Federal Certification for Molina

Posted by:  :  Category: Medicare

Molina Medicaid Solutions, an operating subsidiary of Molina Healthcare, Inc. (MOH), announced that the Centers for Medicare and Medicaid Services (“CMS”) has endowed complete federation certification to implement the Medicaid Management Information System (“MMIS”) in Idaho. The system underwent stringent monitoring for a week, followed by further evaluation by CMS to successfully receive the certification.
Source: topstockanalysts.com

Video: Newly Accepted Insurances & Current Services at American Indian Health & Family Services

Medicaid/Medicare Show Path to Profits for Healthcare Providers

It’s neither. It’s just the law of the land at the moment. Our country’s history is fraught with laws passed that were thought to be the spark of the Apocalypse. Laws have come and gone and we are still here. Now those who take the practical approach to a changing political backdrop are those who in the end profit from those changes. Healthcare reform is here. What we need to do is look at it as it all comes to light and a better understanding, and then act accordingly.
Source: investmentu.com

Medical health Health Insurance Inventory evaluation July 2012 Zacks com

Health expenditure and also reliance With managed proper care gradually growing. Based on the federal government, national well being expenses are expected to touch 4. Six trillion via the end of the decade from 2. Half a dozen trillion At present, which represents a compounded annual progress fee (CAGR) with just about 7. This clearly factors in order to The fact that a medical care industry will definitely outstrip wider financial development. Additionally, above the same time frame, managed proper care penetration is likely to increase to regarding 1/2 of The entire countrywide medical care shelling out, upward from around 1/3rd Currently, driven by increased reliance With insurance providers Within taking care of governments fee-for-service Medicare and Medicaid items.
Source: co.cc

Pacome Munk’s blog on Netlog

Owing to the uncertainty that surrounds our lives, by using a Medigap insurance as described here Info is becoming everyone’s necessity these days. However, with many different insurance companies, this rider only assures you the right to buy additional coverage before you reach a particular age, usually 40. You’ll pay roughly an extra 10% to 15% of your premium for this rider, says Brian Ashe, treasurer of the Life and Health Insurance Foundation for Education. The premium for the additional insurance purchased with the rider could be based on your age when you purchase it. Anyone can buy guaranteed life insurance and enjoy the benefits associated with a life insurance. Guaranteed life insurance doesn’t make any discrimination based on age, sex, or medical condition. You are asked some simple questions like name, age, and address and you are granted a life insurance policy. Guaranteed life insurance is ideal for people who have been declined life insurance on the grounds of pre-existing conditions. Moreover, you aren’t asked to undertake some kind of medical exam to qualify for guaranteed acceptance life insurance unlike guaranteed issue health insurance. Neither will you be asked endless questions regarding your family medical history. All you need to do would be to give some basic information about yourself. Guaranteed life insurance is whole life insurance, wherein you can build cash value. While some part of the premium funds are kept for the claim, the remaining amount is saved as cash value. Over the passage of time, it is possible to get a loan against your cash value reserve. You could also make use of this reserve in case there are emergency expenses. With guaranteed life insurance you get graded benefits. This implies that when the insured passes away within a stipulated time period, the receivers are entitled for only a fraction of the claim. However, if the death occurs in a couple of years when the policy was bought, the beneficiaries get full death claim. Following the death of a policyholder, guaranteed life insurance provides a lump sum amount as death benefit which can be utilized to settle medical bills, mortgage, death tax, burial expenses, and standing bills if any. Guaranteed Medigap insurance policy is probably the best thing that you can do for your own benefit and your loved ones. And in case one does some legwork, you can sure get the best deal, one that offers maximum advantages and it is budget friendly as well. Together with Medicare, guaranteed life insurance is a must especially to those with chronic illnesses. Purchasing life insurance can be an extremely puzzling process. Numerous options with various prices, requirements and benefits are available in the market. When considering one’s own demise, it certainly adds emotions to the procedure which usually is fairly natural. As Medicare covers for the hospitalization expenses incurred, life insurance deals with the costs left behind of the insured. It’s imperative to research for the various kinds of insurance policies offered in order in making the most beneficial decisions possible. One of those types is guaranteed issue life insurance. Guaranteed issue insurance is guaranteed for any person in almost any physical condition without a health check. It is the most beneficial type of health insurance for individuals in bad health or with pre-existing medical conditions. These policies vary from simple issue policies which usually do not require a medical exam, but will require you to answer some medical related questions. A permanent product by way of taking the existing value of the premium stream verses the money value then you will realize it may be more advantageous to buy term and invest the difference. After you have your Medicare as described [url=]Info[/url] settled, talk with your agent on Term Life Insurance cost.
Source: netlog.com

Molina Healthcare’s CEO Discusses Q1 2012 Results

Our comments today will contain forward-looking statements under the Safe Harbor provisions of the Private Securities litigation Reform Act, including statements regarding our Ohio contract appeal, our Texas and California operations, our expansion opportunities with regards to dual eligible integration programs and our earnings per share guidance for 2012. All of our forward-looking statements are based on our current expectations and assumptions, which are subject to numerous risk factors that could cause our actual results to differ materially. A description of such risk factors can be found in our earnings release and in our reports filed with the Securities and Exchange Commission, including our form 10-K annual report for fiscal year 2011, our form 10-Q quarterly reports and our Form 8-K current reports. These reports can be accessed under the Investor Relations tab of our company website or on the SEC’s website. All forward-looking statements made during today’s call represent our judgment as of April 30, 2012, and we disclaim any obligation to update such statements.
Source: seekingalpha.com

Find Out The Specifics Of Molina Medicare Advantage Plans 2012

Molina Healthcare has grown towards one of the leaders in giving top quality healthcare for financially vulnerable individuals and families. Currently, Molina Healthcare arranges for the delivery of healthcare services or provides health information management alternatives for nearly 4.3 million individuals and families who get their care through Medicaid, Medicare and other government financed programs in 16 states. The Molina Medicare Advantage prescription plan is designed to help with prescription medications. To be sure, prescription drugs can be extremely expensive up front. You can pay hundreds of dollars only to pay for monthly medications. The Molina Medicare Advantage prescription plan is designed to aid in that. This plan will offer you the minimum premium and low co-pays for prescriptions. Actually, many generic prescriptions won’t cost anything at all. The prescription plan is added on to other Medicare plans and it’ll cover the expense of prescriptions perhaps even during the Medicare donut hole.
Source: co.uk

Why Many Find the Medicare Set

Posted by:  :  Category: Medicare

Historic Moment: the Fall of an Empire - 25 SEP. 2008. by eyewashdesign: A. GoldenLike most governmental programs, most everyone involved in Medicare set-aside arrangements as they pertain to Workers’ Comp probably end up confused and anxious. The process, which allocates a portion of a worker’s settlement from Workers’ Comp to go toward future medical expenses can be very complex even for those who are regularly involved in it. Should there be a failure to give Medicare notice of a settlement, steep penalties could result. Further, Medicare is not allowed to make payments which are legally the responsibility of another party. Worst of all, the injured employee could find themselves ineligible for Medicare if all issues were not dealt with properly when the settlement occurred. It is recommended that a set-aside agreement be engaged in which takes a percentage of the settlement from Workers’ Comp for impending medical expenses; once this amount is gone—and accounted for—Medicare will kick in for the injured employee.
Source: joshilaw.com

Video: Medicare for All – MoKan demonstration at Blue Cross/Blue Shield offices in Kansas City, Missouri

Medicare and misinformation : CJR

“Increased revenue from higher premiums along with cuts to Medicare—mostly in the form of payment reductions to hospitals and other providers—are part of a package of savings experts hope will reduce the cost of the Medicare program. IN ADDITION TO CALLING A PREMIUM INCREASE A “SAVINGS” IN TRADITIONAL DEMOCRATIC PARTY SPEAK, THE MEANS TESTING OR INCREASED MEANS TESTING OF THESE TWO PARTS OF MEDICARE IS ACTUALLY A SMALL PART OF THE MONEY THAT IS GOING TO BE TAKEN FROM MEDICARE AND GIVEN TO SUBSIDIZED NON-SENIOR INSURANCE. THE SECOND BIGGEST CUT AFTER THE CUTS TO HOSPITALS AND OTHER PROVIDERS (WHICH THE ACTUARY HAS PREDICTED WILL NEVER HAPPEN) IS TO PART C REBATES.
Source: cjr.org

Medicare Whistleblower Lawsuit Settles For $6.1 Million

Between 2004 and 2008, the hospice company submitted improper Medicare claims. The benefits the company was seeking were for individuals who were not expected to live more than six months. The hospice company did not admit to any wrongdoing in the settlement and pointed out that there was never a question as to the quality of care patients were receiving from Hospice Care of Kansas, LLC.
Source: federalwhistleblowerlawyers.com

Health law lowers deficit, costs for consumers

The nonpartisan Congressional Budget Office has again determined that the federal health care law will reduce the deficit, contrary to the rhetoric of many Republicans. What’s more, it calculated that Republican legislation to repeal the law would increase the deficit by $109 billion from 2013 to 2022. That’s not to say that there aren’t serious concerns about the law, including that it doesn’t do enough to control costs. But it won’t create large deficits, at least not during the time period examined by CBO. The law also is lowering some costs for consumers. A new federal analysis found that Kansans on Medicare have saved more than $41 million on prescription drugs since the law was enacted ($3.9 billion saved nationwide). Just in the first half of 2012, Kansans saved an average of $576 on prescriptions that used to be in the Medicare “doughnut hole” coverage gap.
Source: kansas.com

the Kansas Citian: 3 in 4 Doctors Will Quit Medicare if Obamacare Upheld

These numbers should scare even the most ardent supporter of the President’s healthcare reform law.  Not only will wait times increase significantly and the industry fail to attract new doctors, but the poor and elderly will find it even more difficult to get the healthcare they need.
Source: blogspot.com

Proposed Cutbacks in Health Care for Poor Hang in Political Limbo 

Posted by:  :  Category: Medicare

DAMN!! -- I THINK WE'RE F*%KED by SS&SSAnn-Marie Adams Attorney General Bank of America Census 2010 Census 2010 and Hartford Commentary Congressional Black Caucus Dan Malloy Education FOODSHARE foreclosure gas prices Gov. Dannel P. Malloy Gov. Jodi Rell green jobs Hartford Hartford City Council Hartford Mayor Pedro Segarra Hartford Police Hartford Public Library Hartford Public Schools Hartford Shooting Health homicide Housing Jamaica jr. latinos Mayor Eddie Perez Mayor Eddie Perez on Trial Mayor Pedro Segarra Michelle Obama police Police Arrests President Barack Obama Race and Culture recession Snow Storm in CT Tea Party The Hartford Guardian Uconn Huskies unemployment WeekEnd Movie Review Wells Fargo Youth
Source: thehartfordguardian.com

Video: How to Apply For Medicaid in Florida Online

LeadingAge: Care Management as the Essence of Long

How do they view aging-services providers? We are finding that now that we have 153 Medicare ACOs, a shift has begun and hospitals and health systems are becoming very interested in working with post-acute and non-acute providers. I just started working with a health system of four hospitals developing their [ACO] application. In the initial meeting I pointed out that having an effective skilled nursing continuing care network is important when your attributed Medicare lives have an acute care episode. However, to successfully bend the cost curve, ACOs must think beyond episodic care. How do you manage a typical dual-eligible living in the community or in a long-term care facility? How do you manage to avoid the high-cost incidents? It was a shift in thinking for them. They realized the secret to success is not just having a network for post-acute care, but to have a continuing care network for chronic needs of older adults.
Source: leadingage.org

Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011

Interested in learning more about meaningful use, patient-physician interactions and electronic documents? Join Albany Medical College, Federation of American Hospitals, and The Southern New Jersey REC as they discuss the very same topics during their panel discussion, “Meaningful Use: The Long Journey to Attestation” at the upcoming iHT2 Health IT Summit in New York City taking place at The New York Academy of Medicine, September 19
Source: iht2blog.com

CMS Call: Medicare Shared Savings Program and Advance Payment Model Application Process (July 31) : Health Industry Washington Watch

On July 31, CMS is hosting a call on the Medicare Shared Savings Program application and Advance Payment Model application processes for the January 1, 2013 Shared Savings Program start date. These two initiatives are designed to help providers participate in Accountable Care Organizations (ACOs) to improve quality of care for Medicare patients. Registration is required.
Source: healthindustrywashingtonwatch.com

Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline, CPT Code Billing: Which enrollment form to use 855A, 855B, 855I , 588 for what reason

Medicare Enrollment Application In the enrollment process, CMS collects information about the applying provider or supplier and secures documentation to ensure that the he or she is qualified and eligible to enroll in the Medicare Program. Depending upon provider or supplier type, one of the following forms is completed to enroll in the Medicare Program  Form CMS-855A/Medicare Enrollment Application for Institutional Providers: Application: Application used by institutional providers to initiate the Medicare enrollment process or to change Medicare enrollment information  Form CMS-855B/Medicare Enrollment Application for Clinics/Group Practices and Certain Other Suppliers: Application used by group practices or other organizational suppliers, except DMEPOS suppliers, to initiate the Medicare enrollment process or to change Medicare enrollment information  Form CMS-855I/Medicare Enrollment Application for Physicians and Non-Physician Practitioners: Application used by individual physicians or NPPs to initiate the Medicare enrollment process or to change Medicare enrollment information  Form CMS-855R/Medicare Enrollment Application for Reassignment of Medicare Benefits: Application used by individual physicians or NPPs to initiate reassignment of a right to bill the Medicare Program and receive Medicare payments or to terminate a reassignment of benefits; and Form CMS-855S/Medicare Enrollment Application for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Suppliers: Application used by DMEPOS suppliers to initiate the Medicare enrollment process or to change Medicare enrollment information. The following forms are often required in addition to the Medicare Enrollment Application: Form CMS-588/Electronic Funds Transfer (EFT) Authorization Agreement: Medicare authorization agreement for EFTs (for providers who choose to have payments sent directly to their financial institution); And CMS Standard Electronic Data Interchange (EDI) Enrollment Form: Agreement executed by each provider of health care services, physician, or supplier that intends to submit electronic media claims (EMC) or other EDI transactions to Medicare. This form is available from Medicare Carriers, FIs, A/B MACs, and Durable Medical Equipment Medicare Administrative Contractors and must be completed prior to submitting EMC or other EDI transactions to Medicare. The following optional form is submitted if the provider or supplier wishes to enroll as a Medicare participating provider or supplier:  Form CMS-460/Medicare Participating Physician or Supplier Agreement: Agreement to become a Part B participating provider or supplier who will accept assignment of Medicare benefits for all covered services for all Medicare beneficiaries. The Participating and Nonparticipating Providers and Suppliers Section of this chapter provides additional information about participating in the Medicare Program. The above forms are available at http://www.cms.hhs.gov/CMSForms/CMSForms/list.asp on the CMS website.
Source: medicarepaymentandreimbursement.com

FLORIDA MEDICARE BUY IN APPLICATION

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Source: projectedu.com

Wake Up Narcolepsy’s Blog

The CareLine is staffed by a team of professional case managers with both nursing and social work backgrounds, and non-clinical case managers who have an insurance industry background with coding and billing expertise.
Source: blogspot.com

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

Prescription cards are part of Medicare program

Posted by:  :  Category: Medicare

"Every citizen should be a soldier. This was the case with the Greeks and Romans, and must be that of every free state." ` Thomas Jefferson. by eyewashdesign: A. GoldenThe  uninsured and underinsured in the U.S. are now at a record high. Millions of people who lack insurance coverage or are without prescription medications inclusion are forced to pay out-of-network prices.  The prescription cards provides users with savings of up to 10-45% on prescription medications.
Source: wordpress.com

Video: JFK-Annis 1962 Medicare debate – Part I

Medicare Supplement Insurance Boynton Beach Fl

Giving up Medicare Part A and Medicare Part B is necessary, because it allows the person to sign with the insurance company that is selling the medicare -advantage-plan. This is a potentially dangerous sacrifice, considering the insurance company is not obligated to renew their contract with Medicare each year. If the insurance company did drop out of their medicare-advantage contract, you would be dis-enrolled from that medicare-advantage-plan.
Source: floridahealthinsurancebroker.com

United American Medicare Supplement Insurance Quotes

Fortunately, United American is one of those companies.  At present, they offer some of the lowest priced High Deductible F Plans across the state.  That is great for seniors who want a low priced Medicare insurance plan with a reasonable deductible.  (As of 2012, the HD Plan F deductible is $2,070 yearly.)
Source: ohioinsureplan.com

Medicare Part D Disclosure to CMS Due Soon

STERLING HEIGHTS wnj.com Medicare Part D Disclosure to CMS Due Soon 2/8/2011 Norbert F. Kugele Have you made your 2011 Medicare Part D Disclosure to the Centers for Medicare and Medicaid Services (CMS) yet? If not, we at Warner want to remind you that employers who sponsor group health plans that cover any prescription drugs must disclose whether the plan provides creditable or noncreditable prescription drug coverage to CMS within 60 days of the start of a new plan year. If your plan year begins on January 1, you must file your disclosure with CMS by March 1. Filing is done electronically using the CMS Web site. Instructions also are available there. This filing requirement applies to health plans that cover anyone who is eligible for the Medicare Part D prescription drug program, whether as an active employee, spouse, dependent or retiree. There are limited exemptions for plans that contract with a Medicare Part D plan or directly with Medicare to become a Part D plan. No disclosures are required for health flexible spending accounts (FSAs) or health savings accounts (HSAs); but disclosures are required for Health Reimbursement Arrangements (HRAs), either on a stand-alone basis or, more likely, in connection with a high deductible health plan if the HRA reimburses prescription drug expenses. Note that this disclosure is in addition to the Notice of Creditable (or Noncreditable) Coverage that you provide annually to Medicare-eligible participants. Remember also that if, after filing this disclosure, you terminate prescription drug coverage or change from creditable to noncreditable coverage (or vice versa), you must file a new electronic disclosure within 30 days (and also provide an updated notice to participants in your plan). If you have any questions about the creditable coverage disclosure to CMS, or about Medicare Part D generally, please contact Norbert F. Kugele (616.752.2186 or nkugele@wnj.com) or any other member of the Employee Benefits Practice Group at Warner Norcross & Judd.
Source: jdsupra.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

If I buy a medicare part F plan, why do I still need Long term care insurance?

About Advantage affordable article Benefits best Business Care comparison costs Coverage dental drug find Free from Good Guide Health Healthcare home Individual Insurance Life Medicaid Medical Medicare much News Nursing online Part Plan Plans Private Program. Quotes Reform Reviews Security Small Social Supplemental there Trends
Source: healthinsuranceandmedicareupdate.com

Why the F Medicare Supplement Plan Works Best

Your mailbox is full. After turning 64 and 1/2, you’re suddenly the most popular person on the block and the poor mailman can barely find room to stuff all those shiny brochures into the box. In terms of Healthcare, turning 65 really is a second birthday welcoming you to the world…of Medicare. Assuming you don’t have a better group option or other coverage, Medicare should reflect a significant reduction in your out of pocket medical expenses and a big part of this is the Medicare supplement insurance plans that works in conjunction with traditional Medicare. Let’s take a look at these plans and how they differ but most important, look at which plans stand out as best options to cut through some of that mailbox overload where everyone’s trying to sell you something. First, a quick introduction is in order. The Medicare supplements plans are different from Advantage plans, the other primary option available on the market. The Advantage plans are typically less expensive on a monthly basis (if not free) but have more constraints on how care is accessed (like traditional HMO”s) and share more medical costs that are incurred as a trade off. This last piece is an important distinction which we’ll address in more detail with our Medicare supplement versus Advantage article, but let’s stay with Medicare Supplemental plans for now. The supplements in a nutshell, fill in the holes of traditional Medicare with the deductibles (physician and hospital) plus the 20% co-insurance being the primary financial pitfalls of original Medicare. This filling in of the “gap” inherent in traditional Medicare is why these policies are interchangeably referred to as “Medigap” plans. There are other smaller gaps in traditional Medicare but these two, especially the 20% coinsurance can really pose a problem without supplemental coverage. The Supplement’s coverage increase from alphabetically from A to K with a few letters missing in the middle. The traditional supplements run A, B, C, D, and F. These have been pretty established for decades now. Make a mental note on the F plan as that tends to be the darling of the Medigap world. Let’s discuss the really critical pieces of Medicare in terms of gaps we need to fill now that medication is taken care of with Part D. We want to make sure that we do not have uncapped exposure to medical expenses especially since we are more likely to see facility based care (loosely translated as very expensive) as we get older. Fixed deductibles are one thing but an unlimited percentage of a $50K bill is quite another not to mention $250K of charges over a year’s time. Granted, the medicare supplement plans cover the 20% coinsurance but let’s look at excess. This is critical. Excess is the amount that providers can charge above the allowed Medicare rate and it amounts to 15%. With more pressure on the finances of Medicare going forward, the trend of providers charging this excess amount will likely intensify. This becomes a primary concern for Medicare recipients looking to protect themselves and the F plan becomes are plan of choice to cover this excess charge. Now let’s look at all the high deductible and/or fixed max out of pocket plans. Here’s the issue. These plans will be less expensive in terms of premium for sure but we’re entering a period of time when the likelihood of hitting any high deductible or max out of pocket is at it’s highest. On average, health care expenditures increase with every decade of a person’s life so to be conservative, let’s assume at some point we will hit the full deductible or max out of pocket. Now the premium savings isn’t such a good offset against the richer benefits of the F plan. If you’re gambling on being healthy and keeping the premium savings, the house might have the odds against you. The problem is that we likely will be unable to change plans if health deteriorates so we’re really making a decision for a long period of time. Again, in the long run, this points to the F plan. Obviously, you need to find the right plan for your health and financial situation but definitely keep in mind both current and future concerns. The future is right around the corner.
Source: abcarticledirectory.com

Regional Clinical Manager

UnitedHealthcare Medicare & Retirement is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. Imagine joining a group of professionals and clinicians who are working to improve health care for people over 50. Consider the influence you can have on the quality of care for millions of people. Now, enhance that success with enthusiasm you can really feel. That’s how it is at UnitedHealthcare Medicare & Retirement. Every day, we’re collaborating to improve the health and well being of the fastest growing segment of our nation’s population. And we’re doing it with an intense amount of dedication. Here, you will discover a culture that grows through challenge. That evolves by being flexible. That succeeds by staying true to our mission to make health care work effectively and efficiently for seniors. Put your best to work for us, and discover extraordinary opportunities for growth.
Source: careers.org

Florida Hospitals Score Highest, Lowest in Nation on Readmissions

5010 ABC Home Health Care Inc. accountable care organizations Agency for Health Care Administration Barack Obama Bill Nelson Bobby Lolley Centers for Medicare & Medicaid Services companionship services exemption ContinuLink Copays 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 Joe Biden 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

Getting Your Flu Shots with Medicare

The Medigap Plan’s Coverage of Flu Shots One other way to avoid paying extra for a flu shot or other Medicare-covered services is to purchase a Medigap policy that covers Medicare Part B excess charges. Medicare Supplement Plan F and Plan G both cover these excess charges, along with a number of other Medicare out-of-pocket costs. So even if your Medicare provider does not accept Medicare’s assigned rates, and he is one of the providers who charge extra, your Medicare supplement picks up that excess charge for you. Then you don’t have to pay anything out of pocket.
Source: mondaysorchids.com

Medicare Supplement Plan F – Coverage Details & Affordability

The best and most popular plan to cover the gaps is Medicare Supplement Plan F. Plan F will get you the most complete coverage possible. When purchasing Plan F, you will likely have no out-of-pocket costs for hospital and doctor visits. This plan also includes hospitalization which pays Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.  This great plan also covers medical expenses which pays Part B coinsurance; generally 20 percent of Medicare-approved expenses or copayments for hospital outpatient services.
Source: auto-insurance-data.info

Cigna Medicare Plans And Blue Cross Medicare Plans An Overview

Posted by:  :  Category: Medicare

HMO (Health Maintenance Organization) plans are the least expensive option. The effect of lower cost is reflected as restricted access to health care. Plans have a set monthly fee, covering doctors within the plan. If you visit a doctor outside of the plan, you are then responsible for the bill. Within a given plan, you have given the right to choose a Primary Care Physician (PCP) who will look after your care. The HMO CIGNA medicare plans cover regular and preventive care costs, referrals to a network specialist or facility when necessary, treatment for injuries and illness. There is no need of paying any additional fees in HMO plans as it has no fees for doctor visits. The CIGNA Part D plan is called CIGNA Medicare Rx offers coverage for 94% of available drugs, access to over 58,000 network pharmacies, no deductibles for select plans, no copayments for common drugs and diseases like diabetes and drug pressure. The CIGNA plan D in turn offers three types of plans namely, Plan 1, Plan 2 and Plan 3.
Source: arcadiamax.net

Video: Udall Bennet

Medicare trumps private plans in patient satisfaction

The study finds that Medicare beneficiaries have better access to care and greater financial protection than adults with private coverage. In 2010, about one-fourth of Medicare beneficiaries went without needed health care because of costs, compared with 37 percent of those with employer coverage. Adults with employer-based insurance (39 percent) and individual insurance (39 percent) reported medical bill problems at almost double the rate of Medicare beneficiaries (21 percent).
Source: benefitspro.com

Cigna Medicare Access Not Renewing For 2011

Cigna Medicare Access Advantage plan ends 12/31/2010 Cigna announced in June that they would not be renewing their national Medicare Advantage contract for Private Fee-For-Service (PFFS) plans. PFFS Medicare Advantage plans are plans that do not ?
Source: posterous.com

Health Insurance Outlet: Providing Access To All Major Carriers

American Heart Association American Red Cross Americans blood sugar Breast Cancer cardiovascular disease Centers for Disease Control and Prevention dentists diabetes diet dietary guidelines Drugs FDA FDA news FDA Warning food health Health Advices healthcare Healthcare Costs Health Costs health insurance Health News health plans health technology Health tips healthy lifestyle Heart Disease Kaiser Permanente Long-Term Care Lung Cancer Medicaid Medicare medicine nutrition Obesity Oral Health patients skin cancer Thomson Reuters treatment Type 2 Diabetes U.S. Food and Drug Administration weight issues weight loss
Source: healthinformer.net

Is 200 dolores too much to pay for HMO Tufts Health Insurance in Massachusetts for a single person?

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSAbout Advantage affordable article Benefits best Business Care comparison costs Coverage dental drug find Free from Good Guide Health Healthcare home Individual Insurance Life Medicaid Medical Medicare much News Nursing online Part Plan Plans Private Program. Quotes Reform Reviews Security Small Social Supplemental there Trends
Source: healthinsuranceandmedicareupdate.com

Video: SWH Massachusetts Medicare Advantage Commercial 1

Mass. Calls For Bids To Manage 111,000

WBUR: For The Most Expensive Patients: Better Care, More Savings (Hopefully) Massachusetts is rolling out a pilot project that aims to provide better care and save money for some of the state’s most expensive patients. About 111,000 young and middle aged adults with serious medical problems are on both Medicare and Medicaid. Figuring out which services the different programs cover can be a nightmare. There are a few programs that pool Medicare and Medicaid money for older Americans (65 and up). Now, for the first time, Massachusetts will merge Medicare and Medicaid resources for younger adults so that they have one package of coordinated medical and support services (Beibinger, 6/19).
Source: kaiserhealthnews.org

Medicare issues proposed rules on thorny PI settlement issue

This entry was published on Wednesday, July 11th, 2012 at 10:25 am and is filed under News Story, Personal Injury/Tort. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.
Source: masslawyersweekly.com

DownWithTyranny!: Mitt Romney And Medicare: A Story Of Fraud, A Story Of Big Profits, Big Lies

One of the key questions voters will have to ask themselves in November is whether or not Mitt Romney’s experience as a business man– he started rich and made himself richer– is the kind of experience that would be beneficial for the country. Keeping in mind that the last two Republican businessmen elected president were the two most disastrous presidents, especially in terms of the economy– Herbert Hoover and George W. Bush– voters have to ask themselves if, in the end, Romney was much more than just a con man with a good teeth-whitening job. The video above, made by Republicans, for Republicans was a response to one of Romney’s unending lies about his past, this time about his public denial that Bain did any work with the government like Medicaid and Medicare. Now, as these Republican operatives working to nominate Newt Gingrich, reported, “we learn that Bain, under Romney’s ‘supervision,’ purchased and ran the Damon Corporation, who pled guilty to Federal conspiracy charges as a result of tens of millions of dollars in systemic Medicare fraud committed under Romney’s and Bain’s control. Damon was fined over $119-million which was, at the time, the largest criminal healthcare fine in Massachusetts history and Mr. Romney’s participation was characterized in 1996 by Corporate Crime Reporter thusly: ‘As manager and board member of Damon Corp, Mitt Romney sits at the center of one of the top 15 corporate crimes of the 1990’s.” It may look like a Democratic Party hit piece but Blood Money: Mitt Romney’s Medicare Scandal was made by Republicans and paid for by none other than Romney’s now #1 funder, Vegas/Macau Organized Crime figure Sheldon Adelson. This is the quintessential Mitt Romney and his Bain business model– ruthlessly cheating everyone else to get richer and richer. It’s why Romney and crooks like him oppose government and oppose regulation. His business experience is clear– it’s why he’s been known as a predator and a vulture capitalist for his entire career in the business world. And it’s why Bain Capital is so universally hated. And it’s why his presidential campaign is being financed by the people– and corporations– that are spending hundreds of millions of dollars to get him into the White House. This film is a clear indictment of a con man who, in effect, is just a smoother version of Florida Governor Rick Scott. Romney bilked Medicare of millions of dollars to enrich himself. Is that the kind of president we should ever consider. Gingrich warned America. But Gingrich was a flawed messenger. It’s hard to watch this short film without a sense of panic about how close this presidential contest has become and how close we are to hiring a vampiric criminal to lead the nation. When Romney sold his medical fraud company– just before the company got hit with the largest criminal healthcare fraud fine ever levied in Massachusetts history– Bain made a $12 million profit (of which Romney personally pocketed $473,000) while thousands lost their jobs, he company went bankrupt and American taxpayers were bilked for another $40 million so Romney and his partners could get richer.
Source: blogspot.com

False balance and the Medicare scare : CJR

Trudy, excellent piece. I do wish, though, you had pointed out the insidious role of the “fact checkers,” notably PolitiFact, in enabling the news media in this bogus, false-equivalence coverage of the Medicare issue. PolitiFact’s most recent piece got a key fact wrong. It said the latest Ryan Medicare plan would cap Medicare spending at GDP plus 1%. In fact, Ryan’s budget bill — which the House passed earlier this year and which supersedes Ryan’s “bipartisan” Medicare proposal with Democrat Ron Wyden– would cap Medicare spending at GDP plus .5%, a difference which adds up fast. In addition, Henry Aaron has pointed out that talking with Ryan’s staff, it’s not clear whether that cap would apply to Medicare spending in total or to per capita Medicare spending, which makes a huge difference because if you cap total Medicare spending without adjusting for the large increase in Medicare enrollment over the next 20 years, you get a really really big cut in per capita Medicare spending, which would mean much poorer coverage. PolitiFact and the other “fact checkers” have consistently called the Democrats’ statements about Ryan’s and Romney’s Medicare proposals last year and this year false, when they are quite factually accurate. The NY Times, in its recent story quoting Romney saying Obama’s statement was dishonest that Romney’s Medicare proposal was a “voucher” plan, cited PolitiFact saying Obama’s ads were “mostly false.” In fact, as Trudy notes, Romney’s and Ryan’s proposals, which are quite similar, are precisely voucher plans. PolitiFact also missed the fact that Ryan’s proposal is no longer “bipartisan” because Wyden reportedly has refused to support it, on the basis that the GDP plus .5% cap is too low, Ryan’s plan would raise the Medicare eligibility age to 67, and Ryan’s block granting of Medicaid would hurt Medicare dual eligibles.
Source: cjr.org

This Week in Polling: Massachusetts Health Reform & Medicare

Health care makes both lists when ABC News/Washington Post asks Americans what President Barack Obama has done especially well and especially poorly. The survey also asks who the public trusts to protect Medicare, if the House-passed Ryan plan would save money for future Medicare recipients, and whether Republican-leaning independents like the health plan newly declared Republican candidate Mitt Romney enacted as governor of Massachusetts. The Harvard School of Public Health and The Boston Globe provide an in-depth look at Massachusetts residents’ views of their state’s 5-year-old universal coverage law. The Pew Research Center for the People and the Press examines support for Congressman Paul Ryan’s proposed changes to Medicare to reduce the deficit. A CBS News poll tracks favorable views of the health care law and public opinion around proposed changes to Medicare.
Source: kff.org

Two New ACOS Approved in Massachusetts

2012 Election Accreditation ACO Affordable Care Act Billing Careers in Home Care care transitions CMS dual eligibles Education Emergency Prep EOEA Face-to-Face Falls Prevention Family Caregiving federal budget Federal Regulations Home Care & Hospice Alliance of Maine Home Care Association of New Hampshire Home Care Careers Home Health Care Home Health Compare hospice House of Representatives innovation Managed Care Massachusetts MassHealth Mass Regulations Medicaid Medicare New England Careers New England Home Care Conference & Trade Show nurse delegation nursing patient choice Patient Satisfaction PECOS PPS Redistricting Rhode Island Partnership for Home Care State Budget telehealth U.S. Congress VNA
Source: wordpress.com

Oyster Radio News: DISASTER AID DOES NOT AFFECT SOCIAL SECURITY, MEDICARE BENEFITS

Those who have experienced damage from the storms may be eligible for FEMA’s Individuals and Households Program.  This may cover expenses for temporary housing, home repairs, replacement of damaged personal property and other disaster-related needs, such as medical, dental or transportation costs not covered by insurance or other programs.
Source: blogspot.com

Blue Cross Blue Shield of Massachusetts and the Retailers Association

Blue Cross Blue Shield of Massachusetts and the Retailers Association of Massachusetts announce partnership to help … By D.C. Denison, Globe Staff Five popular health plan options from Blue Cross Blue Shield of Massachusetts will soon be… Mobile App Built For Premera Blue Cross By Neudesic Wins Mobile-Web Award for Outstanding Achievement IRVINE, Calif., July 9, 2012 /PRNewswire/ — The Premera Blue Cross Mobile App, built by Neudesic, the trusted technology partner in business innovation and a Microsoft National Systems Integrator and …
Source: medicare-news.com

Details On Medicare Fraud

Posted by:  :  Category: Medicare

These people commit medicare fraud through identity theft or tampering of bills. Some gather the medicare information of people and use them to fill up bills and have them refunded. Others superimpose or change the bills of some of their patients or clients. They fill the bill out with more expensive meds and services. This makes the government pay more than what the people have actually availed of.
Source: chicagoautoinsurance606.com

Video: Maryland Senator Ben Cardin Goes On Record On Medicare Fraud

Protect Yourself from Medicare Fraud

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

What You Need To Know About Medicare Fraud

There are two major ways of committing medicare fraud namely: tampering bills or faking them. Some gather the medicare information of people and use them to fill up bills and have them refunded. Others superimpose or change the bills of some of their patients or clients. Instead of a simple service they change it into a more complicated and expensive one. in the end the government is at a loss because it pays for something which the citizens did not actually avail of.
Source: dosclub.com

Seniors Blow the Whistle on Medicare Fraud

5010 ABC Home Health Care Inc. accountable care organizations Agency for Health Care Administration AHCA quarterly report Barack Obama Bill Nelson Bobby Lolley 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

AG Koster announces settlement with Walgreens over gift cards

Nationally, Walgreens will pay participating states and the federal government $7.9 million in civil damages for the Medicaid, Medicare, TRICARE, and Federal Employees Health Benefits programs. This amount is based on the total amount Walgreens offered in gift cards and gift checks. Medicaid programs nationwide will receive $643,230 of the settlement, with the rest going to other federal programs.
Source: mo.gov

Spikie Marley’s blog on Netlog

http://www.presstv.ir/detail/236677.html Again we see a classic case of our troops dying in a war that serves no justification other than simply lining the pockets of the elite fraudsters some of whom are connected to very senior MP’s and Lords in the UK! You will recall that Gordon Bowden and I have been pulling our hair out for a few years now trying to force some sort of action against the massive fraudster that operate in this country from corporate executives to bank CEO’s to very senior MP’s and the elite in the House of Lords. Ever asked yourself why the Serious Fraud Officer, Police or even “clean” (if we have any!) Members of Parliament never raise such issues during Prime Minister’s Question Time? I keep asking myself why is it that no one speaks out and brings these “Political Crooks” to justice? Why don’t the Unions and their members take to the streets and hold a peaceful protest outside the House of Parliament, 10 Downing Street or even at one of the many ”Boiler Rooms” in the City of London? Why is everyone so afraid to reveal the very thing that has and continues to ruin the economy of the United Kingdom? We have our Prime Minister telling us all that severe austerity measures have to be implemented in order to pay off this huge toxic debt that has been handed down to us from the previous government under Gordon Brown. It’s an absolute joke…. When are you, the British public, going to open your eyes and understand that you will always be screwed and always remain the underdogs as long as our leaders get away with it. We now see a US congressional probe into such fraud and yet two of the companies are British and operate out of one of those “Boiler Rooms” right here in the City of London at 788-790 Finchley Road, NW11 7TJ. How come we the British are not investigating the massive fraud being carried out by those two companies at the above address that were privileged to share in some of the $1.069 billion that has been handed out in US contracts? Will we eventually see our own police or government investigate our own companies or should I say “Virtual Companies” that operate out of their “Not so Plush Headquarter” in Golders Green, London. You can bet that if and when a massive police raid takes place on these premises one can expect a putrid smell from within as most of the companies and oil conglomerates who are registered here have never used the place…. Having said that however one could expect the smell of jet fuel that should have been delivered to our boys in Afghanistan! It is obvious that David Cameron is not going to initiate such an investigation as he himself is implicated in some dodgy deals, not to mention the £17.8 million that he was personally involved in some years ago! I remember so vividly taking part in Shakespeare’s Merchant of Venice as a schoolboy and some of those lines I guess relate to the boiler rooms of today that house many such characters as Shylock! Just listen to some of his spoken words and herein lies a message: “He hath disgraced me, and hindered me half a million; laughed at my losses, mocked at my gains, scorned my nation, thwarted my bargains, cooled my friends, heated mine enemies; and what’s his reason? I am a Jew. A little further in the passage he says, “If you wrong us, shall we not revenge?” This certainly became reality when they took down the World Trade Centre on 9/11. Before delving into the bowels of this massive fraud I would again repeat that this corruption and tax evasion is a world problem that forms the backbone of the “Zionist Run” New World Order”(NWO) and is basically how it runs and is funded. It has the power to shut down any company or country anytime it so chooses. It is the NWO that is responsible for the “Arab Spring” and the current “Western Spring” and for the collapse of Ireland, Greece, Italy, Portugal and that other country on the brink of financial disaster, Spain. Believe me this is only the start and we are yet to see the second “Financial Tsunami” that will target mainly Europe and obviously will cause major implications for the United Kingdom as well as possibly taking out the Euro! The elaborate corporate headquarter situated at 788-790 Finchley Road, Golders Green, London has in its time housed some massive and pretty impressive companies ranging from Truck Sales – Oil/Gas Companies – Administrative Services etc and yet the investors and potential clients of these companies did not realise that this building is simply a “Boiler Room of Virtual Companies” that have only one ambition in life and that is to take investors money, avoid taxes and run. I am 100% sure that after this article start bouncing around the world the occupants or should I say the lack of occupants in this building will again abandon ship and re-emerge under a different name in yet another boiler room somewhere else in London! We are truly being ripped off to the tune of billions if not trillion of pounds and still we do nothing. What I find so frustrating is the fact that people always ask for authentic evidence on the basis of a sort of “Put Up Or Shut Up Mentality”…. Well folks as Gordon and I have repeatedly told you so many times before “we have the forensic evidence” and the fact that the US Congress is investigating these two British companies is proof in itself. It was so interesting to read the comments by a well known journalist and Zionist, James Kirchick who gave reference to this fuel scandal in Kyrgyzstan as being a former Soviet republic once known as the “Switzerland of Central Asia” and now suffering in recent years under Bakiyev from grinding poverty and widespread corruption and that the US remains a reliable supporter of the country. Western imperialism bankrupts every country it enters, rapes it of its resources and then leave them with extremes of poverty…. Not to mention poor Afghanistan that the west has nuked! I have to give this guy Kirchick due credit, however, I also find him slightly hypocritical based on the fact that the New World Order is controlled by his own Zionist backed empire which clearly shows up in some of his published articles…, especially those that appear in Israeli newspapers! I should add that our dear ex-PM Tony Blair has been sniffing around Kyrgyzstan on behalf of the British Government for some time trying to stitch up some lucrative oil/gas deals and despite his Labour background is more than happy to represent Cameron and the Conservative Party… He and David Cameron make a perfect pair of “fraudulent gangsters.” I would even hazard a guess that Tony Blair had something to do with this as he himself operates out of another London boiler room at the HQ for Arlington Associates at 22 Arlington Street with many other highly suspect companies. Just to rub salt in the wound this virtual company then came out with the following press release: Mina Group press release 7th March 2012 “Mina Corp has successfully completed deliveries of jet fuel to the Manas Transit Center (MTC) in Kyrgyzstan under a United States Department of Defense contract.” Red Star Enterprises Ltd. and Mina Corp Ltd are now the subjects of this congressional probe into potentially improper fuel contracting at the Manas Transit Center in Kyrgyzstan (a logistics hub for US and NATO forces serving in Afghanistan). We could be looking here at fraud amounting to over $720 million. To give my source (Gordon Bowden) due credit he has been assisting the Investigative Contractor Company, covertly instructed by sections of the AREVA BOD regarding the massive French AREVA Nuclear Fuel Company, defrauded out of $2.5 Billion in a worthless Namibian Mine fraud, URAMIN. Gordon has correspondences from the Company MD that congratulate him for his excellent assistance in providing forensic corporate details that are at this time being structured into a report for presentation for possible High Profile criminal Prosecutions. So there you have it yet another massive fraud uncovered by Gordon and I but what happens to it after such exposure is not clear. The Serious Fraud Office, the police, all Political Parties and many more have all been advised and still nothing happens… maybe the probe by US Congress will come to the UK and force a UK inquiry into the activity of so many British fraudsters in the corporate sector, banking and in Westminster… I look forward to such a day! Peter Eyre – Middle East Consultant DISCLAIMER: The authors’ views expressed in this article do not necessarily reflect the views of Press TV News Network. SAB/HE
Source: netlog.com

Hang Up On Unsolicited Offers of “Free” Diabetic Supplies

The Department of Health and Human Services (HHS) recently issued a warning about an ongoing fraud targeting people with diabetes. According to a HHS news release, the scam works like this: You get an unsolicited phone call from someone who claims to work for Medicare, a government agency, or a diabetes association. The caller offers to send you “free” diabetic supplies but first they need your Medicare ID number and other sensitive personal and/or financial information. “The call is a scam” HHS says.
Source: seiu1.org

False balance and the Medicare scare : CJR

Posted by:  :  Category: Medicare

ObamaCare - Where you're just a Tax Figure by Richard Loyal FrenchTrudy, excellent piece. I do wish, though, you had pointed out the insidious role of the “fact checkers,” notably PolitiFact, in enabling the news media in this bogus, false-equivalence coverage of the Medicare issue. PolitiFact’s most recent piece got a key fact wrong. It said the latest Ryan Medicare plan would cap Medicare spending at GDP plus 1%. In fact, Ryan’s budget bill — which the House passed earlier this year and which supersedes Ryan’s “bipartisan” Medicare proposal with Democrat Ron Wyden– would cap Medicare spending at GDP plus .5%, a difference which adds up fast. In addition, Henry Aaron has pointed out that talking with Ryan’s staff, it’s not clear whether that cap would apply to Medicare spending in total or to per capita Medicare spending, which makes a huge difference because if you cap total Medicare spending without adjusting for the large increase in Medicare enrollment over the next 20 years, you get a really really big cut in per capita Medicare spending, which would mean much poorer coverage. PolitiFact and the other “fact checkers” have consistently called the Democrats’ statements about Ryan’s and Romney’s Medicare proposals last year and this year false, when they are quite factually accurate. The NY Times, in its recent story quoting Romney saying Obama’s statement was dishonest that Romney’s Medicare proposal was a “voucher” plan, cited PolitiFact saying Obama’s ads were “mostly false.” In fact, as Trudy notes, Romney’s and Ryan’s proposals, which are quite similar, are precisely voucher plans. PolitiFact also missed the fact that Ryan’s proposal is no longer “bipartisan” because Wyden reportedly has refused to support it, on the basis that the GDP plus .5% cap is too low, Ryan’s plan would raise the Medicare eligibility age to 67, and Ryan’s block granting of Medicaid would hurt Medicare dual eligibles.
Source: cjr.org

Video: Ron Paul – End Medicare, Social Security & Medicaid?

Medicare Part D Resource for you by Mature Health Center

Some categories of beneficiaries are not bound by the lock-in rules and may enroll or disenroll from a PDP plan in other than the AEP. An individual may at any time, during a designated Special Election Period (SEP), discontinue the election of a PDP plan offered by an PDP organization and change his or her election to original Medicare or to a different PDP plan. Examples of situations which may entitle an individual to an SEP include the termination or discontinuation of a plan, a change in residency out of the service area, the organization violating a provision of a contract or misrepresenting the plan’s provisions, or the individual meeting other exceptional conditions as CMS may provide. CMS has also designated an SEP for individuals entitled to Medicare A and B and who receive any type of assistance from Title XIX (Medicaid), including full-benefit dual eligible individuals, as well as those eligible only for the Medicare Savings Programs. This SEP lasts from the time the individual becomes dually eligible until such time as they no longer receive Medicaid benefits. Individuals who are eligible for an SEP under the guidance for Part D enrollment and disenrollment may use that SEP to also make an election into or out of an MA-PD plan. from Medicare.gov, Prescription Drug Coverage (2012), Prescription Drug Coverage: Basic Information (2012) Return to top
Source: stewardshipmatters.net

The Consequences of Missing Medicare Signup

Paying for the gaps in Medicare Part A and B coverage out-of-pocket can be financially devastating for a prolonged or serious illness or injury. Supplemental insurance is very important to control this risk. One choice is to enroll in both a Medigap policy plus a drug plan, known as Medicare Part D. Another choice is to sign up for a Medicare Advantage Plan, also known as Medicare Part C. Neither enrollment is automatic. You will have to choose these plans from private insurers. Again, the “Medicare and You” handbook is very good at outlining the types of coverage plan choices. Once you decide on the type of plan(s) you want, choosing your policies from the array of available private insurers can be overwhelming. A good insurance broker can be very helpful at this point.
Source: ga-cpa.com

Romney vs Obama on Medicare. Neither is telling you the truth.

[…] Who is going to save Medicare? Who is going to save Medicare without any adverse impact on current or future beneficiaries? Answer, no one! Oh, Medicare will be preserved, but from the point of current expectations it will be painful.The Obama approach is pie in the sky. It is based on changes (cutting provider payments) that have never been followed through with enactment (and with serious consequences if they were). Look at his pre-election statement below and then look at extract from the 2012 Medicare Trustees Report, especially the second paragraph below. What do you think is the probability that 165 provisions affecting Medicare within Obamcare will be implemented, work as planned and be sustained? The answer is zero. To think you can put Medicare on a path to fiscal solvency by cutting payments to providers and insurers is naive at best (especially when you are increasing the benefits). To think you can do that without an adverse impact on everyone not on Medicare is foolish and irresponsible.Source: quinnscommentary.com […]
Source: quinnscommentary.com

Community Health: Health Care Reform, the Medical Community, and You

The next issue that stands out is the promise of reforming health care thereby significantly reducing costs. If we look at Medicare and Medicaid as examples and understand the tremendous deficit that is growing due to poor management and excessive fraud, how could we even imagine we could increase the size and responsibility of a program and then believe it would be operated efficiently enough to reduce costs. These are wonderful dreams, but they are just dreams. TARP is operating with little control or knowledge of recipients use of funds, the American Recovery and Reinvestment Act has been unable to disperse funds or lower unemployment as projected and the Cash for Clunkers program was so grossly miscalculated that it ran out of funds in the first week and hasn’t been able to issue reimbursement payments to auto dealers effectively. We were told these programs would work great and they had to be in place immediately.
Source: blogspot.com

The Medicare Part D “Doughnut Hole” & You: How Diplomat Can Help

At Diplomat, we know that no one wants to feel as though they need to choose between  health and money. Our dedicated funding assistance team works with Medicare Part D patients in order to fill out applications for any available and applicable 501c3 organizations; sometimes we can even complete the whole application for the patient. Stephanie Turnbull, one of our knowledgeable staff, says that “these grants are generally offered based on drug and/or disease and may have income limitations.  In the event that there is not a foundation able to assist the patient with their out of pocket costs, our staff would then pursue any available assistance programs offered by the manufacturer or other resources.”
Source: wordpress.com

Castagnera on Higher Ed, HR, and Risk Management: Monday is Medicare’s 47th Anniversary

Before delivering the cake, seniors will have the opportunity to talk about the importance of Medicare and how Congressman Fitzpatrick’s record in Congress is hurting our district’s seniors. Fitzpatrick voted for the disastrous Paul Ryan budget that would end Medicare as we know it. We will be sending Mike Fitzpatrick a message: Don’t you dare vote to end Medicare as we know it. Will you join us?
Source: blogspot.com

Social Security and You: Medicare premiums

There is an exception. If you are covered by an employer or union group health plan through your or your spouse’s current or active employment, you may qualify for a special enrollment period. The SEP is a period of time during which you may enroll if you did not enroll during your initial enrollment period. You must be covered under a group health plan, and your health plan must be based on your or your spouse’s current employment. The SEP may occur during any month you are covered under a group health plan based on current employment or during an eight-month period that begins the first full month after employment or group health plan coverage ends, whichever comes first.
Source: mysanantonio.com

In Florida, Obama criticizes Romney over Medicare

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteyNowhere is the campaign potentially more pivotal than in Florida, which decided the 2000 election and remains the ultimate swing state. With a large pool of retired voters, Medicare has been used by both parties to rally support from seniors in Florida and elsewhere, mostly by warning that the other party had in mind changes that would curb the national insurance program for older Americans.
Source: news9.com

Video: Oklahoma Medicare Advantage Plans and Supplemental Insurance

Oklahoma’s Harmon Memorial Hospital, Physician Pay $1.5M Qui Tam Health Care Fraud Settlement

A popular lecturer and widely published author on health industry concerns, Ms. Stamer continuously advises health industry clients about compliance and internal controls, workforce and medical staff performance, quality, governance, reimbursement, and other risk management and operational matters. Ms. Stamer also publishes and speaks extensively on health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns. Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.  You can get more information about her health industry experience here. If you need help responding to concerns about the matters discussed in this publication or other health care concerns, wish to get information about arranging for training or presentations by Ms. Stamer, wish to suggest a topic for a future program or update, or wish to request other information or materials, please contact Ms. Stamer via telephone at (469) 767-8872 or via e-mail here.
Source: wordpress.com

In The Know: Congressman John Sullivan loses GOP primary

Oklahoma has modernized its Medicaid eligibility and enrollment system so that applicants can apply online anytime and receive a determination immediately. Few states, if any, are as far along as Oklahoma – which went live with its system in 2010. Most states are still plotting how they will overhaul their systems and procedures to prepare for the streamlined enrollment of millions of individuals in 2014 under health reform. State Medicaid and Children’s Health Insurance Programs (CHIP) must be able to integrate with health insurance exchanges. For Oklahoma Medicaid, 70 percent of the applications are now performed online, said Tracy Turner, applications and operations manager for online enrollment for the Oklahoma Health Care Authority. “We want people to be able to apply whenever they want, like at night and at home,” she said, adding that 20 percent of the online applications come in between 5 p.m. to 12 midnight, so the site has to be available 24/7. “We do real-time eligibility decision and enrollment. The decision comes back in less than half a second from the time they submit. Then they can hand that print out of eligibility to a pharmacist or a doctor to have a claim paid at that time,” Turner said.
Source: okpolicy.org

False balance and the Medicare scare : CJR

Trudy, excellent piece. I do wish, though, you had pointed out the insidious role of the “fact checkers,” notably PolitiFact, in enabling the news media in this bogus, false-equivalence coverage of the Medicare issue. PolitiFact’s most recent piece got a key fact wrong. It said the latest Ryan Medicare plan would cap Medicare spending at GDP plus 1%. In fact, Ryan’s budget bill — which the House passed earlier this year and which supersedes Ryan’s “bipartisan” Medicare proposal with Democrat Ron Wyden– would cap Medicare spending at GDP plus .5%, a difference which adds up fast. In addition, Henry Aaron has pointed out that talking with Ryan’s staff, it’s not clear whether that cap would apply to Medicare spending in total or to per capita Medicare spending, which makes a huge difference because if you cap total Medicare spending without adjusting for the large increase in Medicare enrollment over the next 20 years, you get a really really big cut in per capita Medicare spending, which would mean much poorer coverage. PolitiFact and the other “fact checkers” have consistently called the Democrats’ statements about Ryan’s and Romney’s Medicare proposals last year and this year false, when they are quite factually accurate. The NY Times, in its recent story quoting Romney saying Obama’s statement was dishonest that Romney’s Medicare proposal was a “voucher” plan, cited PolitiFact saying Obama’s ads were “mostly false.” In fact, as Trudy notes, Romney’s and Ryan’s proposals, which are quite similar, are precisely voucher plans. PolitiFact also missed the fact that Ryan’s proposal is no longer “bipartisan” because Wyden reportedly has refused to support it, on the basis that the GDP plus .5% cap is too low, Ryan’s plan would raise the Medicare eligibility age to 67, and Ryan’s block granting of Medicaid would hurt Medicare dual eligibles.
Source: cjr.org

Disabled Workers May Be Able to Buy Into SoonerCare

In Oklahoma, both disabled and non-disabled workers are able to buy into SoonerCare under certain conditions. For disabled workers, they can buy in as long as they earn below 200 percent of the federal poverty level. This coverage can be a lifeline for workers and their families who may not qualify for disability benefits or regular Medicaid coverage. For non-disabled workers, they can buy into SoonerCare if they are unemployed, self-employed or working for small businesses. They must also have an income less than 185 percent of the poverty line.
Source: troutmanlawblog.com

Upcoming CMS Jurisdictionon JH Medicare Contractor Change

The Centers for Medicare and Medicaid Services (CMS) has awarded the Medicare Administrative Contractor (MAC) Jurisdiction JH contract to Novitas Solutions, Inc. (Novitas), formerly known as Highmark Medicare Services, for the payers listed below. The clearinghouse is currently working with Novitas to obtain additional transition information and will provide that information when it becomes available. Providers must be aware of the following: Transition dates to Novitas: Currently processed by Pinnacle Business Solutions, Inc: CPID 2455 Arkansas Medicare Part B: 08/13/2012 CPID 1526 Arkansas Medicare Part A: 08/20/2012 CPID 1460 Louisiana Medicare Part B: 08/13/2012 CPID 3579 Louisiana Medicare Part A: 08/20/2012 CPID 5556 Mississippi Medicare Part A: 08/20/2012 Currently processed by Cahaba Government Benefits Administrators (GBA): CPID 2451 Mississippi Medicare Part B: 10/22/2012 Currently processed by Trailblazers Health Enterprise, LLC: CPID 1547 Colorado Medicare Part A: 10/29/2012 CPID 1449 Colorado Medicare Part B: 11/19/2012 CPID 5566 New Mexico Medicare Part A: 10/29/2012 CPID 1457 New Mexico Medicare Part B: 11/19/2012 CPID 1558 Oklahoma Medicare Part A: 10/29/2012 CPID 1458 Oklahoma Medicare Part B: 11/19/2012 CPID 5502 Texas Medicare Part A: 10/29/2012 CPID 1440 Texas Medicare Part B: 11/19/2012 CPID 3650 J4 Mutual of Omaha CO, NM, OK, TX: 10/29/2012 Payer ID (Contractor Number) changes: The clearinghouse will manage the Payer ID changes for our customers so only the CPID is required in the claim. Providers should be aware of the dates and watch for future notifications regarding this transition. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

The Mad Is On in Oklahoma: Medicare Information..VERY IMPORTANT!!!!

$96.40, rising to: $104.20 in 2012 $120.20 in 2013 And $247.00 in 2014.” These are Provisions incorporated in the Obamacare Legislation, purposely delayed so as not to confuse the 2012 Re-Election Campaigns. Send this to all Seniors that you know, so they will know who’s throwing them under the bus.
Source: the-mad-is-on.com

When Does Medicare Not Pay First?

When insurance companies have to deal with splitting the cost of care it can get a little bit nasty and confusing.  Insurance companies are notorious for not wanting to pay for things and this is especially true when other insurance companies are involved.  Medicare is a little different since it is run by the government so there are some situations where the other insurance will always come first.  These situations include:
Source: medicare-medicaid.com

High Deductible Medicare Supplement Plan F

Posted by:  :  Category: Medicare

DAMN!! -- I THINK WE'RE F*%KED by SS&SSThe Medicare supplemental insurance policy labeled high deductible Plan F is a standard plan F plan with a $2070 dollar yearly deductible and a significantly less monthly premium.  When choosing a form of Medicare insurance there are two common alternatives, they are:  Medicare A and B with a Medigap insurance policy or a Medicare Advantage plan.  A Medigap policy is the most popular alternative of these choices.  Once you have decided that a supplemental insurance policy is the best option for your health care needs the choice of which supplement policy comes next.  The Medicare Supplement Plan F is the Medigap policy with the most benefits and provides the best protection from medical bills.  A sometimes forgotten alternative to the plan F is the High Deductible Plan F.  The high F provides the exact same benefits as a standard F plan except it has a $2076 dollar yearly deductible.  The High F plan can be a less costly alternative for individuals that are in good health.
Source: medicare-supplement-advisor.org

Video: Switching To Medicare Supplement Plan F

United American Medicare Supplement Insurance Quotes

Fortunately, United American is one of those companies.  At present, they offer some of the lowest priced High Deductible F Plans across the state.  That is great for seniors who want a low priced Medicare insurance plan with a reasonable deductible.  (As of 2012, the HD Plan F deductible is $2,070 yearly.)
Source: ohioinsureplan.com

I Am On Medicare, Am I Covered Outside the Country?

If you have purchased a supplemental plan, like Plan F, than you are covered outside the United States for up to 60 days, up to $50,000.00.  After 60 days, you are uncovered.  The Medicare Supplement plans are great for people who make short trips out of the U.S. each year.  If this sounds like you, then there is no need to worry, you are covered.  In fact, each time you enter and exit the country, your 60 days start over, so you can take multiple trips a year and feel confident your Medicare Supplement Plan will take care of you as long as your hospital stay does not exceed $50,000.00.
Source: americaninsuranceforexpats.com

Medicare Supplement Plan F – Coverage Details & Affordability

The best and most popular plan to cover the gaps is Medicare Supplement Plan F. Plan F will get you the most complete coverage possible. When purchasing Plan F, you will likely have no out-of-pocket costs for hospital and doctor visits. This plan also includes hospitalization which pays Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.  This great plan also covers medical expenses which pays Part B coinsurance; generally 20 percent of Medicare-approved expenses or copayments for hospital outpatient services.
Source: auto-insurance-data.info

Medicare Supplement Insurance Boynton Beach Fl

Giving up Medicare Part A and Medicare Part B is necessary, because it allows the person to sign with the insurance company that is selling the medicare -advantage-plan. This is a potentially dangerous sacrifice, considering the insurance company is not obligated to renew their contract with Medicare each year. If the insurance company did drop out of their medicare-advantage contract, you would be dis-enrolled from that medicare-advantage-plan.
Source: floridahealthinsurancebroker.com

Why the F Medicare Supplement Plan Works Best

Your mailbox is full. After turning 64 and 1/2, you’re suddenly the most popular person on the block and the poor mailman can barely find room to stuff all those shiny brochures into the box. In terms of Healthcare, turning 65 really is a second birthday welcoming you to the world…of Medicare. Assuming you don’t have a better group option or other coverage, Medicare should reflect a significant reduction in your out of pocket medical expenses and a big part of this is the Medicare supplement insurance plans that works in conjunction with traditional Medicare. Let’s take a look at these plans and how they differ but most important, look at which plans stand out as best options to cut through some of that mailbox overload where everyone’s trying to sell you something. First, a quick introduction is in order. The Medicare supplements plans are different from Advantage plans, the other primary option available on the market. The Advantage plans are typically less expensive on a monthly basis (if not free) but have more constraints on how care is accessed (like traditional HMO”s) and share more medical costs that are incurred as a trade off. This last piece is an important distinction which we’ll address in more detail with our Medicare supplement versus Advantage article, but let’s stay with Medicare Supplemental plans for now. The supplements in a nutshell, fill in the holes of traditional Medicare with the deductibles (physician and hospital) plus the 20% co-insurance being the primary financial pitfalls of original Medicare. This filling in of the “gap” inherent in traditional Medicare is why these policies are interchangeably referred to as “Medigap” plans. There are other smaller gaps in traditional Medicare but these two, especially the 20% coinsurance can really pose a problem without supplemental coverage. The Supplement’s coverage increase from alphabetically from A to K with a few letters missing in the middle. The traditional supplements run A, B, C, D, and F. These have been pretty established for decades now. Make a mental note on the F plan as that tends to be the darling of the Medigap world. Let’s discuss the really critical pieces of Medicare in terms of gaps we need to fill now that medication is taken care of with Part D. We want to make sure that we do not have uncapped exposure to medical expenses especially since we are more likely to see facility based care (loosely translated as very expensive) as we get older. Fixed deductibles are one thing but an unlimited percentage of a $50K bill is quite another not to mention $250K of charges over a year’s time. Granted, the medicare supplement plans cover the 20% coinsurance but let’s look at excess. This is critical. Excess is the amount that providers can charge above the allowed Medicare rate and it amounts to 15%. With more pressure on the finances of Medicare going forward, the trend of providers charging this excess amount will likely intensify. This becomes a primary concern for Medicare recipients looking to protect themselves and the F plan becomes are plan of choice to cover this excess charge. Now let’s look at all the high deductible and/or fixed max out of pocket plans. Here’s the issue. These plans will be less expensive in terms of premium for sure but we’re entering a period of time when the likelihood of hitting any high deductible or max out of pocket is at it’s highest. On average, health care expenditures increase with every decade of a person’s life so to be conservative, let’s assume at some point we will hit the full deductible or max out of pocket. Now the premium savings isn’t such a good offset against the richer benefits of the F plan. If you’re gambling on being healthy and keeping the premium savings, the house might have the odds against you. The problem is that we likely will be unable to change plans if health deteriorates so we’re really making a decision for a long period of time. Again, in the long run, this points to the F plan. Obviously, you need to find the right plan for your health and financial situation but definitely keep in mind both current and future concerns. The future is right around the corner.
Source: abcarticledirectory.com

Medigap Plan F Is Still Popular

You can find useful information from the Medicare.Gov website that should allow you to understand whether or not to choose to enroll for this additional policy. It is recommended that the best time to purchase this supplementary plan would be within six months of becoming eligible, I. E. Six months after turning sixty-five years old or enrolling in Medicare Part B. There may be specific enrollment time frames in your state that you should familiarize yourself with if you intend on purchasing this plan.
Source: medicarequotefinderblog.com

AHIP Medicare Survey: F Gets an A

Plan F will pay for the first 3 pints of blod, for example, and it also will pay the Part A hospice care coinsurance or copayment amount. Part F also will pay skilled nursing facility care coinsurance bills, Part A and Part B deductibes, some foreign travel emergency bills, and physician fees that Medicare Part B classifies as “excess charges.”
Source: lifehealthpro.com

View And Compare Medicare Supplement Insurance Online

Online Medicare Supplement Insurance help is never farther than a click or phone call away. Thankfully it is easier than ever to maneuver through the maze of Medicare Part A and Part B as well as the many Medigap plans used to fill in the holes. The first step when taking the leap into the world of Medicare is to find out as much as you can about what is covered and what is not by Medicare Part A and Part B. When it comes to taking the leap into gap insurance online advisors will guide you through what is available and help shop the Medigap market to find the best premiums that you qualify for. As rates change each year you will want to contact your online Medicare Supplement Insurance provider to get updates on lower rates from other Medigap Insurance providers. An online advisor is helpful in helping determine exactly what gap insurance program you should enroll in according to prior history and current lifestyle. An over view to Medicare Supplement Insurance plans will give clients the most basic look into the different plans available. A sample of the Supplement Insurance Plans Medicare has to offer is listed below. You can see just from glancing below how vary different the coverage is and why it is important to determine which plan is best on an individual basis. Medicare Supplement Plan F Medigap Plan F is the most comprehensive supplement plan available for 2012. 100% of the gaps left by Medicare Part A and Part B are covered under Plan F. Individuals are free to see any doctor or specialist, who accepts Medicare, without needing a referral. This plan allows individuals to pay nothing out of pocket for any Medicare approved expense. Plan F is the most widely used plan for Medicare participants. Medicare Supplement Plan G Medigap Plan G is often compared directly to Plan F; the main difference being that individuals pay the Medicare Part B deductible out of pocket as it is not covered by Plan G. Another popular option in Medicare Supplement Insurance plans to enroll in. Once the Medicare Part B deductible is covered, 100% of the Medicare Part A and Part B gaps are covered with Medigap Plan G. Lower premiums than Plan F. Medicare Supplement Plan N Similar to the above plans, Medicare Supplement Plan N offers the convenience of being able to be seen by any doctor that accepts Medicare without being part of a network. Lower monthly premiums than Supplement Plan F and Plan G. Cost-sharing option for emergency room visit co-pays, doctor visits co-pays up to $20 each visit after the Medicare Part B deductible has been met. When entering into the Medicare Supplement maze it is best to find a source for information that is reliable and up to date. Online Medicare Supplement Insurance advisors will help individuals find the best plan for your needs while offering the ability to compare rates from the hundreds of private insurance companies offering Medicare Supplement Insurance for sale.
Source: zsnare.com