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Source: avidtrader.com

Video: Medicare Part B_1.wmv

Teachers Are Not the Problem: Medicare meets Obamacare.

This blog’s target audience is retired teachers in WNY, which means that Medicare is probably at the top of your list of questions about the Affordable Care Act (ACA). Before addressing the specifics of the ACA with regard to Medicare, however, we need to do a little background work on some of the details of Medicare’s inner workings. Medicare comes in two “flavors”: traditional (sometimes called “fee-for-service” Medicare) and Medicare Advantage plans. Seventy-five percent of Medicare participants are in traditional Medicare while the remaining 25% are in Medicare advantage plans. That 3/1 ratio of traditional Medicare participants to Medicare advantage participants is important, and will have a tremendous bearing on how you personally view the Medicare changes in the ACA. Traditional Medicare is run by the government. It consists of Part A (hospital costs), Part B (doctor costs) and Part D (prescription drug costs). There is no cost to the participant for Part A, although there is a deductible for each hospital admission. Participants pay a monthly premium of $96.40 (or close to this amount) for Part B coverage. There is a yearly deductible for Part B costs. In addition Medicare only pays 80% of the covered Part A and B expenses. Traditional Medicare participants may, if they choose, purchase supplemental (Medigap) insurance to cover all or part of these costs not covered by Medicare. Traditional Medicare participants may also purchase Part D drug insurance through private insurance companies approved by Medicare. Traditional Medicare is a “fee-for-service” plan. Whenever you receive a covered medical service, Medicare provides a set fee for that service to the provider. Medicare providers have agreed to accept whatever fee Medicare provides as payment in full. (Actually, Medicare only pays 80% of this fee to the provider. The other 20% is billed to the patient or their Medigap insurance, if they have purchased it.) If you receive no covered services during a year, Medicare spends no money on your behalf. There is no upper limit on your yearly cost to Medicare if you do receive covered services. Medicare Advantage plans (also known as Medicare Part C) began in the 1970’s with the idea that the private sector could do Medicare more cheaply than the government. Over the years, Congress has made several changes to Medicare Advantage so that its focus now is attracting more private participation. Medicare Advantage plans are run by private insurance companies such as Univera, Independent Health, etc. Medicare pays these companies a flat fee to provide hospital and doctor services to their members. Some Medicare Advantage plans also include Part D drug coverage, while others require that their members purchase it as a separate entity. While participants in traditional Medicare are free to use any doctor or hospital and do not require a referral to see a specialist, Medicare Advantage plans usually require members to use only hospitals or doctors in their network. Going “out-of-network” usually results in the member paying either a larger share of the cost or, in some cases, the full cost of the service. If you are unsure which “flavor” of coverage you have, if you pay a “co-pay” when seeing your doctor, you are probably a Medicare Advantage member. Medicare Advantage members also pay their Part B premium to Medicare, usually through direct deduction from the Social Security payment each month. The amount that Medicare pays to the Medicare Advantage insurer for each member is a flat rate based on the average yearly cost to Medicare of traditional Medicare participants in your county. And there’s the rub. Medicare currently pays Medicare Advantage insurers about 15% more for each member than the average cost to Medicare for a traditional Medicare participant. Many Medicare Advantage providers use this extra money to provide services not covered by traditional medicare such as dental, eyeglasses and gym memberships. Everyone agrees that Medicare has financial problems. The Part B premium, for example, covers only about 25% of the cost of doctor services to Medicare participants. We Medicare participants often boast that we’re “paying our way” through our premiums. Sadly, that’s simply not the case. The ACA attempts to help stem the rise in Medicare costs by scaling back the increase in payments to Medicare advantage providers by about $322 billion over the next 10 years. Note that this is NOT a decrease of $322 billion from the current payment level. Instead, it is a decrease in the expected rise in these payments. If you are one of the 3-out-of-4 traditional Medicare participants, you will probably view this as a good thing. There will be no change in your Medicare services and the overall cost of Medicare will be $322 billion closer to being under control. If you are the 1-out-of-4 person who participates in a Medicare Advantage plan, you will likely see some decrease in the “extra” services such as gym memberships. To be fair, however, with everyone paying the same dollars into Medicare, it’s hard to make a case that it’s fair that Medicare spend an extra 15% on 25% of participants allowing them to receive benefits that the other 75% do not receive. And, in addition, we help bring Medicare costs under control. And, this $322 billion in savings is used to help pay the costs of the ACA. Believe it or not, there’s even more to say about Medicare in the next post. [NOTE: Click here for an excellent side-by-side comparison of traditional vs Medicare Advantage provided at the Medicare website. Click here to download a much more complete explanation of Medicare Advantage plans from the Kaiser Family Foundation.]
Source: blogspot.com

Benefits of the Affordable Care Act (ObamaCare)

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Source: tntribune.com

Medicare Part B Premium Costs In 2010

Commonwealth of Pennsylvania treasury DePartment2009 UNCLAIMED PROPERTY ANNUAL REPORTINGBT ERM . Mc CAT ETREASURPropertyER2008ROForORDSTCommonwealth of Pennsylvania Treasury Department Harrisburg, Pennsylvania 17120The Pennsylvania Treasury Department is committed to increasing volun.
Source: propdfsearch.com

Looking for Insurance Articles

In addition you will need a Medicare Part D drug plan to help cover your prescription drugs since Original Medicare does not offer prescription drug coverage. The national average for a prescription drug plan premium is $38/month. You could pay around $200/month for a Medicare supplement. Added together you are now looking at $338/month for your Part A and B, Medicare supplement, and Part D drug coverage. The MAIN benefit of having Original Medicare with a supplement is that you know what your medical costs will be each month, and you can go to any provider that accept Medicare! The alternative is to look at a Medicare Advantage plan like Humana or Health Springs in order to save money.
Source: lookingforinsurance.net

A Quick Introduction to Part

Now that we have a good understanding of Part A benefits and it’s general coverage for facility (loosely translated as hospital, surgicenter, skilled nursing, and hospice care) based care, let’s look at Part B, logically our next letter in the alphabet. Generally, Part A is facility care while Part B can be thought of as physician, out-patient, and preventative benefits. You can think of Part B as everything Medicare covers outside of inpatient care (Part A) and out-patient medication (Part B). It’s quite different from both so let’s take a closer look at Part B. First, we need to speak about Part eligibility and cost because this a major difference. Most people are going to pay for Part B coverage. Part A is generally paid for through taxes during employment over the course of a person’s life. Part B is different and will likely feel the blunt of cost controls going forward. First, you must sign up for Part B. It is not automatically extended to eligible members the way Part A generally is. You must also pay a premium for Part B coverage. As Medicare started to show signs of financial strain, Part B became means tested which means that you will pay more for Part B premium if you have great income on average. You can expect to see this increased premium go higher over time as Medicare tries to shore up it financial house. The premium is paid monthly and can even be taken from your Social Security check automatically. The key take away is that you probably (most people do) need to actually enroll and that you will pay for this coverage separately from any charge to have medicare supplemental insurance. Now, let’s look deeper into what Part B covers. First, you will have an annual deductible that you need meet. This deductible is $162 for 2011 but you can expect that it will go up over time. The deductible is calendar year (Jan 1st through Dec 31st) and resets each January. Once the deductible is met, you will then pay 20% of the charges for allowable expense for the remainder of the year. If you have additional coverage such as Medicare supplement insurance or Advantage plan, you may get this deductible and 20% co-insurance covered depending on the plan you choose. Part B generally covers physician charges and outpatient expenses that are allowed and not covered under Part A on an inpatient facility basis. This can be the doctors office, labs, outpatient surgeries, and allowed preventative services. Medication is not covered under Part B and we’ll cover that in Part D. There are two ways to find out if a particular benefit is covered under Part B. First there, the Medicare benefit handbook (different from the Medicare and You handbook) which is handy since it’s alphabetized by actual benefit name such ad Diabetes screening. This is generally how people search for a given medical issue they are dealing with so we advise this first. There’s also the medicare.gov benefit database where you can get even more specific information by entering in keywords such as “routine physical”, etc. Both resources have made searching for eligible benefits much easier in the last few years. One quick but important note on Part B. If you choose to wait to elect Part B after you are eligible (assuming you do not have another eligible window such as leaving group etc, you may a higher rate for this benefit if you eventually opt for it. There may also be a delay from when elect Part B to when the benefits actually kick in. It’s best to discuss your situation with a licensed agent as Medicare is only getting more complex in terms of the rules.
Source: abcarticledirectory.com

Practical Insights: Dealing with Medicare Part B and COBRA Coverage

Posted by:  :  Category: Medicare

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

Video: Do I need to enroll in Medicare part B if I have VA benefits

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

AHIP’s Ignagni Suggests Health Care Law Won’t Work

As examples, she cited the penalties in Medicare Part D and Part B. Under those provisions, the longer beneficiaries delay enrollment, the higher the premiums for prescription drug coverage and doctor care. “We think structured open-enrollment periods are valuable,” she said. “And I know that folks who are operating exchanges in the states and at the federal level are looking at a range of incentives as well.” She didn’t specify what such inducements might be.
Source: pulseperspectives.com

Preventive Health Services Under Medicare

Danielle Kunkle is the co-owner of Boomer Benefits, a Texas-based insurance agency specializing in Medicare-related insurance products for seniors. Though insurance is nowhere near as glamorous as whitewater rafting (her favorite hobby), she finds that helping people make sense out of confusing government health insurance programs is rewarding in its own way.
Source: mondaysorchids.com

Tricare Help – What if I’m still working when I become eligible for Tricare for Life?

You have several options. First, you can simply put off Medicare and Tricare For Life enrollment and stay with your employer plan. As long as you’re still employed and covered by an employer health plan, you can delay enrollment in Medicare Parts A and B without having to worry about the premium penalty that applies to people who do not sign up for Medicare Part B when they first become eligible. However, when you finally do decide to stop working, you must enroll in Parts A and B within eight months of your last day of work or the last day of coverage under your employer health plan, whichever comes first, in order to avoid that premium penalty. If your spouse is younger, she’ll continue under her or your employer’s health plan or stay under Tricare Standard or Prime until age 65.
Source: militarytimes.com

Medicare Advantage Enrollment Climbs, Premiums Fall

For 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

Mary Beth Franklin: One surefire way to sabotage a retirement plan

Based on those assumptions, the retirement income plan clocked in with a 96% success rate. The only problem was the healthcare cost estimates were way out of whack. Most retired couples should expect to pay at least $7,500 in premiums for Medicare Part B, Medicare drug coverage and a supplemental Medigap plan, according to Nationwide estimates. Throw in some basic out-of-pocket costs, and that couple should budget for about $9,100 in healthcare expenses—enough to drop the probability of success for that retirement income plan from 96% to 67%.That hurts.
Source: avidtrader.com

How Does Medicare Affect TRICARE?

Effective October 2009, TRICARE beneficiaries who are awarded retroactive benefits based on disability or permanent kidney failure do not have to pay for Part B for those months in the past in order to keep TRICARE. You should, however, contact the Department of Defense to find out whether you would now need to enroll in Medicare Part B in order to keep your TRICARE.
Source: specialneedsplanning.net

Medicare Shared Savings Program And ACO Proposed Regulations: A Summary

Posted by:  :  Category: Medicare

OBAMAS DEATH PANEL------ GUESS WHAT FOLKS IT'S ALIVE AND WELL---"CRAZY PALIN" NOT SO CRAZY NOW by SS&SSAlerts and Updates MEDICARE SHARED SAVINGS PROGRAM AND ACO PROPOSED REGULATIONS: A SUMMARY April 8, 2011 On March 30 2011, the Centers for Medicare and Medicaid ("CMS") issued the long-awaited, proposed regulations for the Medicare Shared Savings Program. These proposed regulations include details concerning the requirements for qualifying as an accountable care organization ("ACO"), such as: Eligible legal entities; Criteria for shared governance; Assignment of beneficiaries to ACOs; Different types of risk contracts; Benchmarks and calculations of savings; and Shared savings, antitrust issues and policies, Medicare anti-kickback, and other regulatory requirements as applied to ACOs. This brief summary of the proposed regulations is not intended to be exhaustive. Rather, it is a description of several key highlights. A more detailed analysis will soon be available on the Healthcare Reform Center. The Background The Patient Protection and Affordable Care Act (Pub. L. No. 111-148) and the Health Care and Education Reconciliation Act of 2010 (Pub. L. No. 111-152), which amended certain provisions of Pub. L. No. 111-148 (collectively referred to as the "Act"), were passed on March 23 and March 30, 2011, respectively. Section 3022 of the Act added a new section under title XVIII, section 1899 of the Social Security Act which provides for a Medicare Shared Savings Program (the "Program") and the creation of ACOs. The Program is an extension of CMS’s strategy to expand value-based purchasing concepts through a program that shares realized savings in the Medicare Fee For Service program, under parts A and B. Under the Program, providers and suppliers who participate in ACOs can continue to receive traditional fee-for-service payments under Parts A and B of Medicare as well as be eligible for additional payments based on meeting certain quality and savings requirements. CMS is seeking comments on these proposed regulations by no later than May 28, 2011. The Medicare Shared Savings Program The Program is voluntary, and eligible entities are permitted to apply to the Program if they meet the requirements of an Accountable Care Organization. The Program must be implemented by CMS no later than January 1, 2012. What Are Accountable Care Organizations? The proposed regulations explain more fully the "bells and whistles" that make up an ACO. The eligible entities include: (1) "ACO Professionals," which are defined as physicians, nurse practitioners, physician assistants and clinical nurse practitioners; (2) hospitals that employ ACO Professionals; (3) a network of ACO Professionals, partnerships and joint ventures between hospitals and ACO Professionals; and (4) any other entity that the Secretary may approve. Several important points about ACOs under the Program are: ACOs must have shared governance that includes ACO suppliers, providers and beneficiaries in the governance structure, but not necessarily include members of the board of directors or managers, depending upon the structure. Shared governance may include advisory boards to the governing board of the ACO. Importantly, at least 75% of the control must be in the hands of the ACO participants—providers, suppliers and beneficiaries. Federally Qualified Health Centers ("FQHC") and Rural Health Centers ("RHC") are not considered eligible entities, but ACOs that include FQHCs and RHCs in their network will receive enhanced payments based on the number of visits. Each ACO must enter into an agreement with CMS for a three-year term and must have at least 5,000 beneficiaries assigned to the ACO. Under the Program, any agreement between CMS and an ACO may be terminated for failure to meet quality and other performance criteria, avoiding at-risk beneficiaries and other compliance requirements. How Are Beneficiaries Assigned to ACOs? Under the proposed regulations, the beneficiaries are allocated to the ACO based on the physicians with a specialty designation of general practice, family practice, geriatrics and internal medicine that provide the plurality of primary care services to the beneficiaries. The plurality is based on the sum of the allowable charges provided by the ACO physicians to the beneficiaries during the contract year. How Are the Shared Savings Contracts Structured? The total savings to be shared depends upon the type of risk contract the ACO enters into. There are two types of contracts: "One-Sided" and "Two-Sided" contracts. The One-Sided contract shares only the savings and not the losses between CMS and the ACO. In the Two-Sided risk contract, the ACO shares both the savings and the losses. How Are the Shared Savings Calculated and Shared? CMS will determine a benchmark, which includes the risk adjusted, per capita FFS expenditures for Parts A and B for the past three years. It will also be adjusted for certain trends for those beneficiaries assigned to the ACO. To minimize variation based on catastrophic claims, CMS will make certain adjustments to the benchmark. A minimum savings rate ("MSR") will be determined by CMS based on a sliding scale of the total number of beneficiaries. As the number of beneficiaries increases, the MSR will decrease. To determine the savings to be shared, the applicable minimum savings rate is applied to the benchmark, and if the ACO per capita expenditure for beneficiaries assigned to the ACO under Parts A and B is less than the adjusted benchmark, then the difference between the actual per capita expenditures and the benchmark reduced by the minimum savings rate will be shared between CMS and the ACO. For One-Sided contracts, ACOs shall receive 50 percent of the savings, not to exceed 7.5 percent of the benchmark. For Two-Sided contracts, ACOs shall receive 60 percent of the shared savings up to 10 percent of the benchmark. On all contracts, CMS may also withhold up to 25 percent of the savings to be shared to protect against premature termination. Each ACO with a Two-Sided contract must also provide for reinsurance and place funds in escrow, or other repayment mechanisms to assure the repayment of losses. How Do Quality Measures Factor into the Savings Calculation? In order to receive shared savings payments, the ACO must also meet certain quality performance measures which include patient safety, patient care, care coordination, high-risk/frail elderly and preventative health measures. In addition, the ACO must meet other related quality measures including but not limited to "Meaning Use" criteria required for electronic health records under the HITECH Act. Finally, all ACOs must demonstrate that their Programs are patient-centered. What About Anti-trust Considerations Which ACOs Have Raised? The Department of Justice and the Federal Trade Commission have issued an Antitrust Policy Statement that applies to ACOs approved for participation in the Program. The chart below illustrates what conditions necessitate antitrust review based on the potential for reducing competition within the primary service area ("PSA") by the ACO. ACO PSA Share Review Process Less than 30 percent (with a rural exception) Safety Zone—No antitrust review necessary by the antitrust agencies. Greater than 30 percent and less than 50 percent Expedited Review—Comply with list of conduct restrictions, or proceed without antitrust assurances. ACOs may: 1. Request an expedited review by the antitrust agencies and submit letter from the reviewing antitrust agency confirming that it has no present intent to challenge or recommend challenging the ACO, 2. Begin to operate and abide by a list of conduct restrictions, reducing significantly the likelihood of an antitrust investigation, or 3. Begin to operate and remain subject to antitrust investigation if it presents competitive concerns. Greater than 50 percent Required Expedited Review—ACO must seek review by the antitrust agencies to assess likelihood of procompetitive and anticompetitive effects. ACO eligibility to participate in Shared Savings Program is contingent on the ACO’s submission of a letter from the reviewing antitrust agency confirming that it has no present intent to challenge or recommend challenging the proposed ACO. No ACO will be approved for the Program if the ACO requires antitrust approval and does not receive it. These proposed regulations are complex and offer many opportunities for innovative contracting. The payment system based on shared savings raises concerns about whether providers and suppliers will be better off financially under these programs. Providers and suppliers must consider all the financial, operational and governance ramifications before joining an ACO. About Duane Morris Duane Morris has an online Healthcare Reform Center to help guide employers, hospitals, physicians, nursing homes, and providers of home care services and new nursing home alternatives in their efforts to comply with the Patient Protection and Affordable Care Act of 2010. To access links to the relevant legislation and other online resources, a timeline of what to do and when to do it, and changes and provisions affecting healthcare providers, visit www.duanemorris.com/HealthcareReform. For Further Information If you have any questions about this Alert or would like more information, please contact C. Mitchell Goldman, any of the attorneys in our Health Law Practice Group or the attorney in the firm with whom you are regularly in contact. Disclaimer: This Alert has been prepared and published for informational purposes only and is not offered, or should be construed, as legal advice. For more information, please see the firm’s full disclaimer.
Source: jdsupra.com

Video: clinical chart documentation review crosswalking CMS Medicare 2010 regulations.mov

FAH: Hospitals face inconsistent Medicare audits

A single entity should conduct Medicare audit activity, rather than the current approach of multiple audits, the Federation of American Hospitals (FAH) told the Senate Finance Committee on Friday. "Hospitals currently are subject to activities by numerous Medicare auditors, many of which employ inconsistent auditing standards. … [T]here is a wide variability in auditor qualifications and experience. Multiple audit sources, all looking into the same issue or types of issues, creates confusion and imposes significant additional costs," FAH stated.
Source: fiercehealthcare.com

Federal Circuit Court Finds Part C Medicare Advantage :Gould & Lamb

The court also recognized that Congress’s goal in creating the Medicare Advantage program was to harness the power of private sector competition to stimulate experimentation and innovation that would ultimately create a more efficient and less expensive Medicare system. See, e.g., H.R. Rep. No. 105-217, at 585 (1997) (Conf. Rep.) (stating that MA program was intended to “enable the Medicare program to utilize innovations that have helped the private market contain costs and expand health care delivery options”). It was the belief of Congress that the MA program would “continue to grow and eventually eclipse original fee-for-service Medicare as the predominant form of enrollment under the Medicare program.” Id. at 638. The MA program was thus, like the MSP statute, “designed to curb skyrocketing health costs and preserve the fiscal integrity of the Medicare system.” Fanning v. United States, 346 F.3d 386, 388 (3d Cir. 2003).
Source: themedicarecomplianceblog.com

Are Hospitals Claiming Inappropriate Observation Stays to Avoid Medicare’s Inpatient Readmission Regulations?

Under Medicare regulations, a hospital is entitled to only one payment if a same-day readmission occurs for symptoms related to the prior stay’s medical condition. This regulation was crafted to deter unnecessary discharges and readmissions solely intended to increase reimbursement. However, according to the results in a recent study in Health Affairs, hospitals may be sidestepping the Medicare same-day readmission regulations by simply coding the second stay as an “observation stay.”  The researchers from Brown University looked at Medicare data from 2007 to 2009, and they found that observation stays have skyrocketed 25% in three years, while inpatients admissions have gone down. Medicare claims for medically unnecessary observation stays trigger federal False Claims Act liability. Based on this report, this Medicare fraud pattern is costing Medicare millions of dollars each year. In addition to setting off Medicare fraud alarms, this billing and coding practice has also caught the ire of patient groups.  In fact, a class-action lawsuit has been filed against HHS, arguing that the rampant inappropriate use of observation status has illegally denied patients Medicare coverage and burdened them with hospital bills that racked up to hundreds or even thousands of dollars. Notably, patients who are under observation status rather than admitted are covered by Medicare Part B instead of Medicare Part A, which results in patients picking up a larger share of the healthcare tab. More information for whistleblowers is located at the Nolan & Auerbach, P.A. website.
Source: medicare-fraud.net

Medicare says it will enhance beneficiary role in quality care review … say what?

CMS is proposing to increase HOPD payment rates by 2.1 percent. The increase is based on the projected hospital market basket—an inflation rate for goods and services used by hospitals—of 3.0 percent less statutory reductions totaling 0.9 percent, including an adjustment for economy-wide productivity. CMS is also proposing to increase ASC payment rates by 1.3 percent – the projected rate of inflation of 2.2 percent minus an adjustment required by law for improvements in productivity of 0.9 percent. Medicare uses the consumer price index for urban consumers (CPI-U) as the inflation rate for ASCs. CMS is asking for public comment on potential data that Medicare could collect to develop an inflation index that would explicitly measure ASC cost growth.
Source: quinnscommentary.com

‘Protected Classes’ Prescription Drug Mandates Would Hike Small Business …

WASHINGTON, July 18, 2012 /PRNewswire-USNewswire/ — Imposing a federal “protected classes” prescription drug mandate on individual and small employer plans would raise premiums, grant drug companies unlimited pricing power, and create strong opposition from small businesses, the Pharmaceutical Care Management Association (PCMA) said today.  The Centers for Medicare Medicaid Services (CMS) says a similar mandate is dramatically increasing costs in Medicare Part D.
Source: techsciencenews.com

Nurse Officer Opening; CMS; Boston, MA

Familiarity with all aspects of the Medicare program, including federal laws, regulations, policies, and procedures.  Understanding of the terms and conditions of Medicare Part A and B contracts and operational aspects of the assigned contractors. Knowledge of interrelationship of CMS programs with other federal and/or state programs. Provides authoritative advice, assesses contractor performance, implements program changes, and builds relationships with regional partners.
Source: phs-nurse.org

Repairing the Healthcare System: Another Big Mistake!

http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4405&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date
Source: typepad.com

Xerox Healthcare Recovery Services: CMS and Medicare Advantage Plans by Myco Dang

In response to recent adversarial position against the federal regulation, the Centers for Medicare & Medicaid Services (CMS) issued a memorandum regarding Medicare Secondary Payment Subrogation rights. (See attachment). CMS reaffirmed its intention in its regulations to give Medicare Advantage Organizations (MAOs) and Prescription Drug Plan (PDP) the right under the existing Federal law to be secondary payers. CMS reaffirmed its position that MAOs are entitled to exercise the same rights to recovery that the Secretary exercises under the Medicare MSP regulations. Despite recent court rulings to the contrary, CMS maintains that the existing MSP regulations apply to MAOs and PDPs and are not limited to seeking remedies in State Court.
Source: blogspot.com

Daily Kos: Romney and Bain profited from massive Medicare Fraud

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karmacop, BachFan, LeighAnn, Patriot Daily News Clearinghouse, myboo, Kingsmeg, cybersaur, Clytemnestra, Compost On The Weeds, BlueInARedState, hungrycoyote, tonyahky, HoundDog, rl en france, cookseytalbott, Dvalkure, kestrel9000, technomage, KenBee, Son of a Cat, fou, luckydog, blueoasis, SherriG, global citizen, Ashaman, gpoutney, agnostic, Libby Shaw, real world chick, JVolvo, Zwoof, MikMouse, middleagedhousewife, AllDemsOnBoard, bumbi, rage, CA Nana, profh, doingbusinessas, Clive all hat no horse Rodeo, Lovo, Stripe, frankzappatista, blueoregon, Statusquomustgo, kurious, bstotts, matx, AllanTBG, OHdog, Aaa T Tudeattack, cpresley, DBunn, tegrat, One Pissed Off Liberal, FlamingoGrrl, fisheye, Cronesense, Loudoun County Dem, SharonColeman, devis1, gloriana, cobaltbay, Wino, LillithMc, Matt Z, terabytes, deepeco, joedemocrat, davehouck, bnasley, Kentucky Kid, HCKAD, jayden, jedennis, cyncynical, Back In Blue, SeaTurtle, jnhobbs, Librarianmom, Wreck Smurfy, uciguy30, GeorgeXVIII, 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schnecke21, Leftcandid, Larsstephens, Lefty Ladig, ruscle, cassandraX, Clyde the Cat, Amber6541, hotdamn, smileycreek, just like that, icemilkcoffee, roadbear, The Jester, NJpeach, eXtina, estreya, drainflake77, gramofsam1, Susan from 29, Observerinvancouver, blueyescryinintherain, vixenflem, secret38b, fidellio, Anima, Crabby Abbey, LOrion, mjbleo, Garfnobl, RJP9999, Eddie L, gulfgal98, pixxer, ItsSimpleSimon, Kristina40, itswhatson, elengul, MsGrin, BlueFranco, ericlewis0, Floande, eclecta, USHomeopath, debk, Anne was here, whatever66, Actbriniel, slice, Quantumlogic, Mike08, Maximilien Robespierre, spindr27, TAH from SLC, kerflooey, surfermom, muzzleofbees, mama jo, I love OCD, Dretutz, ozsea1, sfcouple, afisher, Mr MadAsHell, freesia, BPARTR, anyname, FarWestGirl, skip945, KelleyRN2, Alice Olson, trumpeter, mrsgoo, Haf2Read, marleycat, PorridgeGun, zukesgirl64, Kokomo for Obama, Cinnamon, sethtriggs, Cinnamon Rollover, thomask, BarackStarObama, muddy boots, rk2, Grandma Susie, createpeace, DeviousPie, antooo, peregrine kate, VTCC73, Caddis Fly, Jamie Sanderson, Andrew F Cockburn, SNFinVA, randomfacts, Vatexia, Pope Buck I, MattYellingAtTheMoon, Sunspots, thejoshuablog, DRo, Mentatmark, CoyoteMarti, Auriandra, DEMonrat ankle biter, ParkRanger, Nashville fan, ArtemisBSG, No one gets out alive, johnnr2, bearette, AnnetteK, Only Needs a Beat, jacey, ridemybike, gnostradamus, Liberal Granny, JTinDC, RhodaA, OldDragon, TheLizardKing, HotAsMaPacman, Siri, IndieGuy, James Renruojos, S F Hippie, orangecurtainlib, barkingcat, a2nite, Deep Texan, rukidingme, HoofheartedBC, congenitalefty, Horace Boothroyd III, This old man, Mike RinRI, Karelin, Spirit Dancer, TBug, My Name Isnt Earl, Arahahex, MartyM, marking time, wxorknot, redstella, Vote4Obamain2012, arizonablue, Victim of Circumstance, Kinak, ItsaMathJoke, dotdash2u, wasatch, databob, Melanie in IA, Robynhood too, Ron Ebest, Near Miss, Lily O Lady, Blue Bell Bookworm, DamselleFly, ebailey, The grouch, Herodotus Prime, Late Again, dear occupant, patchmo13, parsonsbeach, howabout, Icicle68, bob152, ET3117, tngirl, blue91
Source: dailykos.com

Emdeon Current: New Payer Transactions

Posted by:  :  Category: Medicare

Claims Management Services, Payer ID: 39141 Clarian Health Plans Inc., Payer ID: 95444 Connecticare – Medicare, Payer ID: 78375 CoreSource Little Rock, Payer ID: 75136 DiaTri LLC, Payer ID: 36439 Employee Benefit Systems, Payer ID: 42149 Fallon Community Health Plan, Payer ID: 22254 GHI – Medicare Private Fee for Service, Payer ID: 22937 GHI – New York (Group Health Inc.), Payer ID: 13551 GHI HMO, Payer ID: 25531 Geisinger Health Plan, Payer ID: 75273 Group Health Cooperative of South Central Wisconsin, Payer ID: 39167 Group Health Inc., Payer ID: 22937 HIP – Health Insurance Plan of Greater New York, Payer ID: 55247 Harrington Health-Kansas (formerly known as Fiserv Health-Kansas), Payer ID: 62061 Harvard Pilgrim Health Care, Payer ID: 4271 ISLAND HOME INSURANCE COMPANY, Payer ID: IU Medical Group Primary Care, Payer ID: SX172 Integra Group, Payer ID: 31127 LIFE Pittsburgh, Payer ID: 25181 Landmark Healthcare Inc, Payer ID: LNDMK MED PAY, Payer ID: 88058 MEDICA HEALTH CARE PLAN INC., Payer ID: 78857 March Vision Care Inc., Payer ID: Call Meritain Health / Agency Services, Payer ID: 64158 Meritain Health/North American Administrators, Payer ID: 64157 Metropolitan Health Plan, Payer ID: 10850 Montefiore Contract Management Organization, Payer ID: 13174 Network Health, Payer ID: 4332 Network Health Insurance Corp-Medicare, Payer ID: 77076 North American Administrators Inc., Payer ID: 64157 North American Health Plan, Payer ID: 64157 North American Preferred, Payer ID: 64157 Northstar Advantage, Payer ID: 60058 ODS Health Plan, Payer ID: 13350 PacificSource Health Plans, Payer ID: 93029 Paragon Benefits Inc., Payer ID: 58174 Prism-First Health, Payer ID: 37303 Screen Actors Guild, Payer ID: 99289 Touchstone Health PSO, Payer ID: 23856 Trellis Health Partners, Payer ID: 36397 Vytra Healthcare, Payer ID: 22264 Weyco Inc., Payer ID: 38232 Wisconsin Department of Corrections, Payer ID: 74101 Anthem Blue Cross, Payer ID: 47198 Associated Benefits, Payer ID: 50266 Blue Cross Blue Shield of New Mexico, Payer ID: SB790 Blue Cross Blue Shield of Oklahoma, Payer ID: SB840 Illinois Medicaid, Payer ID: SKIL0 Nebraska Medicaid, Payer ID: SKNE0 New Hampshire Medicaid, Payer ID: SKNH0 Eligibility Inquiry and Response Ameritas Group, Payer ID: AMERITAS Ameritas Life Insurance Company, Payer ID: 425 CoreSource – FMH, Payer ID: CORSE00204 CoreSource – FMH, Payer ID: CRSKC CoreSource – Little Rock, Payer ID: CORSE00205 CoreSource Little Rock, Payer ID: CRSAR Coresource – FMH, Payer ID: 204 Coresource Little Rock, Payer ID: 205 First Ameritas of New York, Payer ID: 426 First Ameritas of New York, Payer ID: AMTAS00426 First Reliance Standard Life Ins Co., Payer ID: 428 First Reliance Standard Life Insurance Company, Payer ID: AMTAS428 MMSI, Payer ID: 85 MMSI, Payer ID: MMSI Medica, Payer ID: 404 Medica, Payer ID: MEDIC Medical Mutual of Ohio, Payer ID: 211 Medical Mutual of Ohio, Payer ID: MMO00211 Nippon Life Benefits, Payer ID: NIPON Peoples Health, Payer ID: PPLSH Reliance Standard Life Insurance Company, Payer ID: 427 Reliance Standard Life Insurance Company, Payer ID: AMTAS00427 SAMBA Health Benefit Plan, Payer ID: SAMBA Standard Insurance Company, Payer ID: 429 Standard Insurance Company, Payer ID: AMTAS00429 Standard Life Insurance Company of New York, Payer ID: 430 Standard Life Insurance Company of New York, Payer ID: AMTAS00430 ameritas, Payer ID: AMTAS00425 Blue Cross Blue Shield of Pennsylvania (Highmark), Payer ID: BCPAC Blue Cross Blue Shield of Pennsylvania – Highmark, Payer ID: 440 Mountain State, Payer ID: MTNST Affinity Health Plan, Payer ID: AFNTY New Jersey Medicaid, Payer ID: AID19 New Jersy Medicaid, Payer ID: NJ South Dakota Medicaid, Payer ID: AID28 South Dakota Medicaid, Payer ID: SD Claim Status And Response: Ameritas Group, Payer ID: AMERITAS Ameritas Life Insurance Company, Payer ID: 425 CoreSource – FMH, Payer ID: CORSE00204 CoreSource – FMH, Payer ID: CRSKC CoreSource – Little Rock, Payer ID: CORSE00205 CoreSource Little Rock, Payer ID: CRSAR Coresource – FMH, Payer ID: 204 Coresource Little Rock, Payer ID: 205 First Ameritas of New York, Payer ID: 426 First Ameritas of New York, Payer ID: AMTAS00426 First Reliance Standard Life Ins Co., Payer ID: 428 First Reliance Standard Life Insurance Company, Payer ID: AMTAS428 MMSI, Payer ID: 85 MMSI, Payer ID: MMSI Medica, Payer ID: 404 Medica, Payer ID: MEDIC Nippon Life Benefits, Payer ID: NIPON Peoples Health, Payer ID: PPLSH Reliance Standard Life Insurance Company, Payer ID: 427 Reliance Standard Life Insurance Company, Payer ID: AMTAS00427 SAMBA Health Benefit Plan, Payer ID: SAMBA Standard Insurance Company, Payer ID: 429 Standard Insurance Company, Payer ID: AMTAS00429 Standard Life Insurance Company of New York, Payer ID: 430 Standard Life Insurance Company of New York, Payer ID: AMTAS00430 For all payers, visit https://access.emdeon.com/PayerLists/
Source: blogspot.com

Video: Astoria Urgent Care Steinway.MOV

I am 64. If I already have a FEP health insurance plan (BC/BS), what is the advantage…?

I am being flooded with solicitations from health insurance companies to purchase supplemental health care coverage for medicare part B. I am confused by the literature I have read; and non of my peers seem to know any more than I do. I see no advantage to dropping my current health plan to enroll in medicare part b and purchase additional coverage to provide what I already have.
Source: xmastips.com

GHI Simply Slim Premier Digital Mini

The G.H.I. Original Factory Replacement Tubes and Domes are designed for Simplicity Brand Hearing Aid Models. Included are three women’s size, small length, right side replacement tubes and domes. General Hearing Instruments’ tubes and domes are an essential part of your Simplicity brand open-fit hearing aids. Replacement tubes not only look and feel better, but they also help your open ear hearing aids fit better. Your tubes and domes should be replaced about once every three months, for your h
Source: chha-ifhohcongress2008.com

Constance (connie) Erdmann, Clinical Social Work/Therapist, Bellmore, NY 11710

Stress, depression and anxiety can leave you feeling overwhelmed. I can help you understand the underlying cause of these feelings. I offer an eclectic approach, allowing me the ability to adapt to best suit individual needs. I will support and challenge you; providing a safe place to explore your feelings and make positive changes.
Source: psychologytoday.com

Medicare MSPRC contract change

Although there has not  been a formal announcement  it appears that the new contactor to perform recovery activities on behalf of Medicare will be Group Health Incorporated (GHI).  GHI is a familiar entity to Medicare as GHI has been the Medicare Coordination of Benefits (COB) since 1999. Under the new contract GHI will expand its role to include the recovery portion of the Medicare process.
Source: lienresolutiongroup.com

EHR PHR Patient Portals with Meaningful Use = Patient Centered Medical Home (PCMH)

Use of Electronic Health Record Systems in 2011 Among Medicare Physicians Providing Evaluation and Management Services They found that 57 percent of Medicare physicians used an EHR system at their primary practice location in 2011. Twenty-two percent of physicians first began using EHR systems to document E/M services in 2011, the year that CMS commenced its incentive program. Additionally, three of every four Medicare physicians with an EHR system used a certified system to document E/M services. Finally, although many EHR systems can assist physicians in assigning codes for E/M services, we found that most Medicare physicians manually assigned E/M codes. GAO Report
Source: blogspot.com

“Medicare” Lunch N Learn with Golf for CPA’s

Posted by:  :  Category: Medicare

"We hang the petty thieves and appoint the great ones to public office." ~AESOP. by eyewashdesign: A. GoldenRetirement planning goes beyond investment models and cash flow analysis. It means recognizing options and helping your clients make decisions, including those pertaining to Medicare. This course will debunk common myths and explore the mechanics of how the program works and how to supplement the coverage and grow your business.
Source: patch.com

Video: Medicare Supplement Insurance

Healthcare Act Still Leaves Some Hurdles For Seniors (Part Two)

Consumer’s Guide to Medicaid, Veteran’s Benefits for Long Term Care Needs and Incapacity Planning Consumer’s Guide to Hospice Care in Florida – It’s Much More Than You Think Consumer’s Guide to Alzheimer’s Disease – The Plain Truth Special Report: The “Time Bomb”…Why You Need a Board Certified Elder Law Attorney to Apply for Your Veteran’s or Medicaid Benefits Special Report: Making a Loud Statement – The Indispensable Guide to Wealth and Legacy Preservation for Florida’s Silent Generation Special Report: Special Concerns in Estate Planning for Same-Sex Couples
Source: florida-elderlaw.com

Study examines variation, factors involved with patient

“Characteristics of physicians’ patient populations also were associated with the presence of ties between physicians. Across all racial and ethnic groups, connected physicians had more similar racial compositions of their patient panels than unconnected physicians. For instance, connected physician pairs had an average difference of 8.8 points in the percentage of black patients in their 2 patient panels compared with a difference of 14.0 percentage points for unconnected physician pairs. Similarly, differences in mean [average] patient age and percentage of Medicaid patients also were smaller for connected physicians than unconnected physicians. Medical comorbidities [co-existing illnesses] were also more similar, suggesting that connected physicians had more similar patients in terms of clinical complexity than unconnected physicians,” the authors write. “Physicians thus tend to cluster together along attributes that characterize their own backgrounds and the clinical circumstances of their patients.”
Source: sciencecodex.com

New figures: Medicaid expansion would save Arkansas money

No, Drackman, let’s go back to the current system with local hospitals closing and if you’re in a car acciodent outside the major metro areas, well too damn bad. The current system with 40% of the population uninsured and dependent on ERs for any medical casses may make sense to you but probably so did a bunch of other things that intelligent nations changed a generation ago. It’s not “free money” but until we get a tax code that reflects the way that responsible countries work and doesn’t favor the rich and well-connected over everyone else, we will be either going with ACA or we will keep the current broken system with insurance company “death panels”. If ACA is defunded, the chances of rural hospitals going under get real and since most of this state is still rural and the average age is probably close to 60 already, congratulations. Rural areas across the south will just die out (and “die” is a real word). While we are at it on this get rid of “free money” kick, let’s get rid of the 47% of the state budget that comes from the “blue” states. If that happens, you can kiss a lot of state services good-bye. Let the fires burn in the forests along with the houses as they shouldn’t have built near trees, let the floods occur as anyone who lives near water is taking chances, and don’t regulate any industry as we sure like to see the earth move (ask those who saw a 250% increase in their earthquake insurance premium this month).
Source: arktimes.com

Larimer County Republicans Office Locations

The Loveland Office is located near King Sooper Shopping Center at S. Taft and 14th St SW on 10th Street.  Address is 1480 10th Street SW. Phone: (970) 672-9610 We have lots of information about candidates, yard signs, bumper stickers, etc.  We need volunteers for helping with phone calling, and mailing activity.
Source: rightturncolorado.org

Judgment Blog: Dead Debtors And SSDI

Posted by:  :  Category: Medicare

The Old Crown, Digbeth - Beer garden / carpark by ell brownOne way that judgment debtors avoid paying off judgments is to die. When a judgment debtor dies, it is usually game over for most creditors. However, some judgment owners either check their late debtor’s estate situation. Depending on what they find out, some creditors might try to recover something on their judgment by filing a claim. For judgment owners, there is only a short time after their judgment debtor’s death, to file their creditor’s claim on the judgment debtor’s estate. The reason you want to verify if your judgment debtor died, is so that you can file a timely claim, to include their judgment debt in your judgment debtor’s estate. If you are polite and respectful, sometimes their family will pay or settle a deceased judgment debtor’s debt, occasionally even if an official claim has not been filed. This article is my opinion, and not legal advice. I am a judgment broker, and am not a lawyer. If you ever need any legal advice or a strategy to use, please contact a lawyer. One way to discover the death of your judgment debtor is to use the Social Security Death Index (SSDI). The SSDI includes a Death Master File, which is a list of all persons who are reported as having died, to the Social Security Administration. This list is not perfect or guaranteed, however it is usually accurate. Usually, the younger your judgment debtor or person of interest was, the more specific the SSDI tends to be.  Full access to the SSDI is not free. The Social Security Administration does not make their Death Master File records directly available online. However, the records are usually available through genealogy websites; search for “SSDI” or “Social Security Death Index”. Web sites such as www.ancestry.com, www.familysearch.org, and others; allow you to search and access some historical death records for free. The best search results usually cost money. The SSDI data includes the dead person’s year of death, given (first) name, surname (last name), and middle initial. Really old SSDI records have only the year of death, old records have the month and year. The more recent the death, the better chance there will be exact and complete dates of birth and death, with zip codes. Note that if you do not find a listing in the SSDI, it does not mean the person is still living, or that the Social Security Administration (SSA) has no records on the deceased. On publicly accessible search sites, social security numbers are now one-way. One can search by the full social security number, however the full social security number is never shown on (legal) public web sites. Paid professional databases, available for those having permissible purpose to subscribe to, may allow their subscribers to see their judgment debtor’s full social security number. Once somebody dies, their privacy rights fade fast, because of the Freedom of Information Act (FOIA). By making dead people’s social security numbers available, much fraud is prevented. To get a copy of a dead person’s social security information, you must pay, and provide a copy of their death certificate.  If you know your judgment debtor is dead, search on the web for “Form SSA-711″ to get an application and pay for a copy of the SS card of a dead person, or a “computer extract” (which seems only a slightly more useful option). This will likely list their place of birth, father’s name, and mother’s full maiden name. Another way to go is to search for form “SS-5″, to get the application form for copy of a dead person’s social security card. ——- Don’t assign your judgment, http://www.JudgmentBuy.com – Judgment Enforcement. The free, easiest, fastest, smartest, and best way to recover your judgment money nationwide for 33% or less, worldwide for 50% (Mark D. Shapiro)
Source: blogspot.com

Video: How to Win Your Social Security Disability Case Early

What is a Representative Payee?

A representative payee is an individual or organization appointed by SSA to receive Social Security and/or SSI benefits for someone who cannot manage or direct someone else to manage his or her money. The main responsibilities of a payee are to use the benefits to pay for the current and foreseeable needs of the beneficiary and properly save any benefits not needed to meet current needs.  A payee must also keep records of expenses.  When SSA requests a report, a payee must provide an accounting to SSA of how benefits were used or saved.
Source: tampabaydisabilityattorney.com

Every Document and Form You Need For Your Home Business

Because each state has different laws regarding the regulation of home-based businesses it’s best if you visit the Small Business Administration website to search for what you need.  Find out if you need to register your business, if you need any licenses or permits, etc.  Here is a screenshot that shows you how to search for what you need:
Source: freelancemom.com

COMMON CENTS: Rep Allen West “Social Security is a form of Modern Day Slavery”

Courtesy of Mediaite.  Fox News interviewed Rep Allen West who tears into the modern day welfare system.  West brings up the point that 85,000 people went on Federal Disability in June while only 80,000 jobs were created.
Source: blogspot.com

Social Security For Disabled Children

Social Security benefits are intended to help Americans that are in need of financial support because of a debilitating injury or illness. Although many applicants are senior citizens who have developed age-related limitations, children may be eligible for this type of support through their parents. If they require special care from their parents in the form of time, energy, and finances, Social Security benefits may be the best way to help the family manage the associated costs.
Source: gloucesterpharma.com

Health information technology questions and answers

Accountable Care Organizations, ACO, ACOs, Clinical IT, CDS and data analytics, cloud computing, Coding and documentation, Data exchange, Data management and data standards, Devices, DICOM, ehr, EHR Certification, EHR implementation, EHR Incentive, EHR Integration, EHR systems, electronic health record, Electronic Health Record (EHR), EMR, Hardware and software, Health care applications and vendor organizations, Health care models and frameworks, Health care reform and federal initiatives, Health information exchange, healthcare, HIE, HIPAA, HL7, ICD-10, Imaging, Industry organizations, associations and events, Interoperability and health information exchange, iPad, Meaningful use, mhealth, Mobile devices and telehealth, Networking, PACs, PHRs and patient engagement, Practice and care management, Privacy and security, RECs, Regional Extension Centers, RIS, SaaS, security, Staffing, Storage and PACS, tablets, Virtualization and cloud computing …  
Source: techtarget.com

Allen West On Social Security: ‘Modern, 21st Century Slavery’

“Now, when people are running out of the unemployment benefits, now they are looking toward going on social security disability. … So, once again, we are creating the sense of economic dependence, which to me is a form of modern, 21st century slavery.”
Source: businessinsider.com

Will I be subject to the3.8% Medicare surtax in January 2013?

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 marsmet481Timing outlier events that may increase AGI such as sales of a business or sales of your residence or rental properties. If any of these events can take place prior to January 2013, do it. If not, make sure your accountant is apprised to the situation to determine if any planning can be done to reduce the tax exposure.
Source: greenhausriordan.com

Video: Medicare Part D | How to Apply for Medicare Part D

How do I sign up for Medicare in Texas?

If you are not receiving Social Security benefits when you turn 65, you actually need to apply for Medicare Parts A and B. You can do this at the same time you file for your Social Security retirement benefits, or you can choose to postpone Social Security and just apply for Medicare. There are three ways to do this: • Sign up for Medicare online: This is very easy to do. Just visit the Social Security website at www.ssa.gov and click “Apply online for Medicare” on the left side of the page. • Sign up for Medicare by phone: You can also call Social Security at 800-772-1213 and tell them that you’re ready to apply for Medicare. They may be able to help you right away or, if their call volume is high, they may schedule a phone appointment where a representative can take your Medicare application by phone. • Sign up for Medicare in person: If you prefer to do business face-to-face, you have the option of applying for Medicare at your local Social Security office. This may be the best option if you are near age 65 and need your application processed quickly.
Source: insurancemedicaresupplementtexas.com

How the New Medicare Tax Will Affect Real Estate

The investor has a full-time job and his salary is $90,000 per year.  He invested in several rental properties with gross rents of $150,000. The investor is able to deduct depreciation, debt service and other overhead expenses related to the rentals (at least as we speak today).  For argument sake, let’s say those expenses amount to $120,000.  The net rental profit is $30,000.  Now his new Adjusted Gross Income is $120,000.  Since this AGI falls well below the $200,000 limit, no tax has to be paid.
Source: newresalehomes.com

Kentucky Academy of Family Physicians

Up to 75 practices will be selected within the region to participate—your practice could be one of them! Physicians in these practices will receive a monthly care management fee averaging $20 per month for each Medicare patient to support enhanced primary care services. This is in addition to traditional fee-for-service reimbursement. Ohio Medicaid and nine other private payers will also be participating in this blended payment model.
Source: kafp.org

Medicare Beneficiaries Less Likely To Experience Cost

The experiences of people covered by Medicare and those with private employer insurance can help inform policy debates over the federal budget deficit, Medicare’s affordability, and the expansion of private health insurance under the Affordable Care Act. This article provides evidence that people with employer-sponsored coverage were more likely than Medicare beneficiaries to forgo needed care, experience access problems due to cost, encounter medical bill problems, and be less satisfied with their coverage. Within the subset of beneficiaries who are age sixty-five or older, those enrolled in the private Medicare Advantage program were less likely than those in traditional Medicare to have premiums and out-of-pocket costs exceed 10 percent of their income. But they were also more likely than those in traditional Medicare to rate their insurance poorly and to report cost-related access problems.
Source: globalhealthhub.org

Student Visa (572)> Lodged Partner Visa (820) = Medicare?

Hi guys, I currently holding student visa TU 572, and had lodged my partner visa application (820 & 801) last week and been issued with receipt and acknowledge letter. Just wondering if I may be able to apply for a medicare? anyone hav done this and hav experiencsed about this before? I hav private insurance with medibank as per required my student visa to have health insurance. but my partner would like us to get a same medicare card with both us name in one card. I rang the immigration, the lady from melb picked up my phone and was so rude. I asked her and she said its not their problem. I have to ask medicare office for that. I mean to go to medicare office to ask them, but I worry they gonna treat me so rude as many times when I deal with government body they are always so rude. why is that?
Source: australiaforum.com

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

Medicare Select: Are sales opportunities passing you by?

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CareAssured Life Medicare Supplement Combined Insurance Customer Retention Customer Service Gerber Life Medicare Supplement Leads Medicare Select Medicare Supplement Medicare Supplement Plan F Medicare Supplement Plan G Medigap Med Select Mutual of Omaha Medicare Supplement Omaha Insurance Company Medicare Supplement Plan F Plan G Senior Market Advice Senior Market Success Technology United of Omaha Medicare Supplement Web Tips Woodmen of The World Medicare Supplement Combined Insurance (1) Med Supp (2) MedAmerica (1) Medicare Select (1) Medicare Supplement (2) Medigap (2) Plan F (1) Plan G (1) Short Term Care Insurance (1) STC Insurance (1)
Source: psmbrokerageblog.com

Video: Medicare Supplement AARP Plan F Select is A Good Option

UnitedHealth Profit Rises as Medicare Plan Increase

UnitedHealth Profit Rises as Medicare Plan Increase Bloomberg UnitedHealth Group Inc. (UNH), the biggest US health insurer, said second-quarter profit rose 5.5 percent, as the company boosted enrollment among private employers and government Medicare plans. The insurer raised its 2012 forecast. UnitedHealth profit tops views, helped by plan growth
Source: wallstreetexaminer.com

Medicare Select Supplement Insurance Plans

Much like Medicare Advantage plans, the primary disadvantage is simply the constraints of the network. It is important to be certain of any network limitations by first checking with the insurance company and/or the agent before purchasing a policy. And consumers must be aware that certain doctor groups and facilities may be in the approved network one year and out the next.
Source: ohioinsureplan.com

MedicareSupplementPlans.com Connects Consumers With the Best Medicare Supplement Insurance Plan Offers

With the ever-increasing costs of medical care, even Medicare coverage can leave too many unpaid medical bills for the typical consumer to afford. Although Medicare was once considered an effective way to meet the medical care costs of older Americans and people with disabilities, today it simply isn’t enough, which leaves consumers seeking Medicare supplement insurance plans to cover additional costs. MedicareSupplementPlans.com recently launched its redesigned website to provide greater support, in-depth information and quotes for the best Medicare supplement insurance plans available. Also known as Medigap, Medicare supplement insurance plans are private health insurance plans designed to pay some of the health care costs not covered by Medicare, such as co-payments, co-insurance and deductibles. Visitors to MedicareSupplementPlans.com can simply fill out the form available on the site’s landing page to find and compare the best Medicare supplement insurance plans and rates from all of the top insurance companies. After filling out the form and clicking Get Quote, a licensed Medicare supplement insurance agent follows-up with a no pressure, free insurance quote with detailed information about plan options and benefits to meet individualized needs. “The advantage of choosing a supplemental Medicare insurance plan over Medicare Select or Medicare Advantage is that with a Medigap plan you have absolutely no network restrictions; in other words you can go anywhere for your health care as long as the provider accepts Medicare,” explained a MedicareSupplementPlans.com spokesperson. The site connects consumers with highly trained licensed agents. The agents help consumers cut through the jargon so they can select the plan that is most appropriate for them at the best possible price. The site offers a whole host of reference material with brochures, rates and applications for the top suppliers available to download. To assist consumers in choosing the correct plan the site offers a detailed but simple to follow Medicare supplement insurance plan benefit comparison chart. The chart details the benefits of different Medigap policies so consumers can quickly identify which plan is appropriate for their circumstances. Editorialized content accompanies the chart guiding consumers through the technicalities of the policies. About MedicareSupplementPlans.com MedicareSupplementPlans.com is Health and Life Insurance Services, LLC, one of California’s largest independent insurance agencies specializing in the best Medicare supplement insurance plans from leading brands. Visitors to the site can easily access comparison quotes, full customer service and detailed information about Medicare supplement insurance plans, as well as in-depth editorial content to guide them through the decision-making process. Learn more at http://www.medicaresupplementplans.com
Source: sbwire.com

Medicare Select: Are sales opportunities passing you by?

The main difference is that a Medicare Select plans require patients to go to a hospital in the carrier’s affiliated network.  With several locations all over the United States, SELECT plans are especially beneficial to those seniors already utilizing the hospital in the network.  In cases of emergency, a hospital outside of the network may also be used and the costs still covered.
Source: wordpress.com

Texas Medicare Supplement Plan G

Plan G is also available in a money saving Medicare Select option. Basically, if you’re looking to save on premiums, you can receive the same benefits as the standard Plan G but for a reduced premium.  By agreeing to use Medicare Select hospitals and doctors, your monthly payment is reduced. Need emergency care? No problem, with Medicare Select, you can get treatment at any hospital for no extra charge. Plus, you can still choose your own doctor. Remember, to be eligible for Medicare Select Plan G, you must live within 30 miles of a Medicare Select participating hospital.
Source: medicareinsurancetexas.com

Illinois Medicare Supplement Plan G: Is this your Best Option?

Remember, simply because providers must offer the same plans does not mean they are all reputable or dependable. And when it comes time to collect on your benefits, a low cost will not help you if the insurance company cannot deliver. Stay with the major names and get peace of mind in knowing you’re insured with a stable, reliable provider. Blue Cross Blue Shield of Illinois, for example, has been providing Medicare supplement insurance to folks just like you for years. Because they are dependable, they will continue to offer competitive prices and great benefits for years to come.
Source: ssiinsure.com

Aetna Medicare 2012 Review

[…] […] […] You probably have heard of Aetna either through employer group plans or just their extensive advertising.  Aetna does offer Medicare Advantage HMO and PPO plans in many areas throughout the country.  Each plan is different depending on what county you live in.  This review will offer a brief overview of the Aetna Medicare offerings for 2012 as well as their additional benefits and Value Added bonuses that many of their plans include.  Aetna offers four Medicare Advantage plans labeled Aetna Medicare Premier Plan, Aetna Medicare Select Plan, Aetna Medicare Standard Plan, and the Aetna Medicare Value Plan.  As the names imply, the different plans have increased benefits based on plan choice.Source: medicare-plans.net […]Source: medicare-plans.net […]Source: medicare-plans.net […]
Source: medicare-plans.net

IF I Drop Medicare Select Can I Get A Medicare Supplement Plan?

Dropping a Medicare Select plan does not mean a person has to go with a Medicare Supplement Plan. It just means he has to go with one of the standardized plans, provided he can find one. The Medicare select plans were offered prior to 1998. The process of getting the new plan is the same as it would be for someone else. Dropping one plan means he must go through the Medical underwriting process and he does not have a guaranteed issue rights, unless the company dropped him from a Medicare Select plan for any reason.
Source: seniorcorps.org

Nebraska: Nebraska Medicaid Application

Posted by:  :  Category: Medicare

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Source: blogspot.com

Video: Nebraska Medicaid Trying To Silence Me At Any Cost,Even My Life..wmv

Medicaid expansion outlook hinges on viewpoint of law (AUDIO)

Sen. Ben Nelson, during his weekly conference call with Nebraska reporters, harshly criticized Gov. Dave Heineman for refusing to consider expansion of Medicaid. Heineman has argued that the state cannot afford it, even if the federal government eventually pays 90% of the cost. Nelson countered that Nebraskans already pay a huge tab for uncompensated health care, siting a report that estimates hospitals absorb nearly $1 billion in uncompensated care and bad debt, which is transferred to insurance premiums.
Source: nebraskaradionetwork.com

Nebraska: Medicaid In Nebraska

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Source: blogspot.com

Nebraska: Nebraska Medicaid Application

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Source: blogspot.com

Nelson Asks Reid To Cancel Nebraska Medicaid Deal

Roll Call: “Sen. Ben Nelson (D-Neb.) on Friday asked that a deal he secured for his state on Medicaid funding be removed from the health care reform bill, a move that follows weeks of unrelenting political blowback.” The letter asks that Senate Majority Leader Harry Reid, D-Nev., replace their deal for the federal government to pay Nebraska’s new Medicaid bills with a provision that would extend that deal to every state. “However, his letter appears to make clear that regardless of whether that request is granted, he wants the provision affecting Nebraska removed, Roll call reports” (Drucker, 1/15).
Source: kaiserhealthnews.org

Nebraska Medicaid clients urged to enroll in health plans

Nebraska officials are urging Medicaid clients in 83 counties to enroll in a managed health care plan before June 26.    Officials with the Nebraska Department and Health and Human Services say clients should choose one of two expanded health plans before the deadline, and select their primary care provider.    Arbor Health and CoventryCares of Nebraska are offering the health plans. Department officials say Medicaid clients should check to see if their medical provider is listed.    Medicaid clients in 10 southeast Nebraska counties are already enrolled in managed care, and are not affected by the change. The counties not affected are Cass, Dodge, Douglas, Gage, Lancaster, Otoe, Sarpy, Saunders, Seward and Washington. The other 83 counties are moving to managed care on July 1.
Source: ktiv.com

Autism Society of Nebraska

On May 18, 2012, Nebraska Appleseed and the National Health Law Program (NHeLP) filed a class action lawsuit against Vivianne Chaumont and Kerry Winterer, in their official capacities as officers of the Nebraska Department of Health and Human Services (HHS).  The lawsuit challenges Nebraska Medicaid policies that deny coverage for certain mental and behavioral health treatments for children with particular diagnoses and conditions, including developmental disabilities and autism.  The lawsuit, if successful, would effectively strike down Nebraska’s Medicaid policies as in violation of federal law and would ensure that Medicaid eligible children would receive necessary early behavioral health interventions as recommended by their providers.
Source: autismnebraska.org

Nebraska: Nebraska Medicaid Eligibility

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Source: blogspot.com

Lawsuit: State of Nebraska Medicaid Benefits

Nebraska Appleseed Center for Law in the Public Interest filed a class action lawsuit claiming the state of Nebraska refused to give transitional, or temporary, Medicaid benefits to single working parents. According to the class action lawsuit, Medicaid recipients who get new jobs, raises or begin working enough hours that they exceed income limits must be given transitional benefits so they can find an alternative to meet their medical requirements.
Source: lawyersandsettlements.com

Nebraska: Hospitals In Nebraska

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Source: blogspot.com

The security of your future with Medigap insurance

Posted by:  :  Category: Medicare

Gravel MediGap by Mike Licht, NotionsCapital.comTherefore, the best thing that can be done in this respect is to compare Medicare supplement plans before deciding to choose any of them. A random choice of a Medigap insurance is not always a recommended option. In order to compare Medicare supplement plans the best thing that can be done is to visit the Medicare supplement plans websites or any other such websites where you can purchase Medigap plans online and go through the offer documents of all these plans. Therefore, through this process it is always essential to get the best help of the Medicare supplement insurance in order to get the best benefits and the best coverage for your future. However, for every person having the Medicare supplement plans at hand is one of the wisest ideas for a better coverage for your future. You can also seek the aid of an insurance agent for this purpose who can easily offer the best assistance in respect of the choice of the best Medicare supplement plans. In this respect you can easily choose your Medicare supplement plans without any mistake. Therefore, have your Medicare supplement plans handy in order to get the best support for your own future security.
Source: ezinemark.com

Video: Learn About Medigap Plans