Medicare Premiums Qualify Are Deductible Above the Line (in some cases)

Posted by:  :  Category: Medicare

However, for S corporation shareholders and partnerships, a notice issued previously by the IRS requires that these premiums actually be reimbursed by the corporation (or paid directly by the employer which is not normally applicable with Medicare premiums).  This requires a check be issued by the employer to the employee paying the Medicare premiums.  These payments would then be included in the income of the employee (deducted by the employer) and then deducted on page 1 of form 1040.  If these guidelines are not followed completely, then the deduction is not allowed.
Source: farmcpatoday.com

Video: Medicare Supplement plan F High Deductible Explanation

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 Premiums, Deductibles & Coinsurance: Rates for 2011

Because of the zero COLA increase in 2011, some Medicare beneficiaries will not pay more for coverage. If your premium is deducted from your Social Security check and your income is $85,000 or less ($170,000 if you file a joint tax return), then you won’t have to pay more. Your monthly premium will stay at either $96.40 or $110.50.
Source: suite101.com

Did You Miss Deduction Medicare Premium as Health Insurance???????

CCA 201228037 said a partner in a partnership may pay premiums directly and be reimbursed by the partnership, or the premiums may be paid by the partnership, and still qualify for the deduction. “In either case, the premiums must be reported to the partner as guaranteed payments, and the partner must report the guaranteed payments as gross income on his or her Form 1040,” the memo said. Similarly, the office said a 2 percent shareholder-employee in an S corporation may pay the premiums directly and be reimbursed, or the premiums may be paid by the S corporation. In either case, the premiums must be reported to the shareholder-employee as wages on Form W-2 and reported by the shareholder-employee as gross income on Form 1040, it said.
Source: easchensky.com

Medicare Deductible Changes For 2012

If you have purchased a Medigap policy (Medicare supplement) you are more than likely responsible for less out-of-pocket costs. Medigap Plan A is the only plan that does not pay any of the Part A deductible. Plan K and M pay 50% and Plan L 75% of the Part A deductible. The remaining plans including the most popular, Medicare supplement plan F pay 100% of the Part A deductible.
Source: affordablemedicareplan.com

Young patients caught in conflict between MCG and Blue Cross

Posted by:  :  Category: Medicare

ObamaCare - Where you're just a Tax Figure by Richard Loyal FrenchYoung patients caught in conflict between MCG and Blue Cross Blue Shield MCG and its physician group have given notice to Blue Cross patients that it is terminating its contract with the insurer as of Aug. 15 because 10 months of negotiations have gone nowhere. Whatley Kallas Files First Antitrust Case Challenging The Anti-Competitive Rules Of The Blue Cross Blue Shield … BIRMINGHAM, Ala., July 26, 2012 /PRNewswire/ — The Whatley Kallas Litigation and Healthcare Group has filed the first antitrust action on behalf of healthcare providers challenging the restrictions of … Standoff could cut off Blue Cross patients at MCG Hospital and Clinics Patients with Blue Cross Blue Shield of Georgia insurance are being told they might not be able to use Medical College of Georgia Hospital and Clinics or its physicians after Aug. 15 because contract talks with the insurer have broken off. Blue Cross of Minnesota CEO out of job after just six months Kenneth Burdick, the CEO of Blue Cross and Blue Shield of Minnesota, is out of a job after the nonprofit health plan had concerns about a "lack of disclosure" related to "anticipated business activities."
Source: medicare-news.com

Video: Florida Blue Medicare

Daily Kos: Romney and Bain profited from massive Medicare Fraud

Meteor Blades, grytpype, OkieByAccident, JWC, buffalo soldier, Sylv, TXdem, zane, CJB, Sean Robertson, Chi, MadRuth, murphy, grollen, askew, BigOkie, Outsourcing Is Treason, greenbird, bosdcla14, karlpk, sara seattle, Shockwave, Psyche, jazzizbest, Sherri in TX, donna in evanston, Wintermute, Andrew C White, SanJoseLady, hyperstation, jdld, mslat27, Mnemosyne, movie buff, TX Unmuzzled, saluda, frisco, SallyCat, MarkInSanFran, hubcap, Creosote, davelf2, dweb8231, TexasDemocrat, Bugsby, Paulie200, concernedamerican, bronte17, 88kathy, TracieLynn, sponson, indybend, howd, susakinovember, ellefarr, highacidity, sayitaintso, stevej, themank, Minerva, Jeffersonian, mkfarkus, barath, Aquarius40, farmerhunt, chimpy, Frederick Clarkson, pollbuster, ivote2004, itskevin, oceanview, kitebro, Cedwyn, jted, antirove, Chrisfs, revsue, Lilyvt, kharma, dejavu, psnyder, TexDem, Miss Jones, roseeriter, duncanidaho, wdrath, Jujuree, manwithlantern, Steveningen, RuralLiberal, Tillie630, papercut, rlharry, RebeccaG, riverlover, Dood Abides, barbwires, bwintx, Matt Esler, zerelda, ybruti, Sembtex, glattonfolly, KellyB, bobnbob, Vicky, tomjones, Deward Hastings, lyvwyr101, boran2, Sybil Liberty, bibble, sawgrass727, Gowrie Gal, Los Diablo, ExStr8, maybeeso in michigan, Bluesee, DianeNYS, Ckntfld, el dorado gal, titotitotito, LarisaW, alaprst, subtropolis, stlawrence, Lying eyes, PBen, PsychoSavannah, sap, offred, Flint, dewtx, ChemBob, HillaryIsMyHomegirl, Brooke In Seattle, Laurence Lewis, reflectionsv37, fixxit, eru, owlbear1, Beetwasher, majcmb1, SaraBeth, Pam from Calif, Sun Tzu, where4art, Inland, Fury, Kayakbiker, cassidy3, Little Lulu, Phil S 33, CompaniaHill, blue jersey mom, markdd, Sandino, deep, rb608, SBandini, Savvy813, Shotput8, Ginny in CO, sodalis, LivesInAShoe, Lisa Lockwood, Cory Bantic, Brian B, bookwoman, coloradorob, peacestpete, Ekaterin, SocioSam, xanthippe2, kathny, Paper Cup, xaxnar, Jim R, begone, RJDixon74135, martini, third Party please, LeftOverAmerica, althea in il, 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, SingerInTheChoir, bumbi, rage, CA Nana, profh, doingbusinessas, Clive all hat no horse Rodeo, Lovo, Stripe, frankzappatista, blueoregon, Statusquomustgo, kurious, bstotts, matx, AllanTBG, mapman, 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, madgranny, janatallow, spearfish, dizzydean, South Park Democrat, Empower Ink, JDWolverton, MKinTN, gundyj, TruthFreedomKindness, Scioto, TX Freethinker, wyvern, HappyinNM, wayoutinthestix, Sixty Something, Youffraita, Foundmyvoice, bill warnick, NewDealer, bythesea, elwior, CDH in Brooklyn, ajr111240, OutCarolineStreet, Akonitum, jamess, inHI, here4tehbeer, rssrai, royce, pickandshovel, carver, Jeff Y, catly, Gemina13, glendaw271, petulans, luckylizard, mikeymike68, Nica24, dmhlt 66, watercarrier4diogenes, GrannyOPhilly, vmdairy, JBL55, oldliberal, clent, MrsTarquinBiscuitbarrel, Bule Betawi, pileta, McGahee220, rubyclaire, MufsMom, Fogiv, Calouste, litoralis, greengemini, divineorder, Scott Wooledge, Carol in San Antonio, CanyonWren, Nebraskablue, Norm in Chicago, Gorilla in the room, janmtairy, shopkeeper, CamillesDad1, Cuseology, DefendOurConstitution, TheOpinionGuy, papahaha, Shelley99, Keith Pickering, realwischeese, sfarkash, 57andFemale, Tortmaster, jfromga, jan0080, Livvy5, 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, pbgv23, 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

Blue Medicare RX Value: Blue Cross Blue Shield of Texas Prescription Coverage

To be eligible to enroll , you must be entitled to receive benefits under Medicare Part A and be enrolled in Medicare Part B. In addition, you have to live somewhere in the plan service area in Texas. As always, you cannot enroll in Blue Medicare RX if you are enrolled in any other Medicare Part D plan. Remember, if you are already enrolled in a Medicare Advantage plan, you will be receiving your prescription drug benefits from your Advantage plan. However, if you have Medigap insurance or only Original Medicare (Part A and Part B), you are eligible to enroll in Blue Medicare RX.
Source: texasmedicarehealth.com

Ask The Experts: Retirement

A. Enrollment in Medicare Part A is automatic unless you decline that coverage. And it’s not clear to me why you’d do that because you have already paid for it through payroll deductions while you were working and will receive it free of charge. On the other hand, because your wife is currently employed and you are covered under her Federal Employees Health Benefits plan, you can postpone a decision about enrolling in Part B until she retires.
Source: federaltimes.com

USDOJ: Obama Administration Announces Ground

Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius today announced the launch of a ground-breaking partnership among the federal government, state officials, several leading private health insurance organizations, and other health care anti-fraud groups to prevent health care fraud. This voluntary, collaborative arrangement uniting public and private organizations is the next step in the Obama administration’s efforts to combat health care fraud and safeguard health care dollars to better protect taxpayers and consumers. The new partnership is designed to share information and best practices in order to improve detection and prevent payment of fraudulent health care billings. Its goal is to reveal and halt scams that cut across a number of public and private payers. The partnership will enable those on the front lines of industry anti-fraud efforts to share their insights more easily with investigators, prosecutors, policymakers and other stakeholders.  It will help law enforcement officials to more effectively identify and prevent suspicious activities, better protect patients’ confidential information and use the full range of tools and authorities provided by the Affordable Care Act and other essential statutes to combat and prosecute illegal actions. “This partnership is a critical step forward in strengthening our nation’s fight against health care fraud,” said Attorney General Holder.  “This administration has established a record of success in combating devastating fraud crimes, but there is more we can and must do to protect patients, consumers, essential health care programs, and precious taxpayer dollars.  Bringing additional health care industry leaders and experts into this work will allow us to act more quickly and effectively in identifying and stopping fraud schemes, seeking justice for victims, and safeguarding our health care system.” “This partnership puts criminals on notice that we will find them and stop them before they steal health care dollars,” Secretary Sebelius said.  “Thanks to this initiative today and the anti-fraud tools that were made available by the health care law, we are working to stamp out these crimes and abuse in our health care system.” One innovative objective of the partnership is to share information on specific schemes, utilized billing codes and geographical fraud hotspots so that action can be taken to prevent losses to both government and private health plans before they occur. Another potential goal of the partnership is the ability to spot and stop payments billed to different insurers for care delivered to the same patient on the same day in two different cities. A potential long-range goal of the partnership is to use sophisticated technology and analytics on industry-wide healthcare data to predict and detect health care fraud schemes.  The Executive Board, the Data Analysis and Review Committee and the Information Sharing Committee will hold their first meeting in September.  Until then, several public-private working groups will continue to meet to finalize the operational structure of the partnership and develop its draft initial work plan. The following organizations and government agencies are among the first to join this partnership:   • America’s Health Insurance Plans • Amerigroup Corporation • Blue Cross and Blue Shield Association • Blue Cross and Blue Shield of Louisiana • Centers for Medicare & Medicaid Services • Coalition Against Insurance Fraud • Federal Bureau of Investigations • Health and Human Services Office of Inspector General • Humana Inc. • Independence Blue Cross • National Association of Insurance Commissioners • National Association of Medicaid Fraud Control Units • National Health Care Anti-Fraud Association • National Insurance Crime Bureau  • New York Office of Medicaid Inspector General • Travelers • Tufts Health Plan • UnitedHealth Group • United States Department of Health and Human Services • United States Department of Justice • WellPoint, Inc. The partnership builds on existing tools provided by the Affordable Care Act, resulting in: • Tougher sentences for people convicted of health care fraud. Criminals will receive 20 to 50 percent longer sentences for crimes that involve more than $1 million in losses. • Enhanced screenings of Medicare and Medicaid providers and suppliers to keep fraudsters out of the program. • Suspended payments to providers and suppliers engaged in suspected fraudulent activity. The administration’s efforts to date have already resulted in a record-breaking $10.7 billion in recoveries of health care fraud over the last three years. For more information on this partnership and the Obama administration’s work to combat health care fraud, please visit: www.healthcare.gov/news/factsheets/2012/02/medicare-fraud02142012a.html and www.stopmedicarefraud.gov. Contact: Department of Justice Main Switchboard – 202-514-2000 Reported by: US Department of Justice
Source: 7thspace.com

Dave Fluker’s California Health Insurance Blog: Blue Shield CA Extends Medicare Supplement Special Enrollment Period

Blue Shield of California has announced the extension of their “special enrollment period” for Medicare Supplement plans in California to November 30, 2012. Previous end date was September 30, 2012. The special enrollment period is basically a full-time “birthday rule”. In California, those who are covered by Original Medicare and a Medicare Supplement Plan (Medi-Gap) (A-N) have the right, on their birthday, to move to any other insurance companies’ like or lesser Medicare Supplement Plan with no medical underwriting. California is one of the few states that has a “birthday rule” in regard to Medi-Gap plans. The current Blue Shield CA special enrollment period allows those covered by a Medicare Supplement with another insurer to move to a “like or lesser” Supplement plan with Blue Shield with no medical underwriting in any month, not just the month of your birthday. Additionally Blue Shield CA has also extended the “new to Medicare” $20 per month discount for the first year. This discount for those who are new to Medicare (either turning 65 or enrolling in Part B for the first time) makes their Medi-Gap plans very competitive for that first year. With the California birthday rule, a person can change to another carrier should the rates increase after the discount and lower rates are available from another insurer in California.
Source: blogspot.com

Medicare Blue Button, More Data Than Ever Before!

No longer are health records something that sit in a folder in your doctor’s office never to see the light of day! The power of having personal health data at your finger tips is a new and growing phenomenon with help from Medicare Blue Button.  Blue Button allows Medicare beneficiaries to access their health data on a website or mobile device and download their personal health data from a personal health record or from their doctors’, hospital’s or clinical laboratory’s patient portal.  Since its launch, hundreds of thousands of Medicare beneficiaries have downloaded their personal health data.  The power of personal health data has taken another step forward, with new opportunities between beneficiaries and their providers as demonstrated at Health Datapalooza IIIwith the announcement of the Blue Button Mash Up Challenge.
Source: medicareindex.com

Blue Cross Blue Shield of Texas Medicare Supplement Plan

Medicare Supplement Insurance in Texas, like all other traditional forms of coverage does have rate increases and I dislike them as much as you do. BCBS seems to have some of the most stable rates in the industry, where some carriers have pounded the rates some 10 and 12% these guys have not exhibited that type of behavior. They actually experienced a rate decrease this last October which was a pleasant surprise to most seniors. Of course there is no way of knowing what may or may not happen from one year to the next so yes, they could raise rates soon, but so far so good.
Source: medicareinsurancetexas.com

High Cost of Medicare Fraud

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SSWhile new age technology can identify patterns there by eliminating some fraud, common sense, physical investigation and old fashion leg work has its advantages too. In one case a hidden camera recorded a very active and healthy 82 year old grandmother telling her doctor she was in good health, yet official documentation indicated she was homebound, needed assistance in all activities and was unable to safely leave home. Recently in 2011, a 9 state raid involving health care facilities arrested more than 100 doctors, nurses, therapists and healthcare executives for racking up more than $200 million in fraudulent services and medicines never received. In Houston a nurse was sentenced to 8 years in prison after she was convicted for her participation in a fraud scheme that netted over $5 million.
Source: mkcmedicalmanagement.com

Video: Medicaid Fraud Costs Millions and No One is Stopping It

The Caucus for Women In Statistics

The analyst will possess strong analytical skills and able to use statistical software including SAS, SQL, Business Objects, MS Excel, and MS Access. Specifically, the analyst should possess SAS programming knowledge and intermediate level experience with SAS macros, PROC REPORT, SAS/GRAPH procedures, SAS ODS, PROC UNIVERIATE, PROC TTEST, PROC MEANS, and PROC FREQ, SAS/GIS. The analyst should also have experience applying statistical concepts including t-tests and chi-square, to large datasets. The analyst should have experience with analyzing and interpreting data, maintaining and manipulating large datasets, ensuring integrity of the data, performing quality assurance, and formally writing results for submission in final reports. Additionally, the analyst may research specific regulatory and industry information regarding Medicare and Medicaid to support statistical analysis.
Source: caucusforwomeninstatistics.com

Healthcare In Crisis: Government signs on insurers to fight healthcare fraud

Fraudulent claims to the government’s Medicare health plans for the elderly are estimated to cost $60 billion a year, making it a focus of large-scale busts by the U.S. Department of Justice. In May, U.S. authorities conducted the biggest Medicare fraud sweep to date, arresting more than 100 people across the country – including doctors, nurses, office managers and other providers – for trying to defraud the system of nearly half a billion dollars.
Source: blogspot.com

State Medicaid Fraud Control Units Fiscal Year 2011 Grant Expenditures and Statistics

Investigations resulted in 1,408 individuals being indicted or criminally charged: 1,011 for fraud and 397 for patient abuse and neglect. In total, 1,230 convictions were reported in FY 2011, of which 824 were related to Medicaid fraud and 406 were related to patient abuse and neglect.
Source: fulltextreports.com

Data Mining in Medicare Fraud: Usage and Effects on Healthcare Providers

For instance, in the case described above, data mining was clearly used to review the psychologist’s claims history and determine that what he was billing was likely both impossible and fraudulent.  Nevertheless, it is important to always keep in mind that although data mining may strongly suggest that a provider is engaging in improper conduct, at the end of the day, an outlier is merely a provider whose billing patterns differ from those of his / her peers.  A review of the documentation must still be conducted to ascertain whether, in fact, fraudulent conduct has occurred.  While ZPICs and MICs handle the majority of the data mining work being conducted, when the data appears to suggest that fraudulent conduct is taking place, providers should expect HHS-OIG and possibly the Department of Justice or the Federal Bureau of Investigations to step into investigation.  Unfortunately, while data mining can detect aberrant patterns in billing data, it can’t explain them, and often times, this leaves well-intentioned providers facing scrutiny if their billing history appears aberrant for an otherwise innocent reason.  For instance, a specialist who is renowned in his area of practice may be referred serious, highly complex patients by his peers. This could result in his billing patterns appearing to be different from those of similarly-situated physicians.  Despite the fact that there is an innocent explanation for the specialist’s billing patterns, the data alone may appear to suggest that fraud is taking place.  Health care providers should take affirmative steps to determine whether their coding and billing patterns are “normal” or whether their practices are irregular when compared to other providers.
Source: pmimd.com

People Today Involved In Medicare Fraud Scams And Statistics About Report Medicare Fraud In Usa Of The United States

U.s. of America is considered to become one of the potent developed nations about the globe. Medicare is regarded as to become among the best achievements with the social security act of 1965 in United states of America which favors the wellness insurance for the those who are aged on or previously mentioned sixty 5 many years. You can find amount of scams recently discovered concerning this Medicare and it really is defined as Medicare Fraud. This write-up photos the stats to become identified about these kinds of Medicare Fraud carried out in usa of America. There is certainly one organization called Medicare Fraud Strike Power. This organization assists out a whole lot in discovering each one of these types of issues. The organization has amount of people who are interested in obtaining out these sorts of ripoffs / Medicare fraud which is happening all over the united states of America. The biggest rip-off related to Medicare fraud was identified lately by these Report Medicare Fraud strike force. There was a lot more than 1 hundred individuals accompanied with the fraud more than two hundred and fifty million pounds. On account of this United state government announced specific sorts of reward for the same. People today incorporated in these sorts of rip-off includes like business owners, medical suppliers, health care equipment suppliers, Medicaid agents, medical practitioners. Medical professionals, Surgeons etc continues to be provided imprisonment for involving in Medicare fraud circumstances in and about various states in United states of America. There are countable amount of folks associated with these types of actions. They are about folks involved in Medicare fraud and statistics about it. Source: gnuriderschoicebtx.info
Source: medicaresupplementalco.com

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

Solo Docs, So Long: What is Fraud?

     What do any of these terms mean?        What is an “outlier”?  Medicare defines the term, but does not share information about “average” coding practices until after a physician has already “committed fraud” by being an outlier.  Physicians (like me) who purchase and use equipment such as ultrasound or stress test machines are likely to have more patients who agree to undergo testing because it’s quick–therefore we are more likely to be outliers because we are able to persuade our patients to do what they need.      What is “incorrect coding”?  In many cases coding guidelines differ from one insurance provider to another.  For example, if I perform a physical exam on a Medicare patient, I must code V70.0-G0438;  but if I do the same physical on a non-Medicare patient, I must code V70.0-99397.  If the patient is younger than sixty-five the CPT code may be 99396, 99395, 99394, 99393, 99392 or 99391–unless it’s the patient’s first visit, or he hasn’t been to the office in three years.  Then the codes change to 99387, 99396, 99385, 99384, 99383, 99382 or 99381.  If the patient is younger than twenty-one the diagnosis code has to change from V70.0 to V20.2.  The exact same service is provided for a patient, but the codes for billing that service depend on the patient’s age, insurance company, or status as a new or established patient.        To make matters worse, specific aspects of the physical exam must be coded separately.  For example, if I perform a Pap and pelvic as part of the yearly physical, I must also submit to the insurance company, V72-31-Q0091 if there are no signs or symptoms, V76.2-Q0091 if the patient is low-risk, and either 622.1, V15.85, or 795.1-Q0091 if the patient has risks for cervical cancer.  There are hundreds of other options–all for the exact same service!  If the patient’s insurance is Medicare, the procedure codes change to P3000 or P3001, and if the insurance is Medicaid 88164 must be used instead.  The pelvic exam, as separate from the Pap, is coded as V72.31-G0101, depending on the patient’s situation, or it could be V10.41-G0101, V10.43-G0101, or V10.48-G0101.  A rectal exam must be coded as V76.11-82270, but only if the patient is over age 50 and doesn’t have Medicare.  If the patient has Medicare the codes may be V76.11-G0102 or V76.44-G0102, unless the patient has symptoms or it happens to be the second rectal within a 365-day period, in which case a specific code must be selected from a long list of other options–whichever exactly represents the patient’s problem.  For example, if a rectal is done because of new constipation, the codes may be 564.10-82270.  Even with exact codes Medicare is not likely to pay for this charge–its computers say that a rectal can’t be performed more than once a year, and only on patients over age fifty.  Exceptions are impossible to justify–we’re talking to computers, not people.  Most insurance companies will not pay for a Pap or pelvic exam if performed on the same day as the rest of the physical exam–in order for a physician to get paid for a Pap exam the patient must return to have it done another day.        In addition, all these codes must be appended by “modifiers”.  The office visit must be submitted as V70.0-99396-25, the pelvic exam V72-31-G0101-59, and the rectal V76-41-G0102-59-51.  If modifiers are submitted to some insurance companies, the services won’t get paid, because those insurance company computers don’t “recognize” modifiers.  But if -25 and -59 aren’t appended to charges for other insurance companies, the charges won’t be paid.  There are dozens of different modifiers for various uses, and no consensus among insurance carriers about when and how to use them–only denials of payment or allegations of fraud if they aren’t used “correctly.”      My office provides many services on-site.  Each service is complicated by a Pandora’s box of coding rules that vary across insurance companies.  Errors in coding are inevitable, given a system which isn’t centralized and involves so many variables.  Coding and billing have become entrapments for physicians, none of whom can master the ever-changing rules contained in hundreds of thousands of pages of “updates.”  Therefore we are all vulnerable to charges of fraud–and can easily become targets of stupendous fines for breaking the rules.       What is a “medically unnecessary service”?  Who should decide whether a patient needs an EKG or a chest x-ray?  The insurance carrier?  The doctor?  If I decide to obtain a chest x-ray on a patient with low sodium (a condition that suggests a pulmonary abnormality) it probably won’t be “covered,” because insurance companies cannot think this way.  Therefore, the chest x-ray would be considered fraudulent, whatever my medical reasons for obtaining it.      Since “adverse patient outcomes” and “failure to diagnose a patient on time” are examples of fraud we’re all in trouble.  All patients die, eventually–and death is an “adverse outcome.”  A medical malpractice article in the August issue of Family Practice Management states that 75% family physicians will face a malpractice lawsuit before age 65, and of those 77% will be for “failure to diagnose a patient on time.”  Ten years ago statistics showed that a family physician is likely to be sued every seven years.  Given the government’s definition of fraud, physicians who are sued for failure to make a diagnosis on time or for an adverse patient outcome could also face charges of fraud.      Failure to document what is said and done for a patient is the biggest physician land-mine.  Is it really possible to represent what happens between a doctor and a patient on paper?  The malpractice article says, “If your note doesn’t indicate how you arrived at a differential diagnosis, you’re asking for trouble,” and tells us that writing, “risk-benefit assessment discussed” is no longer adequate protection in a malpractice case–nor is it enough for insurance companies.  “Boilerplate notes”–or computer templates designed to meet documentation requirements for insurance companies–constitute red flags for auditors.  Physicians tell same patients the same things all day long–but we can’t use forms to document this.  We have to write individual essays in their charts explaining in excruciating detail what we said, why we said it, and the process by which we made one diagnosis rather than twenty others.        My codes for a test–for example, 786.05-71020-59 means we did a chest x-ray because the patient had a bad cough–aren’t enough in the way of explanation.  I am required to give a description of the cough, duration, triggers, and associated symptoms, as well as the patient’s history of a similar cough, contact with others who have been sick, travel outside the country, exposure to tuberculosis, and particulars like cough with sputum, or cough with blood, or paroxysmal coughing…all described in detail.  If not, I might not get paid for the office visit.  If the chest x-ray still doesn’t seem legitimate to auditors, the I may be accused of fraud, fined, banned from seeing patients covered by that insurance company, or reported to the government. 
Source: blogspot.com

Health Care Hustle: Patients caught in middle of high

The CNBC investigative team, Investigations Inc., spent six months on the front lines with federal agents for the upcoming documentary “Health Care Hustle.” Among the findings: the fee-for-service model that guides most of American health care in the 21st century has created a high-stakes numbers game pitting government authorities against increasingly sophisticated crooks, with patients often caught in the middle.  
Source: nbcnews.com

Breaking Down Medicare Prior to Annual Enrollment

Posted by:  :  Category: Medicare

Louisville, Kentucky — The Medicare Annual Enrollment period is fast approaching. Enrollment runs from October 15 to December 7 this year. Annual Enrollment is the time during which senior citizens become eligible for Medicare products or, if previously enrolled, can select different products. Medicare is not limited to one traditional plan. There are a dizzying array of coverage options, and for this reason, it is wise to enter the shopping process armed with background knowledge on each product. The team at Preferred Insurance Group, a leading provider of Kentucky insurance, discusses some of the issues that have raised questions among senior citizens:
Source: release-news.com

Video: Patty and Richard say, “Apply online for Medicare” (20 seconds) – Social Security

South Leads U.S. in Receiving Medicare EHR Incentive Pay

The South leads the rest of the U.S. in the number of health care providers who received Medicare meaningful use incentive payments in 2011, according to a new report from the Government Accountability Office, Modern Healthcare reports.
Source: ihealthbeat.org

Major Improvements to Medicare Online Enrollment System

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

Q1Medicare com Simplifies the Medicare Part D Plan Selection Process for Long

“Our online LTC drug tool was designed in partnership with a long-term care facility that was seeking an efficient way to help residents find a qualifying Medicare plan that best meets their prescription needs,” notes Dr. Susan Johnson, co-founder and technical director of the Q1Medicare.com site. “We hope that the admissions staff of other LTC facilities will also benefit from our new LTC drug tool and we welcome suggestions for updates.”
Source: eyugoslavia.com

Stimulus dollars: Medicare Vs Medicaid » Meet New People Online

The Medicare EHR Incentive Program will begin in 2011 and is about 2016.The Medicaid EHR incentive program can as early as 2011 and lasts until 2021. The last year begin to participate in the Medicaid incentive program is 2016.To qualify for the Medicaid incentive program have 30 percent of the eligible provider patient encounters to be Medicaid. The threshold is 20 percent for pediatricians.Eligible professionals, the meaningful use of certified EHR technology demonstrate up to a maximum of $ 44,000 over 5 years under the Medicare EHR Incentive Program. To obtain this maximum, however, Medicare eligible starting professionals need participation 2012.Medicare payments to eligible professionals are 75 percent of the physician allowed annual costs to the maximum annual bonus.For each year bound about 2012 that Medicare eligible professionals appropriate use of a certified product demonstration , the maximum incentive bonus will be reduced. When implemented in 2013, the maximum incentive payment is $ 39 000 over three years. When implemented in 2014, the maximum incentive payment of $ 24,000 over two years.For 2015 and later, is Medicare eligible professionals who demonstrate unsuccessful wise use have a payment adjustment to their Medicare reimbursement.Medicaid Eligible Professionals Up to $ 63,750 over 6 years, when they begin participating at any time between now and 2016. There is no reduction of the maximum potential incentive payment no matter when a Medicaid Eligible professionals will begin to participate in required on the net cost of purchasing, implementing and maintaining an EPA-based and when they do so no later than 2016.The incentive payments for Medicaid a flat fee refunded. The Medicaid incentive calculation is not on the reimbursement rates or any claims in the Medicaid EHR way.States do not offer incentive programs tied. You make the area capable of this decision on a voluntary basis. Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas: From January 2011 was opened together with the entry in the following states. It is expected that other states follow suite in the spring and summer of 2011. Click here for more information regarding the anticipated Medicaid EHR programs in your state. www.cms.gov / apps / files / Medicaid HIT sites / There are no penalties for the adoption is not connected to the Medicaid program. Professionals who are eligible for both Medicare and Medicaid EHR incentive programs are, you will need one or the other. An eligible professional can switch between the Medicare and Medicaid programs, a professional in order time.An Medicare program can also participate in the PQRI system, but is not entitled to incentive payments through the ePrescribing incentive program.Eligible professionals in Medicaid program are eligible to receive incentive payments from both the PQRI program and get the ePrescribing incentive program provided they meet the eligibility requirements of each.Eligible within the same practice may choose to participate with various EHR incentive program. For example: In a two-doctor practice, an opt-in to the Medicare program and the Medicaid program.
Source: mi2ave.com

Online Medicare Forms: Appeal, Payment, Disclosure, Application

Medicare insurance forms for parts A, B, C and D are accessible online for electronic filings and mail in. Online forms include an application for Medicare, claim forms for patients requesting payments and Medicare appeal forms. Older Americans can apply for Medicare even if not planning to retire, as long as the person is close to 65 years old. Even when a person has been denied Medicare, appeal forms can be submitted online requesting a hearing or case review.
Source: suite101.com

Compare Hospitals or Nursing Homes Using Medicare’s Online Tools 

These two consumer tools are highly popular with patients, their families, and caregivers.  In the first half of 2012 there were over 1.2 million visits to the Hospital Compare site, and over 500,000 visits to Nursing Home Compare. The sites can be found at Hospital Compare and Nursing Home Compare. The Eldercare Locator can be found at www.eldercare.gov. This public service of the Administration on Community Living is a nationwide service that connects older adults and their caregivers with information on senior services. 
Source: medicareadvocacy.org

Michigan Insurance News & Tips: Applying Online For Michigan Medicare Supplement Coverage

Also seen a in a press release that just came out, Michiganhealthbroker, INC is going to online applications for consumers looking for Medicare supplement coverage. Michigan is home to one of the most populous states when it comes to seniors.  With this understanding, the agency now is specializing more into the Michigan Medicare market.  When it comes to supplements, the agency now is representing some of the most popular carriers on the market.  They include HAP, Standard Life, Omaha Insurance, and many more.  Some of these carriers (not all), have the option of these consumers applying directly online with help from our agency.  This has been a tremendous advantage as some people just do not want brokers at the table. To learn more about the Michigan Medicare supplement market, contact us today.
Source: blogspot.com

eHealth, Inc. Announces Second Quarter 2012 Results

EHEALTH, INC. CONDENSED CONSOLIDATED BALANCE SHEETS (In thousands, unaudited) December 31, June 30, 2011 2012 ———— ———— Assets (1) Current assets: Cash and cash equivalents $ 123,607 $ 122,055 Accounts receivable 8,055 3,661 Deferred income taxes 4,622 4,259 Prepaid expenses and other current assets 3,377 5,891 ———— ———— Total current assets 139,661 135,866 Property and equipment, net 4,631 5,760 Deferred income taxes 3,390 3,954 Other assets 5,641 9,094 Intangible assets, net 10,526 9,619 Goodwill 14,096 14,096 ———— ———— Total assets $ 177,945 $ 178,389 ============ ============ Liabilities and stockholders’ equity Current liabilities: Accounts payable $ 2,391 $ 3,748 Accrued compensation and benefits 7,904 6,335 Accrued marketing expenses 6,195 3,156 Deferred revenue 314 402 Other current liabilities 1,547 3,482 ———— ———— Total current liabilities 18,351 17,123 Non-current liabilities 3,920 4,047 Stockholders’ equity: Common stock 26 26 Additional paid-in capital 215,364 220,922 Treasury stock, at cost (81,557) (89,998) Retained earnings 21,661 26,091 Accumulated other comprehensive income 180 178 ———— ———— Total stockholders’ equity 155,674 157,219 ———— ———— Total liabilities and stockholders’ equity $ 177,945 $ 178,389 ============ ============ (1) The condensed consolidated balance sheet at December 31, 2011 has been derived from the audited consolidated financial statements at that date. EHEALTH, INC. CONDENSED CONSOLIDATED STATEMENTS OF INCOME (In thousands, except per share amounts, unaudited) Three Months Ended Six Months Ended June 30, June 30, ——————— ——————— 2011 2012 2011 2012 ——— ———- ——— ———- Revenue: Commission $ 30,079 $ 30,603 $ 60,839 $ 62,067 Other 6,107 4,904 12,902 10,515 ——— ———- ——— ———- Total revenue 36,186 35,507 73,741 72,582 Operating costs and expenses: Cost of revenue 2,555 764 5,206 2,439 Marketing and advertising (1) 11,668 12,167 24,577 25,154 Customer care and enrollment (1) 4,610 6,358 10,020 12,329 Technology and content (1) 5,415 5,033 10,885 10,515 General and administrative (1) 6,661 6,590 13,382 13,194 Amortization of intangible assets 427 460 854 907 ——— ———- ——— ———- Total operating costs and expenses 31,336 31,372 64,924 64,538 ——— ———- ——— ———- Income from operations 4,850 4,135 8,817 8,044 Other income (expense), net (21) 16 (40) 37 ——— ———- ——— ———- Income before provision for income taxes 4,829 4,151 8,777 8,081 Provision for income taxes 2,097 1,846 4,064 3,651 ——— ———- ——— ———- Net income $ 2,732 $ 2,305 $ 4,713 $ 4,430 ========= ========== ========= ========== Net income per share: Basic $ 0.13 $ 0.12 $ 0.22 $ 0.23 Diluted $ 0.12 $ 0.11 $ 0.21 $ 0.22 Weighted-average number of shares used in per share amounts: Basic 21,390 19,624 21,371 19,580 Diluted 22,119 20,497 22,079 20,471 (1) Includes stock-based compensation expense as follows: Marketing and advertising $ 276 $ 362 $ 522 $ 602 Customer care and enrollment 74 74 181 153 Technology and content 470 217 925 550 General and administrative 1,117 709 2,170 1,682 ——— ———- ——— ———- Total $ 1,937 $ 1,362 $ 3,798 $ 2,987 ========= ========== ========= ========== EHEALTH, INC. CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (In thousands, unaudited) Three Months Ended Six Months Ended June 30, June 30, ——————– ——————– 2011 2012 2011 2012 ——— ——— ——— ——— Operating activities Net income $ 2,732 $ 2,305 $ 4,713 $ 4,430 Adjustments to reconcile net income to net cash provided by operating activities: Deferred income taxes 1,887 678 3,664 1,045 Depreciation and amortization 597 538 1,266 1,114 Amortization of intangible assets 427 460 854 907 Stock-based compensation expense 1,937 1,362 3,798 2,987 Excess tax benefits from stock-based compensation (1,464) (636) (2,553) (1,187) Deferred rent (11) (7) (20) (17) Loss on disposal of property and equipment — — 3 — Changes in operating assets and liabilities: Accounts receivable 1,100 2,579 6,577 4,394 Prepaid expenses and other current assets 1,218 310 1,525 715 Other assets 56 (300) 26 (439) Accounts payable 211 514 (1,169) 1,356 Accrued compensation and benefits 1,504 860 (679) (1,572) Accrued marketing expenses (335) (508) (230) (3,039) Deferred revenue (1,245) (1,187) (2,129) 88 Other current liabilities (798) 664 (1,055) 1,943 ——— ——— ——— ——— Net cash provided by operating activities 7,816 7,632 14,591 12,725 ——— ——— ——— ——— Investing activities Purchases of property and equipment (734) (1,943) (1,239) (2,146) Books of business transfers (3,004) (1,870) (3,769) (6,243) ——— ——— ——— ——— Net cash used in investing activities (3,738) (3,813) (5,008) (8,389) ——— ——— ——— ——— Financing activities Proceeds from exercise of common stock options 46 1,376 72 2,370 Cash used to net-share settle equity awards (2) (6) (544) (986) Excess tax benefits from stock- based compensation 1,464 636 2,553 1,187 Repurchases of common stock — — (3,796) (8,441) Principal payments in connection with capital lease (16) (12) (30) (18) ——— ——— ——— ——— Net cash provided by (used in) financing activities 1,492 1,994 (1,745) (5,888) ——— ——— ——— ——— Effect of exchange rate changes on cash and cash equivalents (11) 1 (19) — ——— ——— ——— ——— Net increase (decrease) in cash and cash equivalents 5,559 5,814 7,819 (1,552) Cash and cash equivalents at beginning of period 130,334 116,241 128,074 123,607 ——— ——— ——— ——— Cash and cash equivalents at end of period $ 135,893 $ 122,055 $ 135,893 $ 122,055 ========= ========= ========= ========= EHEALTH, INC. SUMMARY OF SELECTED METRICS (Unaudited) Three Months Three Months Ended June Ended June Key Metrics: 30, 2011 30, 2012 ———— ———— Operating cash flows (1) $ 7,816,000 $ 7,632,000 IFP submitted applications (2) 101,600 103,400 IFP approved members (3) 87,600 87,900 Total approved members (4) 124,400 148,500 Commission revenue (5) $ 30,079,000 $ 30,603,000 Commission revenue per estimated member for the period (6) $ 37.47 $ 35.47 Total revenue (7) $ 36,186,000 $ 35,507,000 Total revenue per estimated member for the period (8) $ 45.08 $ 41.16 As of As of June 30, June 30, 2011 2012 ———— ———— IFP estimated membership (9) 688,100 684,000 Total estimated membership (10) 804,100 876,900 Three Months Three Months Ended June Ended June 30, 2011 30, 2012 ———— ———— Marketing and advertising expenses (11) $ 11,668,000 $ 12,167,000 Marketing and advertising expenses as a percentage of total revenue (12) 32% 34% Other Metrics: Source of IFP submitted applications (as a percentage of total IFP applications for the period): Direct (13) 45% 47% Marketing partners (14) 32% 31% Online advertising (15) 23% 22% ———— ———— Total 100% 100% ============ ============
Source: ulitzer.com

Heather Wilson Tries to Re

Posted by:  :  Category: Medicare

KNOW WHO YOUR CZARS ARE --ENOUGH TO MAKE YOU SICK ---ONLY OBAMA COULD CREATE POSITIONS FOR THESE INCOMPENTENT COMMUNISTS AND SOCIALISTS by SS&SSWilson Supported Cut, Cap, & Balance Plan That Would Force Deep Cuts To Social Security And Medicare While Protecting Tax Breaks For Millionaires And Big Corporations. In June 2011, Wilson released a video announcing her signing of the Cut, Cap and Balance Pledge. According to the Center on Budget and Policy Priorities, “It is inconceivable, however, that policymakers would meet the bill’s severe annual spending caps through automatic across-the board cuts year after year; if they did, key government functions would be crippled. Policymakers would have little alternative but to institute deep cuts in specific programs. […] Reaching and maintaining a balanced budget in the decade ahead while barring any tax increases would necessitate deep cuts in Social Security, Medicare, and Medicaid.” [Heather Wilson Youtube Channel, accessed 8/15/11; Center on Budget and Policy Priorities, 7/16/11]
Source: donaanademocrats.com

Video: Dozens charged nationwide in $163M Medicare scam

Medicaid expansions saves lives, Harvard study says

Rates of death also declined among elderly adults, though the relative changes represented only one third of the mortality decline among adults between the ages of 20 and 64 years. One possible explanation for these findings is that expanding coverage had positive spillover effects through increased funding to providers, particularly safety-net hospitals and clinics. Publicity about the expansion may also have encouraged uninsured higher-income and elderly persons to obtain insurance from other sources, including those over the age of 65 years who did not meet lifetime earnings requirements for Medicare.
Source: elgritonm.org

Medicaid Expansion Could Cut Death Rate

aging AHRQ bacteria cancer children’s_health clinical_trials diabetes doctor_patient_relations doctor_patient_relationships Environmental health environmental_health ethics exercise fda flu genetics global health Health care health information health_care health_care_costs health_care_services health_information heart_disease influenza Medical research Medicare Mental Health mental_health NIH NLM nutrition obesity pain Physical exercise physician patient relations physician_patient_relations prescription_drugs Public health public_health PubMed Social media stress Twitter violence
Source: wordpress.com

Medicaid Expansion May Lower Death Rates, Study Says

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

A new study suggests dietary supplement can protect against preeclampsia

This cost and relatively simple procedure can have a low value in reducing the risk of preeclampsia and preterm, the authors conclude. But they say further studies are needed to determine whether these results can be repeated and if they are due to L-arginine alone or the combination of L-arginine and antioxidant vitamins.
Source: yerbabuenainstitute.org

The Medicare Secondary Payer Act: Ethical Considerations in Settling Cases

Posted by:  :  Category: Medicare

Before the MSP Act became a major issue in workers’ compensation and other cases involving personal injuries, attorneys were often not mindful of their obligations under the act and its potential ethical ramifications. Prior to the year 2000, a number of jurisdictions issued advisory opinions regarding the conduct of lawyers with respect to the settlement of liability or workers’ compensation claims, or both, and the resolution of unpaid liens for medical providers as a condition of settlement. However, these advisory opinions were short and vague. For example, in 1996, the state of North Carolina issued a rather benign statement indicating that lawyers in a personal injury claim may not execute an agreement to indemnify the tortfeasor’s liability insurance carrier against unpaid liens for medical providers.
Source: mnbenchbar.com

Video: Part 2: Romney greeted in Eagan MN by seniors waving “Mitt(s) Off My Medicare!” Signs

MN Republicans Awarded For Healthcare Leadership

Regarding the Medicare reform agenda, David Lipschutz, a policy attorney at the Center for Medicare Advocacy, expressed a concern that the amount given to beneficiaries in the form of vouchers will not keep up with the costs of health care and health care inflation. In effect, health care costs will be passed on to the beneficiary. Lipschutz also believes that claims that Medicare is bankrupt are grossly exaggerated. “It’s true that Medicare costs are increasing, because of the growing Medicare population, but the whole notion of Medicare going bankrupt is pretty misleading,” Lipschutz said. “Right now when people talk about bankruptcy and solvency, they’re talking about Medicare Part A, the Hospital Fund. It’s pretty healthy compared to where it’s been over the past decades.” Lipschutz said that the projected date of insolvency has fluctuated anywhere between three years to 20 years, based on the health of the economy at the time the Medicare trustees release their annual report. Most recently, the trustees’ 2012 report projected that the exhaustion date (when the program won’t have enough money to pay all of its obligations) is 2024. “The important point to make is, say if everything stays the way it is now, at the point the trust fund can’t pay 100 percent of the costs, it will be paying something like 87 percent. It’s still covering the vast majority of the cost,” Lipschutz said. “The dangers are being overstated. There are things that can be done that would have much less impact on Medicare beneficiaries.” Lipschutz said the organizations pushing premium support should let the Affordable Care Act show its full potential before resorting to measures that he said would harm beneficiaries.
Source: mnpoliticalroundtable.com

Today’s news update

the solicitor then goes on to steal money from the beneficiary’s bank account. The caller initially explains that the beneficiary will be receiving updated Medicare cards within the “next three to five days”, but first, the beneficiary must verify over the phone, personal information, such as name, address and other information. As a lure to get the banking account number, the caller then reads the root number of the person’s bank (the first series of numbers on a check), then asks the beneficiary to complete the sequence by providing the numbers of their actual banking account. The caller’s tone is particularly authoritative, and if the beneficiary does not readily comply, an alleged “supervisor” is put on the line to exert additional pressure.
Source: kymnradio.net

Organizations Unite to Urge Caution in Demonstration Programs Serving Low

[1] See cover letter, summary recommendations and full document. [2] Senator Rockefeller’s letter is here; the MedPAC letter is here and the FAH letter is here. [3] Section 2602 of the Affordable Care Act (ACA), Pub. L. 111-148 (March 23, 2010) [4] Section 1115A of the Social Security Act, as added by § 3021 of the ACA.  See letter of December 13, 2010 to Health and Human Services Secretary Kathleen Sebelius concerning provisions of § 3021 affecting dually eligible beneficiaries and signed by 38 individual scholars or practitioners, state and national advocacy organizations, available at: http://www.medicareadvocacy.org/2011/07/15/recommendations-for-beneficiary-protections-in-models-approved-by-cmmi/ [5] These states are MO, CA, IL, MA, OH, WI, CO, CT, IA, NC, WA, MI, MN, OK. [6] Information about the demonstrations, including proposals from all 26 states, is available at: http://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialModelstoSupportStatesEffortsinCareCoordination.html [7] Letter of June 27, 2012 to Secretary Kathleen Sebelius, available at: http://www.medicareadvocacy.org/wp-content/uploads/2012/07/Savings-letter-to-Sebelius-062712.pdf [8] Section 1115A of the Social Security Act, added by § 3021 of the Affordable Care Act, Pub. L. 111-148 (March 23, 2010)
Source: medicareadvocacy.org

Medicare Health Insurance Counselor Needed!

Our service area includes Hennepin and Wright Counties. However, we answer questions from all over Minnesota.  The 21 hr training includes a training manual, meeting some of the seasoned volunteers and lunch each day. Then after training, we work on client assignments. Many volunteers shadow with another MHIC volunteer when working with clients. We always have staff available to be in support to our volunteers.
Source: patch.com

ACHI Career Center: General Nursing jobs, Minneapolis jobs, Minnesota jobs, RN

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota’s leading health plans. We provide more than 250,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.
Source: communityhlth.org

DealCurry.com : Baring India To Raise Fund IV

Baring Private Equity Partners India commenced investment management activities in 1998 as part of the Baring Private Equity Partners Group and it provides investment advisory services to Baring Funds, which have cumulative AUM of around $1 Bn, in the IT/ITeS, life sciences, banking, financial services & insurance, energy & infrastructure and consumer goods sectors. Some of the portfolio entities of its recent fund – Baring India Private Equity Fund III include Sphaera – a startup engaged in discovery and development of pharmaceutical drugs, Muthoot Finance Ltd., Shilpa Medicare Ltd. and TD Power Systems Ltd. among others.
Source: dealcurry.com

South Leads U.S. in Receiving Medicare EHR Incentive PayReporting Technology’s Impact on Healthcare

Posted by:  :  Category: Medicare

Deal 3, Table 7: Initiation enter Trick A~ contract taker leads King of Risks by KevinHutchins314A new report from the Government Accountability Office finds that hospitals and physicians in the South lead the U.S. in receiving Medicare meaningful use incentive payments. Forty-four percent of the hospitals and 32% of the eligible health care professionals who received Medicare meaningful use incentive payments in 2011 were located in the South. Modern Healthcare et al.
Source: ushealthcrisis.com

Video: Buy Best Medicare Leads – Don’t Get BURNED!

Medicare Leads, Medicare Supplement Leads, Medicare Sales Leads

PRLog (Press Release) – Jan 26, 2011 – Medicare Leads are something that virtually every insurance agent eventually looks for. The reason could be as simple as the fact that they are sick and tired of spinning their wheels on cold calling. For the most part it is often better and much easier to have leads that are already screened and verified for you. More often than not if you are cold calling – which had been and at times still is the accepted practice – you do not know if the prospects are actually ready to buy. This is why so many people decide that they are going to get their Medicare Leads from Senior Marketing. instead of anywhere else. For the most part the leads lists that insurance agents get from Senior Marketing are better than anything else. The fact that Company goes the distance to make sure that the leads that they provide to agents are as current as possible. They also go the distance to make sure that those prospects are as well qualified and able to buy as possible. There is nothing more frustrating than calling on a prospect and finding out that they are not in the position to buy and/or simply do not want to be bothered. Think about this for a little while if you would; which is better for you, preset appointments that you know are ready to hear what you have to say or cold calling? Most insurance agents would prefer to have preset appointments to call on for so many reasons. The first and foremost being that they are not wasting their time or the prospect’s when they call. Another reason is that they know that those whose names appear on those lists are already aware of the products that they want to talk about. When it comes to Medicare Leads lists it is always more helpful when you know that those you want to call on are actually in the mood and position to buy. What is the point of calling on someone when you do not know what their personal and financial situation happens to be? That frustration is not something that you really need to have to deal with. This is precisely the reason that so many people choose Senior Marketing’s services. Let’s take a look at the many other thoughts that may be occurring to you when you are considering using Senior Marketing for your leads in this area. One of the major thoughts has already been discussed; eliminating the frustrations. Having the assurance that the leads that you are given are yours and yours alone is also a good thing that many insurance agents value. Having to share leads lists is not exactly something that many insurance agents are too thrilled about, for obvious reasons to be sure! When you are looking at the prospect of having to do cold calling it can be rather daunting no matter how you look at it. It is these Medicare Leads that make the difference. Call toll free to order quality Medicare Leads: 1-888-997-7778 Ext.1. http://www.medicaresupplementleads.com/
Source: prlog.org

Medicare Leads, Medicare Sales Leads, Medicare Supplement Leads

All Web Leads offers high quality lead generation services to the health insurance industry. We generate over 200,000 health, life and Medicare leads on a monthly basis serving over 15,000 agencies and carriers. By operating our own proprietary network of websites, we have full control over our lead generation process.
Source: nazuka.net

Medicaid and Medicare PACE Plan

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

The South Leads In Scoring Federal EHR Payments

California Healthline: Direct Messaging Called Major Advance In State’s HIE Effort Health information exchange conference attendees clustered around a series of kiosks, crowding in to see a hands-on demonstration of direct messaging — a relatively new electronic interface promoted by the national Direct Project that allows secure transmission of a wide variety of files, from MRIs to lab results, even between health care providers with different electronic health record systems. … One of the ways to speed up while taking that turn lies in the use of direct messaging — also known as direct exchange — between providers, [an official with California’s Health Information Exchange] said. The inability to quickly convey information is one of the bigger issues facing providers who use EHR systems, she said (Gorn. 7/26).
Source: kaiserhealthnews.org

LivingSenior Debuts SeniorLeads.org Supplemental Medicare Leads Services

The face of lead generation is changing with the baby boomers and businesses simply have to keep up with that change. When a company deals with supplemental Medicare insurance the quality of the lead needs to be at its highest percentage and SeniorLeads understands that. For To obtain quality leads SeniorLeads works through a process that insures a business is receiving pre-screened leads eager and ready for the service they provide. The services available work to develop a researched lead, which has been weeded out and pre-screened not just for overall senior need but also for specific needs that fit with the plans a supplemental insurance company, has to offer.
Source: inc100news.com

Reviews for Medicare Leads

Secondly, an appointment shows willingness on the art of the client. This means it will not be as hard to get a sale out of the client when you meet them. As a result, the number of appointments you have should directly translate to sales. If your marketing team is good, they should have at least 90% percent of the appointment leads turned into sales or promising clients. This is the reason why you should consider such Medicare Leads over telemarketing leads. In the case o telemarketing leads, you will need a very experienced and determined marketing team for you to match the effectiveness of appointment based leads. So how do you go about getting them?
Source: wordpress.com

LivingSenior Debuts SeniorLeads.org Supplemental Medicare Leads Services

The face of lead generation is changing with the baby boomers and businesses simply have to keep up with that change. When a company deals with supplemental Medicare insurance the quality of the lead needs to be at its highest percentage and SeniorLeads understands that. For To obtain quality leads SeniorLeads works through a process that insures a business is receiving pre-screened leads eager and ready for the service they provide. The services available work to develop a researched lead, which has been weeded out and pre-screened not just for overall senior need but also for specific needs that fit with the plans a supplemental insurance company, has to offer.
Source: towerofconfidence.com

Gordon Marketing Awarded Number One Anthem Medicare National FMO 2011

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSGordon Marketing has become a leader in the Medicare Supplement Insurance industry as well as Medicare Advantage plans and in Medicare Part D. This is part of Gordon’s commitment to seniors and in support of all of their agents that market these products. Continuing education seminars and telephone training classes is a hallmark of their company. Train, train, train is what Gordon Marketing does best. They don’t just ask for more business, they show HOW to make more business! Gordon Marketing was founded in 1980 by Dick and Margaret Gordon and has made a national name from humble beginnings. Gordon Marketing is an independent, family-owned and operated brokerage company located in the heart of Indiana. Gordon Marketing specializes in Senior, Health, Life & Annuity products for independent agents across the nation. President, Sylvia Gordon and Vice President, Rebecca Gordon work together with their brother Frank, sister Theresa and a wonderful staff of 45 to service agents in 49 states. Gordon Marketing has grown over 127% in the last 3 years in the areas of senior, life, health and annuity insurance products. Gordon Marketing will be moving into their new Corporate Office at 20236 Hague Road in Noblesville, IN on June 1st 2012. This facility incorporates a state of the art training center, and will serve to take the company to a much higher level of service to their clients and agents. In 2009 and 2010 Gordon Marketing was named the Small Business of the Year. In 2011 Gordon Marketing also received the Small Business of The Year Award by the City of Noblesville Mayor Distlear. Dick Gordon, founder of Gordon Marketing is also the founder of the Riverview Hospital Gordon “Brick Layer” Club. Gordon Marketing also supports various charities throughout the year in giving back to the local community. Gordon Marketing now has 75 full-time employees and is projected to build another Corporate Building within the next 5 years to house an additional 30 employees. Gordon Marketing not only markets to agents, but is using their current facilities to operate their retail and consumer based program. These agents sell life, annuities, senior and health insurance products. For more information about Gordon Marketing, their services and products, please visit http://www.gordonmarketing.com.
Source: sbwire.com

Video: Anthem Medicare Advantage Plans | Enroll in Medicare

Anthem Medicare Advantage Plans: Offering Affordable Freedom of Choice

BCBS Medicare PPO Advantage Plan gives you more of the benefits that you need and expect, including built-in prescription drug coverage. All three plans under the BCBS Medicare PPO umbrella offer all of the benefits of original Medicare along with several services that are not generally covered, as well as the convenience of one of the largest provider networks in the state.
Source: abchealthplans.com

Anthem Medicare Advantage Plans in Ohio

Medicare Ohio ! Again, for I know. Ready to share new things that are useful. You and your friends. What I said. It isn’t outcome that the true about Medicare Ohio . You look at this article for facts about anyone wish to know is Medicare Ohio .
Source: blogspot.com

Dragons, Anthem Blue Cross and Blue Shield Team up for

Dragons, Anthem Blue Cross and Blue Shield Team up for "Home Run for Life" Dayton, Ohio — Anthem Blue Cross and Blue Shield and the Dayton Dragons will host eight-year-old Morgan Hamer during the unique "Home Run for Life" program on Wednesday, July 18th, at 7 p.m. when the Dayton Dragons take on the Clinton LumberKings at Fifth Third Field. 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… Business HMO Blue Care Network sells high-deductible savings accounts Blue Care Network, the health maintenance organization affiliate of Blue Cross Blue Shield of Michigan, this week began selling a high-deductible health savings account.
Source: medicare-news.com

Update Regarding Anthem Medicare Supplement Rate Adjustments in Colorado

The state of Colorado has approved a move by Anthem Blue Cross Blue Shield to keep rates for its Medicare Supplement plans the same in 2010 as they were in 2009. Accordingly, there will be no rate change for Anthem Medicare Supplement plans available in Colorado. However, Anthem Blue Cross Blue Shield does remind customers that there is no rate guarantee for new businesses. More information about rate adjustments Rate adjustments for Medicare plans are common and are seen as necessary by health insurance providers for several reasons. One of the most common reasons for rate adjustments has to do with the increase in deductibles and coinsurance amounts from the Center for Medicare and Medicaid Services that became effective on January 1, 2010. As of January 1, 2010, CMS increased the Medicare Part A deductible from $1,068 to $1,100. Part A coinsurance amounts increased from $267 to $275 per day for hospital stays from the 61st day in the hospital through the 90th day in the hospital. The coinsurance rate increase from $534 to $550 per day for the 60 lifetime reserve day. Also, coinsurance for Skilled Nursing Facility Care increased from $133.50 per day to $137.50 per day for days 21 through 100. There were also changes to Medicare Part B deductibles; the deductible amount will increase from $135 to $155 per month and the premium rate will increase from $96.40 to $110.50 per month. There will be no corresponding increase in Social Security benefits in 2010 to help cover the cost of the increased rates. Also, based on income filing status, the CMS has set a higher Medicare Part B premium rate for higher-income participants and couples. Again, Anthem Blue Cross Blue Shield subscribers may have the same rates in 2010 as they had in 2009 because of Anthem’s choice to forgo the rate increase. According to Blue Cross Blue Shield, instead of increasing cost of coinsurance and deductibles to customers, Anthem Blue Cross Blue Shield plans will cover these increases as long as the plan already covers deductibles and coinsurance amounts. As a result, the amount of money that Anthem pays out to health care providers in benefits for its participating members will increase. Another reason that many rates for health insurance plans increase is become of the increased cost in providing health care services. This cost correlates to an increase in the number of Medicare beneficiaries who also enroll in Medicare Supplemental insurance plans. According to Anthem Blue Cross Blue Shield, the health insurance provider received the cost and use of its Medicare Supplemental insurance benefits and determined that they do not need to change the premiums for the plans for Colorado residents yet. The move to keep the rates the same as they were in 2009 will help to save Anthem Medicare Supplemental insurance plan members money. Medicare Supplemental insurance helps to cover the doughnut hole coverage gap that applies to many individuals enrolled in traditional Medicare plans. With Supplemental insurance, participants can have increased coverage even when traditional Medicare plans do not provide adequate coverage for their healthcare services or products. Medicare beneficiaries should work with an experienced Medicare advisor to learn more about which Medicare Supplemental insurance plans are right for them.
Source: submityourarticle.com

Latest Anthem Medicare News

But the most long run budget savings by far would be achieved by allowing younger workers to save and invest their Medicare payroll taxes in personal accounts. In retirement, those accounts would finance their health insurance vouchers, and would be able to finance far more because of the accumulation of all the market returns over the years. This would shift huge amounts of spending out of the federal budget altogether, and to the private sector. The general revenues currently used to finance so much of Medicare would be used for means tested supplements for lower income seniors to ensure that they could afford essential coverage and care. But these general revenues devoted to Medicare would be limited to grow no faster than the rate of growth of GDP, providing further huge savings over the long run.
Source: signupformedicare.net

Dave Fluker’s California Health Insurance Blog: Anthem Medicare Advantage LPPO and Sutter Health Group

Sutter Health Group and Anthem Blue Cross MAPD LPPO (Medicare Preferred PPO and Medicare Preferred Select LPPO) have been unable to reach agreement on a new contract. As of February 1, 2012, Sutter will no longer be a participating provider for Anthem Blue Cross CA hospital and professional network. The ancillary services for Sutter will continue to be a participating provider. Again, this contract issue affects Medicare Advantage PPO and Medicare Advantage LPPO subscribers. The following Sutter Health facilities are affected: Sutter Roseville Medical Center – Roseville, CA Alta Bates Summit Medical Center – Alta Bates/Herrick – Berkeley, CA Alta Bates Summit Medical Center – Summit Campus – Oakland, CA California Pacific Medical Center – California – San Francisco, CA California Pacific Medical Center – Davies – San Francisco, CA California Pacific Medical Center – Pacific -San Francisco, CA California Pacific Medical Center – St. Lukes – San Francisco, CA Eden Hospital Medical Center – Castro Valley, CA Memorial Hospital Medical Center – Modesto – Modesto, CA Memorial Hospital of Los Banos – Los Banos, CA Menlo Park Surgical Hospital – Menlo Park, CA Mills Hospital – San Mateo, CA Novato Community Hospital – Novato, CA Peninsula Hospital & Medical Center – Burlingame, CA San Leandro Hospital – San Leandro, CA Sutter Amador Hospital – Jackson, CA Sutter Auburn Faith Hospital – Auburn, CA Sutter Coast Hospital – Crescent City, CA Sutter Davis Hospital – Davis, CA Sutter Delta Medical Center – Antioch, CA Sutter General Hospital – Sacramento, CA Sutter Lakeside Hospital – Lakeport, CA Sutter Maternity & Surgery Center – Santa Cruz, CA Sutter Medical Center of Santa Rosa – Santa Rosa, CA Sutter Memorial Hospital – Sacramento, CA Sutter Solano Medical Center – Vallejo, CA Sutter Tracy Community Hospital – Tracy, CA I expect that at some point a contract agreement will be reached and will post when that happens.
Source: blogspot.com

MB Customer Care: HOT OFF THE PRESS…Anthem And Walgreens Reach Multi

Anthem has announced that Express Scripts, Inc. (ESI) and Walgreens have reached an agreement for Walgreens to participate in Anthems retail pharmacy network and members will be able to use their pharmacy benefit at Walgreens stores beginning September 15, 2012.  This will impact members in commercial, Medicare and Medicaid. Also, Walgreens-owned pharmacies including BioScrip, Duane Reade, and Happy Harry’s will be part of the pharmacy network.  Express Scripts members can log in to www.express-scripts.com to search in network pharmacies and starting September 15th, this will include Walgreens pharmacies. Anthem is currently working with Express Scripts to ensure there are no problems for members who may want to transfer prescriptions to Walgreens.  Usually, members an take their medicine bottle to the new drug store.  However, some state regulations as well as certain medications will require members to contact their doctor to have them call the new store with prescription details.  To make sure there is no delay in receiving medications, you may want to contact your local Walgreens prior to needing your prescription filled to clarify the best way for the prescription to be transferred.
Source: blogspot.com

In Florida, Obama Attacks Romney On Medicare Plan

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 marsmet481Miami Herald: As Thrill Fades, President Barack Obama Fires Up Supporters On Medicare, Tax Cuts But Obama steered clear of attacks on Romney’s business record and instead tailored his message toward seniors and the middle class on the first day of a two-day campaign swing in the nation’s biggest battleground state. He stops in Fort Myers and Orlando on Friday. The president warned that Romney’s proposal to repackage Medicare as a fixed benefit is a “voucher” system “will end Medicare as we know it” as it forces seniors to purchase private health insurance. He said his health care reforms have helped seniors receive discounted prescription drugs and get access to free preventive care (Klas and Caputo, 7/19).
Source: kaiserhealthnews.org

Video: Florida Medicare Advantage Plans – Supplement Health Insuran

Obama in Florida: Romney’s Medicare Plan Leaves Seniors ‘Out of Luck’

“Florida, that is wrong. It’s wrong to ask you to pay more for Medicare so that people who are doing well right now get even more,” the president added. “That’s no way to reduce the deficit. We shouldn’t be squeezing more money out of our seniors. My plan is to squeeze more money out of the health care system that is being wasted.”
Source: wbobradio.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

Obama kicks off Phase II in Florida

As Jon Chait noted, “The Obama campaign’s attacks on Mitt Romney’s business record and personal finances will probably continue for a long time. But I think that, when the campaign is remembered in history, they will not be seen as the central element but rather as a prelude. The main event is going to be a fight over the priorities of the Paul Ryan budget.”
Source: msnbc.com

Pharmacy Association Fights Medicaid Restrictions

Saying its members have been locked out and patients are suffering, the Florida Pharmacy Association joined others in a suit filed Thursday in Leon County circuit court to stop the Agency for Health Care Administration from restricting which pharmacies are allowed to serve Medicaid and Florida Healthy Kids patients.
Source: cbslocal.com

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

Local Public Forums Provide Original Medicare Education

Tagged With: Brevard County, BREVARD COUNTY FLORIDA, Cape Canaveral Hospital, Cocoa Beach, Crane Community Center, Florida, Government, Health, Health First Health Plans Inc., healthcare needs, Healthcare reform in the United States, Holmes Regional Medical Center, Indian River County, Indian River County Chamber of Commerce, Margaret Haney, Medicare, Melbourne, Rockledge, Social Issues, United States National Health Care Act, Vero Beach
Source: spacecoastmedicine.com

Florida Elder Law and Estate Planning: Will your Medicare be impacted by the Affordable Care Act?

Reducing Costs for Prescription Drugs.  People with Medicare are already benefiting from the phase-out of the “Donut Hole” coverage gap that requires Medicare Part D enrollees to pay the full price for their drugs after a certain threshold of coverage has been met and until a catastrophic limit has been met.  Beneficiaries now pay only 50% of the cost of brand name drugs in the Donut Hole and 86% of the cost of generic drugs. So far, beneficiaries have saved an average of $635 per person on their drug costs from this provision, a figure that is expected to rise to $4,200 per person by 2021. The Affordable Care Act is on track to fully eliminate the Donut Hole by 2020, ensuring that people enrolled in Part D plans have better access to the drugs they need.
Source: blogspot.com

Florida Medicare Plans: FOR THE BENEFIT OF THE BENEFICIARIES

According to the recent news the Medicare Rights centre released its June, 2012 report in which it highlighted the fact about the effects of the measures in the Patient Protection and Affordable Care Act (ACA) to reduce federal reimbursements to private health insurance plans that provide Medicare benefits through the Medicare Advantage (MA) program in New York. However the report has dired the predictions that a reduction in payments to MA plans under the ACA would cause insurers to exit the market, decrease plan benefits or immediately pass costs to Medicare beneficiaries.
Source: blogspot.com

Q1Medicare com Simplifies the Medicare Part D Plan Selection Process for Long

“Our online LTC drug tool was designed in partnership with a long-term care facility that was seeking an efficient way to help residents find a qualifying Medicare plan that best meets their prescription needs,” notes Dr. Susan Johnson, co-founder and technical director of the Q1Medicare.com site. “We hope that the admissions staff of other LTC facilities will also benefit from our new LTC drug tool and we welcome suggestions for updates.”
Source: eyugoslavia.com

Under Romney’s budget plan, seniors would pay an extra $6,400 a year for health care

Romney has said that he would eliminate the Affordable Care Act in his first week in office, and has previously endorsed Paul Ryan’s budget plan, a plan that’s very popular among Republicans as a whole. Ryan’s plan would, among other things, raise the Medicare eligibility age to 67 and turn Medicare into a voucher program—which the Congressional Budget Office estimates will cause the typical senior to pay around $6,400 more for Medicare per year than they do today.
Source: msnbc.com

Pinellas County: Medicare Advantage Plans Florida

Medicaid Florida . What is Medicare Advantage? Medicare Advantage Plans Florida are a popular alternative to Original Medicare and Medicare Supplement Plans. Learn how to compare Medicare drug plans and medicare health plans known as Medicare advantage plans. Our video library explains in detail the operation of this Medicare subject. www.medicareadvantageflorida.com call us at 1-888-836-7303 for a no obligation enrollment kit -Pinellas County – Bay Pines, Belleair, Belleair Beach, Belleair Bluffs, Belleair Shore, Boca Ciega, Clearwater, Crystal Beach, Dunedin, East Lake, Gulfport, Indian Rocks Beach, Indian Shores, Kenneth City, Largo, Madeira Beach, North Redington Beach, Oldsmar, Palm Harbor, Pass-A-Grille Beach, Pinellas Park, Redington Beach, Redington Shores, Safety Harbor, Seminole, South Pasadena, St. Pete Beach, St. Petersburg, Sunset Beach, Tarpon Springs, Tierra Verde, Treasure Island, Ozona. Hillsborough County – Apollo Beach, Balm, Bealsville, Bloomingdale, Brandon, Carrollwood Village, Dover, Gibsonton, Lithia, Lutz, Mango, Orient Park, Plant City, Riverview, Ruskin, Seffner, Sun City Center, Tampa, Temple Terrace, Thonotosassa, Valrico, Wimauma, Ybor City.
Source: blogspot.com

Q1Medicare com Simplifies the Medicare Part D Plan Selection Process for Long

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ...More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524“Our online LTC drug tool was designed in partnership with a long-term care facility that was seeking an efficient way to help residents find a qualifying Medicare plan that best meets their prescription needs,” notes Dr. Susan Johnson, co-founder and technical director of the Q1Medicare.com site. “We hope that the admissions staff of other LTC facilities will also benefit from our new LTC drug tool and we welcome suggestions for updates.”
Source: eyugoslavia.com

Video: Medicare Covered Power Chair – Do You Qualify? – Toll Free Phone Hotline

GAO highlights low participation in Medicare EHR Incentive Program

A new report from the Government Accountability Office (GAO) confirms predicted trends and reveals some humbling truths about the success of the Centers for Medicare & Medicaid (CMS) Electronic Health Record (EHR) Incentive Program for Medicare. While all of the estimated $30 billion in funding for meaningful use incentives from 2011 to 2019 will come from federal coffers, the portion of the program directly administered by CMS on the national level (i.e., Medicare) will constitute more than half of total funds, a reported $17.7 billion. However, if the low level of participation continues, it’s unlikely that enough recipients will emerge to collect these dangling carrots.
Source: ehrintelligence.com

Medicare Supplements Get High Marks

When asked what they liked most about their Medicare supplement coverage, enrollees highlighted a variety of benefits, including limits on out-of-pocket costs, ease of dealing with medical bills and paperwork, and the ability to budget for unexpected medical costs.  Beneficiaries also said they valued the fact that Medigap allows them to see the doctor of their choice and that it covers hospital expenses and physician costs not covered by Medicare.
Source: seniorconnectionnewspaper.com

Texas Vascular Associates Sued in Dallas for Alleged Medicare, Insurance Fraud

The lawsuit, Cortez Mills v. Texas Vascular Associates, et al., No. CC-12-04630-D, was filed July 26, 2012, in Dallas County Court at Law No. 4. The doctors named in the lawsuit are Gregory J. Pearl, William P. Shutze, Dennis R. Gable, Brad R. Grimsley, Toby J. Dunn, Stephen E. Hohmann, John C. Kedora, Taylor C. Hicks and Bertram L. Smith.
Source: freeprnow.com

Today’s news update

the solicitor then goes on to steal money from the beneficiary’s bank account. The caller initially explains that the beneficiary will be receiving updated Medicare cards within the “next three to five days”, but first, the beneficiary must verify over the phone, personal information, such as name, address and other information. As a lure to get the banking account number, the caller then reads the root number of the person’s bank (the first series of numbers on a check), then asks the beneficiary to complete the sequence by providing the numbers of their actual banking account. The caller’s tone is particularly authoritative, and if the beneficiary does not readily comply, an alleged “supervisor” is put on the line to exert additional pressure.
Source: kymnradio.net

Steady Hospital Readmission Rates Prove Costly for Medicare

Not everyone agrees with these findings. Nancy Foster, a vice president at the American Hospital Association, has stated that these findings downplay improvements made in the last year given the prior two years of readmission data. She suspects that more patients are being better managed in the ambulatory setting and that sicker patients, who end up being admitted, are more likely to return and be readmitted into the hospital. Additionally, industry and health policy experts believe that patients intentionally returning or being readmitted to the hospital for new, unrelated ailments, are not properly counted in Medicare’s calculations.
Source: ehealthinsurance.com