Medicare disability eligibility

Posted by:  :  Category: Medicare

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Source: fluxfeatures.com

Video: Continued Medicare Eligibility and Work Incentives

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

SSD benefits don’t continue for life, Part 1 of 2

Medical improvement. Once you begin receiving SSD benefits, the SSA will periodically review your case to make sure you are still disabled and unable to work. You will be responsible for notifying the SSA if you get better, return to work or feel you are able to work because of advances in treating your disability. The SSA reviews most cases for continued eligibility either every three or every seven years.
Source: newyorkdisabilityblog.com

The Complication of Kaiser Permanente Medicare Eligibility

With State Farm homeowners insurance, you can rest assured that your beloved house and valuable items are well protected. If disaster strikes, the company will give funds for you to repair or rebuild the house. Besides, State Farm can recommend a list of participating contractors for the repair/rebuilding and guarantee their work for 5 years. Other additional costs incurred during the process are also covered. Read more
Source: insurance-how-to.com

How to get or keep TennCare for your adult child with disabilities

These adult children are called DAC or CDB (childhood disability beneficiaries). The Department of Human Services (DHS) decides DAC eligibility for TennCare/Medicaid. Apply for your child to get TennCare through the DAC category if your child gets a letter (notice) that says her TennCare will end unless she is eligible for TennCare in another category.  The letter should include an application (called the Request for Information or RFI).  DHS will need this information to see if your child is still eligible for TennCare.  You will need to verify this information every year, if not more.  You have 10 days to tell DHS if  your child’s circumstances change (for example income, resources, address).
Source: tnjustice.org

Medicare Eligibility Disability

Medicare is a kind of wellbeing insurance coverage obtainable for individuals above 65 or individuals below the age of 65 with specific disabilities, this kind of as Finish-Stage Renal Illness, which benefits in long term kidney failure that needs either a kidney transplant or dialysis. If you have Medicare Component A or Component B, you are eligible to also purchase Medigap insurance coverage. Medicare Component A is Hospital Insurance, and assists to cover inpatient care in hospitals as effectively as skilled nursing facilities, hospice, or property wellbeing care. Component B is medical insurance coverage, and assists cover doctors’ and other wellbeing care providers’ services, outpatient care from hospitals, and preventative services to support preserve your wellbeing or to quit specific illnesses from getting worse. There are also Component C and Component D coverage. Component C is frequently known as Medicare Advantage Plans, and they cover prescription drugs and other rewards. Component D is the Medicare Prescription Drug Coverage, which assists to cover the fees of prescription drugs and may support reduce prescription drug fees and support safeguard against increased fees. These Component D plans are run by Medicare-authorized personal insurance coverage companies.
Source: virginiamedicarepros.com

States need better Medicare data to fight Medicaid fraud

Billing for dual-eligible beneficiaries is vulnerable particularly to fraud and abuse, largely because their care is funded separately. For example, ambulance companies charge Medicaid to transport elders and adults with disabilities to the emergency room, and then Medicare foots their hospital bills. As a result, ambulance company owners and operators can bill Medicare for millions of dollars for ambulance rides that are medically unnecessary or never occur.
Source: fiercehealthcare.com

MA EOHHS, CMS Request Bids for MA Demonstration Project to Serve Dual

On June 18, 2012, a joint request for bids was issued by the Massachusetts Executive Office of Health and Human Services and Centers for Medicare & Medicaid Services (CMS) for Integrated Care Organizations (ICOs) to participate in an 1115A Demonstration program to integrate the delivery of Medicare and Medicaid services for adults ages 21 to 64 who are eligible for both programs (“Dual Eligibles”).  According to the procurement announcement, “ICOs procured under this Request for Responses (RFR) will be accountable for the delivery and management of all covered medical, Behavioral Health, and Long-Term Services and Supports (LTSS) for their Enrollees”.  The purpose of this three-year Duals Demonstration is to improve quality of care and reduce health disparities, improve health and functional outcomes, and contain costs for the Dual Eligible members. 
Source: publicconsultinggroup.com

Health Coverage and Disability

I just looked at your profile. It says you had a long work history as a LPN. You are probably eligible for SSDI and Medicare. You don’t have to do anything to sign up for it. After you are approved for SSDI, you will receive two letters from the SSA. One is called an approval letter. This letter will basically tell you that you were approved for SSDI and explain why they found you disabled. You will then get a second letter called A Notification of Award letter. This letter will explain your benefits in detail. (e.g., how much your monthly payments will be, when you will start receiving medicare, CDR date, backpay award amount, benefits start entitlement date, etc.)
Source: mdjunction.com

Medicare and Social Security Disability

Administrative law Judge ALJ application attorney benefits Cavey & Barrett Cavey and Barret Cavey and Barrett claim claims claims process Disability disability benefits experts Florida Grids Hurdle 5: Other work law lawyer lawyers light work listing of impairments medium work Nancy Cavey Request for Reconsideration residual functional capacity RFC sedentary work Sharon Barrett Social Security Social Security Administration Social Security benefits Social Security Disability social security disability attorney Social Security disability benefits social security disability claim social security disability lawyer social security lawyer social security regulations SSA St. Petersburg Supplemental Security Income Tampa Tampa Bay www.caveylaw.com
Source: socialsecuritydisabilitybenefitslawblog.com

MedicareIsSimple: MedPAC Reviews Blending Medicare and Medicaid

MedPAC devotes five pages of its report to comments on the demonstration initiatives currently underway under the auspices of the Medicare and Medicaid Coordination Office (MMCO) of the Centers for Medicare & Medicaid Services (CMS) to integrate service delivery and financing of Medicare and Medicaid services for dual eligibles.  After describing the initiatives and the authority for them, MedPAC raises issues and concerns as falling into three areas: the large proposed scope of the demonstrations, the standards for the plans that participate in the capitated (per-member-per-month fee for covered services) models and passive enrollment.  It notes that these characteristics could have negative effects on dually eligible beneficiaries’ access to and quality of care.
Source: blogspot.com

MedPAC Recommends Higher Upfront Costs for Medicare Beneficiaries

Posted by:  :  Category: Medicare

Judy by Thomas HawkThe 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: California Medicare Advantage

Daily Kos: Medicare for All California Bus Tour 2012 Kicks Off Tuesday, June 19!

No matter the outcome of the U.S. Supreme Court ruling on the Affordable Care Act, the grassroots fight to expand Medicare to all Americans forges ahead. Starting Tuesday, the California Nurses Association, National Nurses United and Campaign for a Healthy California are launching a statewide bus tour to conduct free health screenings and town halls, and to educate the public about how Medicare for all is less expensive and more equitable than our current fragmented, profit-driven healthcare system. The tour will run from June 19 to July 12 and will stop in 18 cities across California. The schedule is as follows:
Source: dailykos.com

Medicare for All California Bus Tour 2012 Kicks Off Tuesday, June 19!

No matter the outcome of the U.S. Supreme Court ruling on the Affordable Care Act, the grassroots fight to expand Medicare to all Americans forges ahead. Starting Tuesday, the California Nurses Association, National Nurses United and Campaign for a Healthy California are launching a bus tour to conduct free health screenings and town halls, and to educate the public about how Medicare for all is less expensive and more equitable than our current fragmented, profit-driven healthcare system. The tour will run from June 19 to July 12 and will stop in 18 cities across California. The schedule is as follows:
Source: californiaonecare.org

Medicare Insurance California » Yapperz.com

It is a particular person who is accountable to reviewing application employing actuarial tables. Actuarial tables are statistics done by the insurance companies, hospitals, medical professionals, scientists that predict the value of insuring some a single with a particular health-related historical past. Some states like New York, New Jersey and Washington demand insurance policy organizations to insure everyone. That is to say, if the open enrollment window of time has been missed, then health care underwriting may be required and individuals with a disability might not qualify for complete protection. Those who are taken into disability, but coated underneath an employer sponsored plan can later on apply for Medigap insurance coverage when they separate from support. California Medicare Anniversary or Birthday Rule California is extremely special in that it provides a annually anniversary when Medicare beneficiaries can swap to like protection. Quite few states provide this gain. The annually anniversary is also referred to as the “birthday rule” and encompasses the thirty day period of the insureds birthday. Throughout this one thirty day period window, buyers can change Medicare insurance policy strategies so long as they are not upgrading to far more complete coverage. If an improve is wanted, then health-related underwriting will be necessary. Like coverage basically indicates the very same (or considerably less) Medicare supplement insurance policies protection. For case in point, customers on Prepare F can buy a new Strategy F from a competing insurance firm in purchase to decrease their month-to-month rates. This may possibly be carried out each couple of years when Medicare health supplement rates have had an above regular top quality increase. In summary, citizens of CA who are suitable for Medicare have several possibilities offered to them when searching for a Medicare supplement insurance program. It may be smart to perform with an impartial agent who can supply quotes from several competing companies. This can help maintain regular monthly prices minimal at inception as nicely as in the foreseeable future. Consumers possessing Medigap insurance policy over or underneath age sixty five must examine all of their possibilities in the course of their birthday thirty day period. This annually anniversary can be used to acquire like coverage at a reduced price tag, hence preserving lower rates every year. Medicare is a wellbeing insurance policies plan that is presented by the federal government and is managed by the Centers for Medicare and Medicaid Solutions. The eligibility standards for a man or woman to implement for Medicare Insurance coverage plan are as follows: 1. Getting sixty five a long time aged or a lot more, two. Being sixty five several years and obtaining some kind of imparity or imparities, 3. Possessing conclude stage renal condition, necessitating kidney transplant or dialysis remedy method. Medicare offers a few benefits to the customers. They are categorized in 4 unique teams. Let us get a brief appear at the various types of rewards that Medicare has to offer you to men and women. Element A gives the Hospital Insurance policy. It aids in covering for inpatient treatment in hospitals and experienced nursing amenities. Component B gives the Health care Insurance policies. This classification covers healthcare amenities to people who are undergoing remedy techniques outside hospitals, providers from medical professionals and physicians and particular occupational therapies. medicare insurance california, medicare plans california, california medicare plans
Source: yapperz.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

$19 million HHS grant for new approach to treating chronic illness in Medicare patients

The Intensive Outpatient Care Program will bring in specially trained care managers and place them in newly established Ambulatory Intensive Care Units, or A-ICUs, where they will build close relationships with patients with medically complex conditions. By promoting more consistent, personalized communication and care for these targeted patients, PBGH and its partners hope to prevent emergency room visits, reduce avoidable hospitalizations, and mitigate or eliminate complications.
Source: stanford.edu

'Observation stays' for Medicare patients create coverage problems

Jackson, the Santa Rosa hospital patient, joined a national class-action lawsuit in April against Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, who oversees Medicare. Filed by the Center for Medicare Advocacy and the National Senior Citizens Law Center, the suit claims that Medicare recipients have been harmed by the use of hospital observation status because it results in the denial of one type of Medicare coverage, which then triggers out-of-pocket costs for prescription drugs and post-hospitalization care in skilled nursing facilities.
Source: californiawatch.org

Daily Kos: Standing Room Only Crowd Greets San Diego Opening of Medicare for All Tour, Next Stop Santa Ana

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Source: dailykos.com

CMS, Sebelius Tout Medicare Benefits in Health Reform Law

During the first five months of 2012, 14.3 million Medicare beneficiaries took advantage of a federal health reform law provision that ensures access to preventive health care services without a copayment or deductible, according to a recent announcement by CMS. Meanwhile, HHS Secretary Kathleen Sebelius recently promoted the law’s role in strengthening Medicare and criticized GOP proposals that would privatize the program.
Source: californiahealthline.org

Medicare And California Sales Tax: An Analysis

There’s a rumor going around that a 3.8 percent sales tax will be applied to home sales in order to fund Medicare under the Affordable Care Act. Although that rumor is patently false, there has always been sales tax associated with certain Medicare-covered transactions. Specifically, if your firm sells medical supplies and has been treating sales under Medicare Part B (Medicare B) as exempt from California sales tax, it is sitting on a fiscal time bomb. Since the program began, the California State Board of Equalization (Board) has been regularly assessing sales tax on Medicare B transactions in its audits. Even businesses reporting correctly are generally confused about why sales under Medicare B are treated differently from sales under Part A. This article will discuss the different treatments and explain how sales tax applies to Medicare receipts in general. Some sales under Medicare are always exempt, simply because the products involved fall under the general California exemption for prescription medicines. However, such transactions are outside the scope of this article, which solely addresses products ordinarily considered taxable when sold to patients. (Medical services are exempt from sales taxes in general, in California and nearly everywhere else.) In order for an otherwise taxable product to be exempted from sales tax under Medicare, the product must be considered sold to the United States government rather than to the patient. Sales to the U.S. government are exempt from sales tax for Constitutional reasons. This exemption has been codified in California Revenue and Taxation Code Section 6381 and is further delineated by Sales and Use Tax Regulation 1614. Whether a Medicare transaction is considered an exempt sale to the U.S. government or a taxable sale to an individual patient depends on whether the sale falls under Medicare Part A or Part B. All sales under Part A are regarded as exempt sales to the U.S. government. Sales under Part B are considered made directly to the patient, and they are taxable unless some other exemption applies (such as the exemption for sales for resale or sales in interstate commerce). Differences between Parts A and B that give rise to this distinction are discussed below. Financing and Participation: Medicare A is financed through payroll withholding and self-employment taxes. Participation is mandatory for anyone within the Social Security system. Most people who pay the taxes that fund Medicare A are under retirement age and not yet eligible for Medicare coverage. Medicare B is financed partly through monthly premiums paid by those covered under the program. The rest of the financing comes from general funds of the federal government. Anyone covered by Part A is eligible for Part B, but participation in Part B is optional. Once participants enroll in the Medicare B program, they are required to pay the monthly premiums, generally through withholding from their Social Security checks. Cost to Participants: Medicare A is funded entirely through self-employment taxes and the Medicare percentage withheld from employee paychecks and matched by employers. There are no costs specific to participants. Medicare B is charged directly to each participant, generally by a monthly deduction from the participant’s Social Security check. The monthly costs are considered medical insurance premiums and may be claimed as an itemized deduction on the participant’s income tax return. Payment of Claims: Medicare A payments are made directly to providers of medical products or services under a procedure mandated by federal law. Since the law requires direct payment by the U.S. government to providers, medical supplies sold by providers under Medicare A are considered sold to the U.S. Government. Medicare B payments may be made either to providers or patients. If a provider has agreed to accept assignment of Medicare benefits (which essentially constitutes agreement to accept Medicare’s version of “reasonable charges”), the provider prepares and submits a claim form and is reimbursed directly by the insurer acting on behalf of the U.S. government. The patient pays only the deductible, co-insurance or non-allowable costs. If the patient uses a provider who has not agreed to accept assignment of benefits, the patient pays the entire charge and then files a claim for reimbursement. Any such reimbursement goes directly to the patient. Under Medicare B, payments are considered reimbursements of charges to the patient, whether the payments go directly to the patient or to the provider on the patient’s behalf. The U.S. Government’s Position: Medicare A does not allow reimbursement for sales taxes charged on medical supplies, based on the theory that providers are selling to the U.S. government and the sales are therefore exempt. Medicare B has built sales taxes into its calculations of “reasonable charges,” as stated in Medicare Carriers Manual section 5213. In accepting sales taxes as allowable charges under Medicare B, the U.S. Department of Health and Human Services has taken the position that sales under the program are not sales to the U.S. government. Sales Tax Effect: Medicare A payments are made directly by the U.S. government to providers under federal law, which theoretically results in sales to the United States as discussed above. Medicare B payments may be made either directly to patients or to providers for the benefit of patients, depending on each patient’s choice of provider. The patient’s ability to make this choice has been interpreted to mean that payments under Medicare B are simply reimbursements to patients. Under this “patient reimbursement” theory, any sale by the provider under Medicare B is made to the patient rather than the United States, regardless of which party prepares the claim form or receives the reimbursement check. Both the U.S. Department of Health and Human Services and the State Board of Equalization have accepted these legal interpretations, and it appears unlikely that an effort to re-characterize sales under Medicare B as sales to the U.S. government would prevail. If the law is ever changed to make direct payments to providers mandatory under Part B, the application of sales tax could well change with it. Although subject to tax, amounts claimed for 80 percent reimbursement under Medicare B are considered to include applicable sales taxes, because the Medicare Carriers Manual defines “reasonable charges” as including such taxes. Accordingly, when providers report their taxable sales to the Board, they are entitled to claim a deduction for sales taxes included in Medicare B reimbursements. Conclusion: The theoretical justification for distinguishing sales under Medicare A from sales under Medicare B may not be entirely logical, but compliance with the Board of Equalization’s interpretation is the only prudent approach. If you have been treating all sales under Medicare B as exempt, you should now begin reporting those sales as you would report sales to any private party. But what about earlier periods? If your firm is selected for a Board audit, you undoubtedly will be billed for additional taxes for those periods. However, the amount of additional taxes may be subject to adjustment. This is true not only for Medicare sales but for any area where tax changes are recommended by Board auditors. Audits incorporate assumptions and tests that often can be modified and occasionally can be overcome. Always remember that you have the right to review any tax auditor’s working papers or have a sales tax expert review the audit on your behalf. Exercising that right will at least bring you peace of mind. It might also result in significant tax savings.
Source: articlesnatch.com

Daily Kos: On the Road Again, Cancer Does Not Wait for Nine Robed Judges

The nurses care, though.  And that is why the bus tour through California is bringing the message of the only way we can begin to make our care truly be our care – Medicare for all for life.  Improved, expanded and providing a single standard of high quality care Medicare for all for life.  For all and without financial barrier.  That’s healthcare.  And that’s care that will help me and millions of others facing cancer or other illness and injuries know that we are the ones who are served by our healthcare system not any presidential candidate here or other politician or media giant.  Healthcare.  Not Supreme Court decision care.
Source: dailykos.com

Cahealthadvocates.org Estimated Value $5,400.00 USD

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:D15496525-LROR Domain Name:CAHEALTHADVOCATES.ORG Created On:17-Dec-1999 18:06:43 UTC Last Updated On:18-Dec-2011 01:30:29 UTC Expiration Date:17-Dec-2012 18:06:43 UTC Sponsoring Registrar:Domain.com, LLC (R1915-LROR) Status:OK Registrant ID:DOT-V413E9KP11NB Registrant Name:Jasmine Gutierrez Registrant Organization:California Health Advocates Registrant Street1:5380 Elvas Avenue, Suite 104 Registrant Street2: Registrant Street3: Registrant City:Sacramento Registrant State/Province:CA Registrant Postal Code:95819 Registrant Country:US Registrant Phone:+1.9162315110 Registrant Phone Ext.: Registrant FAX:+1.9162315114 Registrant FAX Ext.: Registrant Email:jsuo@cahealthadvocates.org Admin ID:DOT-T0GQBRI8N2SC Admin Name:Elaine Wong Eakin Admin Organization:California Health Advocates Admin Street1:5380 Elvas Avenue, Suite 104 Admin Street2: Admin Street3: Admin City:Sacramento Admin State/Province:CA Admin Postal Code:95819 Admin Country:US Admin Phone:+1.9162315112 Admin Phone Ext.: Admin FAX:+1.9162315114 Admin FAX Ext.: Admin Email:eweakin@cahealthadvocates.org Tech ID:DOT-NK9L96M4631P Tech Name:Matt Jalbert Tech Organization:California Health Advocates Tech Street1:5380 Elvas Avenue, Suite 104 Tech Street2: Tech Street3: Tech City:Sacramento Tech State/Province:CA Tech Postal Code:95819 Tech Country:US Tech Phone:+1.4156477275 Tech Phone Ext.: Tech FAX:+1.9162315114 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

States need better Medicare data to fight Medicaid fraud

Posted by:  :  Category: Medicare

Sign: Hands Off Social Security Medicare Medicaid www.saynocuts.org by Fifth World ArtBilling for dual-eligible beneficiaries is vulnerable particularly to fraud and abuse, largely because their care is funded separately. For example, ambulance companies charge Medicaid to transport elders and adults with disabilities to the emergency room, and then Medicare foots their hospital bills. As a result, ambulance company owners and operators can bill Medicare for millions of dollars for ambulance rides that are medically unnecessary or never occur.
Source: fiercehealthcare.com

Video: Medicare and Medicaid: What’s it all mean?

Using Medicare Data To Curb Medicaid Fraud

Stateline:  States Seek Medicare Data To Keep Fraudulent Providers Out Of Medicaid The federal government says it has ambitious projects underway to make Medicare data more useful to states, and to help states share information about their respective Medicaid programs. The problem, federal officials say, is that Medicare, which provides health coverage for seniors, is organized very differently from Medicaid. And each state organizes its Medicaid program in a different way, making data matches difficult (Vestal, 6/21).
Source: kaiserhealthnews.org

More than 100,000 health care providers paid for using electronic health records

“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,” said Acting Administrator Tavenner. “Not only have state Medicaid programs, public health departments, and many other stakeholders given their support to the Medicare and Medicaid EHR Incentive Programs, but numerous health professionals and hospitals have recognized the potential of EHRs to provide better patient care, cut down on paperwork, and eliminate duplicate screenings and tests.” Read more
Source: medicareindex.com

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

Romney Lies About Medicare/Medicaid Change Of Address Form

There were periods during my government service when the business-does-it-this-way was fashionable.  Public private partnership (acronym PPP) became popular.  At some point what tended to happen or be realized was the understanding that the public service does not have, cannot have the same “bottom line” as a for-profit organization.  Wall Street exemplifies the outsize for-profit situation these days…I do not think most people want the government to emulate that value system when it comes to exercising government authority.  And, frankly, when you look at it, the basic myth at bottom of the business school takeaway about efficiency has a lot of flaws…not the least of which is that large, major corporations with their overpayment of failing executives and with their taking-care-of-the-top first motif are the opposite of even the the narrowest definition of “efficiency.”  
Source: talkleft.com

Booman Tribune ~ A Progressive Community

During “active investigations” regarding potential criminal activity, fraud, or theft regarding a prescribed controlled substance, a law enforcement agency may request a patient’s prescription information through the prescription drug monitoring program director. Proponents of the prescription database claim that it will be used as a tool to flag potential problems with prescriptions and alert medical staff rather than as a direct method of generating criminal charges. Supporters say it will really serve to help doctors and pharmacists who “suspect” a problem by allowing them to assess whether or not a patient is “shopping” for the prescriptions at multiple locations. On the other hand, the potential for law enforcement to comb the database during a “pending investigation” seems quite likely. In the past, such an investigation may have required a search warrant authorized by an impartial judge or at least a lawfully issued subpoena. Now, the information is available simply upon request to a bureaucratic agency.
Source: boomantribune.com

Reducing Potentially Avoidable Hospitalizations for Patients Receiving Medicare and Medicaid Could Save Millions

Individuals in Medicaid home and community-based services waiver programs had higher rates of total hospitalizations than Medicaid nursing home patients, which reflects the complex medical, functional and supportive service needs of this community-dwelling, long-term care population. The study also found that hospitalization rates varied widely from state to state. African Americans were hospitalized more frequently and at a higher cost than white patients from all settings, and Hispanics were hospitalized more frequently from nursing facility stays and less frequently from the community.
Source: newswise.com

New to Medicare? Beware of penalties

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 marsmet481Penalties?  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

Video: How To Enroll In Medicare | Redlands CA, Yucaipa, Banning CA

Daily Kos: Americans enrolled in the ACA Pre

The Affordable Care Act remains the law of the land and we are continuing to carefully and effectively implement this law to improve the health of all Americans. The Affordable Care Act created the Pre-Existing Condition Insurance Plan, which is available to people who are U.S. citizens or residing here legally, have a pre-existing condition or have been denied health coverage because of their health condition, and have been without health coverage for at least 6 months. This program will be available until 2014. In 2014, you will have access to affordable health insurance choices through a new competitive marketplace called an Exchange. An Exchange will provide a transparent and competitive insurance marketplace where individuals and small businesses can buy affordable and qualified health benefit plans. Exchanges will offer you a choice of health plans that meet certain benefits and cost standards. In addition, starting in 2014, it will be against the law for an insurance company to discriminate against you based on a pre-existing condition. We recognize how important the Pre-Existing Condition Insurance Plan is to you and will let you know if there are any changes that could affect your coverage.
Source: dailykos.com

Romney, Now 65, Won’t Enroll In Medicare

The Hill: Gingrich Ad: Romney ‘Can’t Beat Obama’ Because Of Health Care Mitt Romney “can’t beat Obama” because of the similarities in their healthcare laws, Republican presidential candidate Newt Gingrich said in a Web video Monday. Gingrich and former Sen. Rick Santorum (R-Pa.) have argued before that Romney won’t be able to draw a sharp contrast with President Obama on healthcare. The new ad, though, goes further than simply arguing that Gingrich would be stronger on the issue, and claims that Romney would lose a general-election match-up (Baker, 3/12).
Source: kaiserhealthnews.org

MedPAC Reviews Blending Medicare and Medicaid 

In 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

Practical Insights: Dealing with Medicare Part B and COBRA Coverage

Generally, the Socal Security Act provides that individuals may enroll in Medicare Part B (which covers doctors visits and other outpatient services) when they reach age 65. If they fail to do so during a seven-month initial enrollment period surrounding their 65th birthday, they can enroll during an annual “general enrollment” period that occurs each January 1- March 31, with coverage becoming effective the following July1, though they will incur a penalty in the form of permanently higher Part B premiums (10% increase for each year of available coverage that is foregone). However, actively employed individuals who have employer-provided health coverage can postpone signing up for Medicare Part B until after age 65. When they lose the employer-provided coverage or terminate employment, whichever happens first, they are then provided an eight-month “special enrollment period” (“SEP”) during which they can sign up for Medicare effective immediately and without penalty.
Source: fordharrison.com

Nine out of Ten Seniors Satisfied with Their Medigap Coverage

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Source: ahipcoverage.com

2012 Will Bring New Medicare Open Enrollment Period

Medicare will start with a two week time frame that begins on the first of October and extends to October 15th, this will allow you to see any changes to plans and rates for next year. A benefit to customers with this changes is that you get to take a little more time to begin analyzing the best option for your life. Start building the right plan for yourself by contacting your Medicare provider on October 15th and see if you have made the right decisions.
Source: medicare-benefits.com

Do you need to Enroll for Medicare of Illinois?

If you decide to keep your group health plan and are enrolled in Medicare Part A, then the employer’s plan pays first and Medicare is considered to be the secondary payer. This means if a group insurance policy doesn’t pay all of the expenses for s certain procedure or service then Medicare could cover a portion of the costs, all of them, or none at all. Group insurers aren’t allowed to offer Medigap (Medicare Supplement) insurance to actively-employed people unless the business has fewer than 20 employees or if you’re disabled, the company has less than 100 employees.
Source: abchealthplans.com

MedPAC Recommends Higher Upfront Costs for Medicare Beneficiaries

The 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

Consumer Complaint Reports

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSFor insurance agents wanting to take their pursuit of success to the next level, few things are more valuable than Medicare supplement leads. In a difficult economy, every advantage helps, and the right leads give agents a competitive advantage. ParasolLeads understands the importance of staying one step ahead of the competition and takes the danger of scam artists and lead generation services that offer deep discounts but deliver low quality leads out of the picture.
Source: consumer-complaintreport.com

Video: 090129 EMG Postal

Medicare Supplement Leads Are Trending Says Benepath.net CEO

Insurance agents know the value of Medicare supplements leads. They can turn a modest agency into a thriving business. “It’s not hard to sell Medicare supplement leads and with good reason,” says Clelland Green, RHU, CEO, and president of Benepath.net in Pennsylvania. “The next few years will see even more Americans become a part of the Grey Wave sweeping across the nation. These individuals will become eligible for Medicare and as a result, will need Medicare supplements to fill in any gaps in coverage. This is where an enterprising insurance agent comes in.” The modern way of sourcing business is to purchase Medicare supplement leads. For certain, the new way beats the old way of trying to sell Medicare supplements to every homeowner an agent could find, on the theory that anyone who owned a house could benefit from Medicare protection. Times have changed and so have the ratios for converting leads. “In the ‘olden’ days, every 10 Medicare supplement leads may cough up about three appointments and out of those three appointments, perhaps one sale. Cold calling, word-of-mouth referrals, direct mail and the like did return results, but it was a long, tough road to travel. Welcome to the 21st century and the luxury of one click Medicare supplement leads,” said Green. Today, insurance agents will grow their business best by buying pre-qualified Medicare supplement leads; leads that come in real time and have not been worked by anyone else. This is important to agents, because if the leads are not exclusive, they have lost any leverage they had to work the lead by the time they eventually get it. “The direct purchase of exclusive Medicare supplement leads is one of the smartest business moves an agent looking to expand their business can make,” added Green. “It offers them prospects fast, in real time and often results in a high conversion rate because they are dealing with people who ‘want’ the product.” Gone are the days of 50 to 60 hour work weeks of cold calling, setting up appointments, working leads the old-fashioned way, and not making much money. Buying Medicare supplement leads means the marketing has already been done, and the only thing that remains is to call or meet the potential client. Even though technology moves fast, the innovation of pre-qualified, exclusive insurance leads is a real plus to agents wanting to make their business successful. To learn more, visit http://www.benepath.net.
Source: sbwire.com

Part 3: 10 Things That Matter Most When Buying Insurance Leads

Some agents prefer shared leads because they are less expensive than so-called exclusive leads. If you are purchasing shared leads, ask the seller how many times the leads have been shared and with what types of businesses. Purchasing leads that have already made the rounds extensively in your niche or geographic location might not be a good use of your money.
Source: nextwavemarketingstrategies.com

Which is the best quality Medicare Supplement Leads?

Medicare is a (US) government sponsored health insurance scheme, for the provision of health insurance to senior citizens and other financially vulnerable groups. If you are a health insurance provider, and particularly a health insurance provider, or a medication vendor, and are keen for an easy – yet effective – way to get high quality health insurance or medication leads, then optimizing on Medicare leads is something you should seriously think about. But how, exactly, do you go about getting such Medicare leads?
Source: ezinemark.com

Medicare Is Already In Economic Trouble; Let’s Stop The Fraudulence activity

To be eligible for supplemental Medicare policy, it is required for you to enroll in part A and B of original health insurance policy. Either you can opt for these plans during open enrolling period or you can undergo medical screening and buy the policy individually. The supplemental Medicare plans in California are sold by private insurance companies which are allowed to offer 12 such standard plans. Each plan comes with different benefits though all the benefits cover under part A and B are also found in all these insurance plans (because they are part of basic health insurance plan). Those planning to enroll for supplemental Medicare policies in California should be aware there are some terms and conditions to participate in the same. If you have enrolled in Standalone Part D, you cannot continue to avail drug coverage. Whichever company in California you buy the supplemental Medicare plan from; the plans offer the same benefits though the premium may vary. Source: kaiserpermanentelocations.com
Source: medicaresupplementalco.com

Colonial penn medicare supplement

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Source: fluxfeatures.com

Nevada Medicare Part D Plans

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSAn enhanced formulary will include all the drugs on the basic formulary and then some. This type of formulary is often best for people with chronic conditions or those who require less common medications. The enhanced formulary will typically have a low or $0 deductible to off-set the higher premium.
Source: partdplanfinder.com

Video: Nevada Medicare- 1-800-643-7544

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

Richard Charles for US Senator Nevada: Did Dean Heller Vote to Cut Medicare?

Okay Karen, you have added to my list of adjectives for Republican strategies (or “strateegery”?) with “diabolical fiendish”… Great post! It is hard for folks to recognize that the whole Grover Norquist affiliation and ongoing allegiance practically guarantees six figure money from Koch Brothers and big oil. Remember, Amodei received bucks from Koch, Exxon and big mining… Has anyone else noticed how the oil industry has started their campaign via TV ads painting themselves as warm and cuddly? Has anyone also noticed that as Washoe County has “battleground” fame now, OUR oil prices are a lot HIGHER than other areas? You see, high oil prices get blamed on a president (the president has the price stamper right there at his desk in the oval office) and the oil companies would add more PROFITS in a big big way with a Romney win. The oil companies humongous profits under Obama are just not enough… ah, greed – it’s alive and well across the fruited plain.
Source: blogspot.com

Medicare Supplement Plans In Nevada, Colorado, as well as Utah

Usually the healthier the state the lower the levels. Every one of the of these states boast a good wellness rating. Whenever a Medicare Supplement Company has lower wellness claims they have lower costs which they usually pass along to the consumer since lower rate for there plans. Really these companies can look in many years last to test to determine there future costs for claims, once they see that in years last claims costs have been comparably lower than different states they can keep prices lower because of which. All these rocky mountain area states thus tend to be benefiting from a healthy life style, All of these states have a lot of outdoor activities which aide in keeping a great wellness rating reviews on Capsiplex.
Source: wordpress.com

Nevada State Health Insurance Assistance Program (SHIP) advises Seniors in Medicare enrollment

The Nevada State Health Insurance Assistance Program (SHIP), a federally funded statewide network of volunteers offering information, counseling and assistance to Medicare beneficiaries in Nevada at no charge, will be available this fall to assist Medicare recipients in evaluating their current Part D prescription drug plans and adjusting these plans as necessary. Once a year, from Nov. 15 to Dec. 31, Medicare beneficiaries can change their prescription drug plans, and SHIP volunteers are available for one-on-one assistance and counseling to advise seniors regarding their care options. “Many seniors have tight, fixed-income budgets and making the right decisions when it comes to their Medicare programs can make or break their finances for the entire year,” said Christine Caufield, SHIP program coordinator. “There could potentially be some serious ramifications if Medicare recipients do not review their current drug plan and ensure they are using the correct option for their budget.” Prescription plan prices can fluctuate yearly anywhere from $10 to $100 per month and prescription availability can also change annually. In 2010, there will be 46 Medicare Prescription Drug Plans (PDPs) available to Medicare beneficiaries. “With 84 percent of Medicare recipients having prescription drug coverage, the free consultation offered by our SHIP volunteers is applicable to the majority of northern Nevada’s seniors receiving Medicare,” said Caufield. To receive a free consultation regarding Medicare, beneficiaries and advocates can contact the northern Nevada SHIP at 1-877-328-2205, or by emailing nevadashiphelp@gmail.com from now until Dec. 31. Volunteers are also available in many senior centers in northern Nevada. To locate the SHIP representative nearest you, call 1-877-328-2205. Beyond a consultation specific to a Medicare program, SHIP volunteers are also available throughout the year to assist with any Medicare questions, appeals, prescription plans and more. The northern Nevada SHIP is administered by Access to Healthcare Network (AHN), an innovative Nevada-based nonprofit medical discount plan offering low-cost healthcare services to uninsured Nevadans. The northern Nevada SHIP is also funded by the State of Nevada Aging and Disability Services Division (ADSD) set of programs and services, which represents Nevadans 60 years and older.
Source: nzhealthinsurance.com

Elder Care in Buckhead, GA

Posted by:  :  Category: Medicare

Save Medicare --Jim Parker by faulYou may be eligible for benefits through Medicaid. Medicaid programs vary by state, so you will need to check with your state Medicaid office for more information. • Eligibility: People with disabilities are eligible in every state. In some states, people with disabilities qualify automatically if they get Supplemental Security Income (SSI) benefits. In other states you may qualify depending on your income and resources (financial assets). • “Buy-Ins”: Some states also have “buy-in” programs that allow people with disabilities with incomes above regular Medicaid limits to enroll in the Medicaid program. Children with disabilities can qualify for Medicaid either under these disability-related rules, or based on family income. • Expansion in 2014. Starting in 2014, the Affordable Care Act will expand the Medicaid program to cover people under age 65, including people with disabilities, with income of about $15,000 for a single individual (higher incomes for couples and families with children). • Help for disabled people: This expansion helps low-income adults who have disabilities but don’t meet the disability requirements of the SSI program. The expansion also helps those whose income is above their state’s current eligibility levels.
Source: atlantahomecaretoday.com

Video: Georgia Health Insurance Medicare

Medicaid News: Ga. Working On Reshaping Program

Stateline: Medicaid Fraud Busters Learn From Experience Nationwide, the federal government estimates it lost $22 billion of its share of Medicaid funding last year to what it calls “improper payments,” according to its payment accuracy survey. This suggests that the loss to state treasuries was also in the tens of billions. How do flagrant violations of Medicaid procedure go unnoticed by federal and state regulators for so long?  The answers are not simple. … As fraudsters’ schemes grow bigger and more elaborate, state Medicaid agencies are forced to create equally elaborate schemes to thwart them. But the more paperwork and audits they require from doctors, dentists, pharmacists and other health care providers who serve the needy, the more Medicaid officials worry they will have trouble attracting enough providers willing to accept Medicaid’s low fees (Vestal, 6/4).
Source: kaiserhealthnews.org

MedPAC Head Testifies on Medicare Payment Biannual Report

Health insurance executives called the Affordable Care Act “necessary” Thursday at a Senate Finance Committee roundtable discussion on Medicare payments to physicians. Committee Chairman Max Baucus asked the panel about the Supreme Court’s upcoming decision on the Affordable Care Act and its affect on health care. CareFirst Blue Cross Blue Shield President said the changes underway were “unstoppable regardless of what the Supreme Court decides.”
Source: c-span.org

Choosing Georgia Medicare Providers

GAMedicarePlans.com can provide you more resources for different Medicare Insurance plans in Georgia.  We know that it is very important for every individual to choose a quality health plan.  We focus more on giving the best options so that individuals can select the best plan.  By visiting our website https://www.gamedicareplans.com/, you can find a lot of useful information for Medicare, insurance quotes and Georgia Medicare Providers for you compare.  You can call us at 404-551-5116 anytime for your inquiries and questions.
Source: gamedicareplans.com

Hospital Owner Makes $43 Million Medicare Settlement

The settlement resolves allegations pertaining to twenty-five inpatient rehabilitation facilities that Dallas-based Tenet has owned and operated throughout the country.  These facilities are designed for patients who need an intense rehabilitation program that requires a multidisciplinary, coordinated team approach to improve their ability to function. Because the patients treated at these facilities require more intensive rehabilitation therapy and closer medical supervision than is provided in other settings, such as acute care hospitals or skilled nursing facilities, Medicare generally pays at a higher rate for rehabilitation care.
Source: patch.com

Daily Kos: Mitt Romney: Let’s make it easier to commit Medicare fraud than to register to vote

who will point this out? We do it all the time here, because we are among tens-hundreds?-of thousands of careful, literate readers who want to know the truth. The mainstream media? Not so much. Politicians will not call each other out, apparently, given their use of the terms “misspoke” and “misrepresented” instead of “lied” when discussing even their opponents. The sheer number of them from Republicans makes it nearly impossible for us make any of them “stick” in the voters minds–and of course, most get hit with the “both sides do it anyway” stance by everyone–so there is little to no downside to lying when slandering one’s opponent, other than to one’s conscience. And this is where most Dems (well, most liberals, at any rate) get hurt; we have consciences, so we feel bad if we lie, we try to avoid it, and we apologize or atone for misdeeds when caught, at the very latest. Paradoxically, that makes us weaker in the eyes of the voting public, instead of more reliable and honest.
Source: dailykos.com

COURTS NOT PRECLUDED FROM ENFORCING AN AGREEMENT TO EXCLUDE MEDICARE AS A CO

The appellate court disagreed, overturning this portion of the trial court’s grant of summary judgment. The court reasoned that the real issue was the TPA’s knowledge of the existence of a right of reimbursement by Medicare. While a dispute of fact existed as to whether the plaintiff’s former counsel represented that Medicare would not have an enforceable claim, the parties mutually agreed to exclude Medicare as a co-payee in the absence of Medicare’s intent to seek reimbursement. As a result, the court concluded that it is not contrary to public policy to enforce an agreement to exclude Medicare as a co-payee, especially where the plaintiff signs a release acknowledging responsibility to indemnify against a Medicare lien. However, the court limited its holding by expressing no opinion as to whether it violates public policy to exclude Medicare as a co-payee where the plaintiff does not sign an indemnity agreement.
Source: themedicarespa.com

States need better Medicare data to fight Medicaid fraud

Posted by:  :  Category: Medicare

Sign: Hands Off Social Security Medicare Medicaid www.saynocuts.org by Fifth World ArtBilling for dual-eligible beneficiaries is vulnerable particularly to fraud and abuse, largely because their care is funded separately. For example, ambulance companies charge Medicaid to transport elders and adults with disabilities to the emergency room, and then Medicare foots their hospital bills. As a result, ambulance company owners and operators can bill Medicare for millions of dollars for ambulance rides that are medically unnecessary or never occur.
Source: fiercehealthcare.com

Video: Medicare and Medicaid: What’s it all mean?

Romney Lies About Medicare/Medicaid Change Of Address Form

There were periods during my government service when the business-does-it-this-way was fashionable.  Public private partnership (acronym PPP) became popular.  At some point what tended to happen or be realized was the understanding that the public service does not have, cannot have the same “bottom line” as a for-profit organization.  Wall Street exemplifies the outsize for-profit situation these days…I do not think most people want the government to emulate that value system when it comes to exercising government authority.  And, frankly, when you look at it, the basic myth at bottom of the business school takeaway about efficiency has a lot of flaws…not the least of which is that large, major corporations with their overpayment of failing executives and with their taking-care-of-the-top first motif are the opposite of even the the narrowest definition of “efficiency.”  
Source: talkleft.com

MedPAC Reviews Blending Medicare and Medicaid 

In 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

Eyes on Trade: TPP could undermine Medicare, Medicaid and Veterans’ Health

Eyes on Trade is a blog by the staff of Public Citizen’s Global Trade Watch (GTW) division. GTW aims to promote democracy by challenging corporate globalization, arguing that the current globalization model is neither a random inevitability nor “free trade.” Eyes on Trade is a space for interested parties to share information about globalization and trade issues, and in particular for us to share our watchdogging insights with you! GTW director Lori Wallach’s initial post explains it all.
Source: typepad.com

Booman Tribune ~ A Progressive Community

During “active investigations” regarding potential criminal activity, fraud, or theft regarding a prescribed controlled substance, a law enforcement agency may request a patient’s prescription information through the prescription drug monitoring program director. Proponents of the prescription database claim that it will be used as a tool to flag potential problems with prescriptions and alert medical staff rather than as a direct method of generating criminal charges. Supporters say it will really serve to help doctors and pharmacists who “suspect” a problem by allowing them to assess whether or not a patient is “shopping” for the prescriptions at multiple locations. On the other hand, the potential for law enforcement to comb the database during a “pending investigation” seems quite likely. In the past, such an investigation may have required a search warrant authorized by an impartial judge or at least a lawfully issued subpoena. Now, the information is available simply upon request to a bureaucratic agency.
Source: boomantribune.com

Medicaid and Medicare PACE Plan

It is very unique and also optional.  It covers complete medical and social amenities.  They can be used in your own home, or a day center, or even at inpatient facilities.  This option is sometimes wanted mainly because people can get all the care they need in the comfort of their own homes.  Many people do not intend on being institutionalized so having PACE is favorable in this situation.  People in PACE wind up receiving a complete health care plan.  There are many people involved in creating this plan including physicians, nurses, and other healthcare specialists.  They evaluate the needs of the client, create care plans, and then when it is needed they will deliver the services that were decided upon.  PACE is only obtainable in certain states that have chosen to offer it.
Source: wordpress.com

Walgreens Reaches Settlement in False Claims Act Case

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Source: wordpress.com

Medicare, Medicaid Share Blame for Out of Control Health Care Costs, CBO Says

 The CBO offers some suggestions to lawmakers in dealing with the grim situation, commenting that “the explosive path of federal debt under the alternative fiscal scenario underscores the need for large and timely policy changes to put the federal government on a sustainable fiscal course.”  There are, of course, difficult trade-offs in deciding how quickly the budget deficit must be fixed. CBO notes that,  “on the one hand, cutting spending or increasing taxes slowly would lead to a greater accumulation of government debt and might raise doubts about whether longer-term deficit reduction would ultimately take effect. On the other hand, abruptly implementing spending cuts or tax increases would give families, businesses, and state and local governments little time to plan and adjust, and would require more sacrifices sooner from current older workers and retirees for the benefit of younger workers and future generations.”
Source: wolterskluwerlb.com

Medicare supplement insurance company gets fined for overcharging for a Medicare supplement policy.

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSOne of the items that is reviewed is the medical claims as compared to incoming revenue from premiums paid by clients. This helps the department understand if the insurance company is requesting excessive increases.  Should it be determined that the insurance company is requesting excessive rate increases the DoI can reject the request and/or let them know what they feel is a more satisfactory percentage increase.
Source: gomedigap.com

Video: Medicare Supplement Insurance Plans – Where Do I Start?

Central States Indemnity Medicare Insurance

Berkshire Hathaway is of course the large investment conglomerate run by none other than Warren Buffett.  In 1992, Berkshire acquired Central States and due to the immense resources behind such a well respect holding company, CSI is afforded an extremely high rating for a midsize Medicare supplement provider.
Source: ohioinsureplan.com

West Bloomfield Township, Michigan Medicare Supplement Plan G

In an earlier post on this blog, we looked at Medicare supplement plan F, and how it is the most popular supplement plan on the market.  With this post, we are going to look at Michigan Medicare supplement plan G, and how it might be the available product on the market.
Source: cheapinsuranceinmichigan.com

Supplement Health Insurance Plans

make sure you are not really by now coated below yet another plan. When you have team health insurance having an company or perhaps ex- company or perhaps get Medicare insurance Benefit prepare insurance coverage it is likely you do not require far more dietary supplement protection. You can even examine together with your current provider to find out what coverage you already have.
Source: aninsurance.org

United Healthcare Oxford Medicare Advantage Denies Coverage

Posted by:  :  Category: Medicare

Florida Health Insurance . ABC NEWS/GOOD MORNING AMERICA: Senior With Fractured Back Battles UnitedHealthcare Oxford Health Insurance Company Medicare Advantage Plan GMA segment shows UnitedHealthcare/Oxford’s Medicare Advantage Plan would not authorize woman’s care due to alleged age discrimination. Audit shows Medicare Advantage providers with backlogs of unanswered patient complaints, plans that improperly denied claims, and concerns about marketing practices which do not follow government guidelines.
Source: blogspot.com

Video: United Healthcare Oxford Medicare Advantage Denies Coverage

United Healthcare Secure Horizons & Oxford

2012 about affordable article benefits Best business california Care Cheap cost Costs Coverage exchange family find Free from Getting good guide Health Healthcare home Individual insurance Know life Medical Medicare Movie National Need Official online Plan Plans policy Private quotes Reform Small state Trailer Virginia
Source: 123homesolution.com

Horizon Medicare Advantage Blue Value with Rx

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

Amalgamated Life vs. Oxford Life Insurance Company

 To protect assets from tax and probate issues, the Advance Wealth Transfer and Efficient Wealth Transfer Single Premium Policies assist in the transfer of assets to heirs after a policyholder’s death. Offering a guaranteed death benefit and a guaranteed cash value with annual increases, these policies may also include accelerated benefit options for chronic or terminal illness and nursing home care. Advance Wealth Transfer is available to purchasers between 50 and 85, while the Efficient Wealth Transfer option can be purchased by those between 60 and 80.
Source: insuranceproviders.com

NEW JERSEY MEDICARE ADVANTAGE PLANS FOR 2012

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Source: onepoly.com

Medicare Contractors Lacked Controls To Prevent Millions in Improper Payments for High Utilization Claims for Home Blood

This report summarizes the results of our individual reviews of the 4 contractors that processed claims for home blood-glucose test strip and/or lancet supplies (test strips and lancets) for Jurisdictions A through D, which included all 50 States, 5 territories, and the District of Columbia.  Medicare Part B covers test strips and lancets that physicians prescribe for diabetics. The quantity of test strips and lancets that Medicare covers depends on the beneficiary’s usual medical needs.
Source: fulltextreports.com

Lauren Antonucci, Nutritionist/Dietitian, New York, NY 10019

Lauren is the owner/director of Nutrition Energy and combines her experience as a Clinical Nutritionist, Certified Diabetes Educator, Certified Sports Dietitian and athlete to lead the Nutrition Energy team. She provides comprehensive nutrition therapy and personalized nutrition planning for individuals. She also travels around New York and the country, leading nutrition clinics and lectures for a variety of small and large groups.
Source: healthprofs.com

J.A.G. Security (248) 331

Detroit-area resident Louisa Thompson could spend up to 10 years in prison and be forced to pay up to $250,000 after pleading guilt to her role in a $16-million Medicare fraud scheme, officials from U.S. Department of Justice officials said in a release Wednesday.
Source: michigansecuritycompany.com