental clinics will serve more than 25,000 Vermonters at health centers which accept Medicare, Medicaid, private insurance and allow patients to pay on a sliding scale depending on their income. In addition to expanding dental access at community health centers, an effective way to address the problem is to provide dental care in schools. “Putting dental clinics in schools is a real opportunity to address some of the serious problems we have been talking about,” Sanders said. Sanders is also drafting legislation he plans to introduce in the Senate to address the national crisis. His bill would:
Source: blogspot.com

Ct, RI, and Mass Dentists Accused Of $24 million Fraudelent Medicaid Claims

Department of Social Services Commissioner Roderick L. Bremby, said “We greatly appreciate the Attorney General’s dedication of both resources and expertise to bring forward this major case of alleged provider fraud. DSS investigators first identified the suspected fraudulent activity and worked with the AG’s Office and federal authorities to develop the case. The role of the Department of Consumer Protection is also important in our collective efforts to root out fraud and abuse on behalf of taxpayers.”
Source: ctwatchdog.com

Medicaid vs. Private Insurance Providers’ Perspective

http://www.medicalbillersandcoders.com End to End Medical Billing Solutions Medicaid vs. Private Insurance: Providers’ Perspective Medicaid not only plays a significant role in helping disabled and indigent people in the country but also provides important financial support for long term care patients. However, Medicaid also has a pivotal role to play in crowding-out private players in the insurance industry. Medicaid is essentially for poor people or indigent individuals and families and those with disabilities or people living with HIV/AIDS and since it is publicly funded, the reimbursement is on the lower side compared to other private health insurance payers. The fact that private insurance is usually acquired by financially stable families and individuals is a vital point in favor of private insurance companies. However, one of the most palpable benefits of accepting Medicaid patients is the incentive provided by the government for `meaningful use’ of EMR/EHR systems which is higher compared to the incentive for accepting Medicare patients. In relation to Medicaid, the law only covers low-income and indigent families and individuals but does not make it compulsory for providers to accept Medicaid patients. This creates further complications in the form of more and more Medicaid patients for those providers who do accept Medicaid. The distributions of disadvantages for physicians who accept Medicaid are geographic and differ from one state to another. Many states have not raised the reimbursement rates of providers for more than a decade and this has been a dampener for the expansion plans that were recently undertaken to improve Medicaid. The effect of the reluctance of providers to accept Medicaid patients is not just limited to the revenue of providers but also puts undue pressure on those who accept Medicaid plans by concentrating Medicaid patients to such providers. Private insurance providers and Medicare are faring much better since Medicare laws do not vary by state and private insurers pay more compared to Medicaid plans. Moreover, many physicians end up accepting Medicare patients since it pays better for the same services rendered in Medicaid. The irony is not just the fact that many physicians want to accept low-income indigent individuals but are not able to do so due to the lower reimbursement, but also the fact that even though the laws for Medicaid vary by state, the willingness (or reluctance) to accept Medicaid patients has almost remained the same across various states. The health reforms have improved the outlook for Medicaid and physician revenue due to the incentives provided, but there are numerous challenges for physicians when it comes to managing their revenue in such a dynamic payer environment. The growing need for better interaction with payers and a scientific and professional approach towards managing the revenue is being felt in contemporary medicine due to the recent reforms and the challenges faced by both publicly funded insurance plans as well as private payers. For more information about Medicare and Medicaid reimbursement plans, revenue cycle management, EMR/EHR implementation, consultancy, medical billing and coding, and other related services, please visit medicalbillersandcoders.com, the largest consortium of medical billers and coders in the United States. For more regarding medicaid or even private insurance please visit medical billing companies www.medicalbillersandcoders.com Copyright (c)-2011 M.D.C.P. All Rights Reserved. Page 1 of 1
Source: pdfcast.org

Dental Practice Operators Charged in an Alleged $20 Million Medicaid Fraud Conspiracy

It is alleged that Anusavice hired Zamani at Landmark Dental in October 2008 and that Zamani soon became aware of Anusavice’s disciplinary history. In January 2009, Zamani submitted a Medicaid Provider Enrollment Application with the DSS in order to obtain a Medicaid provider number for Mehran Zamani LLC, listing his group practice name as Landmark Dental. In May 2009, Zamani submitted an application with the DSS for a Medicaid provider number for Landmark Dental. In the applications Zamani submitted, he failed to disclose that Anusavice had an ownership or control interest in Landmark Dental, even though Zamani knew that Anusavice was running the practice and profited from it. From approximately February 2009 to March 2011, Mehran Zamani LLC and Landmark Dental received more than $12.9 million in Medicaid reimbursement payments.
Source: federalcrimesblog.com

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

Posted by:  :  Category: Medicare

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Source: dailykos.com

Video: Mitt Romney Embraces Privatizing Medicare and Social Security and Raising Eligibility Ages

Brad DeLong: Raising the Medicare Eligibility Age Is a Really Bad Idea Blogging: Is This a Problem with the Media or with the Congressional Budget Office?

Director’s Blog: Raising the Ages of Eligibility for Medicare and Social Security: If the eligibility age was raised above 65, fewer people would be eligible for Medicare, and outlays for the program would decline relative to those projected under current law. CBO expects that most people affected by the change would obtain health insurance from other sources, primarily employers or other government programs, although some would have no health insurance. Federal spending on those other programs would increase, partially offsetting the Medicare savings. Many of the people who would otherwise have enrolled in Medicare would face higher premiums for health insurance, higher out-of-pocket costs for health care, or both.
Source: typepad.com

Romney Proposes Raising Medicare Eligibility Age in 2022

A cogent example is the value of colonoscopies. The NE Journal of Medicine study shows that the procedure reduces the incidence of colorectal cancer and saves lives, cutting the death rate in half.   The procedure can cost thousands of dollars. The GAO found that only a quarter of all Medicare beneficiaries ages 65 to 75 had been so screened, and about 59 percent of men and women between the ages of 50 and 74  were tested.  While not the most pleasant procedure, it is important for all over 50.  Implementation would not be without new cost, certainly in the shorter term.
Source: talkleft.com

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

Daily Kos: BREAKING: Obama won’t touch Social Security or increase Medicare age!

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Source: dailykos.com

3 Reasons Why We Should Raise Medicare’s Eligibility Age

In attempting to address the problems of Medicare and medical expenses on the whole, members of Congress should look to the history of the program. The House Ways and Means Committee, when charged with assessing the costs of the program, projected that total costs for the first year would run no more than $1.3 billion when total spending in the first year actually was $4.6 billion. The committee did not improve its accuracy over time, projecting that hospital spending would amount to just $3.1 billion in 1970 when it was actually $7.1 billion. John Goodman, president of the National Center for Policy Analysis, explains that these chronic projection mistakes are because analysts failed to account for increased demand as 19 million people were given free access to unlimited health care. Today, Congress makes the same mistakes in different ways, failing to account for a dynamic market that undermines direct controls and ignores price-controlling efforts.
Source: reason.com