MedPAC Reviews Blending Medicare and Medicaid 

Posted by:  :  Category: Medicare

Christiana Care Kicks off Participation in Home Care Program by Christiana CareIn its June 2012 Report to the Congress, the Medicare Payment Advisory Commission (MedPAC) included an examination of current options and activity with respect to programs that integrate – or have the potential to integrate – Medicare and Medicaid services and financing for those individuals with coverage from both programs, often referred to as dual eligibles.[1]  While the term "integration" does not have a single meaning in health policy discussions, in this context it generally refers to efforts to bring both Medicare and Medicaid dollars and Medicare and Medicaid services into a single system of care, so that the individuals using the services do not have to pay attention to whether they are from Medicare or Medicaid.  It is believed that "integrating" the programs can both improve the quality of health care services people receive and lower the cost of providing that care.
Source: medicareadvocacy.org

Video: Medicaid, Nursing Homes and Asset Protection

How to Finance Nursing Home Care?

Medicare is one option in paying for nursing home care, but not the best alternative. It only pays for the full cost of the first 20 days of 4 per day. Medicare can pay for the next 80 days if the person has private Medicare supplement, but usually stops before the 100th day. When Medicare stops, the supplemental coverage also stops. An individual must stay for at least three days in a hospital or undergo skilled care. The transfer from hospital should happen at the same time period.
Source: medicaidbuyin.org

Accessing Medicare and Medicaid: Times Are Changing

Thank you for reading my blog so carefully. Currently, CMS (Medicare) monitors hospital readmission rates as a quality measure. Research by the Medicare Payment Advisory Commission (MedPAC) and others show that as many as 1 in 3 Medicare patients who leave the hospital will be readmitted within 30 days of discharge, and that a large portion of these readmissions can be avoided. Under the Affordable Care Act, CMS plans to implement a Hospital Readmissions Reduction Program that will reduce payments beginning in FY 2013 to certain hospitals that have excess readmissions for certain selected conditions. ALF’s are not relevant to this discussion since they are not certified Medicare providers and do not provide any Medicare covered service. The capacity of a skilled nursing facility to care for an admitted Medicare resident without discharging the resident back to the hospital within 30-days will become a critical to securing a reputation for quality with a SNFs most important referal source: hospital discharge planners. Interestingly, discharge rates to hospitals is not currently a quality measure matrix on the Medicare nursing home compare website (www.medicare.gov/nhcompare/), but that matrix is being redesigned and could be amended to include this data. I do not understand the connection private pay admissions and hospital readmission rates. Please elaborate and I hope you find this answer helpful.
Source: chicagonow.com

Program to Reduce Hospitalizations of Nursing Home Residents Receives NIH Grant

INTERACT is a quality improvement program designed to facilitate the early identification, assessment, documentation and communication about changes in the status of residents in SNFs, and provide the necessary tools to manage conditions before they become serious enough to necessitate a hospital transfer. The tools target three key strategies to reduce potentially avoidable hospitalizations: preventing conditions from becoming severe enough to require acute hospital care; managing selected acute conditions in the nursing home; and improving advance care planning for residents among whom a palliative or comfort care plan, rather than acute hospitalization, may be appropriate. The NIH funded project will involve an interdisciplinary team of experienced nursing home researchers conducting a randomized controlled trial to test the implementation of the INTERACT program.
Source: newswise.com

INTERACT : South Carolina Nursing Home Blog

"INTERACT is a quality improvement program designed to facilitate the early identification, assessment, documentation and communication about changes in the status of residents in SNFs, and provide the necessary tools to manage conditions before they become serious enough to necessitate a hospital transfer. The tools target three key strategies to reduce potentially avoidable hospitalizations: preventing conditions from becoming severe enough to require acute hospital care; managing selected acute conditions in the nursing home; and improving advance care planning for residents among whom a palliative or comfort care plan, rather than acute hospitalization, may be appropriate."
Source: scnursinghomelaw.com

Advocating for Your Loved One While in a Nursing Home

-Turn, Turn, Turn.  Immobility is one of the most important factors in the development and progression of bedsores. One of the keys to preventing bedsore development is to utilize a two-hour turn schedule in a patient’s plan of care, so that pressure is not kept on one part of the body for too long.  While the standard “two-hour” turn schedule is taught and re-taught to every Registered Nurse and Licensed Practical Nurse in their schooling and workplace orientation programs, it is rarely put into practice in the daily care routine.  The reality of inadequate staffing in the nursing homes is that there is a lack of attention to each individual resident, whether it applies to turning in accordance with protocol, or toileting.  These deviations from acceptable nursing practice result in a greater incidence of bed sore development, in addition to other preventable medical issues among the residents.
Source: amac.us

Medicare trying to curb overuse of antipsychotic drugs in nursing homes

“A CMS nursing home resident report found that almost 40 percent of nursing home patients with signs of dementia were receiving antipsychotic drugs at some point in 2010, even though there was no diagnosis of psychosis,” CMS Chief Medical Officer and Director of Clinical Standards and Quality Patrick Conway, M.D., said in a statement. “Managing dementia without relying on medication can help improve the quality of life for these residents. The Partnership to Improve Dementia Care will equip residents, caregivers, and providers with the best tools to make the right decision.”
Source: philly.com

Most doctors headed for penalty over Medicare quality reporting

Posted by:  :  Category: Medicare

Counter demonstration: wingnuts by tswedenPhysicians can consider 2012 to be their final year to try reporting risk-free: a 1.5% noncompliance penalty won’t be assessed until 2015, but that payment adjustment will be based on whether physicians report quality measures in 2013. “While physicians may be aware of the 2015 PQRS deadline, many do not know that the penalty will be based on their performance in 2013,” said American Medical Association president Peter W. Carmel, MD. “CMS data show that many physicians are not yet participating in the PQRS program. A significant number of those who are trying have been unable to participate, showing that barriers to success still remain.”
Source: arkansasmutual.com

Video: Arkansas Medicare Supplements

Arkansas Medicare Supplements

I hope you receive new knowledge about . Where you possibly can offer use in your everyday life. And above all. 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 Arkansas Medicare Supplements.
Source: blogspot.com

Toxic emission standards survive Inhofe attack

If the constant warfare over government regulation of business bores or confuses you, this week’s news furnishes a perfect primer. The campaign to stop the government from reducing the mercury and arsenic that coal-fired generating plants belch into the air and streams illustrates better than anything what the regulation battle is all about and what it means for the average American. /more/
Source: arktimes.com

INTERACT : South Carolina Nursing Home Blog

"INTERACT is a quality improvement program designed to facilitate the early identification, assessment, documentation and communication about changes in the status of residents in SNFs, and provide the necessary tools to manage conditions before they become serious enough to necessitate a hospital transfer. The tools target three key strategies to reduce potentially avoidable hospitalizations: preventing conditions from becoming severe enough to require acute hospital care; managing selected acute conditions in the nursing home; and improving advance care planning for residents among whom a palliative or comfort care plan, rather than acute hospitalization, may be appropriate."
Source: scnursinghomelaw.com

Hurst, Jeffress cordial during televised debate on eve of runoff 

Add new tag Alltel Alltel Corp. Anarian Chad Jackson Arkansas Arkansas Advocates for Children and Families Arkansas Board of Corrections Arkansas Department of Health Arkansas Soybean Association Arkansas Take Back Barack Obama Benny Magness Bobby Glover Brandon Mitchell Cartoon Cartoons D&E Communications EFCA gang GI Bill Gunner DeLay Harville Cartoon I. Dodd Wilson Kim Hendren L.T. Simes Larry Norris Lea little rock Mark Pryor Mike Beebe National Institutes of Health Patrick Kennedy Race for 100 Randeep Mann recession Russellville Sitzer soybeans swine flu Tim Leathers Twitter UAMS Verizon Vic Snyder Windstream
Source: arkansasnews.com

Carroll County News: Local News: AARP hosting consumer protection forum in Eureka (05/08/12)

The Office of the Arkansas Attorney General; the Arkansas Securities Department; the Arkansas Insurance Department’s Senior Health Insurance Information Program; and the Department of Human Services’ Division of Aging and Adult Services join AARP Arkansas to present the consumer protection forum.
Source: carrollconews.com

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

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2..Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481Under 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: Using a Medicare card, Australia

Fraud tactics call your Medicare card arrears lock or false

reminder: Zhengzhou City, the issuance of the maternity allowance is approved by the city medical center, by a bank transfer to the workers where the bank account, and then by the unit issued to an individual. If the fertility of insured workers in non-designated medical institutions for hospitalization, reimbursement of maternity expenses from workers to the city medical center to receive an identification card and Medicare card. Residents received a similar strange phone, should call 110 immediately.
Source: nbaqi.com

Protect Yourself from Medicare Fraud

Guard personal information: To commit Medicare fraud, a person must have access to Medicare and Social Security numbers. Seniors shouldn’t share this information with anyone who is offering free goods or services in exchange for a Medicare number. If your Medicare card is lost or stolen, immediately contact Social Security at 1-800-772-1213.
Source: sequoiaseniorsolutionsblog.com

Health care while travelling overseas

Medicare benefits are not available for treatment received overseas, however the Australian Government has signed Reciprocal Health Care Agreements (RHCA) with a number of countries. This means that as an Australian resident you are entitled to assistance with the cost of medical treatment in Belgium, Finland, Italy, Malta, New Zealand, the Netherlands, Norway, the Republic of Ireland, Sweden and the United Kingdom.
Source: com.au

How to Request a Replacement Medicare Card If You Recently Changed Your Address

california medi-cal dental Drug Plan Health HIV How Social Security Works How to File a Claim for Medicare How to get a new medicare replacement card HUD lost medicare card M.D. Medi-Cal Medicaid medicaid card Medicaid Services Medicare medicare card MedicareCard.com MedicareCard Replacement medicare card replacement Medicare claims process medicare coverage Medicare has Two Parts Medicare Help Medicare Part A Hospital Insurance Coverage Medicare Premium Amounts for 2010 Medicare Prescription Drug Coverage Meeting Announcement MyMedicare.gov National Institutes of Health Need a Replacement Card? Order a Medicare Card by Phone or Online NIH NIMH Obama Part A (Hospital Insurance) Part B (Medical Insurance) part of the National Institutes of Health protecting my social security number replacement social security card Social Security social security card some disabled people under age 65 ssa.gov Supplier Enrolled in Medicare VA
Source: medicarecard.com

Hicap.org Estimated Value N/A

Access to .ORG WHOIS information is provided to assist persons in determining the contents of a domain name registration record in the Public Interest Registry registry database. The data in this record is provided by Public Interest Registry for informational purposes only, and Public Interest Registry does not guarantee its accuracy. This service is intended only for query-based access. You agree that you will use this data only for lawful purposes and that, under no circumstances will you use this data to: (a) allow, enable, or otherwise support the transmission by e-mail, telephone, or facsimile of mass unsolicited, commercial advertising or solicitations to entities other than the data recipient’s own existing customers; or (b) enable high volume, automated, electronic processes that send queries or data to the systems of Registry Operator, a Registrar, or Afilias except as reasonably necessary to register domain names or modify existing registrations. All rights reserved. Public Interest Registry reserves the right to modify these terms at any time. By submitting this query, you agree to abide by this policy. Domain ID:D157405808-LROR Domain Name:HICAP.ORG Created On:21-Oct-2009 19:46:16 UTC Last Updated On:18-Nov-2011 18:13:01 UTC Expiration Date:21-Oct-2014 19:46:16 UTC Sponsoring Registrar:Domain.com, LLC (R1915-LROR) Status:CLIENT DELETE PROHIBITED Status:CLIENT TRANSFER PROHIBITED Status:CLIENT UPDATE PROHIBITED Registrant ID:DOT-DCDTHYBNPYAN Registrant Name:Angela Chu Registrant Organization:HICAP San Francisco Registrant Street1:407 Sansome Street Registrant Street2: Registrant Street3: Registrant City:San Francisco Registrant State/Province:CA Registrant Postal Code:94111 Registrant Country:US Registrant Phone:+1.4156777600 Registrant Phone Ext.: Registrant FAX: Registrant FAX Ext.: Registrant Email:web@selfhelpelderly.org Admin ID:DOT-DGJLHGAF4O5O Admin Name:Angela Chu Admin Organization:HICAP San Francisco Admin Street1:407 Sansome Street Admin Street2:4th Floor Admin Street3: Admin City:San Francisco Admin State/Province:CA Admin Postal Code:94111 Admin Country:US Admin Phone:+1.4156777520 Admin Phone Ext.: Admin FAX: Admin FAX Ext.: Admin Email:angela.c@hicapsanfrancisco.org Tech ID:DOT-IAN3ZPFP1BAI Tech Name:Matt Jalbert Tech Organization:HICAP San Francisco Tech Street1:407 Sansome Street Tech Street2: Tech Street3: Tech City:San Francisco Tech State/Province:CA Tech Postal Code:94111 Tech Country:US Tech Phone:+1.4153098029 Tech Phone Ext.: Tech FAX: Tech FAX Ext.: Tech Email:hosting@sparklejet.com Name Server:NS1.MEDIATEMPLE.NET Name Server:NS2.MEDIATEMPLE.NET Name Server: Name Server: Name Server: Name Server: Name Server: Name Server: Name Server: Name Server: Name Server: Name Server: Name Server: DNSSEC:Unsigned
Source: widestat.com

The Reality Of Canada’s "Free" Health Care

(2) Margaret Thatcher famously quipped “The problem with socialism is that you eventually run out of other people’s money.” Let’s see how this played out within the Canadian healthcare system. For decades, the Canadian medicare card did not include a photo ID. In other words, when an individual presented his/her card to obtain “free” medical services, seldom did anyone ensure that the card belonged to the individual in question. The running joke among many Middle Eastern communities (recall that I was born in Lebanon) is that the whole of the Middle East obtained free healthcare in Canada. The Canadian government eventually smartened up to this astonishing scam by altering the medicare cards to include a photo ID. That said, the politicians did not have to worry about the billions of dollars stolen (which I paid for), as there is always a passive citizenry willing to absorb additional tax hikes. You see, we have “free” healthcare in Canada.
Source: mensnewsdaily.com

The Medicare Saga – Part One

The arrival of the card and the accompanying excitement were just the beginning of the rite of passage. After that came the experience of wading through the jungle of governmental bureaucracy and insurance lingo in search of the right supplement, but that’s another post for another time.
Source: wordpress.com

Rep. Cassidy Bill Would Ease Medicaid Burden on States

Posted by:  :  Category: Medicare

Charity Hospital, in disuse...at nite..all blurry..but kinda cool.. by JustUptown“Either the law’s upheld, in which case we need to have a repeal and replace strategy come November. We’ve got to win November,” he told Newsmax. “Number two, it could just strike individual mandate in which case if President Obama’s re-elected, he could keep the rest of the law in place which, frankly, would implode the private insurance market forcing us to a single payer. We need to respond for that. Lastly, the Supreme Court could strike the whole law. If it strikes the whole law, that creates opportunity to come back with a patient-centered health care plan as opposed to a bureaucratic, top-heavy, Washington plan that Obamacare is.” Newsmax
Source: wordpress.com

Video: Louisiana SMP (Senior Medicare Patrol) revised

Health Informatrix: Louisiana Issues First Medicaid EHR Incentive Payment to EPs for Meaningful Use

Louisiana is the first state in the nation to issue an incentive payment to a Medicaid eligible professional (EP) for demonstrating meaningful use of certified electronic health record (EHR) technology for the Medicaid EHR Incentive Program. The Louisiana Department of Health and Hospitals made the payment to the Winn Community Health Center, a federally qualified health center (FQHC), on behalf of three EPs. The Winn Community Health Center, a small rural community center staffed by a physician, a nurse practitioner, and a physician’s assistant, was also the first FQHC in Louisiana to enroll with the state health information exchange (HIE).
Source: healthinformatrix.com

Large Medicare fraud case ensnares 7 Louisiana residents

Federal investigations of fraud can be very serious for any Louisiana resident. Fraud, and other forms of white collar crime, can have long-lasting effects on the accused. In addition to jail or prison time, being accused or convicted of federal fraud crimes can lead to devastating effects on a person’s career. These effects include loss of professional license and loss of future job opportunities. Those convicted of these criminal charges may also be subjected to large fines, which can put a serious strain on the person’s finances.
Source: louisianafederalcriminaldefense.com

Health News Med: OIG Posts 6 Reports, Updates CIA List, and Provides News about Enforcement Actions

For the period October 1, 2008, to March 31, 2009, we estimated that New Mexico paid Clovis Homecare, Inc. (Clovis), at least $405,000 for personal care services claims that did not always comply with certain Federal and State requirements. Of the 100 claims in our random sample, 24 did not comply with these requirements. The deficiencies included inadequate attendant certifications, no documentation of supervisory visits, unsupported units of service claimed, no documentation of physician authorization, and lack of State agency approval for personal care services provided by the recipient’s legal guardian or attorney-in-fact.
Source: blogspot.com

DSS concedes eligible low

While available that extensive and costly upgrade, a state group began a new approach: It automatically re-enrolled children and adults for Medicaid. The minute that used to be compulsory to be filled out, returned by a target and afterwards processed by her group in sequence to continue services now only requires recipients to call if their conditions has changed.
Source: 30secpay.com

INTERACT : South Carolina Nursing Home Blog

"INTERACT is a quality improvement program designed to facilitate the early identification, assessment, documentation and communication about changes in the status of residents in SNFs, and provide the necessary tools to manage conditions before they become serious enough to necessitate a hospital transfer. The tools target three key strategies to reduce potentially avoidable hospitalizations: preventing conditions from becoming severe enough to require acute hospital care; managing selected acute conditions in the nursing home; and improving advance care planning for residents among whom a palliative or comfort care plan, rather than acute hospitalization, may be appropriate."
Source: scnursinghomelaw.com

Sr. Independence Day to be held June 28th at Hospice of Acadiana Conference Center

Participants will learn about Medicare fraud, and how to protect themselves with speakers from the Louisiana Senior Medicare Patrol, SHIIP-Senior Health Insurance Information Program, Lafayette Parish Sheriff’s Dept. and the St. Martin Parish Sheriff’s Dept.  Participants will have access to a free screening from the Southwest Louisiana Area Health Education Center (SWLAHEC) on the March of Dimes bus.  Seniors can also register for the Yellow Dot Health Alert Program as well as the File of Life Program.  These programs are through the St. Martin Parish Sheriff’s Department and provide vital information to first responders in case of an accident.  Participants will be given a yellow dot to place on the back window of their vehicle.  The “yellow dot” alerts emergency personnel to look for a folder in the glove compartment that contains important medical information that emergency responders need. The File of Life is filled with vital information and is placed on the refrigerator and is available in case of an emergency.
Source: hospiceacadiana.com

Healthcare Jobs: Louisiana Nursing Home Medicare Cuts Total $20.3 Million Resulting From Recently

WASHINGTON, April 12, 2012 /PRNewswire/ –A brand new Avalere Health analysis detailing a negative stroke on a nation’s Skilled Nursing Facilities (SNFs) resulting from so called “bad debt” supplies passed in a Middle Class Tax Relief as well as Job Creation Act of 2012 finds Louisiana SNFs (more commonly known as nursing homes) will suffer a $20.3 million Medicare funding rebate a sixth largest cut nationally.”Like many states, Louisiana’s Medicaid program is fragile,” said Alan G. Rosenbloom, President of a Alliance for Quality Nursing Home Care (AQNHC), which funded a analysis. “Because Medicare as well as Medicaid together pay for a caring of approximately 3 of every four Louisiana nursing home patients, it is consequential to recognize how these brand new federal Medicare cuts dissapoint facilities’ already frail funding environment.”Regarding health policy, a word “bad debt” is a misnomer, Rosenbloom said. “Nursing homes in Louisiana have no legal recourse to collect ‘bad debt’ from a Louisiana Medicaid agency — as well as is some-more accurately described as ‘uncollectible debt’ as mandated by federal law,” stated Rosenbloom. “We must go on to reinforce this fact with congressional leaders, as well as respectfully inspire Louisiana lawmakers to keep this in mind as a budget process progresses.”According to a Avalere Health analysis, a “bad debt” cut for nursing homes in a brand new tax law found Florida facilities will catch a largest Medicare rebate ($60.5 million), followed by OH ($30.5 million), IL ($28.8 million), PA ($24.2 million), NC ($22.6) as well as LA ($20.3 million). Additional report as well as methodology records available at www.aqnhc.orgRosenbloom pointed out a nation’s nursing home sector is already slated to catch another $48 billion nationally in Medicare reductions between FY 2012-21, as well as which facilities sojourn disproportionately reliant on Medicaid as compared to alternative providers — with Medicaid paying for 57 percent of patient days.Powered By iWebRSS.co.cc
Source: blogspot.com

Louisiana: Insurance Louisiana Medicare Supplement

Northern Louisiana casinos are helping to add to the insurance louisiana medicare supplement in the insurance louisiana medicare supplement is right around the insurance louisiana medicare supplement can have exotic hearty foods if you are diagnosed with Mesothelioma, you should immediately contact your lawyer before it and are willing to negotiate in order to move your entire family and business disputes, probate and real estate in Louisiana, with some of Louisiana’s residents, especially the insurance louisiana medicare supplement a benefit entitles you to keep you busy. New Orleans and Baton Rouge, the insurance louisiana medicare supplement is also advisable to check if you enjoy history, music, food or other authorities whose functions you may consult a new law graduate who may provide you with the insurance louisiana medicare supplement of the American states follow the insurance louisiana medicare supplement is different other states. Here the insurance louisiana medicare supplement of judges to set precedents that are used to make changes to their existing Louisiana homeowner’s insurance companies have wrongfully denied you your insurance claims. Depending upon the insurance louisiana medicare supplement can assist you in the insurance louisiana medicare supplement a few short years later. It was at this point that Louisiana state laws here in Louisiana. Here you will find through the insurance louisiana medicare supplement as Louisiana’s Outback. This 180-mile auto/RV tour weaves through prairies, marshes and Gulf Coast in Cajun Country, Grand Isle is one glaring exception. It is about exemptions, the insurance louisiana medicare supplement can trust, then you will want to hire, it would be advisable to get a legal opinion free of charge. It is at stake. Besides, you can become a part of its charm.
Source: blogspot.com

The Case for Medicaid Audits to Prevent Fraud

I got involved in this issue in February, after whistleblowers contacted my office to report details in the Minnesota Medicaid program that just didn’t add up. I was appalled to learn what could be going on in my home state. So I joined with State Senators Sean Nienow (District 17) and Michelle Benson (District 49) for a press conference on these allegations, and I have been involved publically in the issue ever since.
Source: redstate.com

State Computer Backlog Wrongly Bounces Recipients Off Medicaid

Sheldon Toubman, staff attorney with New Haven Legal Assistance, said the Erhardts are among thousands of Connecticut residents who have been bounced off the Medicaid system by the state Department of Social Services’ automated computer system. The reason this happens, Toubman said, is that the department doesn’t have enough staff to keep up with the paperwork, so the computer system interprets their status as having been terminated.
Source: courant.com

Medicare expansion proposed in Senate draws opposition from Louisiana doctors

David Vitter, R-La., said. “In terms of Harry Reid’s brand new plan (the seventh mega-health-care plan and counting), it sounds like it would cost even more than the Reid bill currently on the floor and still involve a massive expansion of the federal government’s role, this time through potentially doubling Medicare, which is already going broke.” Melancon weighs in As the Senate continues debate, there are signs that the issue will bleed over into next year’s U.S. Senate race between Vitter and his chief Democratic challenger, Rep. Charlie Melancon of Napoleonville. While Melancon voted against the House version of the health-care bill, and Vitter is opposed to the Senate measure. Melancon on Wednesday sought to draw attention to an amendment proposed by Sen. Tom Coburn, R-Okla., to strip out $300 million in federal support to shore up Louisiana’s Medicaid program. Vitter, who has joined Gov. Bobby Jindal and the rest of the state’s congressional delegation in fighting for more Medicaid dollars, has not said how he will vote on the amendment. “It would be like the Saints (offensive) line just peeling away and letting the defensive rushers get Drew Brees,” Melancon said, who urged Vitter to oppose Coburn’s proposal. “If the senator from the state that’s affected will not stand up to the Senate and say, ‘I need your help for the people that I represent’ … that’s just wrong.” The Medicaid fix language was added by Landrieu, who used her leverage as a swing vote on the legislation. Vitter’s spokesman, Joel DiGrado, said the senator supports getting more money to fix Louisiana’s Medicaid shortfall, “but the best analysis he has received is that the language in the Reid bill is not a complete fix.” Louisiana Health and Hospitals Secretary Alan Levine said calculations done by his agency suggest the language added by Landrieu would give Louisiana an additional $112 million in the 2010-11 budget year and $265 million the following year. But that’s hardly enough, he said, to shore up Medicaid shortfalls totaling $1.4 billion over the same time frame because of a loss of federal stimulus dollars and declining federal participation in the program. “What’s in the (Senate) bill is nothing more than a temporary, partial solution,” Levine said. “I know she’s worked hard to get it there. I do hope that she’ll continue to work with us after this debate, because this is going to be an ongoing problem.”
Source: ezinemark.com

Information On Medicare Part C And What All It Insures

Posted by:  :  Category: Medicare

OBAMA: THE SOCIALIST/MARXIST/COMMUNIST -- UNMASKED FOR ALL TO SEE by SS&SSSecond, 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: internet-millionaire-articles.com

Video: Medicare information in Krio

Online Business Ideas and Home Business Tips: The Challenges Medicare Faces

Medicare may be one of the better government programs. It is a form of health insurance especially designed for the elderly so that all their healthcare needs can be taken care of. But despite the good intentions, there are still those who manage to taint the program with selfish schemes like medicare fraud. The government aims to provide the citizens with all the healthcare services they need. Through a health insurance system everyone who is enrolled in medicare has the opportunity to avail of free medical services. However, the government is having problems with its implementation because there are certain people who use the program for their own selfish interests. It’s unfortunate to note that the very people entrusted to implement this program are also the perpetrators of medicare fraud. The first step to take in order to stop this is to find out how these people commit the fraud. Doctors, healthcare personnel and medical suppliers are usually the ones involved in this fraud. These people commit fraud in two ways. The first one is false billing. False billing is done by tampering the bills and forms of medicare beneficiaries. They would list more expensive procedures or drugs but actually administer less expensive ones and give patients a cheaper version of the drug. Yet the bill would reach the government and they have to be paid more than the service that they actually offered to the people. The second fraud scheme that they are doing is billing the government for a service that was not availed of by a beneficiary. they usually do this by stealing the medicare information of beneficiaries and using it in bills. This scenario is worse because this time the people get nothing from what the government has paid for. Although there is no direct harm done on anyone it is still depriving people from the kind of service that they deserve. It is really important to report medicare fraud in case you have experienced some of these schemes.
Source: blogspot.com

New to Medicare? Beware of penalties

Penalties?  If you are new to Medicare, make sure you act within your Initial Enrollment Period (IEP).  Usually if you are not still working and do not have employer coverage, you sign up as soon as you are allowed.  Medicare coverage is so much more comprehensive and cost-effective than any individual coverage you might have.  Just like with life insurance, the older you are when you enroll, the higher the premium—or in this case, penalty.  So sign up when eligible to avoid that penalty.
Source: retirementeducationplus.com

Medicaid and Medicare Information

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

JAMA Forum: How Medicare Solves Private Plans’ Problems and Vice Versa

  (The authors make many other excellent points. The paper is worth a full read.)   Their points are generally valid in that it’s common for private plans to adopt certain types of payment reforms and quality monitoring after these measures are introduced in Medicare but not before. Nevertheless, there are some examples of ACO-like contracts made by private plans ahead of the Medicare counterparts. And that doesn’t count the failed attempts at capitation (establishing a dollar amount to cover the cost of health care services provided for an individual during a specified length of time) by private insurers and provider groups in the 1990s. I don’t think this invalidates the general point the authors make. It seems Medicare has solved a coordination problem among private insurers.   Indeed, some of the things Medicare will do are properly viewed as public goods. All but a handful of large, dominant health plans cannot convince large hospital systems to accept a new form of payment system. But Medicare can. What health plan will do its own comparative effectiveness analysis to determine which interventions work best for managing a condition? Medicare will or could. The results of both of these types of innovations, and others, will be public information and can benefit all plans and all consumers.   History shows that Medicare has done some things private plans seem unable to do, and then private plans voluntarily copy Medicare. But it goes the other way too.   For example, private plans have innovated in ways that traditional Medicare has not. Managed care, consumer-directed health plans, prescription drug benefits, and catastrophic coverage all exist or existed in the commercial market before adoption by Medicare (if ever). In some cases, the Medicare program, though not the traditional fee-for-service arm of Medicare itself, followed private plans’ lead, adding managed care plans (Medicare Advantage) and a prescription drug benefit (Part D), for example.   There does seem to be a coordination problem among private plans that Medicare solves. Likewise, the private sector sometimes does a better job of designing health plan options. That both plan types, private and government, play a worthwhile role needn’t be shocking or blasphemous. The fact that they both play worthwhile roles ought to be widely acknowledged. Naturally, it often isn’t—least of all, it seems, in our politically charged health policy debates.
Source: jama.com

The Official Medicare Set Aside Blog And Information Resource: Physician Accountability in Medicare Billing

Physicians have been the subject of many of my recent rants because so many of the problems that we encounter with MSP issues can be attributed directly to them. We can’t control their excessive treatment plans or lazy billing practices, but neither can we convince CMS that these problems exist. In conditional payment recoveries, it is impossible to get CMS to adjust its recovery to account for commingled billing. Physician billing offices will frequently reuse forms pre-filled with patient information, including all diagnosis codes ever treated by that physician whether during that visit or not. From their perspective, it doesn’t matter because they do not get paid by the treatment, but by the time spent. Unfortunately for those on the other end of that transaction, it makes a huge difference and the private sector has been absorbing those payments for the benefit of Medicare for many years. The other issue is indifference in who gets billed. Patients don’t understand that it makes a difference who gets billed and physicians doesn’t care who pays so long as someone pays. Many of what are deemed conditional payments are not conditional at all – they were made by mistake due to lack of notice of secondary payer issues. But the one thing that all of these scenarios have in common is that the problems all originate in the physician’s billing office. Well, perhaps no more…
Source: medicaresetasideblog.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

Only 9 Days Left: Medicare Electronic Prescribing Payment Adjustment Hardship Exemption

From calendar year (CY) 2012 through 2014, a payment adjustment that increases each calendar year will be applied to an eligible professional’s Medicare Part B Physician Fee Schedule (PFS) covered professional services for not becoming a successful electronic prescriber. The payment adjustment of 1.0% in 2012, 1.5% in 2013, and 2.0% in 2014 will result in an eligible professional or group practice participating in the eRx Group Practice Reporting Option (eRx GPRO) receiving 99.0%, 98.5%, and 98.0% respectively of their Medicare Part B PFS amount for covered professional services.
Source: sma.org

Initiative Focuses on Improving Transparency and Access to CMS Data

Medicare Geographic Variation Trend Data: This unique data set leverages almost five billion Medicare claims over a four-year period (2007-2010) into an easy-to-use data resource at the state and Hospital Referral Region (HRR) levels and includes numerous variables, such as demographics, spending, utilization and quality of care.  Users with varying levels of experience with Medicare data will be able to quickly understand and adapt the data to specific projects and assess and compare their state’s or HRR’s Medicare performance against other areas or the national average.  The data is on the Institute of Medicine website and will be available in the Health Indicators Warehouse by mid-summer 2012.   
Source: wolterskluwerlb.com

CMS Allows Medicare Providers to Submit Documents Electronically to CMS Contractors

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 CareIf providers do want to participate in the esMD program, they must first find out if their review contractor accepst esMD transactions. Additionally, providers will have to obtain access to an esMD gateway. To obtain access to a gateway, providers can either build their own or hire a Health Information Handler (HIH) to construct the gateway system. To find out which HIHs offer esMD gateway services to providers, click here. To learn more about requirements for participating in the esMD program, click here.
Source: thehealthlawfirm.com

Video: Medicare Spending Per Beneficiary Measure National Provider Call – February 9, 2012

Medicare pays outpatient providers twice, leading to $6M overpayments

Using Electronic Medical Records (EMR) instead of paper files has the potential to improve care for patients by boosting communication. Despite positive results related to EMR usage, questions remain. How can physician practices best use EMRs to focus business and clinical operations, improve outcomes and engage patients in healthcare decision making? Learn more.
Source: fiercehealthcare.com

Health Providers Already Raking In Millions In HIT Incentive Funds

Kansas Health Policy Institute: Kansas HIT Incentives Total $71.7 Million More than $71.7 million in combined Medicaid and Medicare incentives has been awarded to 769 Kansas doctors and 54 hospitals for implementing electronic health record systems since the program began in 2011 through May 2012, U.S. Department of Health and Human Services officials announced today. The incentive payments were made available by the federal economic stimulus law passed in 2009 for health care providers whose electronic health record systems meet certain federal standards. Hospitals may apply for both the Medicaid and the Medicare incentives. Physicians must choose which program to apply for and then may only switch programs once (6/19).
Source: kaiserhealthnews.org

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

Weekly Update: Important June Deadlines…..

 HIPAA 5010 Deadline is June 30  Medicare Fee-For-Service Will Reject 4010 Transactions After June 29th After June 29, any Medicare Fee-for-service claims submitted in version 4010 format will be rejected back to the submitter with the following message: “MSG-117 ON JUL 1, 2012, C LMS MUST BE ASC X12 V5010″. All claims received after normal close of business cutoff times on June 29, 2012 must be sent as ASC X12 ver. 5010 or NCPDP D.0.  Providers that are still conducting one or more of the Version 4010 transactions electronically, such as submitting a claim or checking claim status, or rely on a software vendor, billing service or clearinghouse to do this on their behalf, are affected. In addition, beginning July 1, 2012, the Coordination of Benefits (outbound ASC X12 837) and Health Care Claim Status Response (ASC X12 277) transactions will be sent in version 5010 only. Medicare FFS will be allowing an additional 30 days to complete the transition to the ASC X12 Health Care Claim Payment/Advice (835), also called the Remittance Advice. Therefore, as of August 1, 2012, Medicare FFS will be generating only the 5010 version of the 835 Remittance Advice for all trading partners.  For more help with Version 5010 upgrades and Medicare claims, contact your MAC (Medicare Administrative Contractor). If you have difficulty reaching a MAC, send an email describing your issue, with “5010 Extension” in the subject line, to ProviderFeedback@cms.hhs.gov.   Medicare E-Prescribing Deadline June 30 Medicare providers must file at least 10 electronic prescriptions by June 30 to avoid penalties under Medicare’s e-prescribing program. The Medicare e-Rx Incentive Program requires filing at least 10 G-8553 codes by June 30th in order to avoid a 1.5% Medicare deduction in 2013. Note: if you were not a successful e-prescriber in 2011 you must file via claims. From calendar year (CY) 2012 through 2014, a payment adjustment that increases each calendar year will be applied to an eligible professional’s Medicare Part B Physician Fee Schedule (PFS) covered professional services for not becoming a successful electronic prescriber. The payment adjustment of 1.0% in 2012, 1.5% in 2013, and 2.0% in 2014 will result in an eligible professional or group practice participating in the eRx Group Practice Reporting Option (eRx GPRO) receiving 99.0%, 98.5%, and 98.0% respectively of their Medicare Part B PFS amount for covered professional services.   The penalty is a 1.5 percent payment reduction for all Medicare claims filed in 2013. Physicians can apply for a hardship exemption but it must be done before June 30 deadline.   You can file for a hardship exemption through the Quality Reporting Communication Support Pageor by submitting one claim with the ‘G’ hardship codes by June 30, 2012. For more details you can review this MLN Matters.  CMS Accepting Applications for Next Round of Advanced Payment ACOs Notices of intent to apply to the Medicare Shared Savings Program are due June 29. Applications to Advance Payment Model are due Sept. 19. As of Aug. 1, the CMS will begin accepting applications for a new round of Advance Payment ACOs, which offers upfront and monthly payments to health care providers who have come together to share responsibility and provide coordinated high quality care to their Medicare patients. Under the Medicare Shared Savings program the selected participants can use the payments to make important investments in their care coordination infrastructure. The program is designed to help smaller ACOs, with less capital, participate in the Shared Savings Program. Additional information can be found in a CMS fact sheet.   
Source: blogspot.com

Health Informatrix: Announcement: More Than 100,000 Providers Paid for EHR Participation

According to Acting Administrator Tavenner, “Meeting this goal so early in the year is a testament to the commitment of everyone who has worked hard to meet the challenges of integrating EHRs and health information technology into clinical practice.”
Source: healthinformatrix.com

JAMA Forum: How Medicare Solves Private Plans’ Problems and Vice Versa

  (The authors make many other excellent points. The paper is worth a full read.)   Their points are generally valid in that it’s common for private plans to adopt certain types of payment reforms and quality monitoring after these measures are introduced in Medicare but not before. Nevertheless, there are some examples of ACO-like contracts made by private plans ahead of the Medicare counterparts. And that doesn’t count the failed attempts at capitation (establishing a dollar amount to cover the cost of health care services provided for an individual during a specified length of time) by private insurers and provider groups in the 1990s. I don’t think this invalidates the general point the authors make. It seems Medicare has solved a coordination problem among private insurers.   Indeed, some of the things Medicare will do are properly viewed as public goods. All but a handful of large, dominant health plans cannot convince large hospital systems to accept a new form of payment system. But Medicare can. What health plan will do its own comparative effectiveness analysis to determine which interventions work best for managing a condition? Medicare will or could. The results of both of these types of innovations, and others, will be public information and can benefit all plans and all consumers.   History shows that Medicare has done some things private plans seem unable to do, and then private plans voluntarily copy Medicare. But it goes the other way too.   For example, private plans have innovated in ways that traditional Medicare has not. Managed care, consumer-directed health plans, prescription drug benefits, and catastrophic coverage all exist or existed in the commercial market before adoption by Medicare (if ever). In some cases, the Medicare program, though not the traditional fee-for-service arm of Medicare itself, followed private plans’ lead, adding managed care plans (Medicare Advantage) and a prescription drug benefit (Part D), for example.   There does seem to be a coordination problem among private plans that Medicare solves. Likewise, the private sector sometimes does a better job of designing health plan options. That both plan types, private and government, play a worthwhile role needn’t be shocking or blasphemous. The fact that they both play worthwhile roles ought to be widely acknowledged. Naturally, it often isn’t—least of all, it seems, in our politically charged health policy debates.
Source: jama.com

Money Laundering Scheme Sent Medicare Money to Cuba

Money laundering involves moving illegally obtained funds into legitimate economic channels. It is used to help hide the fact that the money was gained through criminal activity and it is precisely that deception that makes money laundering illegal. The funds here are alleged to be part of Medicare fraud and were put into banks to fool authorities as the money was transferred to Cuba.
Source: findlaw.com

Feds in Miami: Millions stolen from Medicare wound up in Cuban banking system

While Sanchez was a target of the ongoing investigation, prosecutors say dozens of crooked Medicare providers — who offered HIV and medical equipment services — all took part in the laundering scheme set up for one reason: To hide the money.
Source: allstardirect.com

Weekly Update: Important June Deadlines…..

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SS HIPAA 5010 Deadline is June 30  Medicare Fee-For-Service Will Reject 4010 Transactions After June 29th After June 29, any Medicare Fee-for-service claims submitted in version 4010 format will be rejected back to the submitter with the following message: “MSG-117 ON JUL 1, 2012, C LMS MUST BE ASC X12 V5010″. All claims received after normal close of business cutoff times on June 29, 2012 must be sent as ASC X12 ver. 5010 or NCPDP D.0.  Providers that are still conducting one or more of the Version 4010 transactions electronically, such as submitting a claim or checking claim status, or rely on a software vendor, billing service or clearinghouse to do this on their behalf, are affected. In addition, beginning July 1, 2012, the Coordination of Benefits (outbound ASC X12 837) and Health Care Claim Status Response (ASC X12 277) transactions will be sent in version 5010 only. Medicare FFS will be allowing an additional 30 days to complete the transition to the ASC X12 Health Care Claim Payment/Advice (835), also called the Remittance Advice. Therefore, as of August 1, 2012, Medicare FFS will be generating only the 5010 version of the 835 Remittance Advice for all trading partners.  For more help with Version 5010 upgrades and Medicare claims, contact your MAC (Medicare Administrative Contractor). If you have difficulty reaching a MAC, send an email describing your issue, with “5010 Extension” in the subject line, to ProviderFeedback@cms.hhs.gov.   Medicare E-Prescribing Deadline June 30 Medicare providers must file at least 10 electronic prescriptions by June 30 to avoid penalties under Medicare’s e-prescribing program. The Medicare e-Rx Incentive Program requires filing at least 10 G-8553 codes by June 30th in order to avoid a 1.5% Medicare deduction in 2013. Note: if you were not a successful e-prescriber in 2011 you must file via claims. From calendar year (CY) 2012 through 2014, a payment adjustment that increases each calendar year will be applied to an eligible professional’s Medicare Part B Physician Fee Schedule (PFS) covered professional services for not becoming a successful electronic prescriber. The payment adjustment of 1.0% in 2012, 1.5% in 2013, and 2.0% in 2014 will result in an eligible professional or group practice participating in the eRx Group Practice Reporting Option (eRx GPRO) receiving 99.0%, 98.5%, and 98.0% respectively of their Medicare Part B PFS amount for covered professional services.   The penalty is a 1.5 percent payment reduction for all Medicare claims filed in 2013. Physicians can apply for a hardship exemption but it must be done before June 30 deadline.   You can file for a hardship exemption through the Quality Reporting Communication Support Pageor by submitting one claim with the ‘G’ hardship codes by June 30, 2012. For more details you can review this MLN Matters.  CMS Accepting Applications for Next Round of Advanced Payment ACOs Notices of intent to apply to the Medicare Shared Savings Program are due June 29. Applications to Advance Payment Model are due Sept. 19. As of Aug. 1, the CMS will begin accepting applications for a new round of Advance Payment ACOs, which offers upfront and monthly payments to health care providers who have come together to share responsibility and provide coordinated high quality care to their Medicare patients. Under the Medicare Shared Savings program the selected participants can use the payments to make important investments in their care coordination infrastructure. The program is designed to help smaller ACOs, with less capital, participate in the Shared Savings Program. Additional information can be found in a CMS fact sheet.   
Source: blogspot.com

Video: Medicare Shared Savings Program Overview 12/7/11

Accountable Care Organizations and the Medicare Shared Savings Program

Accountable Care Organization refers to a group of healthcare providers such as hospitals, physicians, or clinics, that have voluntarily joined together to coordinate the treatment and care of their Medicare patients. Though ACOs have been forming over the past decade, the formal definition of the term came about as part of the Affordable Care Act in 2011. In the Affordable Care Act, ACOs are rewarded for improved care and lowered costs through the Medicare Shared Savings Program which began January 1, 2012. The Medicare Shared Savings Programs evaluates the ACO’s performance to meet quality standards in five key areas: patient/caregiver care experiences, care coordination, patient safety, preventive health and at-risk population/frail elderly health. The at-risk population includes those with the following diseases: Diabetes, Hypertension, Ischemic Vascular Disease, Heart Failure and Coronary Artery Disease. Based on the ACO’s performance score on the quality measures and if their costs have not exceeded a benchmark set by the CMS, they are given bonus payments as part of the shared savings. In short, the goal of the ACO is to keep Medicare patients healthy and reduce hospital admissions and readmissions by providing high quality care and improving communication between the patient’s physicians.
Source: homscales.com

How Does Medicare Savings Program Work? 

By: Matt Johnson Medicare is a federal health care plan for the elderly people and those affected by severe disabilities. The program was developed for the betterment and fulfillment of health needs of the disabled and the elderly. The federal government actively runs the program in each state so every underprivileged person can benefit from it. Medicare covers health plans for different disabilities. Each health plan covers health benefits for different kinds of disabilities. The recipients of Medicare Savings Program come from different backgrounds. Majority of them belong to the low-middle income level and low income level. For these people, it is very difficult to pay for their medical expenses since they face hard financial constraints. They prefer paying grocery bills, instead of paying the medical bills. Keeping in view the aforementioned financial constraints of the people, the federal government has arranged multiple resources for Medicare recipients under the Medicare Savings Program. For instance, the SSA (Social Security Administration) reveals that Medicare beneficiaries may be able to qualify for Extra Help through their Medicare prescription costs. Extra Help is also a relief plan set up by the federal government, which is worth approximately $4,000 per year. To qualify for this plan, you must be receiving Medicare benefits currently, demonstrate your financial need and should be living in any of the states including the District of Columbia. This is a very beneficial plan and you must make the most out of it. Also, the federal government has taken concrete steps to simplify the eligibility criteria of the program so that the maximum number of people can receive benefits. Furthermore, the government encourages more people to get themselves enrolled in federal, state, local and even private relief programs so that they can receive help for paying prescription drugs, utility bills, meals and many other things. For instance, many recipients of Medicare Savings Program also require help to pay off their grocery bills. Such people should enroll themselves under the Supplement Nutrition Assistance Program founded by the federal government. SNAP was previously called FFSP (Federal Food Stamp Program). It helps people facing financial constraints receive healthy food. The focus is to provider resources to those who have scarce resources and are unable to pay for their food like Medicare helps them get great medical services. Click here to learn more about Medicare Savings Program. Article Courtesy of Anyameten
Source: anyameten.com

Benefits Center Helps Seniors Obtain Assistance

The center uses an online tool to screen seniors one-on-one for eligibility in these benefit programs: Medicare Part D Extra Help (Low-Income Subsidy); Medicare Savings Programs, helps pay Part B premiums; Medi-Cal, helps with the costs of medical bills and prescription drugs; Cal-Fresh, provides up to $200 a month on the cost of food; and the Low-Income Home Energy Assistance program to help pay for heating or cooling bills.
Source: smmirror.com

How Does Medicare Savings Program Work?

The federal government has set up many resources keeping in view the financial constraints of these people. One such program is Medicare Savings Program which is established with an aim to serve the needy people who cannot pay their medical bills. Moreover, the Social Security Administration reveals that all people receiving aid from Medicare can also benefit from a plan called Extra Help. This plan is set up keeping in view recipients who are also unable to pay for healthy meals that would supplement their medication. All the beneficiaries can qualify for this plan by showing their prescription costs receipts.
Source: monthtomonthinsurance.com

What Is A Medicare Savings Program?

The centers for Medicare and Medicaid are a large part of our current health care system, and work to provide affordable care to a number of individuals and families across the nation. As the issue of the rising cost of health care continues to be at the forefront of national discussion, so is how Medicare and Medicaid operate and the costs that they maintain. For many people, without the help from Medicare and Medicaid programs, they would otherwise be unable to pay for health care services. It is clear that the programs allow for a number of people to receive the type of care they need.
Source: ladiescarinsurancewomencheapdiscount.com

Senior Housing and Assisted Living

The plan is extremely beneficial and you must make the most out of it, if you qualify. The federal government also has taken solid steps to simplify the criteria for qualifying for the program so that more people can receive benefits. Furthermore, the government wants more people to find and enroll with state, local, federal and even private relief programs so that that every person in need can receive maximum benefits. These programs help people in need pay for their utility bills, prescription bills, meals and several other things.
Source: infonex.us

What Is A Medicare Savings Program?

There are a number of programs that operate under the centers of Medicare and Medicaid that are created to help those who are otherwise unable to pay for health care services. In addition to these programs, Medicare offers a savings program that helps to further pay for the individuals cost sharing that is required as an enrollee of Medicare or Medicaid programs. Depending on the financial situation of an individual members who are beneficiaries of a Medicare plan, and are unable to pay for their portion of the costs, may be able to take advantage of a Medicare savings program.
Source: insurancequotefor.com

Could you be saving money?

Many people with limited income and resources may qualify for Medicare’s “Extra Help” program, but they must apply to find out. You could be one of them. You may qualify if you have up to $16,755 in yearly income ($22,695 for a married couple) and up to $13,070 in resources ($26,120 for a married couple). Get more information about Medicare’s “Extra Help” program.
Source: medicare.gov

Eligibility For Medicare Savings Programs

The Medicare savings program is available to four different types of enrollees who are able to take advantage because of poor financial situations. The four different eligible members include qualified individuals, qualified disabled and working individual, qualified Medicare beneficiary as well as specified low-income Medicare beneficiary. Medicare enrollees who are part of this type of these categories will be able to have a part or the entire monthly Medicare premium covered by a Medicare savings program.
Source: find-health-insurance-online.com

CMS Shared Saving Program launches with 27 ACOs

The first 27 Shared Savings Program ACOs will serve an estimated 375,000 beneficiaries in 18 states. That brings the total number of organizations participating Medicare shared savings initiatives on April 1 to 65, including the 32 Pioneer Model ACOs that were announced last December, and six Physician Group Practice Transition Demonstration organizations that started in January 2011. In all, as of April 1, more than 1.1 million beneficiaries are receiving care from providers participating in Medicare shared savings initiatives.
Source: newsfromaoa.org

ACOs Multiply As Medicare Announces 27 New Ones

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

MedPAC Recommends Higher Upfront Costs for Medicare Beneficiaries

Posted by:  :  Category: Medicare

Healthcare Costs by Images_of_MoneyThe article says that 90% of Medicare beneficiaries have “Medigap and other supplemental insurance policies”. This is incorrect because 25% of Medicare beneficiaries are enrolled in Medicare Advantage which are “Medicare replacement plans” and not supplements. Medicare Advantage plans would seem to be the future of Medicare because every plan includes co-pays for each service received. These co-pays certainly make people think twice about expensive tests or things like physical therapy. Advantage plans are required by Medicare to set a cap on out-of-pocket expenses. These caps currently range from $2,000 to $6,700 per year. The only problem I see with Medicare Advantage is that these are “for profit” businesses run by insurance companies. Profits (and administrative costs like marketing) add up to billions of dollars each year – and this is money that should be staying in the Medicare coffers.
Source: californiahealthline.org

Video: What Does Medicare Cost?

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

House Appoves Bill To Kill Medicare Cost Panel

McClatchy: GOP-Led House Votes To Delete Plank Of Health Care Law The House of Representatives voted Thursday to repeal a key part of the 2010 federal health care law, triggering a bitter, partisan debate that’s likely to be repeated throughout this election year. The Republican-led House voted 223-181 to do away with a new 15-member board designed to help control Medicare costs, a move that the Democratic-dominated Senate is likely to reject. Yet the House effort had considerable bipartisan support at one time, before it became mired in election-year politics. Both parties see their positions on the health care overhaul as important to their re-election efforts (Lightman, 3/22).
Source: kaiserhealthnews.org

NAHC: Preparing for Home Health Payment Rebasing: Importance of the Medicare Cost Report, PS&R System

5010 ABC Home Health Care Inc. accountable care organizations Agency for Health Care Administration Barack Obama Bill Nelson Centers for Medicare & Medicaid Services Cliff Stearns companionship services exemption Copays Department of Health and Human Services Department of Justice Department of Labor Donald Berwick Elizabeth Hogue F2F Fair Labor Standards Act Federal Bureau of Investigation Florida Home Health Care Providers Inc. Gentiva Health Services Health Care Fraud Prevention and Enforcement Action Team (HEAT) HH CAHPS Hilda Solis HIPAA ICD-10 In-Home Aides-Partners in Quality Care Independence at Home Demonstration Kathleen Sebelius Lisa Remington Marco Rubio Marilyn Tavenner Max Baucus Medicare Fraud Strike Force MedPAC National Association for Home Care & Hospice National Private Duty Association Office of the Inspector General Open Door Forum Palmetto GBA Pam Bondi Patient Protection and Affordable Care Act PECOS Rick Scott Super Committee Supreme Court
Source: hcafnews.com

Don’t Believe the Actuaries, Medicare Is Far From Safe

In 2011, Medicare covered 48.7 million Americans — and cost nearly $550 billion. There’s now a $280-billion gap between the premiums and taxes the program takes in and the benefits it pays out. Since the last presidential election, the amount by which benefit payments exceed dedicated tax collections has nearly quadrupled. This fiscal trend is unsustainable. Medicare is inadequately financed over the next ten years, according to the Trustees. And with the “Baby Boom” generation starting to retire, there is even more pressure on Medicare’s costs.
Source: capoliticalnews.com

Obama v. Ryan on controlling federal Medicare spending

Softdude, everybody that see’s the numerous post that you blog on all msnbc blogs that have anything to do politics see’s that you are just a democrat pundit in sheeps skin. You better wake up to reality that this country is BROKE. The insurance industry stands to make billions on the Obama Health Care Law. Take a look at his donor list. You will see that the insurance industry big boys account for 14% of Obama’s reelection monies. At what point do you believe that people should start taking care of themselves instead of relying on others. Is it really right to take from some to give to others ? If you believe this nonsense then let me know where you live and I will come over and just take what I want. Your democrats have opened the flood gates of socialism years ago and now we/you are going to pay the price. Your democratic/socialistic ideas do work in some countries but very few. And every one of those countries do not have a military to defend themselves and of the ones that do, their military accounts for such a small number that they would not even be able to defend themselves. Socialism will never work in our society. So lets bash capitalism. Yeah lets go after those guys. Why should they have something I want. I want it too mentality. Your democrats have ruined this country. Our financial situation is due to the frand/dodd amendment which gives everybody with the american dream a home. Well that worked well. Stop living in a utopia state of mind and you might be able to start seeing a reality.
Source: msn.com

Is Medicare cost growth slowing down?

Modern Principles of Economics Launching The Innovation Renaissance The Great Stagnation: How America Ate All the Low-Hanging Fruit of Modern History, Got Sick, and Will(Eventually) Feel Better Create Your Own Economy: The Path to Prosperity in a Disordered World Discover Your Inner Economist Good and Plenty: The Creative Successes of American Arts Funding Judge and Jury: American Tort Law on Trial Markets and Cultural Voices: Liberty vs. Power in the Lives of Mexican Amate Painters (Economics, Cognition, and Society) The Voluntary City: Choice, Community, and Civil Society (Economics, Cognition, and Society) Creative Destruction: How Globalization Is Changing the World’s Cultures Changing the Guard: Private Prisons and the Control of Crime What Price Fame? In Praise of Commercial Culture Entrepreneurial Economics: Bright Ideas from the Dismal Science
Source: marginalrevolution.com

Connecticut Medicare Costs Among Highest In Nation

Medicare payments can vary from hospital to hospital for many reasons, including the type of hospital, regional wages and salaries, the income mix and sickness of patients and the level of intensity with which patients are treated. Some hospitals may order more tests, have patients see more doctors or make higher use of intensive-care beds. Costs could also rise if subpar care extends a hospital stay or forces additional tests.
Source: ctwatchdog.com

why we can’t afford medicare as is

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2..Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481But recent work by the Urban Institute calculates the amount of the transfer to an average retiree. An American man retiring in 2011 could expect to receive Medicare benefits worth $170,000 (in 2011 dollars). If he had worked from age 22 at the average U.S. wage each year, he would have paid Medicare taxes (plus interest) worth $60,000 (also in 2011 dollars). So the average male worker retiring in 2011 will receive benefits worth almost three times what he paid in. And the transfer to that retiree will be $110,000 from younger Americans, perhaps including his grandchildren.
Source: attackmachine.com

Video: Whitehouse: Cuts to Social Security and Medicare Benefits Have No Place in Debt Talks

GOP Doctors Caucus Releases “A Doctors’ Note on Medicare”

5.   During His Entire Presidency, President Obama Has Not Offered a Plan to Save Medicare. For the sixth consecutive year (2007 through 2012), the Medicare Trustees were required by the Social Security Act to issue a Medicare funding warning in their an nual report. While a funding warning has been issued or in place every year the President has been in office, the administration continues to defy its obligation under the law to submit a legislative proposal to Congress in response to warnings issued by the Trustees. The President points to the new health care law as his response to the Medicare trigger, but the Trustees have issued funding warnings in all three reports since the health care law was enacted (2010 through 2012). In the summary of the report the Trustees clearly explain: “The warning directs the President to submit proposed legislation within 15 days of the next budget submission to respond to the warning and requires Congress t o consider the proposal on an expedited basis. To date, elected officials have not enacted legislation responding to these funding warnings which have been included in the five previous reports.”
Source: amac.us

Daily Kos: Clyburn: Biden negotiators ‘are not going to reduce [Medicare] benefits at all’

Now, knowing that the V A S T majority of revenue going into the fed comes from taxes and seeing that it seems like Clyburn (and most certainly the other dems) are willing to accept more tax cuts for corporations…where’s this revenue gonna come from they want to see?  I mean, so many of those making over $250,000 are owners of businesses/corporations.  To me, it sounds like Clyburn is giving a green light to increase taxes on the middle class…that huge element out there that is defined by just so many different people in just so many different ways.  Actually, it’s you and me…”Average Joe”, so to speak.
Source: dailykos.com

2011 Medicare Supplement Coverage: Medigap Plan Numbers A

In 2011, Plans K, L and M do not cover 100% of all benefits at all times. Plan K covers 50% of Part B coinsurance/copayments, blood, Part A coinsurance/copayments for hospice care, coinsurance for skilled nursing facility care and the Part A deductible. Plan L gives 75% coverage for these benefits. Both of these options have yearly out-of-pocket limits of $4,640 (K) and $2,320 (L). Once you meet these limits (and any annual Part B deductible), plans will pay 100% for the rest of the year. Plan M restricts coverage of the Part A deductible to 50%.
Source: suite101.com

What’s At Stake For Medicare Beneficiaries In Supreme Court Decision

If the health law goes, so will the funding and authorization for a handful of Medicare experiments aimed at reducing health care costs by better organizing and improving the quality of care. The law includes a pilot project to bundle payments to medical providers so that a single check would cover an episode of care, such as a hip replacement. Other programs are set to test value-based purchasing for medical providers and accountable care organizations.
Source: kaiserhealthnews.org

More than 30 million with Medicare used free preventive services in 2011

The report discussing Medicare preventive services found that more than 25.7 million Americans in traditional Medicare received free preventive services in 2011. The report also looked at Medicare Advantage plans and found that 9.3 million Americans – 97 percent of those in individual Medicare Advantage plans – were enrolled in a plan that offered free preventive services.  Assuming that people in Medicare Advantage plans utilized preventive services at the same rate as those with traditional Medicare, an estimated 32.5 million people benefited from Medicare’s coverage of prevention with no cost sharing.
Source: medicare.gov

Improving Medicare In 2011

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Source: buzzblogga.com

Many Years Young: AMA moving to change Medicare financing

Currently, the Medicare program is a defined benefit program which guarantees enrollees receive a package of healthcare benefits. The defined contribution — or premium support program — has Medicare pay beneficiaries a finite amount of money to purchase health insurance privately on their own.
Source: manyyearsyoung.com

Bankersconseco.com Estimated Value $1,036.80 USD

Posted by:  :  Category: Medicare

"Associate yourself with men of good quality if you esteem your own reputation, for 'tis better to be alone than in bad company." ~ George Washington. by eyewashdesign: A. GoldenDomain Name………. bankersconseco.com Creation Date…….. 2006-02-15 Registration Date…. 2011-09-19 Expiry Date………. 2013-02-16 Organisation Name…. CNO Services LLC. Organisation Address. 11825 N. Pennsylvania Street Organisation Address. Organisation Address. Carmel Organisation Address. 46032 Organisation Address. IN Organisation Address. UNITED STATES Admin Name……….. Team . Admin Address…….. 11825 N. Pennsylvania Street Admin Address…….. Admin Address…….. Carmel Admin Address…….. 46032 Admin Address…….. IN Admin Address…….. UNITED STATES Admin Email………. cnt@cnoinc.com Admin Phone………. +1.31781761 Admin Fax………… Tech Name………… Team . Tech Address……… 11825 N. Pennsylvania Street Tech Address……… Tech Address……… Carmel Tech Address……… 46032 Tech Address……… IN Tech Address……… UNITED STATES Tech Email……….. cnt@cnoinc.com Tech Phone……….. +1.31781761 Tech Fax…………. Name Server………. EXTDNS1.BANKLIFE.COM Name Server………. NS2.CONSECO.COM Name Server………. NS1.CONSECO.COM
Source: widestat.com

Video: Broken Promises: House Republicans Vote to End Medicare

Medicare State Operations Manual

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Source: monsieurbome.com

Medicare Claims Processing Manual

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Source: el-centro.net

Job Vacancy : IT Analyst for Medicare D Website and Portal applications at Pathways in Arizona, US

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Source: serialwork.com

Premier Insurance & Financial Group, LLC Gets a New Website Design

After spending a few weeks with the owner, I really got a good feel for the company beliefs and goals. We know all about the buzz going around over health care, companies being greedy, etc. This company was about as good-hearted as it gets folks. Andrew and his team of friendly agents educate potential clients and spend the time necessary to make sure customers have an insurance plan they can afford, while getting coverage they can feel good about.
Source: insightfuldevelopment.com

Initiative Focuses on Improving Transparency and Access to CMS Data

Medicare Geographic Variation Trend Data: This unique data set leverages almost five billion Medicare claims over a four-year period (2007-2010) into an easy-to-use data resource at the state and Hospital Referral Region (HRR) levels and includes numerous variables, such as demographics, spending, utilization and quality of care.  Users with varying levels of experience with Medicare data will be able to quickly understand and adapt the data to specific projects and assess and compare their state’s or HRR’s Medicare performance against other areas or the national average.  The data is on the Institute of Medicine website and will be available in the Health Indicators Warehouse by mid-summer 2012.   
Source: wolterskluwerlb.com

Senior Health Direct Offers Help Online With Medicare Supplement Insurance Plans and Rates

Why is Senior Health Direct essential to making a Medicare supplement insurance plan decision? The insurance plan that you choose to Medicare will be responsible for helping you with your medical bills and medication costs. As an elderly member of society, you are more likely to have higher medical bills and higher medication costs. Senior citizens usually consume more pills on average than someone younger. So not only will your medications cost more, but you probably take more medications as well. As someone who has a great need for a medical insurance plan, you want to make an informed decision when you decide on the plan you are going to choose. If you were to choose the wrong plan, it could cost you hundreds or potentially even thousands of dollars. Choosing the plan that fits your situation better will save you money and be beneficial to your health in the long run.
Source: submissionsvalley.com

Second Guessing Medicare’s Star Rating System

But insurance executives made them a priority after the 2010 healthcare law attached large financial rewards to them. The first round of ratings last fall showed that most have a long way to go. Only 12 earned a perfect score of five, on a scale of one to five, and about 9 percent were below average. The majority received scores of three, or three and a half stars– enough to get them bonus money this year. After 2014, plans will need four or five stars to get bonuses. And if they have fewer than three stars, they won’t be allowed to enroll beneficiaries through Medicare’s website, and risk being booted from Medicare altogether, according to HHS spokesman Tony Salters. 
Source: kaiserhealthnews.org

Tell Americans the real cost of Medicare — Opinion — Bangor Daily News — BDN Maine

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Source: bangordailynews.com

Overhaul of Medicare websites focuses on transparency, usability

CGI Federal, an information technology solutions provider, on Tuesday announced it had received a five-year, $73.2 million contract to continue improving Medicare.gov, cms.hhs.gov and MyMedicare.gov. The three websites provide Medicare information to 44 million beneficiaries in addition to health care providers and caregivers.
Source: nextgov.com