Hurdles Remain for People with Disabilities and Seniors with Heathcare Reform

Posted by:  :  Category: Medicare

However, not all provisions of healthcare reform will benefit all Medicare beneficiaries and people with disabilities. For example, starting in 2013, the threshold for itemized deductions for unreimbursed medical expenses increases from 7.5 percent of adjusted gross income (AGI) to 10 percent of AGI. However, this is waived for individuals age 65 and older through 2016. Also in 2013, taxpayers will see increased taxes for Medicare. This includes a 0.9 percent increase in the Medicare Part A tax rate to 2.35 percent on earnings over $200,000 for individual taxpayers, and $250,000 for married couples filing jointly, and a new 3.8 percent tax on unearned income for higher-income taxpayers.
Source: invisibledisabilities.org

Video: Continued Medicare Eligibility and Work Incentives

Homelessness Resource Center

Conclusions: Greateruse of primary care and specialty care visits by disability-eligibleveterans is most likely related to greater health needs not captured bythe patient characteristics we employed and eligibility for VA care atno cost. Outpatient care patterns of disability-eligible veterans mayforeshadow care patterns of veterans returning from Afghanistan and Iraqwars, who are entering the system in growing numbers. This studyprovides an important baseline for future research assessingutilizations among returning veterans who use both VA and Medicaresystems. Establishing effective care coordination protocols between VAand Medicare providers can help ensure efficient use of taxpayerresources and high quality care for disabled veterans. (Authors)
Source: samhsa.gov

Medicare, Disability Benefits and Obamacare

The big political news during the last week of June was of course the decision from the US Supreme Court upholding the majority of the Patient Protection and Affordable Care Act (“PPACA”) (commonly referred to as “Obamacare” by both critics and supporters of the legislation). The one change that the Supreme Court demanded was to the expansion of Medicaid under the PPACA. While the legislation originally conditioned all Medicaid funding on a state’s acceptance of the expansion, the Supreme Court ruled that only the expansion could be conditional; that is, states can stick with their original Medicaid program without fear of losing it if they do not accept the expansion.
Source: troutmanlawblog.com

Should You Be Getting Medicaid or Medicare?

All the information you need to know about eligibility for Medicaid is on the official Medicaid webpage.  But, here’s the quick summary: if your family lives at 133% of the Federal Poverty Level or below, you are generally eligible.  These are Federal guidelines, but each state sets its own specific policies.  To give you an actual figure, 133% of the Federal Poverty Level for a family of four was $29,700 in 2011.
Source: leedisability.com

Extra Benefits Of Medicare Supplemental Plans

The health insurance is very nice option for moving from one insurance company to another. It provides the many benefits of enhanced coverage not provided by the existing insurer and provides to the unsatisfied to switch. Recently, supplemental health programs are very good plans to the senior citizens and aged people, who would like to be more protective for themselves. Medicare Plans are the most effective plans to cover the plans and reduce your cut of pocket costs. This is very good plan to secure your life as well as you will get different kinds of benefits and features. It is well known plan to keep health protected and safe. This is very life time protective plan. Medicare Supplement Comparison enables you to find out the right plan is very good plan to secure your life and make you more comfortable and convenient. Therefore, you should think properly before taking any insurance plan, but this is very good plan for senior citizens.  
Source: ezinemark.com

RBTI Testimonial;
Dental care for people on disability insurance coverage, medicare?

Everyone likes free things but the providers dont work for free and our government cannot afford to pay them to work for you for free. Dental insurance should be purchased in advance for the future. Insurance is purchased in advance of needing services, not at the time of service, because there are waiting periods. Dental plans are cheaper than insurance but very restrictive. Check them out. Call any independent insurance agent where you live and get an idea of whats available.
Source: mediblogger.com

Overview of Medicare Eligibility and Coverage

The vast majority of Medicare coverage is applied to more than 43 million beneficiaries on a local level and executed by the contractors such as insurance companies. Medicare also develops a National Coverage Determination (NCD) with providing Medicare beneficiaries who meet the criteria or coverage. It has limitation of items and services within the scope of Medicare benefits coverage. People who apply for Medicare insurance must be qualified for the Medicare policies and coverage. Here are the types of Medicare plans listed below.
Source: insurance-how-to.com

Medicare Part D’s Important Influence on Access and Adherence to Medicines

Posted by:  :  Category: Medicare

And look at what happens within Medicare when beneficiaries have access to medicines. A study in the Journal of the American Medical Association found that Part D saves Medicare about $1,200 per year in hospital, skilled nursing homes and other costs for each senior who previously lacked comprehensive prescription drug coverage. This resulted in an overall savings to Medicare of $13.4 billion in 2007, the second full year of Part D.
Source: phrma.org

Video: How To Find A Medicare Part D Drug Plan

Medicare Part D and Prescription Drug Helpline

MADISON—The Board on Aging and Long Term Care has launched its Medigap Part D and Prescription Drug Helpline. Counselors are available to assist callers age 60 and over who have questions related to prescription drug insurance, including Medicare Part D and SeniorCare. Counselors will also aid callers in exploring other coverage options for prescription drugs.
Source: cwagwisconsin.org

MEDICARE PART D COVERAGE CRITERIA ZYTIGA (abiraterone)

Azt HPV Hepatitis B Vaccine Chlamydia Nevirapine Coronary Artery Disease Plastic Surgery Clinical Trials Clinical Trials for Pay Bone Cancer Lung Cancer History of AIDS Types of T Cells Free Clinical Trials for Weight Loss Famous People with AIDS Normal Cd4 T Cell Count Clinical Trial Definitions Tay sachs Disease Clinical Trial Process Society for Clinical Trials Diabetes Diet Sickle Cell Anemia Herpes AIDS in Africa Phases Clinical Trials Pregnancy Week by Week Breast Cancer Medical Dictionary AIDS Statistics Aplastic Anemia HIV
Source: starhi.com

Why Did I Lose My Medicare Part D? »

handbook, the new Medicare rule was first explained and Social Security sent out letters informing Medicare beneficiaries that they would have additional premium including the Part D prescription drug premium.  The new IRMAA (Income Related Medicare Adjusted Amount) rule has never really been publicized and only if your income is higher can you be affected.  IRMAA states that if your income is above $85,000 for an individual or $170,000 for a couple, then, you may pay an income related adjustment amount (additional monthly premium), in addition to your Medicare prescription drug premium.  The IRMAA Part D premium can range from $11.40 to $66.40 which is based on your reported income.
Source: medicaretruths.com

Medicare Part D Proves That Competition Lowers Health Care Spending

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

How to Avoid Medicare Land Mines ~ USA Loans

But the clock for the Part B deadline starts when you leave your job, not when benefits end. Mary Kesel, who founded Benefit Advocates, a Winston-Salem, N.C., firm that guides individuals and businesses through the Medicare maze, says this is a common mistake with costly consequences. She advised a banking executive who lost his job and thought he could wait until his Cobra ran out to enroll in Medicare.
Source: blogspot.com

Obama Eyes Medicare Part D

Price controls on medications is a public-policy threat, according to Kenneth C. Frazier, president and CEO of Merck & Co, pharmaceutical company. In an opinion piece in the Wall Street Journal July 13, he wrote Part D “is a successful program” which has allowed seniors “to have comprehensive drug coverage at a cost that is 50 percent below initial projections.” He cites the Battelle study showing that each job in the biopharmaceutical industry supports about 5.95 additional jobs in the economy. So each job lost has a large impact. He said the policy proposed by the Administration and some in Congress would result in 130,000 to 260,000 lost jobs, as cited in the Battelle analysis.
Source: frontpagemag.com

Patient Protection and Affordability Care Act of 2010 & Medicare Part D :Gould & Lamb

About the Author: William F. Bell, Jr. is the Senior Clinical Pharmacy Specialist for Gould & Lamb, LLC. His primary responsibility is the review of a claimant’s pharmacotherapy regimen and the identification of off-label medications in a Medicare Set Aside Allocation. He has given numerous presentations on the subject of medication management and how it relates to Workers’ Compensation and Medicare Set Aside Claims. Bill has also authored two continuing education articles for the Pharmacist’s Letter, a nationally known education resource for practicing pharmacists.
Source: themedicarecomplianceblog.com

FamilyWize.org Discount Prescription Drug Card Blog: Options for MediCare Part D Prescriptions

- Your doctor doesn’t necessarily know what health insurance you have because there are medical billers whose jobs are to handle insurance matters.  (I know this because a good friend is one!)  Let your doctor know that you are a Medicare Part D recipient and have fallen into the donut hole. See if your brand-name prescription medications have generics that could be just as effective.  Your doctor might have some other tricks like changing your medication’s strength or dosage to save you money or even hook you up with some samples to get you through to the other end of the gap.  Who doesn’t love samples! 
Source: familywize.org

Medicare Part D Spending Trends: Understanding Key Drivers and the Role of Competition

This brief commissioned by the Foundation examines factors that contributed to Medicare’s lower-than-expected spending on prescription drugs under the Medicare Part D drug benefit that started in 2006. Since its launch, Medicare has spent about 30 percent less on Part D benefits than the Congressional Budget Office originally projected. Some cite the program’s design, with private plans competing for enrollment, as the driving factor in lower spending; others point to factors in the overall market for prescription drugs as more influential. Author Jack Hoadley of Georgetown University examines the evidence on both sides of this debate. In addition to a discussion of the role of plan competition, the report cites a number of other factors that contributed to lower spending, including the growth in generic alternatives for popular-but-expensive brand-name drugs and a reduction in new brand-name drugs entering the market – trends that dampened prescription drug spending outside of Medicare as well.
Source: kff.org

Changes to Medicare Upheld by the Supreme Court Ruling on the Affordable Care Act

New dates for Medicare’s Annual Enrollment Period (AEP) – During AEP, Medicare beneficiaries have the option to review and change their Medicare Part D and/or Medicare Advantage health coverage prior to the coming plan year when new plan benefits go into effect. Prior to the passage of the ACA, Medicare’s AEP began on November 15 and ended on December 31. But, the ACA changed those dates for the 2012 plan year. The 2012 AEP began on October 15 and ended on December 7, 2011. These dates are currently in place for all AEP’s going forward.
Source: ehealthinsurance.com

Medicare Part D’s Important Influence on Access and Adherence to Medicines

Posted by:  :  Category: Medicare

And look at what happens within Medicare when beneficiaries have access to medicines. A study in the Journal of the American Medical Association found that Part D saves Medicare about $1,200 per year in hospital, skilled nursing homes and other costs for each senior who previously lacked comprehensive prescription drug coverage. This resulted in an overall savings to Medicare of $13.4 billion in 2007, the second full year of Part D.
Source: phrma.org

Video: Part D Part 1

Medicare Part D and Prescription Drug Helpline

MADISON—The Board on Aging and Long Term Care has launched its Medigap Part D and Prescription Drug Helpline. Counselors are available to assist callers age 60 and over who have questions related to prescription drug insurance, including Medicare Part D and SeniorCare. Counselors will also aid callers in exploring other coverage options for prescription drugs.
Source: cwagwisconsin.org

MEDICARE PART D COVERAGE CRITERIA ZYTIGA (abiraterone)

Bone Cancer Hepatitis B Vaccine Sickle Cell Anemia Lung Cancer Chlamydia Clinical Trial Process Clinical Trial Definitions Pregnancy Week by Week Free Clinical Trials for Weight Loss Nevirapine AIDS in Africa Clinical Trials for Pay Breast Cancer History of AIDS Medical Dictionary HPV Phases Clinical Trials Types of T Cells Tay sachs Disease Diabetes Diet Azt Society for Clinical Trials HIV Famous People with AIDS AIDS Statistics Plastic Surgery Clinical Trials Coronary Artery Disease Aplastic Anemia Normal Cd4 T Cell Count Herpes
Source: starhi.com

Why Did I Lose My Medicare Part D? »

handbook, the new Medicare rule was first explained and Social Security sent out letters informing Medicare beneficiaries that they would have additional premium including the Part D prescription drug premium.  The new IRMAA (Income Related Medicare Adjusted Amount) rule has never really been publicized and only if your income is higher can you be affected.  IRMAA states that if your income is above $85,000 for an individual or $170,000 for a couple, then, you may pay an income related adjustment amount (additional monthly premium), in addition to your Medicare prescription drug premium.  The IRMAA Part D premium can range from $11.40 to $66.40 which is based on your reported income.
Source: medicaretruths.com

Medicare Part D Proves That Competition Lowers Health Care Spending

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

Obama Eyes Medicare Part D

Price controls on medications is a public-policy threat, according to Kenneth C. Frazier, president and CEO of Merck & Co, pharmaceutical company. In an opinion piece in the Wall Street Journal July 13, he wrote Part D “is a successful program” which has allowed seniors “to have comprehensive drug coverage at a cost that is 50 percent below initial projections.” He cites the Battelle study showing that each job in the biopharmaceutical industry supports about 5.95 additional jobs in the economy. So each job lost has a large impact. He said the policy proposed by the Administration and some in Congress would result in 130,000 to 260,000 lost jobs, as cited in the Battelle analysis.
Source: frontpagemag.com

Patient Protection and Affordability Care Act of 2010 & Medicare Part D :Gould & Lamb

About the Author: William F. Bell, Jr. is the Senior Clinical Pharmacy Specialist for Gould & Lamb, LLC. His primary responsibility is the review of a claimant’s pharmacotherapy regimen and the identification of off-label medications in a Medicare Set Aside Allocation. He has given numerous presentations on the subject of medication management and how it relates to Workers’ Compensation and Medicare Set Aside Claims. Bill has also authored two continuing education articles for the Pharmacist’s Letter, a nationally known education resource for practicing pharmacists.
Source: themedicarecomplianceblog.com

FamilyWize.org Discount Prescription Drug Card Blog: Options for MediCare Part D Prescriptions

- Your doctor doesn’t necessarily know what health insurance you have because there are medical billers whose jobs are to handle insurance matters.  (I know this because a good friend is one!)  Let your doctor know that you are a Medicare Part D recipient and have fallen into the donut hole. See if your brand-name prescription medications have generics that could be just as effective.  Your doctor might have some other tricks like changing your medication’s strength or dosage to save you money or even hook you up with some samples to get you through to the other end of the gap.  Who doesn’t love samples! 
Source: familywize.org

Medicare Part D Spending Trends: Understanding Key Drivers and the Role of Competition

This brief commissioned by the Foundation examines factors that contributed to Medicare’s lower-than-expected spending on prescription drugs under the Medicare Part D drug benefit that started in 2006. Since its launch, Medicare has spent about 30 percent less on Part D benefits than the Congressional Budget Office originally projected. Some cite the program’s design, with private plans competing for enrollment, as the driving factor in lower spending; others point to factors in the overall market for prescription drugs as more influential. Author Jack Hoadley of Georgetown University examines the evidence on both sides of this debate. In addition to a discussion of the role of plan competition, the report cites a number of other factors that contributed to lower spending, including the growth in generic alternatives for popular-but-expensive brand-name drugs and a reduction in new brand-name drugs entering the market – trends that dampened prescription drug spending outside of Medicare as well.
Source: kff.org

Dodging Medicare’s Hidden Traps

But the clock for the Part B deadline starts when you leave your job, not when benefits end. Mary Kesel, who founded Benefit Advocates, a Winston-Salem, N.C., firm that guides individuals and businesses through the Medicare maze, says this is a common mistake with costly consequences. She advised a banking executive who lost his job and thought he could wait until his Cobra ran out to enroll in Medicare.
Source: topipadfinanceapps.com

Changes to Medicare Upheld by the Supreme Court Ruling on the Affordable Care Act

New dates for Medicare’s Annual Enrollment Period (AEP) – During AEP, Medicare beneficiaries have the option to review and change their Medicare Part D and/or Medicare Advantage health coverage prior to the coming plan year when new plan benefits go into effect. Prior to the passage of the ACA, Medicare’s AEP began on November 15 and ended on December 31. But, the ACA changed those dates for the 2012 plan year. The 2012 AEP began on October 15 and ended on December 7, 2011. These dates are currently in place for all AEP’s going forward.
Source: ehealthinsurance.com

Medicare Premiums, Deductibles & Coinsurance: Rates for 2011

Posted by:  :  Category: Medicare

OOPS I THINK THE SHINE IS OFF THE PEACH ...........IT'S ABOUT TIME by SS&SSBecause of the zero COLA increase in 2011, some Medicare beneficiaries will not pay more for coverage. If your premium is deducted from your Social Security check and your income is $85,000 or less ($170,000 if you file a joint tax return), then you won’t have to pay more. Your monthly premium will stay at either $96.40 or $110.50.
Source: suite101.com

Video: Medicare Open Enrollment 2011 … Compare Medigap Insurance Rates

Many Years Young: Study answers Medicare concerns about paying for CT colonography

“Our study answers several of the questions Medicare asked about this procedure,” said Brooks Cash, MD, one of the authors of the study. The study found that the percentage of patients that would have been referred to colonoscopy as a result of CT colonography was 14%, which is similar to what other studies have found in the younger population, said Dr. Cash. “The prevalence of neoplasia (abnormal growths of cells) detected by CT colonography was 9.3% in patients over the age of 65,” which is also similar to the results of other studies involving younger patients,” he said.
Source: manyyearsyoung.com

Useful resource on uninsured numbers

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Source: wordpress.com

PALADIN COMMUNITY MENTAL HEALTH CENTER SHERRY OSTEEN v. KATHLEEN SEBELIUS DR DONALD BERWICK, No. 11–50682, June 15, 2012

Paladin’s argument is at best a dispute over the Secretary’s interpretation of the “based on ․ hospital costs” language found in § 1395l(t)(2)(C), which is not the “extraordinary” situation that falls within the very limited Kyne exception.  Kirby Corp. v. Pena, 109 F.3d 258, 269 (5th Cir.1997).   Where Paladin asserts that the Secretary should interpret “based on ․ hospital costs” as requiring her to use hospital-based cost data as the sole metric in calculating and adjusting the relative payment weights and ultimate payment rate for 2011, the Secretary has instead decided to base the relative payment weights and ultimate payment rate on both hospital-based and community mental health center cost data.   Even if her interpretation was incorrect, the Secretary’s decision can hardly be said to be “so contrary to the terms of the relevant statute that it necessitates judicial review independent of” the no-review provisions of § 1395l(t)(12).  Id. (noting that there must be a “facial violation[ ]” of the relevant statute to fall within the Kyne exception).   There is enough ambiguity inherent in the phrase “based on ․ hospital costs” that the Secretary’s interpretation deserves deference because it is at least a plausible construction of the statute.   See Chevron, U.S.A., Inc. v. Natural Res. Def. Council, Inc., 467 U.S. 837, 843 & n.11 (1984);  see also Sierra Club v. EPA, 356 F.3d 296, 305–06 (D.C.Cir.2004) (finding “based on” to be ambiguous);  McDaniel v. Chevron Corp., 203 F.3d 1099, 1111 (9th Cir.2000) (finding “based on” generally refers to a “starting point”);  Fed. Recovery Servs., Inc. v. United States, 72 F.3d 447, 451 (5th Cir.1995) (noting Congress could have “insert[ed] the adverb ‘solely’ before ‘based upon’ ”).
Source: findlaw.com

CMS Announces Proposed Rule on 2011 Medicare HH Reimbursement Rates

5010 ABC Home Health Care Inc. accountable care organizations Agency for Health Care Administration AHCA quarterly report Amedisys Barack Obama Bill Nelson Centers for Medicare & Medicaid Services Cliff Stearns companionship services exemption ContinuLink Department of Health and Human Services Department of Justice Department of Labor 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 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

Daily Kos: Pushing back on an Obama hater

What misfortune has Obama caused the country? Employment is up, housing starts are up, business is up, the stock market is up, our cred in the world is up, bin Laden is dead and GM is alive, Obama ended our war in Iraq, 4.4 million private-sector jobs have been created since the trough of the recession, our corporations are harvesting the highest proportion of profits to GDP in the past 80 years, Obama’s budgets have produced the flattest rate of increase in government spending in 60 years (no not Ronnie, no not Poppy, no not Dubya), we’re slowly pulling out of the George W. Bush Depression and the 5+ trillion$$$ in deficits caused by Bush tax and war policies, the Obama administration has issued 5% fewer regulations than the Bush administration and those regulations have produced 25 times the net economic benefit of the regulations issued under Bush, the U.S. now imports 12% less foreign oil than during the Bush administration, domestic oil and gas production are the highest they’ve been since 2003, total federal oil production (offshore and onshore) increased by 13% from 2009-2011 compared to 2006-2008, and Cher is no longer having to volunteer to buy state-of-the-art helmets for our troops. So: an itemized list of misfortunes, please.
Source: dailykos.com

Medicare Reimbursement For Skilled Nursing Facilities Remains High For 2012 Despite Reductions In Overpayments  

The GAO reported as early as 2002 that SNFs had shifted their assessment practices to assign residents to the rehabilitation RUG-III categories that gave them the most favorable reimbursement rates, often without actually providing residents with the number of minutes of therapy they required in order to be placed in those categories.[29]  In addition, the GAO reported that two years after the prospective payment system was implemented, "The patients categorized into the two most common (high and medium) rehabilitation payment group categories typically received 30 minutes less therapy during their first week of care, a 22 percent decline."  Id. 3.  While reimbursement to SNFs increased, rehabilitation services for residents actually decreased.
Source: medicareadvocacy.org

Nothing found for Should

Posted by:  :  Category: Medicare

The page you are looking for no longer exists. Perhaps you can return back to the site’s homepage and see if you can find what you are looking for. Or, you can try finding it with the information below.
Source: healthtipsblogspot.com

Video: colorado medicaid protects your assets from nursing homes

A new contract needed for Medicaid patient transportation in Colorado

As a community psychiatrist, I consult at five Denver-area clinics serving low-income clients. Many clients, due to disability and low income, are unable to drive or take the bus to appointments. They depend on the taxi service provided by Medicaid. When First Transit Inc. became the Medicaid transportation broker for Colorado, patients at each of these five clinics began missing appointments. Not only have adverse patient outcomes ensued, but taxpayer dollars are wasted. As patients miss routine outpatient appointments, there is a resulting increase in 911 calls, ambulance rides, emergency room visits, and hospitalizations costing into the thousands and tens of thousands of dollars (paid in full by Medicaid). Before First Transit took over, taxi drivers provided rides funded by Medicaid reluctantly because the pay was too low — about $30 round trip. Now their reimbursement is so low that they can’t afford to do the work.
Source: denverpost.com

Our View: Medicaid Needs Reform, Not Expansion

Budget experts from both sides of the aisle tend to concede that expanded Medicaid eligibility is the 800 pound gorilla in Colorado’s budget living room. With many colleges and universities around Colorado hiking tuition in the double digits each year to offset cuts in general fund appropriations, we wonder how exactly Governor Hickenlooper plans to pay for the state’s share of this massive entitlement expansion without further eroding access to higher education for Coloradans.
Source: thecoloradoobserver.com

Colorado AG predicts billion

Under last week’s Supreme Court ruling that upheld the ACA, the justices gave states the freedom to opt out of a requirement that all states would need to cover an additional group of poor patients. Since the ruling on Thursday, several Republican governors have vowed not to cover additional poor people. The ACA had required states to cover people with incomes less than 133 percent of the poverty level (or about $30,000 for a family of four). But the justices said that the federal government could not take away Medicaid funding for states that refused to enact this expansion. That, in essence, gives states the choice whether to opt out of the expansion.
Source: healthpolicysolutions.org

Colorado: Settlement with Glaxosmithkline

Colorado Attorney General John W. Suthers today announced that the State of Colorado will receive more than $4.5 million as part of a settlement with pharmaceutical manufacturer GlaxoSmithKline (NYSE: GSK) in the largest health care fraud settlement in history. The settlement, involving the federal government and a majority of states, requires GlaxoSmithKline to pay a total of $2 billion in settlement money plus an additional $1 billion in fines.  In addition, GlaxoSmithKline will plead guilty to federal criminal charges relating to drug labeling and U.S. Food and Drug Administration (FDA) reporting.
Source: ushispanics.com

Colorado Medicaid Expansion

Starting on April 1, 2012, adults who do not have dependent children receiving Medicaid, and who are at or below 10% of the Federal Poverty Level (FPL), may apply for Medicaid. Enrollment in the Adults without Dependent Children (AwDC) expansion will be limited to 10,000 people due to limited funding.
Source: biacolorado.org

Colorado Medicaid expansion brings in new group, but limited to lottery

The Affordable Care Act intends to expand Medicaid to all those adults without children up to 133 percent of the federal poverty level in 2014. Congress agreed to pick up the new costs of the huge expansion until the states have to start contributing more of their share a few years later. But a large group of state attorneys general made Medicaid one of the base challenges to the act that were argued in front of the court last week. The fate of that expansion, the insurance mandate and other aspects of reform should be more clear with a Supreme Court decision over the summer.
Source: denverpost.com

Paratransit Watch: Poor Medicaid NEMT Service Hurting Colorado Mental Health Out

MEDICAID TRANSPORTATION – In a recent guest commentary from the Denver Post: Rides to a Mental Health Clinic Should be Dependable; psychiatrist in training, Rupinder K. Legha relates some of the frustration she and her clients have had with the First Transit operated Colorado NEMT Brokerage for Medicaid. Since taking over the state contract to provide management and coordination of Medicaid transportation in January of 2012, many of her clients who rely on Medicaid NEMT have experienced numerous times when their ride failed to show. Dr. Legha provides multiple examples of how this had detrimental effects upon these individuals. In most cases, these trips are to be provided by taxi companies who are sub-contracted to First Transit to provide the service for Colorado Medicaid. Dr. Legha concluded by suggesting First Transit could improve the service by developing an integrated system that includes input from hospitals, clinics and insurance companies; along with driver education, financial incentives for quality standards, and improved scheduling and coordination. VIDEO: Does Medicaid Cover Mental Health Care?
Source: blogspot.com

Colorado’s tab for Medicaid expansion still a troubling mystery

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Source: wordpress.com

The Basics Of Qualifying For Colorado Medicaid

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Source: pixnet.net

Poor, Sick And Expensive: Colorado’s Scaled

The state is one of just a few that is expanding Medicaid in advance of the major expansion called for in 2014 by the federal health law. Starting in mid-May, Colorado will begin offering Medicaid to adults like Miller who make less than $1,080 per year (that’s 10 percent of the federal poverty line, or $90 per month) – but there’s a catch. Though the state estimates that there are 50,000 people who meet the income bar, Colorado will only be able to offer the health coverage to 10,000 people. Those people will be chosen by a lottery method in each county, designed to distribute the benefits fairly across the state.
Source: kaiserhealthnews.org

A closer look at Medicare D and health reform

Posted by:  :  Category: Medicare

He concluded, “Not all donuts should be gratis.” The donut hole is the lapse in prescription coverage that roughly one-quarter of Medicare beneficiaries reach after taking medicines totaling about $3,000. Assuming health reform stays on track, the donut hole will continue to shrink until it is “filled in” by 2020. At that point, the medicines will not be free but most Medicare beneficiaries will owe approximately 25 percent of the cost (vs. 100 percent in 2010) until they reach the catastrophic level of coverage, where they will pay 5 percent. Many seniors and people with disabilities struggle now – before, during and after the donut hole – to pay their Part D monthly premiums and co-payments. Thus, health reform improves access for many but does not ensure access for all.
Source: coriza.com

Video: Retirement Living Spotlight on Medicare D

The AARP Medicare D Doughnut Hole Calculator: How Does it Work?

Those that want to estimate if they may hit the Medicare Part D drug coverage gap may find it useful to use the AARP’s doughnut hole calculation tool. This can help an individual work out if they may fall into the gap and also gives useful advice on how to save money and stretch budgeting on prescription drugs. What can the AARP Medicare D doughnut hole calculator do and how does it work?
Source: suite101.com

Solutions For Medicare Problems

If you elect to delay your Medicare B enrollment past your 65th birthday because you have group health insurance through your employer, that is not a problem.  Just be aware that when you do retire or lose your group coverage for any reason, you do not have the full 7 month Initial Enrollment in which to secure a guaranteed issue Medigap plan.  You qualify for a Special Enrollment Period for only 63 days.  If you have a pre-existing health condition that would prevent you from medically qualifying for Medigap, you will need to submit your application within 63 days of the Medicare B effective date on your Medicare card.
Source: wordpress.com

Maine Writer: New Majority Agenda and Mad Hatters Disease

The propaganda doesn’t tell viewer that President George Bush 2nd (43rd) blew a balanced budget handed to him during the turnover from the Clinton administration, but he engaged Americans into two wars, plus created a new entitlement called the Medicare D benefit, without increasing taxes.  Republican policies grew the national debt, and that’s the truth. In reality, money used to pay for The New Majority Agenda’s negative lie campaign could fund some of the national debt, if the wealthy ad backers, (probably the filthy rich Koch brothers) paid their fair share in taxes, rather than fund propaganda. But we can’t know who the real wealthy buyers are because they’re protected by the Citizens United Supreme Court free speech ruling. In other words, it’s legal for money to buy lies. It’s makes as much sense as the Mock Turtle’s definition of the different branches of arithmetic,”…Ambition, Distraction, Uglification and Derision”.  
Source: blogspot.com

Choosing the BEST Medicare D Plan · Village Apothecary

There will be two sessions, one in Saugerties at the Senior Citizen Center on Thursday, October 13th from 5:30-7:30pm. The second will be in Woodstock at Woodstock Town Hall on Friday, October 14th from 5:30-7:30pm. Refreshments will be served.
Source: saugertiesrx.com

First, Do No Harm: Leave Medicare D Alone

Medicare Part D is that rarest of government programs: One that has worked better than expected and cost less than expected. Prescription drugs are provided by private insurance plans that compete for customers among enrollees. The profit motive encourages the use of generic drugs instead of name brands, for example, a simple but huge step to hundreds of billions in savings. Free-market conservatives argued that introducing consumer-driven, market based competition to this one aspect of health care would lower costs compared to government-run benefit programs. They’ve been proven right in the five years since Medicare Part D went into effect. Total program costs are about 40 percent lower than forecasted, costs have increased at a slower rate than expected, and consumers report high satisfaction rates in the 90s.
Source: nhjournal.com

Medicare D and the Internet

I recently helped my parents enroll in their new Medicare prescription drug plans using the Medicare.gov website. It was a good-news, bad-news experience. Overall, the good news is that the Medicare.gov website provides very thorough information, is mostly easy to use, and includes efficient functionality. The bad news is that successfully enrolling online requires the guiding hand of a practiced internet user, includes several unanticipated offline data-gathering moments, and probably also includes a few false starts. Here is my mom’s story. Bad news: Before starting, a list of necessary information would have saved several phone calls and re-starts: name, address, social security number, date of eligibility for Medicare’s Hospital Part A and Medical Part B, list of regular drugs and dosages, and individual drug costs, current prescription coverage, preferred pharmacy (if important), and decision on option to deduct plan costs from monthly Social Security check. Good news: First step, to search for and compare plans. I plugged in my mom’s south Florida zip code, which later revealed there are 44 plans available in her area, and her current coverage, “none of the above” — a blessing in disguise as we avoided comparing possible plans to the specifics of any current plan. We were also lucky that, because of her relatively simple drug requirements, she fell into the category easiest to maneuver. There was no need to worry about gaps in coverage beyond certain expenditures. Bad news: I did not know how to answer the polite, but fuzzy Medicare question asking “Did you get a letter from either Medicare or the Social Security Agency that said you are either eligible for or qualified for “extra help” paying for your Medicare prescription drug care costs.” Huh? My mom wasn’t sure, and one very long telephone call to the toll free Medicare number eventually interpreted “extra help” as jargon for Medicaid eligibility. Why not just say that? Good news/bad news: We clicked to “choose a plan” and then “Enter medications”, two steps which seem entirely reasonable in retrospect, but were presented in succession as one of several options where we could easily have tripped up and had to backtrack to get our desired information. Good news: Plugging in the drugs. The process includes excellent, transparent functionality to plug in drugs (including a search-by-alphabet aid for cases where the exact name doesn’t quite match the one on the bottle), the dosage (including a drop-down menu to adjust the dosage, although one dosage that my mom takes wasn’t an exact match), and a query asking if you’ll accept the generic version. (Note to self: Glitch – phone physician to see if generic is acceptable and if it affects ultimate costs.) Excellent news: Comparing coverage plans. (Fair warning: don’t be sidetracked. We chose to bypass the chance to select a specific pharmacy and see what Medicare had to offer. Right choice! The pharmacies are not all current on the website, and you can cross-check for your favorite one later. The point here is to get a cost comparison of the plans.) Eureka! We were quickly offered 44 plans, listed according to estimated annual costs. Clicking within individual plans reveals a goldmine of details of annual costs, including deductibles, monthly co-pays per drug (as price points of different drugs vary wildly among plans, revealing why individually-tailored plan selection is critical), mail-order options, special notes, and many more things. You can also click to compare specifics of up to 3 plans at a time. Bad news: Finding cooperating pharmacies can be frustrating and requires a leap of faith. The website’s pharmacy list wasn’t current, and I was derailed from the internet to the telephone. I called my mom’s favorite pharmacy, talked to her favorite pharmacist, and learned that they expected to cooperate with the plan we liked. Ya gotta love small town south Florida; I know I would not have such quick or trustworthy service where I live. Good news: Enroll. Just plug in the usual information, which included a rather puzzling and unexplained bonus question of whether or not you lived in a nursing home. Total time elapsed: Internet time about 30 minutes. Other time included calls to parents for information and decisions: 30 minutes; call to Medicare: 45 minutes; call to pharmacist: 3 tries and 10 minutes; call to physician re generic drug possibility: did not try. Total cost savings: My mom was self-paying for drugs at a cost of about $3000 per year. Under her new Medicare D plan, it will cost her less than one third of that. Epilog: My mom received her new Medicare D prescription drug enrollment card in the mail. Her pharmacist said the pharmacy does cooperate with her plan. She has not yet tried to get any prescriptions filled. Reality check from findings from the Pew Internet Project: • As of September, 2005, 30% of people age 65 years and over use the internet. • As of 2002, 39% of internet users have helped another person with online medical issues • As of November, 2004, 54% of internet users have gone to a government website to look for information. • In August, 2003, more internet users had visited government websites for information (66%), statistics or documents (41%), and recreation or tourist information (34%), than health or safety issues (28%).
Source: pewinternet.org

How to Avoid Medicare Land Mines ~ USA Loans

Posted by:  :  Category: Medicare

THE LITTLE MAN KILLED MEDICARE FOR EVERYBONE by SS&SSBut the clock for the Part B deadline starts when you leave your job, not when benefits end. Mary Kesel, who founded Benefit Advocates, a Winston-Salem, N.C., firm that guides individuals and businesses through the Medicare maze, says this is a common mistake with costly consequences. She advised a banking executive who lost his job and thought he could wait until his Cobra ran out to enroll in Medicare.
Source: blogspot.com

Video: SEIU/COPE Ad: Medicare

New SEIU and Priorities USA Action Ads Focus on Medicare and Home Foreclosures

“Romney’s dismissive rhetoric regarding the concerns of middle-class and the Latino community clearly indicate how out of touch he is with real people, and the kinds of policies he would champion” said Eliseo Medina, SEIU’s International Secretary-Treasurer. “He comes from a world that broke the economy and made him a millionaire, and he has no interest in helping us repair and regain the American Dream.”
Source: seiu.org

Medicare and the U.S. Financial Crisis: A Collision Course Is Set

The deficit is the annual shortfall of revenue to spending. The national debt is the sum of all outstanding debt owed by the Federal Government. Nearly two-thirds is the public debt, which is owed to the people, businesses and foreign governments who bought Treasury bills, notes, and bonds. The rest is owed by the government to itself, and is held as Government Account securities. Most of this is owed to Social Security and other trust funds, which were running surpluses. These securities are a promise to repay these funds to Baby Boomers as they retire over the next 20 years. For now, they are unfunded liabilities. These unfunded liabilities represent a substantial sum that the federal government has NOT included in its debt calculation. Everyone in Washington knows about this, including all the Presidential candidates, and yet no one is talks about it.
Source: johngself.com

More than 16 million people with Medicare get free preventive services in 2012

July 10, 2012 – The Affordable Care Act – the new health care law – helped over 16 million people with original Medicare get at least one preventive service at no cost to them during the first six months of 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today. This includes 1.35 million who have taken advantage of the Annual Wellness Visit provided by the Affordable Care Act. In 2011, 32.5 million people in Medicare received one or more preventive benefits free of charge. “Millions of Americans are getting cancer screenings, mammograms and other preventive services for free thanks to the health care law,” said Secretary Sebelius. “These new benefits, made possible through the health care law, are helping people stay healthy by giving them the tools they need to prevent health problems before they happen.” Prior to 2011, people with Medicare faced cost-sharing for many preventive benefits such as cancer screenings. Through the Affordable Care Act, preventive benefits are offered free of charge to beneficiaries, with no deductible or co-pay, so that cost is no longer a barrier for seniors who want to stay healthy and treat problems early. The law also added an important new service for people with Medicare — an Annual Wellness Visit with the doctor of their choice— at no cost to beneficiaries. For more information on Medicare-covered preventive services, please visit: http://www.healthcare.gov/law/features/65-older/medicare-preventive-services/index.html To learn what screenings, vaccinations and other preventive services doctors recommend for you and those you care about, please visit the myhealthfinder tool at www.healthfinder.gov.
Source: yubanet.com

Keeping elders out of nursing homes

When the Miami Heat won the NBA championship last month, DJ Laz was standing on the roof of his Los Angeles condo building, the setting of an exclusive weekly happy hour (frequented by Kanye West, Rihanna and other glitterati). He was dressed in full Wade gear. “There were a lot of upset people there, but I had the biggest smile on my face,” Laz says. “I tol […]
Source: cityandshore.com

Buckdog: “Medicare is part of us”

And so it is with other regions in Canada, where geography and demographics may vary, where many waves of immigration began with an initial sense of isolation, but where we all learned to see survival and progress as a test of our ongoing ability to come together and to remain united around shared values. Canada’s history offers a strong and rich legacy of success that has forged our country. It is this legacy of a shared destiny that is key to understanding our young but dynamic history. Today, as we find ourselves living in complicated times, I believe it is this same legacy that remains the road map to our future, at home and abroad. Before we give in to despair around the present-day mantra that our system is unsustainable, there are a few things we must consider. First, a universal, single-payer, public insurance model is both less costly and produces better population health outcomes than multipayer systems like the one that exists in the United States. This has been proven time and time again by study after study. Questions of sustainability can never be successfully addressed by moving incrementally backward to a private, for-profit model, at least not the sustainability of a system that remains accessible to all of us. Second, if our political leaders are genuine in their desire to rein in health costs while maintaining a system for all of us, our task is clear, if not without difficulties. We must lay the groundwork for including catastrophic drug costs and bringing aspects of home care, long-term care and access to advanced diagnostic services into our not-for-profit system. Otherwise, costs will continue to escalate – without restraint and with relentless abandonment of those in need. Third, we must also recognize that the well-being of our citizenry goes beyond health care; it is dependent on preventing illness and tackling the more fundamental barriers to good health, including social, economic and environmental factors. How we treat the environment has a direct impact on our health and the longevity of a sustainable economy. The growing gap between the rich and poor directly affects our health and the fiscal demands on our health-care system. Every day, Canada faces new challenges that prompt key questions about what kind of people we are and what kind of future we wish to shape. As we celebrate the birth of our nation and of medicare, we must ask ourselves: What kind of Canada do we want? Because, as I see it, the choice Canadians make about health care is fundamentally intertwined with our values and future. Roy J. Romanow is co-chair of the Canadian Index of Wellbeing advisory board and a former commissioner of the Royal Commission on the Future of Health Care in Canada.
Source: blogspot.com

LET’S TALK ABOUT DRUGS……..MEDICARE PART D

Under Medicare Part D, private insurance companies will enter into contracts with the Department of Health and Human Services to provide insurance for prescription drugs.  The coverage requirements (such as use of formulary drugs, tier assignments, etc) under the plans will vary by state; to reflect differences in provider costs and patient demographics.
Source: retireusa.net

Invest $1m in Real Estate Medicare Project & Receive European Union Permanent Resident Work Permit.

Bing CargoTraxSingapore Dubai Ports World – D P World Ecademy Economic Development Board Singapore Facebook on CargoTrax Singapore Google http://twitter.com/ http://www.bbc.com/ http://www.bunkerworld.com/ http://www.bunkerworld.com/classifieds http://www.CargoTraxSingapore.com http://www.cnn.com/ http://www.doubleclick.com http://www.ecademy.com/ http://www.facebook.com http://www.hansabaltic.com/ http://www.Linkedin.com http://www.youtube.com Intermodal Container Security, U.S. Customs & Border Protection, Reefer containers, Powerline, Realtime Fuel Monitoring visibility Linkedin Maritime & Ports Authority Singapore maritime container logistics maritime container transport maritime containers vehicle fleet management software shipping container transport container security initiative csi maritime container haulag Port of Singapore Authority PSA Security & Logistics TelematicsUpdate Twellow Twitter Twitter on Supply Chain Security and Logistics Yahoo
Source: wordpress.com

Pelosi Compares Today’s Ruling to Social Security, Medicare

Posted by:  :  Category: Medicare

Grand Bargain Watch - Save Social Security by DonkeyHoteyDespite being all smiles when talking about the Supreme Court’s ruling on health care, House Minority Leader Nancy Pelosi remained hesitant to chalk it up as a political victory. “This politics be damned, this is about what we came to do,” she said. “Anytime we want to waste time on seeing this through a prism of what does this mean in terms of the election, we undermine our purpose in coming here and acting upon our beliefs.” Pelosi said that today’s ruling is as momentous as the establishment of Social Security and Medicare. But this isn’t the end of the health care debate. House Republicans plan to bring a vote to the floor July 11 to vote on repealing the entire health care care. And that “offers an opportunity for clarity” for Democrats to explain the benefits of the law, Pelosi said, characterizing millions of dollars spent on ads critical of the law as having created “such a screen of confusion.” When the health care ruling came down, Pelosi called called Vicki and Paul Kennedy to thank them for the role late Rep. Ted Kennedy, D-Mass., played in pushing health care reform. “I knew that when he left us he would go to heaven and help us pass the bill,” she said. “Now he can rest in peace.”
Source: nationaljournal.com

Video: Dim Outlook For Social Security, Medicare

Seniors Say Protect Social Security and Medicare

It helps to be involved and have a say in the future of these important programs.  It’s even better when we can come together with a strong show of force to say we expect our nation’s leaders to protect middle-class Americans by preserving these family focused income and health security programs. 
Source: patch.com

LACEY: Forum on Social Security, Medicare to be held today

The program includes survey results showing what Washingtonians want from lawmakers and the Medicare and Social Security programs. AARP state director Doug Shadel is expected to make a presentation on the group’s “Ad-Watch” program, which includes a report showing voters are “sick and tired of negative and misleading political ads, and most are misinformed or unaware of what’s behind the spin,” AARP said.
Source: theolympian.com

The “Responsible Person” Penalty 

Fortunately the courts have slowed down the IRS. Let’s say the check writer was unaware of the lapsed payroll deposits, for example. How? One way is lack of financial sophistication. What if the bookkeeper “took care of it,” and the bookkeeper suddenly took ill, became disabled or left town? The business owner or manager could well need time to ramp-up, whether that means payroll, using QuickBooks or any other duty previously performed by the bookkeeper. Can one say there is “willful” intent while the owner or manager is struggling through the learning curve? Let’s swing the other way and say the check writer was financially sophisticated. What is your opinion if told that the check writer wrote checks only infrequently, and that when the primary signor was on vacation or otherwise unavailable? What if the check writer was unaware of any payroll problems? What if the check writer is authorized pay vendor payables but excluded from any payroll responsibilities? What if the check writer was intimidated by his/her boss?
Source: kruseandcrawford.com

Vote for Kenneth S. Stepp for U.S. House: HAL ROGERS ON SENIOR AND SOCIAL SECURITY ISSUES!

75% Interest Group Ratings Public Statements Key Votes Issue Positions (Political Courage Test) Senior and Social Security Issues 2011 Alliance for Retired Americans – Positions 0% 2009 Alliance for Retired Americans – Positions 10% 2009 Alliance for Retired Americans – Lifetime Score 8% 2008 Alliance for Retired Americans – Lifetime Score 8% 2008 Alliance for Retired Americans – Positions 50% 2007 Alliance for Retired Americans – Positions 10% 2006 Alliance for Retired Americans – Positions 0% 2005-2006 National Active and Retired Federal Employees Association – Positions 67% 2005 Alliance for Retired Americans – Positions 0% 2004 Alliance for Retired Americans – Positions 0% 2003-2004 National Active and Retired Federal Employees Association – Positions 40% 2003-2004 Retire Safe – Positions 100% 2003 Alliance for Retired Americans – Positions 0% 2003 Leading Age – Positions 50% 2002 Alliance for Retired Americans – Positions 0% 2002 National Active and Retired Federal Employees Association – Positions 0% 2001-2002 National Committee to Preserve Social Security and Medicare – Positions 31% 2001 Alliance for Retired Americans – Positions 0% 2000 National Council of Senior Citizens – Positions 0% 1999-2000 National Active and Retired Federal Employees Association – Positions 0% 1999-2000 National Committee to Preserve Social Security and Medicare – Positions 33% 1999 National Council of Senior Citizens – Positions 20% 1998 National Council of Senior Citizens – Positions 20% 1997-1998 60 Plus Association – Positions 80% 1997-1998 National Committee to Preserve Social Security and Medicare – Positions 60% 1997 National Council of Senior Citizens – Positions 40% 1996 National Council of Senior Citizens – Positions 20% 1995-1996 60 Plus Association – Positions 100% 1995-1996 National Active and Retired Federal Employees Association – Positions 60% 1995-1996 National Committee to Preserve Social Security and Medicare – Positions 27%
Source: blogspot.com

Social Security, Medicare: Focus of June 12 Maui Debate

Decision 2012 is provided as a public service for campaign-related events. The section includes interviews, campaign profiles, videos, events, and fundraiser information related to the 2012 elections. Our focus is on Maui-related issues and events. We ask that material be submitted at least two weeks prior to the event date. Our staff will do our best to accommodate requests but cannot guarantee coverage. To submit material, please do so by emailing: Click for E-mail Address
Source: mauinow.com

Thomas Friedman Wants to Cut Your Social Security and Medicare Benefits, Again

The whole “deal on immigration that allows the most energetic and smartest immigrants to enrich our country” is nothing more that the continuation of the 10+ year-old scheme to lower the wages of technology worker in the US by flooding the job market with L1, L2 and H1-B visa holders. It is the same crap that he has been pushing since he wrote “The World is Flat”. He periodically updates it with the latest tech buzz-words like “Cloud Computing” so as to appear relevant. I work on cloud computing for a US corporation that appears to have not hired a US citizen as a developer for the past 10 years. I do this work in a city with an official unemployment rate of nearly 15%. No amount of community college education delivered via web-enabled tablet computer (purchased by loans at super-low interests rates) will make up for the fact that those here on work visas effectively work under the employment laws and practices of another country, one that still practices indentured servitude – and even slavery, if you know where to look. Friedman’s career these days seems to be that of a paid corporate intellectual and motivational speaker who travels around giving variations of the same speech at corporate off-site manager “retreats” where he provides intellectual cover for his current client’s next round of offshore related layoffs. On a related note, look for some (un-asked-for by the public) congressional “grand bargain” on “comprehensive immigration reform” by the lame duck congress after the election that will allow offshore software development firms to bring into the US unlimited numbers of their employees on L1 and L2 visas. That will be the last nail in the coffin for corporate IT software developers in the US. But hey, who needs a job when I can get the NY Times online for free, forever …
Source: cepr.net

Kaine campaigns to defend Social Security, Medicare in front of Alexandria seniors

Aces acps Alexandria Alexandria City Public Schools Alexandria Virginia art attic baseball basketball birchmere cartoon chalkboard chamber city council crime del ray development education election government home immigration moran music of old town out out of the attic police politics quick redevelopment schools snow storm t.c. T.C. Williams takes the theatre transportation Virginia waterfront week wrestling
Source: alextimes.com

Who’s most to blame for the coming fiscal collapse of America?

I believe that the baby boomer generation is most responsible for the coming fiscal collapse, but not in the way you might think. Any chain letter, Ponzi scheme, or pyramid scheme; whatever you want to call such programs requires a larger and larger group of people entering the bottom of the pyramid in order to sustain those at the top. Enter the baby boomer generation, who are by far the largest demographic group in the country according to the most recent census. While working, they represented the economic engine of prosperity which allowed our politicians to promise greater and greater benefits to larger and larger groups of constituents, who in turn would vote for those who promised such benefits. Both parties in fact competed to see who could promise more government cheese to the greatest number of voters. Now however, this largest demographic group is approaching retirement age. Approximately 10,000 people in the USA turn 65 years old every day, and this pattern will continue for the next 19 years or so. All of them hope and expect to collect not only Social Security, but Medicare coverage in their senior years. Unfortunately, there are simply not enough younger citizens to pay for even the most meager of benefits. So in my opinion, it is the baby boomer generation who by their collective economic strength as taxpayers allowed for the growth of the welfare state, but by their sheer numbers, they are to blame for the collapse of the same welfare state with trillions of unfunded liabilities in the future.
Source: hotair.com

Medicare Advantage Health Plans For Seniors

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSMany MA plans have a network of medical service providers. With some plans, you have to get your medical services from a network medical service provider in order for those services to be covered. With some of the plans, you may choose to leave the network, but you may have to pay more for covered services. When you see that your own favorite doctors are already on the plan, you may be more satisfied with the network. If you would rather have more freedom to pick and choose doctors, you may not be happy with this type of restriction. This is actually quite similar to the way PPO or HMO plans work on regular health insurance policies.
Source: lowriskhealthplans.com

Video: Blue Cross: A First Choice for Medicare

Medicare Advantage Plans in 2013 will be Different

Secure Horizons is a premiere healthcare company that offers only the best in Medicare Supplement insurance. They make it fast and easy to find what you need, get the coverage you need fast, and find a doctor in your area. They offer options such as Medicare Advantage Plans, Prescription Drug plans, and other extra services. Their services are offered as part of UnitedHealth Group, and take pride in being able to offer all of the services you need at affordable rates. They are extremely dedicated to finding the best plans for their customers across the country.
Source: choicepublic.com

Creating an Unhealthy America is a Pre

Wisconsin Congressman Paul Ryan, the GOP budget “guru” of the House, opposes even the requirement that insurance companies allow children to stay on family policies up to the age of 26. Ryan also continues to be a spokesperson for the contradictory argument that “this law is bad for Medicare” (a single payer government healthcare insurance program for seniors) while railing that the “Supreme Court has allowed this effective government takeover of health care.” Well, then why is Paul Ryan so supportive of Medicare, which is just such a program?
Source: buzzflash.com

Medicare Advantage Enrollment Climbs, Premiums Fall

Posted by:  :  Category: Medicare

Old people read alone... by Ed YourdonFor brokers who want to engage Medicare, Word & Brown will help train them on how to sell these products and will help them establish relationships with carriers.  Brokers can also add Joppel – a CMS approved quoting engine to their own website. Gregg Ratkovic of Joppel said, “Every day 10,000 people are aging into Medicare and that trend is expected to continue for the next two decades. There are close to 50 million individuals enrolled in Medicare or Medicare Advantage plans with an increasing number of employers transitioning their retired workers into Medicare Advantage plans rather than keeping them in company-managed pension programs. Similarly, the individual and family plan market is a growth opportunity as employer groups reduce benefits, unemployment remains high, and group and government markets shrink. The implementation of health insurance exchanges and a growing desire among consumers for portable healthcare as frequent job changes become more common all point to opportunity as Americans look for quality coverage with flexibility and choice. With the recent Supreme Court decision to uphold the individual mandate proposed in the Patient Protection and Affordable Care Act signed into law in 2010, many employers may consider offering their employees lump sums so they can purchase Individual plans rather than maintain group coverage as early as January 2014.” For more information, visit www.wordandbrown.com. Source: calbrokermag.com
Source: medicaresupplementalco.com

Video: Medicare advantage plans 2011: Information on the basics of Medicare Advantage Plans

Changes to Medicare Upheld by the Supreme Court Ruling on the Affordable Care Act

New dates for Medicare’s Annual Enrollment Period (AEP) – During AEP, Medicare beneficiaries have the option to review and change their Medicare Part D and/or Medicare Advantage health coverage prior to the coming plan year when new plan benefits go into effect. Prior to the passage of the ACA, Medicare’s AEP began on November 15 and ended on December 31. But, the ACA changed those dates for the 2012 plan year. The 2012 AEP began on October 15 and ended on December 7, 2011. These dates are currently in place for all AEP’s going forward.
Source: ehealthinsurance.com

The Official Medicare Set Aside Blog And Information Resource: Medicare Advantage Plans do have a Private Cause of Action After All

The second area where the court deviated too far was in the discussion of the capitation rate. There was a lot of discussion about how bonuses and capitation rates are based upon program savings and if the MAO could not recover in secondary payer situations, how it would be at a great disadvantage and that just couldn’t have been Congress’ intent. Well what the court apparently doesn’t know and cannot glean from the regs or CMS policy is just how little support Part C programs get from CMS. There is actually an adjustment to the capitation rate of 0.173 for secondary payer situations, known as the “MSP factor.” It is a flat rate and is triggered simply by an MSP situation existing, not by the nature or extent of the injury leading to the exclusion. A paper cut work comp claim and a double amputation MVA will both reduce the MAO capitation by the same amount. The MAO receives a list of HICNs and perceived associated primary payers with notice of the reduced capitation rate. They are not even afforded the nature of the injury excluded by Medicare. It appears that CMS is only concerned with its payment to the MAO, not the MAO’s ability to recover from a primary payer. Therefore, it is hard to believe that Chevron deference is due to CMS policy supporting MAO recoveries when CMS does not even support the MAO MSP recovery efforts other than to encourage them to pursue recovery despite all of the district court opinions to the contrary.
Source: medicaresetasideblog.com

Cigna Acquires Medicare Advantage Plans From Humana Covering 3,500 in Texas

The federal government required Humana to sell the Medicare Advantage plans as part of approval for buying Arcadian Management Services. Cigna will offer the new customers Medicare Advantage plans through its subsidiary HealthSpring, which the Bloomfield-based health insurer acquired in January for $3.8 billion.
Source: courant.com

DRI MSP Task Force Advisory: The Third Circuit Finds Medicare Advantage Plans Afforded the Same Right of Private Action as Medicare under the Medicare Secondary Payer Act

Humana filed its complaint based on the claim that under the MSP it was granted secondary payer rights and thus it was entitled to reimbursement for covered expenses it paid related to Claimants in the Avandia MDL action.  Humana also sought equitable relief in the form of an order compelling GSK to identify settling Avandia claimants to MAOs who may have covered them.  In dismissing the complaint, the district court determined that:  (1) Medicare’s private right of action set forth in 42 U.S.C. § 1395y(b)(3)(A) does not apply to MA Plans; (2) the secondary payer provisions of the Medicare Advantage program, (found in 42 U.S.C. § 1395w-22(a)(4)), did not create a private cause of action (either express or implied); (3) the MA statute’s silence on the existence of a private cause of action for MAOs was not ambiguous, but rather indicative of Congressional intent to not create a private cause of action for MAOs; and (4) absent any such ambiguity there was no need to defer to a CMS regulation that granted MAOs parity with Medicare.  Finally, the district court denied Humana’s request for equitable relief to order GSK to disclose information about settlements that Humana’s enrollees entered into with GSK, holding that Humana, not GSK, had access to information about which Avandia claimants were enrolled in Humana plans and could act accordingly to remind its enrollees of their obligations to disclose any settlement they might reach with GSK.
Source: forthedefense.org

Frequently Asked Questions about The Affordable Care Act: Medicare Part 2 » Elder Options of Texas

Crescent Place Assisted Living and Memory Care in Cedar Hill, a Capital Senior Living Community, offers superior care services in the comfort of your apartment from medication reminders, to assistance with daily activities of bathing, dressing, and grooming. Our lovely community has studios and one bedroom apartments with walk-in showers and kitchenettes with a refrigerator and microwave oven. We also have memory care apartments with a unique design adapted for residents who have additional needs. MORE DETAILS >>
Source: elderoptionsoftexas.com

Medicare Advantage Premiums To Fall 4% Next Year

The plans were targeted by Democrats who complained that the government pays more per capita for beneficiaries in the private plans than it spends on those in traditional Medicare. The billions of dollars cut from the plans were used to help the Obama administration pay for the cost of expanding coverage to 32 million Americans through expanded Medicaid eligibility and subsidies for people buying coverage in new insurance exchanges starting in 2014.
Source: kaiserhealthnews.org

Medicare Advantage or Medicare Supplement: Which to sell?

Finally, it’s important to look at the value of each specific type of Medicare Advantage plan.  Medicare Advantage plan types are HMO, PPO and Private Fee for Service (PFFS).  Generally speaking, HMO plans are best able to manage networks, coordinate care, manage diseases and limit provider access.  This makes them most efficient in limiting claims cost.  The next most efficient would be PPO products with PFFS products as the least efficient.  Therefore, all other things being equal, an HMO should be able to deliver the most additional value, followed by a PPO and lastly, a PFFS plan.
Source: ritterim.com

Our Lives For Better And For Worse: Who’s laughing now?

R took a man from the fire department and the sister of another firefighter jug fishing several times. They always seemed to come back with a good catch of nice size fish. So, the firefighter decided he wanted to go as well as the other man. They decided they wanted to go on Father’s Day. Come 5:00 that Sunday morning, no fishermen. So R goes fishing anyway and comes back with both live wells full. He calls the men to see if they want them, and of course they do. And, they apologize for not calling him to say they decided they wouldn’t come. R decided he wanted to cook fish yesterday. He goes to the freezer and gets one pack out only to discover we have only one pack left. I so wanted to call the above fishing trip to his attention, and I stifled a laugh too. He had already decided that it is getting too hot to fish, but if he wants fish he better get to fishing. ;) Rocky seems to be doing OK. At least he would if his “parents” would only get their act together. Tuesday, July 10, he had a vet’s appointment to get his booster canine flue booster. I asked R not to back the car out when they got back from their golf cart ride because I didn’t want Rocky to get excited before I could give him the Rescue Remedy (RR). He told me that since we were going to pick up mulch while in town, he planned on taking the truck, which is outside all the time any way. When they left for their ride, I hollowed out cup in a piece of hot dog and put 4 drops of RR in it. So, what does R do when they get back but open the driver’s side door so the truck could be cooling off. That did it, Rocky was almost bouncing off the walls. They come inside, but Rocky immediately runs back out on the porch with R all the time telling him to come back he needed to get his treat. I pick up the hot dog and give it to him on the porch. He takes it and immediately spits it out. I pick it up and try again. Wouldn’t even take it. I get him back inside and R and I both try to give it to him again. Nope. Then he eats the small pieces that I had dug out of the hot dog. So, I pull it apart and get him to eat 2 pieces and that’s it. Finally, the light bulb goes on. I kick the back door shut and he eat the rest and is ready to go. All this was kinda funny after it happened, but the results were anything but funny. R started it by opening the truck door, but we still could have save the day if, when he spit it out the first time, I had put more RR in it. He started out the morning with a BG reading of 258, not good, but it gets worse. His vet appointment was at 10:00, by the time I tested at 1:00 his BG was 278, and just before supper it was 412. (Mentally kicking myself) Oh well, life is just one big learning experience isn’t it. I take Zantac (Ranitidine) for my GERD. I get it through Walmart’s generic Rx plan for $4.00 per month. I got out and since we give Rocky Pepsid, I tried some of those. They worked if I remembered to take them at least an hour before eating. I decided to check the OTC drugs and see if there was something else I could take so I wouldn’t have to fool with getting a Rx as well as having it count toward my Rx limit for my Medicare Advantage Plan. What should I spy but Ranitidine. Same dosage and 65 for $4.00 as opposed to 60 for $4.00 with my Rx. Guess what I will be doing next time. It’s gonna cost me a little more because I will have to pay sales tax on it which you don’t have with an Rx. But, it’s worth it not to have to bother with an Rx, etc. I get Rocky’s insulin, syringes, and my pen needles without an Rx and have to pay sales tax. Like I said, so much easier than having to get an Rx. My pen needles cost me a little more, but at least they aren’t counted against my limit for Rx drugs. So, I don’t have a problem with that. See you in the funny papers.
Source: blogspot.com