West Virginia Medicare Part D Plans

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The following list details all 36 plans available to West Virginians and will allow you to compare premiums, deductibles, type of plan (basic or enhanced), whether or not there is extra coverage while in the Part D donut hole and Medicare Star ratings for each plan.
Source: partdplanfinder.com

Video: Medicare Part D Prescription Drug Plan Basics

Medicare Part D Resource for you by Mature Health Center

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

Low Cost Health Insurance Plans and Companies: Medicare Part D Newsletter from Q1Medicare.com

The Centers for Medicare and Medicare Services (CMS) has issued a reminder that Medicare now provides more preventive services such as a free Medical “Wellness” Exam (if you have had Medicare Part B for longer than 12 months), specific cancer screening, and counseling to stop tobacco use (Tobacco Cessation) for all Medicare beneficiaries.
Source: blogspot.com

EA Files Lawsuit Against Zynga

Despite a weak earnings report, lowered yearly financial projections, and two lawsuits, Zynga’s stock is flying high today, following the public announcement of its forthcoming game, ‘ChefVille.’Last week TNW reported on a very odd occurrence: Following …
Source: silobreaker.com

Mo. To Change Medicare 'Spend Down' Rules

Posted by:  :  Category: Medicare

"Never spend your money before you have it." ~ Thomas Jefferson. by eyewashdesign: A. GoldenAlyson Campbell, the director of the Department of Social Services’ Family Services Division, told lawmakers that, in some cases, department staff had been incorrectly giving credit for the full amount of a person’s medical bill – even if parts of it were paid for by Medicare or private insurance or were written off altogether by the person’s medical provider. That means some people in the program might have received Medicaid coverage for which they were not truly eligible.
Source: kmbc.com

Video: Medicaid spend down

Using Irrevocable Funeral Trusts to Protect Your Burial and Cremation Funds

But what about the rest of your family’s nest egg funds?  Some, if not all, of those funds can also be protected using irrevocable funeral trusts for not only the individual needing long term care, but also for his or her spouse, each of their children, and, in some states, the spouses of the children.   Here is an example of just how beneficial these irrevocable funeral trusts can be: The father needs long term care and wants to apply for Medicaid.  He uses his spend down funds to pre-pay for an irrevocable funeral trust for himself in the amount of $15,000.  He also pre-pays his spouse’s irrevocable funeral trust with $15,000, and he puts $9,000 into irrevocable funeral trusts for each of his five children.  By taking these steps, he has protected his funeral costs and family burial spaces, and, more importantly, he did so within the Medicaid guidelines.  The family has also protected $75,000 of their nest egg, creating a legacy gift that will be remembered for years to come.
Source: efuneral.com

With the Loss of Illinois Cares Rx, Where Can People Turn? : The Shriver Brief

The elimination of Illinois Cares RX is effective on July 1, if the Governor signs the bill as is. As you can tell from this blog, that leaves precious little time for seniors to make the complicated choices and actions necessary to rearrange their drug purchasing and transition to the new system. Advocates have asked that Governor Quinn amendatorily veto the bill to keep Illinois Cares Rx on the books, or, at a minimum, to delay the effective date to January 1, 2013, to allow for a smoother transition—let’s keep our fingers crossed. Of course, we will keep you updated on any developments.  
Source: theshriverbrief.org

Coalition Testimony to Michigan Senate on Dual

*Consumer enrollment is not yet adequately addressed in the draft plan. The state is going to automatically enroll all eligible people, and then those people will have to decide if they wish to disenroll.  Given that the state would not be using the more consumer-friendly tactic of determining whether people wish to enroll in the first place, it becomes imperative that the opportunity to opt out of the program be available at any point in time – something the administration’s draft doesn’t specify. Additionally, it is unclear to us how the plan’s periods for consumer assessment and consumer enrollment mesh; we would remind the administration that until someone is assessed, knows what they’ll be offered and can compare that (in writing) to what they presently receive, an informed decision about whether to accept the automatic enrollment or exercise the opt-out privilege can’t be made. And, while we appreciate the plan’s provision that everyone wanting consultative assistance on enrollment would get it, we believe that every non-respondent to the state’s initial project notification letter should receive proactive consultative outreach, and assistance should not be provided by what the plan calls an “enrollment broker,” but rather what we call a “choice broker” – one that has absolutely no financial stake in whether an individual accepts their automatic project enrollment or decides to opt out of it.
Source: mha-mi.com

The Medicaid Problem Grows and a (Partial) Solution Emerges

Billions of dollars of in-force life insurance policies are regularly abandoned by uninformed seniors as they enter their “long term care years”. Because a life insurance policy is legally recognized as an asset of the policy owner, it is an unqualified asset and counts against them when applying for Medicaid. For Medicaid applicants, it has been standard practice to abandon a life insurance policy if it is within the legally required five year look back spend-down period. But now, it is possible to convert a life insurance policy instead of abandoning it, allowing the policy owner’s care to be covered as a private pay patient by a long-term care benefit plan over an extended time frame.
Source: floridawealthadvisors.com

Nothing found for Medicaid

A lover of the right people, politics, art, the natural world, and some of not so natural. By day I’m an essential part of a Marketing business. By night and weekend, I am helping people across Canada stop their home from going into foreclosure. I have trained under a brilliant and dynamic teacher Navtaj Chandhoke that is a true leader and power house in the Canadian Real Estate Investment world.
Source: westopforeclosurecanada.ca

Common Questions about Asset Protection from Nursing home Medicaid spend down

Medicare provides payment for medical expenses for illnesses. Medicare does not cover the long term custodial care in nursing homes or adult care homes. Medicare will provide assistance only for a maximum of 100 days assuming that certain conditions are met. Medicare does not pay for what is called “custodial care.” Custodial care is the type of care most people receive in nursing homes – meaning not all nursing home residences receive the maximum 100 days of coverage. What Assets will be used to pay for Nursing Home care? Your home, jointly held property, gifted assets, retirement accounts, bank accounts, securities and insurance policies will all be used to pay for nursing home care. All of your assets will be spent. A single person will be left with only $2,000. Can’t I just give my assets to my children? There are many pitfalls to doing this. For example, you no longer control your assets. If your child is sued, your assets will be taken. If your child gets divorced, their spouse may be entitled to a share of those funds. Or, if your child dies, your funds may not go to individuals you have specified. Most important, transfers or gifts are subject to look back periods and penalties. If any of that gifted money is spent or lost and a loved one goes into a nursing home, there could be serious consequences based upon newly signed federal regulations. At Commonwealth Advisory Group, we are experts in MA Medicaid Spend Down planning to save on MA Nursing Home Costs. Commonwealth Advisory Group has helped families to protect assets prior to admission to a nursing home medicaid, and when a loved one has already been admitted to a Massachusetts Medicaid nursing home.  We are Massachusetts leading Senior Asset Protection Planning and Massachusetts Medicaid planning consultants.  Commonwealth Advisory Group specializes in helping Massachusetts elders and their families protect assets from nursing home.
Source: ezinemark.com

Utah’s Medicaid Program Pays People’s Medical Bills

Medicaid is a public, or government run, form of health insurance. Typically, the funding comes from both the federal government and the state government. In Utah, Medicaid benefits are paid with both federal and state funds. Utah’s Medicaid program is jointly administered by the Utah Department of Health and the Utah Department of Workforce Services. Utah has quite a few public programs that can help families to afford health insurance.
Source: families.com

Hip Fracture Surgery Experience In Phoenix, Arizona (My Medicare Father at Banner Thunderbird Hospital, 2012)

Posted by:  :  Category: Medicare

Racism by elycefelizI have taken care of many patients with broken hips over the years.  Hip fracture carries an incredibly high morbidity and morality. Mobility is the absolute key to survival.  If hip fracture patients cannot ambulate again, they can expect a life filled with recurrent complications.  Add on the risks associated with Parkinson’s and I fear for my father’s life from any number of complications from  aspiration pneumonia and bowel impaction to ileus and pulmonary embolism.  The human body was built to move.  His key to survival will be acceptance of  any limitations, prevention of all  falls all the time  and continued aggressive physical therapy,  without dropping  him. Sometimes, it’s best for patients to swallow their pride and accept a walker as their best friend.
Source: blogspot.com

Video: Medicare in Arizona- 1.800.643.7544

Matrix Medical Network to Provide Medicare Advantage Home Assessment Services for Humana

Matrix Medical Network, a Welsh, Carson, Anderson & Stowe company headquartered in Scottsdale, Ariz., provides in-person prospective medical assessment services that help medical plan clients manage costs and provide high-quality medical care. Having pioneered the use of a national network of highly trained employee Nurse Practitioners to conduct medical assessments in plan member homes or nursing facilities, Matrix Medical Network is dedicated to improving the health and lives of elderly Americans; helping clients efficiently, accurately, and securely collect plan member information; and establishing new standards in health care quality, efficiency, and effectiveness. For more information and career opportunities, visit www.matrixhealth.net.
Source: azventurecapital.com

Medicare Advantage Plans Arizona

Medicare Advantage Plans in Arizona are sold through private insurance companies approved by Medicare. While they typically offer similar benefits, there are significant differences between plans, making it well worth your time to compare a few of the providers. Basically, all Medicare Advantage Plans in Arizona must provide Original Medicare benefits (Part A and Part B). Some include extra coverage like dental or vision care and most include Part D (prescription drug coverage). There are a few different types of Medicare Advantage plans available, including HMO plans, PPO plans, Private Fee-for-Service plans and Special Needs plans. Whichever type you choose, Medicare pays a fixed amount for your care to the company providing your Medicare Advantage plan.
Source: medicareadvantageplansarizona.com

Select Arcadian Medicare Advantage Plan Assets in Arizona to be acquired by WellCare

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Source: medigap4seniors.com

The Rapidly Approaching Medicare Investment Tax Coming in 2013

Example 3.  Rob and Cheryl are a married couple.  In 2013 their income consisted of wages of $100,000 for Rob and $75,000 from Cheryl received from their S corporation.  The corporation engages in a capital intensive business with numerous other employees.  The wages paid to Rob and Cheryl are reasonable payments for the services provided.  The S corporation reported $100,000 of additional income that was reported to Rob and Cheryl on their K-1.  They received no distributions from the S corporation as the organization retained the earnings to reinvest in additional equipment.  Both Rob and Cheryl spend more than 500 hours actively working in the business.  The couple has $60,000 of dividend income from investments.
Source: wordpress.com

Something to Celebrate: Three Big Birthdays, One Short Week

In 2008, the U.S Census Bureau reported that the uninsured rate among children was the lowest it had been since 1987. Most of these uninsured children are eligible for Medicaid and CHIP, yet not enrolled. Secretary Kathleen Sebelius issued the Connecting Kids to Coverage Challenge, calling on governors, mayors, pediatricians, community organizations, and many others to work together to cover the 5 million kids who were eligible for either CHIP/Medicaid but still not enrolled. Because of this effort, the number of eligible but unenrolled children has declined nationally.
Source: communitycatalyst.org

Along With Medicare, Select No Medical Exam Life Insurance In Case Medical Exam Is Not Your Cup Of Tea

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CareLife insurance is designed to replace your revenue after your death. Thus figure how much you get, how much you spend, and how much your loved ones would need if you’ll not be around. After that add the cost of whatever medical care and hospitalization you might need before death to that, together with your funeral or cremation expenses. The expenses add up. You’ll be able to guard your family’s financial future, and give yourself peace of mind right when you purchase no medical exam life insurance. It takes just minutes and may be remarkably reasonable. A number of people feel no medical exam life insurance coverage may certainly be a trick, only a policy that can be expensive and isn’t worthy of cost. Also many individuals believe that no health check life insurance coverage is really difficult to get and therefore it simply increases the reasons never to bother even hunting for it.
Source: org.uk

Video: Jazzy Select Elite Power Chair, Medicare Approved

Medicare Select: Are sales opportunities passing you by?

Assured Life Medicare Supplement Combined Insurance Customer Retention Customer Service Gerber Life Medicare Supplement Leads Medicare Select Medicare Supplement Medicare Supplement Plan F Medicare Supplement Plan G Medigap Med Select Mutual of Omaha Medicare Supplement Omaha Insurance Company Medicare Supplement Plan F Plan G Senior Market Advice Senior Market Success Technology United of Omaha Medicare Supplement Web Tips Woodmen of The World Medicare Supplement Combined Insurance (1) Med Supp (2) MedAmerica (1) Medicare Select (1) Medicare Supplement (2) Medigap (2) Plan F (1) Plan G (1) Short Term Care Insurance (1) STC Insurance (1)
Source: psmbrokerageblog.com

Residence Wellness Care in Illinois For the Self

Residence overall health treatment in Illinois is the alternative of decision for seniors who can consider care of by themselves and dwell independent lives, but who even now call for some health care supervision or help. Some of the assistance which property healthcare solutions offer include nursing, physical remedy, and occupational treatment. Supervision and administration of medications is typically offered. At times help is provided with meals, dressing, bathing, and housekeeping. The difference between house treatment solutions and house well being care is that the former relates a lot more to housekeeping, cooking, and many others., whereas care health home Illinois relates far more to health care and nursing care, for patients who are recovering from health-related difficulties but who do not need long lasting healthcare supervision.
Source: bodiesny.org

Medicare Select Supplement Insurance Plans

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

How to Select Travel and Health Insurance Plans During Vacation

When people plan for any trip or vacation, last thing that come in their minds is travel insurance. This is probably one of the psychological things. The reason for this is that nobody likes to think about sickness, accidents or any other problems, while planning for any enjoyable vacation. However, this may result in causing big mistake, particularly if you are planning to leave your country. The experienced people do not recommend for basic travel insurance for people, who are only worried for some stolen or lost baggage. However, in case you are having any types of homeowners or renters insurance, you may get protection against your stolen baggage. Now, if you are thinking that something may happen with you in the flight, definitely you should go for long term or permanent life insurance. The interesting feature about such types of life insurance is that people do not have to purchase such insurance policies each time for making their happy trip. In fact, most of the travel insurance policies have excluded such coverage from their travel plans. The real requirement of any particular travel insurance arises with medical travelling insurance. Now, most of our friends will say that they are already having health insurance policies, which are capable of fulfilling the requirements. Most of the individual or group health insurance policies are capable of providing limited coverage outside the country. For this, you should have to check all the travel and health insurance policies in careful manner. For instance, health insurance policies of Medicaid, Medicare, and Medigap do not incorporate any coverage outside the country. This implies that although, we are having some coverage, but still we cannot say that our travel or medical coverage is adequate or not. The reason for this is that coverage of your travel and medical insurance is solely dependent on your travelling destination.
Source: tecomiami.org

Billing and Insurance Changes

***If you have an insurance plan that I will NOT bill: I will continue to provide the same wellness services for you through October 31, 2012. Services include prescription refills, lab testing, annual exams, screening tests and office visits. Beginning November 1, 2012 you may continue to follow me as your wellness provider as a self-pay patient. Upon request, I will provide an insurance form that you can submit to your insurance for reimbursement. Office visit receipts can be submitted to your insurance and applied towards your deductible. HSA/FSA spending accounts can be used to pay for office visits.
Source: kristierosser.com

Bluster Online: Medicare: How To Select The Right Program

When you are presently looking for a good and cost-effective healthcare offer, then you should truly consider buying some kind of medicare complement insurance as well. Obviously it’s not necessarily easy to find a great discount package, and it may be difficult to start to see the woodland through the bushes with the distinct insurance policies that exist once we attain a certain age to complement our health-related charges. As of now, there is a wide number of complement insurances offered and this short article must assist you in building a rational and cost-effective determination. So let us get going.   First off, allow me to express, that you ought to often check with a realtor that is specialised in complement insurance rates. They will simply take your wishes into account and have probably the very best back ground to provide you with a sensible endorsement predicated on your personal budget and your needs. Contact all of the various agencies, grab some E-Mail or Phone Numbers and just step out there and look for a person quote centered on your own personal choices. Once you accumulated a small number of rates from diverse firms, follow-up by having an comprehensive comparison. Take your time and don’t rush the comparability – in the end, it is your health that’s at stake here. They are able to give you along with that plan after you observed a medicare supplement plan that fits your needs, request add-ons, reductions or some other sort of packages and give the realtor a phone. Plenty of the agents perform commission-based and hence they could alter the prices and add-ons a bit. Follow up with the required forms and you are completed – of course your health is a mind-draining and tedious procedure, but your health is definitely more significant than 2 hours of your time!   In order that is actually it. Take note of what you are looking for in a great medicare supplement plan, get a few rates from unique organizations predicated on your preferences, then review them and then you are accomplished. Now you do not have to be worried about monetary issues that may or may not change from future medical issues.   Read This For More: see rates
Source: blusteronline.com

Medigapcomparisons.com Releases a Revamped Version of Website With Latest Humana Medicare network

With escalating costs of healthcare and the downturn of economy it has become crucial for citizens to explore mediums to make most of their healthcare premiums. There is no dearth of plans from established insurance companies – some cover drug and medical coverage, then there are some which provide stand-alone prescription drug coverage. But as found in UCLA Study – 2011, commissioned by Department of Sociology, when it comes to choosing a plan as per personal needs, lack of standardized and credible information definitely hampers citizens. Medigapcomparisons.com is an effort to bridge this gap with comprehensive, unbiased and authentic information. With this version of the website, the founders have incorporated many features the site’s beta users suggested during 2010-11. “On our site one can find in-depth analysis of all leading Medicare Supplement and Medicare Advantage Plans including those from the likes of market leaders Humana Medicare Health Plans care and Florida Medicare Advantage Plans from Freedom Health” informs Mark Carter, Media representative of Medigapcomparisons.com. Current news, renewal rates and updated benefits are key points to note when making a decision about insurance plans. So, providing updated content is another aspect the site owners are working on. For example the of news story of Humana Inc, which has been at the forefront of health and well-being companies recently announced inclusion of Northwest Medical Center, Oro Valley Hospital and their urgent care centers in Tucson for their Medicare Advantage Plans – PPO, HMO and Private Fee for Service plans. This story is likely to benefit many of the 83000 Humana beneficiaries in Arizona. Such current news coverage will definitely help site visitors. The site now has a tips section as well – It has been noted in the UCLA study that due to lack of information, in many cases citizens find their insurance plan is unable to cover certain illness or procedures, only after they have nowhere to go. These missteps can be easily avoided with proper knowledge about Medicare Supplements like those offered by Humana. These supplement plans could be really beneficial to people who would like to have the benefit of say World-wide coverage and don’t want to take an alternative new plan. With predictable costs one could keep a check on their budget as well. With Advantage plans one gets added benefits to those originally provided with Medicare plans, covering majority of healthcare costs. Both Supplement and Advantage plans also help to remove network restrictions which generally come with Medicare select plans. Such tips could really help seniors who are not abreast with latest information. It has been long said information is one major way we are going to change the present American Healthcare System for the better and we are gradually moving towards it. Scalable user generated information and authentic news in the internet environment is one way to tackle this issue. About Medigapcomparisons (http://www.medigapcomparisons.com ) Medigapcomparisons is an interactive insurance information site oriented toward Medicare-eligible citizens. The site features information about all leading Medicare Insurance and Supplement providers and their most preferred plans. The founders share the vision to make it one-stop site for all to make the most informed decision. Since its creation in 2009, the site has clocked over 10, 000 visitors per month for last 14 months. To learn more and experience the arrived revolution in healthcare, please visit http://www.medigapcomparisons.com/
Source: sbwire.com

Who Can Issue Medicare Select Coverage?

Medicare Select is a managed health care system. If you have purchased a Medicare Select supplemental insurance policy, you have to use a hospital that is approved and on their list of approved health car providers. You can still use your own doctor but you have to use a hospital that is an approved provider of the Medicare Select program. The approved hospitals are local hospitals who have agreed to charge a designated sum as approved by the private insurance companies that underwrite private supplemental insurance to bridge the gap between Medicare and meeting qualifying deductibles, which means how much you have to pay before Medicare covers your health care.
Source: seniorcorps.org

Texas Medicare Supplement Plan G

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

Compare Medicare Supplemental Insurance Plans and View Rates Online

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98Anyone that has individuals and their family that are on Medicaid, know exactly how much of a hassle it can be to try to live with just Medicaid. This is why many people look for supplemental insurance to their Medicaid, in order to pay for the expenses that they have on a day-to-day basis. There are many things that need to be taken into account when you are analyzing these companies, including what they are going to be able to provide. Senior Health Direct is able to provide excellent supplemental insurance health plans to seniors that are looking for a little something on top of the government services that are provided to them. They strive to help every senior with low cost health insurance, that can make their lives much easier than just relying on the Medicaid that they currently have.
Source: pressreleaseprint.com

Video: Medicare Advantage Plan Comparison Tool – PlanPrescriber

Downloads CMS launches Medicare drug comparison tool.(Practice Trends): An article from: Skin & Allergy News e

Medicare EHR Incentive Program update; NLM launches tool to. Centers for Medicare & Medicaid Services (CMS) CMS Provides Health Coverage for 100 Million People. Medicare and Medicaid Rules Policy News and Tools. practices; CBO: removing pay-to-delay by drug. books by Mary Ellen Schneider (manufacturers hyperactivity. Innovation Models Initiative, the program from the CMS. encourage better hospital care will likely adjust Medicare. What is Medicare? What is Medicaid? – Medical News Today: Health News Medical Practice Management; Medical Students / Training; Medicare / Medicaid / SCHIP. CMS launches Medicare drug comparison tool.(Practice Trends): An article from: Skin & Allergy News Mary Ellen Schneider International Medical News Group, 2004 Daily Report – Kaiser Health News . quarterly results, making its view of health-cost trends. . Practice Trends Article from Skin & Allergy News Rehospitalizations among Patients in the Medicare Fee-for-Service. CMS Launches Medicare Drug Card Comparison. Practices to Educate and Reach Out to Seniors on the Medicare Prescription Drug.
Source: livedoor.jp

Compare Medicare Supplement Plans Side By Side

As you can see, comparing plan benefits from one company to the next is mostly a non-issue. Although some companies such as United Healthcare seem to offer small benefits such as vision and prescription drug discounts, this is actually a benefit of being an AARP member.
Source: alabamamedicaresupplement.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

Comparison of Medicare Premium Support Proposals

The brief compares the premium support provisions of these proposals, including how the level of premium support for beneficiaries would be determined; whether traditional Medicare would remain an option; what protections would be provided for low-income beneficiaries; and whether and how the proposals would cap federal spending on Medicare.  These differences have important implications for Medicare beneficiaries, the federal budget, health care providers and private health plans.
Source: kff.org

Medicare announces improved tools to compare hospitals and nursing homes

Both sites contain important data on how well these facilities perform on quality measures such as the frequency of infections that develop in the hospital, how often patients have to be readmitted to the hospital, and the percentage of nursing home residents who report having moderate to severe pain while staying in the nursing homes.
Source: dallasnews.com

The Importance of Comparing Medicare Supplemental Insurance Plans

Many Medigap customers think that comparing Medicare supplement insurance is a highly complicated process and that only insurance agents will know how to compare these supplement to Medicare policies. If you too are holding the same view about Medicare supplemental insurance, then you will be surprised to learn that comparing your Medigap plan options need not be a complicated or tedious process anymore. Today, the internet has empowered the customers so much that they can accomplish a lot of time consuming tasks in a matter of just few clicks. This applies to Medicare supplemental insurance price comparison too. You will be able to compare your Medicare supplement plans easily online. You will not have to visit several websites or spend several hours anymore to compare the various policies. You just need to find a reliable Medicare supplemental insurance website such as Lowcostmedigap.com that will allow you to compare Medigap plans online. Using such online services you will be able to make well-informed choices on your Medicare supplement. You will be able to save not only a lot of money but also a lot of time by comparing your Medicare supplement plans online.
Source: medicarequotefinderblog.com

Vermont Medicare Part D Plans

This can help with any future medications that may be prescribed. Often times a doctor has more than one drug choice to treat a symptom so knowing what your costs will be ahead of time can ensure you get a prescription for the lowest cost.
Source: partdplanfinder.com

Health ins What is wellness Medicare Buz Blog repository Health card Henry

Posted by:  :  Category: Medicare

DAMN!! -- I THINK WE'RE F*%KED by SS&SSHCHC some sort of azines mission to boost the wellbeing of individuals Furthermore our own metropolitan areas through excellent, effective and efficient companies leads to which to become organic suit concerning HCHC To provide promises to raise the well being along with location inhabitants. A few circumstances along with purposes that Obtain area villages incorporate HCHC providing athletic coaching Additionally ambulance suppliers relating to place older senior high school graduation sporting measures, plus the provision Along with Henry County community wellness purposes plus organizations that have positively impacted Healthcare people house places For many years. in addition, excellent emphasis is being put Both equally equally equally nationally additionally locally along with the value of caring for chronic circumstances Like coronary heart problems, big hypertension, diabetes, arthritis, additionally far more. HCHC possesses programs set up to assist people Within taking care of the chronic situations, many lately supplying some sort of a far better choices, better wellbeing some sort of workshop collection made to educate grown ups how you can efficiently come out being self-managers from the chronic health problems. provide Corp. cc
Source: co.cc

Video: Medicare Supplement Insurance

Racial Disparities in Breast and Cervical Cancer: Can Legislative Action Work? Part 2

The quasi-experiment created by the BCCPTA legislation and its implementation showed the potential of our nation to expand access to insurance and treatment, in a very timely fashion, to low-income persons with clear medical needs. This legislation was implemented as the WHMP in Georgia and in such a way that women got into the program more quickly, received appropriate and perhaps more complete treatment. Further, in the case of cervical cancer, treatment was extended to those with pre-in-vasive disease in a timely manner. The latter is a highly cost-effective use of public funds, since it can prevent this disease from becoming invasive. Most important, the positive effects of BCCPTA in Georgia were shared by both Blacks and Whites, and where differences emerged, they reflected somewhat quicker enrollment, a longer time on Medicaid, and more treatment for Blacks—as seen in the case of pre-invasive cervical disease and follow-up after mammography. Another key difference seen in our data, lower hysterectomies among Blacks with cervical cancer, perhaps reflects a choice made to retain reproductive capacity. It is important, however, to assess whether these are fully informed choices and, in turn, if they are related to higher rates of mortality among Black women with this cancer. Finally, the linkage of registry and Medicaid claims data clearly enhanced our ability to look at BCCPTA, and such linkages would allow for analysis of future legislation and, indeed, measuring access for women with breast, cervical, and other cancers in the periods leading up to and following the implementation of the Patient Protection and Affordable Care Act (PPACA) in 2014.
Source: what-when-how.com

FBI — Doctor Pleads Guilty to Billing Medicare and Medicaid for Counseling Sessions with Dead Patients

According to United States Attorney Yates, the charges, and other information presented in court: WILLIAMS was a licensed physician, practicing in the Atlanta area. From approximately July 2007 through October 2009, he contracted with a medical services company to provide group psychological therapy to nursing home patients in a variety of nursing homes. Under his signature, thousands of claims were submitted to Medicare and Georgia Medicaid seeking reimbursement for group psychological therapy that WILLIAMS purportedly provided to beneficiaries at several nursing homes in the Atlanta area. In many instances, however, WILLIAMS did not actually provide the therapy.
Source: fbi.gov

CBO — Medicare’s Payments to Physicians: The Budgetary Impact of Alternative Policies Relative to CBO’s March 2012 Baseline

Medicare’s payment rates for physicians’ services are scheduled to be reduced by 27 percent in 2013, CBO estimates, under the provisions of law known as Medicare’s Sustainable Growth Rate (SGR) mechanism. The SGR mechanism consists of expenditure targets, which are established by applying a growth rate (calculated by formula) to spending for physicians’ services and certain related services in a base period, and annual adjustments to the payment rates, which are designed to bring spending in line with the expenditure targets over time. (For further discussion of the SGR, see the appendix of Changes in Payments to Physicians.) In each of the past several years, legislation has been enacted to override the SGR and to either maintain or increase those payment rates when they were otherwise scheduled to decrease.
Source: fulltextreports.com

Racial Disparities in Breast and Cervical Cancer: Can Legislative Action Work? Part 1

The only national study of the effects of BCCPTA used a pre-post analysis of time to definitive diagnosis and treatment over all women and by race/ethnicity (Lantz & Soliman, 2009). The results indicated both a positive effect—a decrease in time to definitive diagnosis for cervical cancer— and a negative effect—a delay in time to definitive diagnosis for breast cancer cases. Moreover, both the positive and negative effects of BCCPTA held only for White non-Hispanics. While White women were more likely to have a delay in the time to definitive breast cancer diagnosis, this delay was not sufficient in length to indicate that BCCPTA changed the proportion of women who initiated treatment within a 30- or 60-day time period after diagnosis. Another negative effect of BCCPTA—an increase in time to treatment initiation (7-15 days) for cervical cancer—found in this study, held only for non-Hispanic Blacks and Hispanics. This delay was sufficient in length for there to be a significant reduction in the probability of treatment initiation within 60 days of diagnosis. These types of delays reduce the ability of the system to achieve quality benchmarks for these racial/ ethnic groups. The authors noted that these delays might be due to a lack of access to Medicaid-participating providers or, as noted in another study, delays in making and keeping appointments among disadvantaged and immigrant women (Ogilvie, Shaw, Lusk, Zazulak, & Kaczorowski, 2004). Lantz and Soliman (2009) also noted that women of color had longer mean times (days) to: (1) definitive diagnosis after an abnormal screening test, and (2) treatment initiation in both the pre- and post-BCCPTA periods, which is a cause for concern.
Source: what-when-how.com

Georgia Medicare Fee Schedule

Medicare can be confusing, let us help. Our team of experts has the training and tools needed to help you make important decisions about your Medicare Advantage, supplement and Medigap policies from the best Medicare insurance carrier so that you can rest assured that you will get the best possible coverage at a competitive price. Simply fill out our contact us form or click the link to go to our fast free quote engine. The service is free and there is no obligation to you. Protect your financial future with the right insurance plan for your needs, today.
Source: gamedicareplans.com

CMS Update: User Meetings, GAO Report, and Recertification Requirement

CMS implemented a recertification requirement for all responsible reporting entities (RREs). Every year, the authorized representative of each RRE must certify information found on the CMS profile. The schedule for recertification is based on the original registration date. CMS requires insurers to respond within 30 days of receiving the recertification request. Failure to respond will result in discontinued status for the RRE. CMS won’t process any quarterly report files until the RRE recertifies the profile information. You should confirm that CMS has accepted your recertified profile.
Source: business2community.com

Maryland Stem Cell Commission is funding 36 new projects for 2011

Posted by:  :  Category: Medicare

P8020005 Kush Patel: Dont Kill the American Dream by faulAs pointed out in AD 2011, the Commission gave preference to proposals that focus on the advancement of regenerative medicine, the selection of promising research that addresses head injury, heart disease,,,, ALS, DNA damage, the generation of intestinal tissue, projections of clinical medicine, and other debilitating medical conditions and expensive. This round of funding, the Commission has also encouraged partnerships, resulting in 10 winners wants to work with private companies in biotechnology. In a new innovative pilot program, two MCSR-funded researchers will collaborate with scientists funded by the California Institute of Regenerative Medicine .
Source: yerbabuenainstitute.org

Video: Adara Scarlet’s Story

Mitt Romney on Health Care

Deep Reads: The Daily Beast: The Answer Is Unleashing Markets, Not Government Our divide is fundamental: Republicans believe healthcare can be best guided by consumers, physicians and markets; Democrats believe government would do better. Some Democrats would have government buy healthcare for us; set the rates for doctors, hospitals and medicines; and decide what medical treatment we would be entitled to receive for each illness. If you liked the HMOs of the ’80s, you’d love government-run healthcare … But government can’t match consumers and markets when it comes to lowering cost, improving quality, and boosting productivity … The right answer for healthcare is to apply more market force, not less (Mitt Romney, 05/01/09). Boston Globe: Preston’s Blueprint Long before Mitt Romney unveiled his ambitious plan to provide health insurance to everyone in Massachusetts, he hired Ron Preston — “the best health and human services secretary in the nation,” as the governor once called him – to work on a plan to do in the Commonwealth what no other state has been able to do. Romney took the wraps off his vision in November 2004, and Preston, apparently no longer the best health and human services secretary in the nation, was nudged out by the next May. Preston and a tight group from inside and outside the administration spent 6 months answering Romney’s basic question: Could it be done? Their answer: Yes, Massachusetts could insure all its residents. But how the Preston working group planned to do it differed, in critical aspects, from what Romney eventually proposed (Bailey, 1/11/06). FactCheck.org: ‘Romneycare’ Facts and Falsehoods As the 2012 presidential campaign gets under way in just a few months (believe it or not), we expect to see an increasing number of attacks on so-called “RomneyCare.” So as part primer and part preemptive fact-checking, this article is our attempt to set the record straight (Robertson, 5/25/11). Boston Globe: Romney And Healthcare: In the Thick of History The former governor has faced a fusillade from the right for the plan they call RomneyCare. But a look back at the birth of the Massachusetts law shows why he can’t, and won’t, back away. It was an amazing political feat, and no one’s role was bigger than his (Mooney, 5/30/11). Boston Globe: ‘RomneyCare’ — A Revolution that Basically Worked The former governor’s health plan is a policy piñata among his rivals. But a detailed Globe review finds the overhaul has achieved its main goals without devastating state finances. The remaining worry is future costs (Mooney, 6/26/11). New York Times: Ted Kennedy Helped Shape Mitt Romney’s Career, and Still Haunts It When Gov. Mitt Romney signed legislation in April 2006 requiring most Massachusetts residents to have health coverage, Sen. Edward M. Kennedy stood by his side, beaming like a proud father. They were onstage at historic Faneuil Hall in Boston, a setting that had a special resonance for the two (Stolberg, 3/24/12). The Real Romney (book): Pride in RomneyCare Shows in Official Portrait In 2008, for Romney’s official portrait, he had been clear about the image he wanted to convey for posterity. He would be sitting on his desk in front of an American flag, next to symbols of two things he held dear. The first was a photo of his wife, the center of his personal universe. The second was the Massachusetts healthcare law, represented by an official-looking document with a caduceus — often used as a symbol of the medical profession — embossed in gold on the cover. Romney was deeply proud of the law and felt strongly that it should figure prominently in the portrait, which would hang alongside others dating back to the Colonial era. He wanted to be remembered for that (Kranish and Helman, p. 261-262, 1/17/12). NPR: Romney On the Health Insurance Mandate In 2006, as Massachusetts’ governor, he talked about the state’s mandate in decidedly non-ideological terms: “We’re going to say, folks, if you can afford healthcare, then gosh, you’d better go get it; otherwise, you’re just passing on your expenses to someone else. That’s not Republican; that’s not Democratic; that’s not libertarian; that’s just wrong” (Liasson, 5/25/12). New York Times: Jonathan Gruber, Healthcare’s Mr. Mandate After Massachusetts, California came calling. So did Connecticut, Delaware, Kansas, Minnesota, Oregon, Wisconsin and Wyoming. They all wanted Jonathan Gruber, a numbers wizard at M.I.T., to help them figure out how to fix their healthcare systems, just as he had helped Mitt Romney overhaul health insurance when he was the Massachusetts governor. Then came the call in 2008 from President-elect Obama’s transition team, the one that officially turned this stay-at-home economics professor into Mr. Mandate (Rampell, 3/28/12). Los Angeles Times: Romney’s Healthcare Plan May Be More Revolutionary than Obama’s As he pushes to “repeal and replace” President Obama’s healthcare law, former Massachusetts Gov. Mitt Romney has turned to proposals that could alter the way hundreds of millions of Americans get their medical insurance. In public, Romney has only sketched the outlines of a plan, and aides have declined to answer questions about the details. But his public statements and interviews with advisers make clear that Romney has embraced a strategy that in crucial ways is more revolutionary — and potentially more disruptive — than the law Obama signed 2 years ago (Levey, 4/23/12). Boston Globe: Mitt Romney’s Plan May Undercut Mass. Law A proposal by Mitt Romney to curtail Medicaid spending would dramatically undercut the way the Massachusetts healthcare overhaul law has achieved near universal coverage. Although the specifics of Romney’s plan are not public, his overall intent — to rein in how much Medicaid money Washington sends to the states — would probably cripple the Massachusetts healthcare law, which was made possible by an expansion of Medicaid funding. If Romney succeeds, the result could have an ironic twist: the governor who ushered in the country’s first universal health plan would, as president, put in place policies that could undermine one of his signature achievements (Jan, 5/4/12). ### This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
Source: physiciansnews.com

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

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

2011 Medicare Trustees Report 

The HI Trust Fund is a victim of the economy.  Healthcare costs typically rise at a much faster rate than general inflation.  In 2010, healthcare costs rose almost four times faster than the consumer inflation rate.[3] In addition, the high unemployment rate means that fewer people are working and contributing payroll taxes into the Trust Fund.  Payroll tax contributions were also lower than anticipated because wages are not increasing. As a result, the Trustees had to change some of the assumptions they use about economic growth in projecting the solvency of the Trust Fund.   Note that the longest projected solvency period, 28 years, occurred in years in which the country experienced high economic growth and budget surpluses.
Source: medicareadvocacy.org

'''''Social Security Point of Zero Return

taxes and benefits for people turning 65 in different decades. The lifetime value of taxes is based on the value of accumulated taxes paid, as if those taxes were put into an account that earned an annual 2 percent interest rate, plus inflation. The examples are for a married couple in which both spouses earned average wages ($43,500 in 2011). Projected benefits assume that both spouses have average life spans after turning 65. Want more benefits? Live longer.
Source: georgia-medicareplans.com

 Health Care Insights

Posted by:  :  Category: Medicare

AARP * Aetna Inc * Alabama Insurance Department * American Specialty Health * Amerigroup Corporation * Ameri-Plus Select Services * Arcadian Health Plan & Management Services * Arnold & Porter * Balboa Nephrology Medical Group * Barclays Capital * BCBS of Minnesota * Blue Cross Blue Shield of Tennessee * Boehringer Ingelheim * California Association of Physicians Group * Capital District Physicians Health Plan * Care 1st Health Plan * Care N Care Health Plan * Caremore * Clarian Health Plans * DCA Solutions * DCIPA * Deft Research * Dendreon Corporation * Dial America * DMW Direct * Dynamic Healthcare Systems * Endo Pharmaceuticals * Essence Health Care * Essex Woodland * Express Scripts Inc * Family Health Plans * Firstsource * Forest Laboratories Inc * Fresenius Medical Care * Geisinger Health Systems * GemCare Health Plan * Gorman Health Group * Group Health Cooperative * Health Alliance Medical Plans * Health Data Essentials * Healthcare Partners * HealthMetrix Research Inc * HealthNet Government Programs * HealthPlan CRM * HealthSpring * Healthways Inc * Henry Ford Health System * HMS Permedion * Humana * Independence Blue Cross * Inspiris * Inter Valley Health Plan * Kaiser Foundation Health Plan of Colorado * Kaiser Permanente * Leprechaun * Marketing Direct Inc * Matrix Medical Network * Medagate Corporation * MedAssurant * MVP Health Care * North Texas Specialty Physicians * Old Surety Life Insurance Company * Oliver Wyman Actuarial Consulting * Peak Health Solutions * PopHealthMan * Preferred Care Partners * Quest Diagnostics * SCAN Health Plan Arizona * Sharp Health Plan * Silverlink Communications * South Shore * Sterling Life Insurance Company * Texas HealthSpring * The Bright Sight Group * The Harry Walker Agency * The Kaiser Family Foundation * The National Advisory Board on Improving Health Care Services for Seniors and People with Sisabilities* The Permanente Federation * Thoroughbred Research Group * TMG Health * TriZetto Group * Tucson Medical Centre * UMWA Health & Retirement Funds * United American * United Community Health Plans * United Health Care * Univita Health * UPMC Health Plan Inc * Varis * Visiting Nurse Service of New York * VNS Choice Medicare * Wilen Direct
Source: blogspot.com

Video: VNSExtras.flv

Clinical Evaluation Manager

We deliver professional and paraprofessional services throughout all five boroughs of New York City and Nassau and Westchester counties.The VNS CHOICE Medicare program provides full coverage to individuals with Medicare and Medicaid for hospital stays, physicians, ancillary services and care coordination – enabling access to high-quality, cost-effective medical care for New York City’s residents.
Source: findmeajobx.com

New York Immunology, PC: Insurances accepted

1199 32-BJ UNION AETNA AFFINITY ALLIED HEALTH GROUP AMERICAN PROVIDERS NETWORK AMERICHOICE AMERIHEALTH AMERIGROUP ANTHEM ATLANTIS BEACH STREET BETTER HEALTH BLUE CROSS – BLUE SHIELD CCN CIGNA CORPORATE CARE DEVON DOCTOR’S CARE EMPIRE BLUE CROSS EMPIRE PLAN EMPLOYEE SERVICE OF NEW YORK FIRST HEALTH GEHA GHI PPO HMO MEDICAID HEALTH CARE PARTNERS HEALTH FIRST HEALTH PLUS HEALTHNET HIP HORIZON INTEGRATED DELIVERY SYSTEMS I.U.O.E ELDERPLAN EMBLEM MAGNACARE MASTERCARE MCI MDNY MEDICARE MEDICHOICE METROPLUS MULTIPLAN NATIONAL NEIGHBORHOOD ONE HEALTH PLAN OXFORD PERFECT HEALTH PHCS PHS POMCO PREFERRED HEALTH ASSOCIATES PRUCARE RANDOM HOUSE RELIASTAR SELECTPRO TOUCHSTONE TRISTATE UNICARE UNITED – PPO HMO MEDICARE MEDICAID USA-MCO VNS CHOICE VYTRA WELLCARE
Source: blogspot.com

Medical Assistant Sentenced to 36 Months in Prison for His Role in a Fraudulent Home Health Scheme : FERS

Ross, 51, pleaded guilty in July 2010 to one count of conspiracy to commit health care fraud.  According to court documents, Ross received kickbacks from the owners and/or operators of two Detroit-area home health agencies, Patient Choice Home Healthcare Inc. and All American Home Care Inc., in exchange for referring home health patients to those entities.   Ross admitted to receiving $500 per patient, paid either by check or in cash, in exchange for providing co-conspirator Mohammed Shahab with Medicare beneficiary information for various patients he recruited.    After paying the kickbacks to Ross, Shahab, an owner of Patient Choice and All-American, billed Medicare for home health visits purportedly made to the beneficiaries recruited by Ross.   Ross referred 21 patients to Patient Choice and All American.   During the time Ross participated in the scheme, Patient Choice and All American submitted claims for $172,573 in improper benefits.  Shahab pleaded guilty in February 2010 to health care fraud charges in connection with this case.
Source: dehaanbusse.com

Medicare Private Health Insurance

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSWhen comparing policies, start by assessing your needs carefully. Learn what you need and not necessary in terms of coverage. Write a list of the types of care that are used or are beginning to use under the insurance plan. Compare these requirements with various plans that are offered by different companies. Look at personal cost. They can have a big impact on the overall accessibility of your coverage. For example, a high deductible policy will have very low cost of your pocket if you do not use cover more often. However, it can be very expensive, if you visit the doctor often frequent. Therefore, to calculate the maximum out of pocket expenses to be incurred in its plan, considering the worst case.
Source: theinsurgent.net

Video: Medicare Plan Finder at a Glance

Comparing Medicare Options

About Al Castellanos Through several topic specific blogs, we interacts with our members. We are dedicated to making sure that individuals learn how to use financial tools and concepts in a critical way, in order to help you develop sound and effective financial strategies that can be achieved by all individuals.
Source: themoneylog.com

Turning 65 means more choices for Medicare health plans boomers comparison of employer

If you are looking for a reference or register for Medicare, it is important to understand the options provided by the federal health program. This includes the alphabet of the Medicare Part a hospital, Part B-Medical, Medicare Advantage-Part C and Part D prescription-drug and Medigap. In most cases, whatever your choice, it is usually a good idea to enroll in Part A, as it is available free of charge. Registration in the other parts depend on several factors, including those described above. Consumers should also consider the options under each type.
Source: chircovskiidanceproject.com

GAO challenges CMS on cost of removing Medicare SSNs

Which number is larger, 800 million or 13 billion? The answer is obvious. So are why these numbers meaningful for healthcare? According to the Department of Justice, the financial costs associated with identify theft totaled an estimated $13.3 billion. Between 2009 and 2012, the Department of Health and Human Services (HHS) reported more than 400 incidents of health data breaches affecting the protected health information of 500 or more patients, information that often includes a prime target of identify thieves — that, Social Security numbers (SSNs).  According to the Centers for Medicare & Medicaid Services (CMS), the cost to remove SSNs from Medicare cards in one of three ways numbers close to $800 million.
Source: ehrintelligence.com

What Is The Best Medicare Plan?

A Medicare Advantage plan is an alternative way of receiving your Medicare benefits. Although you are still enrolled in Medicare and continue to pay your Part B premium, you receive your benefits from a privater insurance company which is contracted with the Centers for Medicare and Medicaid Services.
Source: seniorsupplementinsurance.com

You Have to Break Some Eggs if You Want to Make an Omelet

Thus far, I have discussed saving money by lower fees. As an alternative, we could hold the line on fees but substitute towards less expensive types of providers. Go to “doc in the box” drug store clinics. Travel abroad for surgery. Visit nurse practitioners instead of doctors. Use nurse anesthetists. While we see all of these substitutions and more, regulations stand in the way of a full-blown revolution. The nurse who treats you at the corner drug store must practice “under the supervision” of a physician, and only some types of nurses can prescribe drugs. Nurse anesthetists must practice under physician supervision, with strict limits on the number of nurses per physician. Yet research evidence suggests that nurses can effectively substitute for more costly physicians under the right circumstances. Should we take down regulations that sustain the dominance of physicians, or will the unintended consequences give us cause for regret?
Source: wordpress.com

Recovery Audits is One Area That Providers Should Not Ignore on ADVANCE for Health Information Professionals

Posted by:  :  Category: Medicare

New Online Rx System Makes UM Student 'Top Entrepreneur' Finalist by University of Maryland Press ReleasesAll of this increased activity is causing providers to beef up the number of staff used in audit processing and the technology needed to manage an expanding administrative process.  Providers are establishing full-time audit teams to help protect the revenue stream. In this world of squeezed margins, we find more revenue being recouped and more expense being incurred to try to protect that revenue. This is not a CFO’s favorite scenario.
Source: advanceweb.com

Video: Medicare Benefits Made Clear: News, Reform & Obamacare Exposed!

The “Summer Olympic Games” Have Begun as Have the EHR Meaningful Use Incentive Audits

Now, CMS has begun its first wave of required retrospective audits for those providers paid under the “meaningful use” EHR incentive program; CMS contracted with the firm of Figliozzi and Company to conduct the audits. The auditors will request information from providers via a letter of inquiry asking for specific, non-identifiable patient information from the EHR system.
Source: himss.org

Supporting Every Provider in Delivering Better, More Coordinated, Patient

We want to make sure that healthcare providers interested in forming ACOs have the opportunity to do so.  That’s why we created the Advance Payment Model—to provide entities such as rural and physician-owned organizations that hope to become ACOs in the Medicare Shared Savings Program with the support they need to invest in staff and in health information technology.  They will repay Medicare through savings they achieve.
Source: cms.gov

Humana Rolls Out Diabetes Engagement Platform

The Office of the National Coordinator for Health Information Technology (ONC) recently announced a mobile app development challenge to help consumers reduce their risk for heart disease by controlling their blood pressure and managing their cholesterol. The contest, the Million Hearts Risk Check Challenge, is looking for developers to create a mobile app that will help consumers take a heart health risk assessment, find places to get their blood pressure and cholesterol checked, and use the results to work with their health care professional to develop a plan to improve their heart health.
Source: healthcare-informatics.com

DOJ & HHS Health Care Fraud Enforcement Nets $4 Billion + In 2011

Health Care Fraud Prevention and Enforcement Action Team (HEAT): One of the most visible examples of increased collaboration is the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a joint effort between HHS and DOJ to fight health care fraud.  It has engaged law enforcement and professional staff at the highest levels of HHS and DOJ to increase coordination, intelligence sharing, and training among investigators, agents, prosecutors, analysts, and policymakers.  A key component of HEAT is the Medicare Strike Force: interagency teams of analysts, investigators, and prosecutors who can target emerging or migrating fraud schemes, including fraud by criminals masquerading as health care providers or suppliers.   In 2011, HEAT coordinated the largest-ever federal health care fraud takedown.  In one action, Strike Force teams charged 115 defendants in nine cities, including doctors, nurses, health care company owners and executives, for their alleged participation in Medicare fraud schemes involving more than $240 million in false billing.  In another takedown, Strike Force prosecution teams charged 91 defendants in eight cities for their alleged participation in a Medicare fraud scheme involving more than $290 million in false billings.
Source: wordpress.com

GAO challenges CMS on cost of removing Medicare SSNs

Which number is larger, 800 million or 13 billion? The answer is obvious. So are why these numbers meaningful for healthcare? According to the Department of Justice, the financial costs associated with identify theft totaled an estimated $13.3 billion. Between 2009 and 2012, the Department of Health and Human Services (HHS) reported more than 400 incidents of health data breaches affecting the protected health information of 500 or more patients, information that often includes a prime target of identify thieves — that, Social Security numbers (SSNs).  According to the Centers for Medicare & Medicaid Services (CMS), the cost to remove SSNs from Medicare cards in one of three ways numbers close to $800 million.
Source: ehrintelligence.com

States Seek Medicare Data to Keep Fraudulent Providers Out of Medicaid

For example, ambulance companies charge the Medicaid program millions of dollars every month to take elders and adults with disabilities to local emergency rooms. Once they arrive at the hospital, Medicare pays for their bills. Without access to Medicare claims and payment data, states have no way of confirming that those ambulance rides actually ended up at an emergency room. Texas officials recently pieced together enough evidence to find that their Medicaid program had been repeatedly defrauded by ambulance operators who were reimbursed for rides that never occurred.
Source: govtech.com

Medicare Provider Enrollment: Revalidation Required: Michigan Attorneys

Health care reform law requires that providers who enrolled in Medicare prior to March 25, 2011, submit enrollment revalidation information upon request by the Centers for Medicare and Medicaid Services ("CMS") or its contractors.  Any provider that fails to submit the requested revalidation information within 60 days of receiving such a request risks interruption or deactivation of Medicare billing privileges.  Revalidation for all providers who enrolled in Medicare prior to the above date will occur between now and March of 2015 on a steady basis.  Providers can check the lists provided at CMS’s website to determine if they were already sent a revalidation notice that was perhaps overlooked in the mail.
Source: healthlawyersblog.com