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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 marsmet481A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z
Source: 1stfind.com

Video: Tim Walz (Medicare Payments)

CBO Sets Price Tag For Delaying Scheduled Medicare Physician Payment Cuts: $271 Billion

Medpage Today: CBO: Delays In SGR Cuts To Cost $271 Billion The Congressional Budget Office (CBO) has released updated figures on the cost of repealing — or continuing to override — the cuts doctors are scheduled to receive under Medicare’s Sustainable Growth Rate (SGR) reimbursement formula. The fresh numbers give Washington lawmakers a better idea of the effect of changes they could make later this year to the SGR cuts. Physician reimbursements are scheduled to drop by 27% next year unless Congress acts, the CBO noted in the report. Every year since 2003, Congress has acted to override the SGR cuts by either maintaining or increasing payments when they were scheduled to drop. The CBO estimates that if cuts are blocked and payments sustained at current rates from now through 2022, it would cost an additional $271 billion from 2013 to 2022. Resetting payments to 2011 levels, only to increase them annually at 2% plus however much the gross domestic product (GDP) grows, would cost an additional $376.6 billion (Pittman, 8/1).
Source: kaiserhealthnews.org

Imaging Cuts in Proposed 2013 Medicare Fee Schedule Rule Potentially Dangerous, Unfounded and Unnecessary

Further cuts to imaging do little, if anything to safely bend the Medicare cost curve. Imaging use in Medicare is down since 2008. Medicare spending on scans is at the same level it was in 2003. Imaging is also the slowest growing of all physician services among privately insured Americans according to the Health Care Cost Institute. A multitude of studies show that medical imaging exams are directly linked to greater life expectancy, declines in mortality rates, and are generally safer and less expensive than the invasive procedures that they replace. Scans also reduce the number of invasive surgeries, unnecessary hospital admissions and length of hospital stays.
Source: newswise.com

Demand and compensation for primary care physicians is on the rise

Steve Messinger, partner at the healthcare consulting firm ECG, says primary care physicians’ two top priorities are fair compensation and flexibility of their schedule. A locum tenens career through Barton Associates meets both of those criteria, offering competitive rates, flexibility, and freedom from bureaucracy that comes with a permanent position. Now is a great time for primary care providers who have been considering a locums career to give it a shot. With primary care providers in such demand, we have a wide array of high-paying assignments available. In short, it’s a great time to be in family practice!
Source: bartonassociates.com

Medicare and The President’s Plan to Reduce the Deficit

Teaching Hospitals: Here again, MedPAC’s analysis suggests that Medicare is overpaying. Medicare is the single largest funder of graduate medical education (GME), laying out $9.5 billion in 2009. The goal is to compensate teaching hospitals for the indirect costs stemming from inefficiencies created from residents “learning by doing.” But MedPAC reports that these Indirect Medical Education (IME) add-on payments are significantly greater than the additional patient care costs that teaching hospitals experience. For example, MedPAC’s June 2010 report reveals that in 2009, Medicare paid $3.5 billion more than the empirically calculated indirect clinical costs associated with teaching. The Fiscal Commission also recommended reducing the IME adjustment. The President’s proposal would trim the IME adjustment by 10 percent beginning in 2013, and save approximately $9 billion over 10 years.  If one assumes that the $3.5 billion overpayment in 2009 was typical, Medicare would need to cut IME adjustments by $35 billion over 10 years in order recoup lost tax dollars. Using that benchmark, a $9 billion cut does not seem Draconian.
Source: healthbeatblog.com

CMS Proposed Changes to 2013 Physician Fee Schedule

The Center for Medicare and Medicaid Services (CMS) released its’ proposed rule (Rule) for changes related to payment policies under the physician fee schedule and other areas on July 6, 2012. According to a copy of the Rule on the Office of Federal Register website, the Rule “…addresses changes to the physician fee schedule, payments for Part B drugs, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services.” As is its’ custom, comments on the Rule may be submitted for a 60 day period after the initial date of filing for public inspection. Likely considered the most significant change is the projected 27 percent cut in Medicare payment rates as suggested by the sustainable growth rate (SGR) formula. However, there are indications that Congress may be acting to delay this projected cut. Representative Michael Burgess (R – TX) has said he will submit legislation that would delay the SGR cuts for one year. If historical precedent is any indication, some sort of delay related to the SGR cuts is highly likely. There is an emphasis on primary care in the Rule; likely a result of healthcare reform and the focus on patient care coordination. For family physicians, the Rule proposes a 7 percent increase in payments while other primary care practitioners would receive a 3 – 5 percent increase. While primary care providers will see increases, the Rule includes payment cuts to several specialty groups. The specialties or areas with the largest proposed cuts – on top of the proposed SGR reduction – are summarized in the chart below: Much of the proposed decline in imaging services is related to a reduction in payment when more than one imaging service is provided by the same physician(s) to the same patient, during the same session (visit), on the same day. This is simply an expansion of the multiple procedure payment reduction (MPPR) often utilized by Medicare. In such cases, the lower priced procedure would receive a 25 percent reduction in payment. Specifically for radiation oncology, payment cuts surround two services: intensity modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT). In both cases, CMS has reviewed the clinical times that were initially utilized to determine reimbursement for these services and has concluded that the times are too high based on current information. Also driving this reduction is a change in the interest rate assumption used to determine the payment component for practice expenses. The interest rate change would decline from 11 percent to a range of 5.5 – 8 percent which would impact services that require significant capital. The final rule is expected to be released on or around November 1.
Source: vmghealth.com

Rule Would Increase Payment to Family Physicians

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on July 6, 2012, which would result in an increase of payment for family physicians by approximately 7% and between 3% to 5% for other practitioners. The potential increase would result from updated payment policies and rates under the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2013. Under the MPFS, Medicare pays more than one million physicians and non-physician practitioners providing vital services to Medicare beneficiaries.
Source: bracheichler.com

Affordable Health Care Act may impact Medicaid and Medicare patients

Author Sandra Decker, PhD, an economist at the National Center for Health Statistics of the US Centers for Disease Control and Prevention (CDC) noted that the findings serve as a useful baseline from which to measure the anticipated impact of Affordable Care Act provisions that could increase Medicaid payment rates to primary care physicians in some states while boosting up the number of individuals with healthcare coverage. She reported a low acceptance rate of new Medicaid patients of 40.4% in New Jersey and a high of 99.3% in Wyoming. In general, acceptance rates generally were higher in states with higher Medicaid fee-for-services rates, expressed as a percentage of Medicare’s rates in 2008. For example, Medicaid rates in Wyoming in 2008 were close to 150% of the reimbursement for a Medicare patient; this marked the nation’s highest rate. In contrast, New Jersey’s Medicaid rates were the nation’s lowest: 37% of Medicare. Nationwide, the average Medicaid-to-Medicare fee ratio is 74.2.
Source: emaxhealth.com

Medicare Physician Fee Schedule

Improving Payment for Primary Care.  The proposed rule includes a number of initiatives designed to increase payments for primary care. Payments for primary care would increase for a variety of reasons, including a proposed new payment for managing a beneficiary’s care when the beneficiary is discharged from certain health care facilities, such as a hospital, skilled nursing facility, inpatient rehabilitation facility, and other similar types of facilities. This would be achieved by creating a new procedure code for providing “post-discharge transitional care management services”, which would apply to all services related to transitional care management within 30 days following the date of discharge from an eligible facility.
Source: beneschhealthlaw.com

Congress Holds Hearings Fixing Flawed Medicare Physician Payment Formula

5010 AARP 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 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 George W. Bush Health Care Fraud Prevention and Enforcement Action Team (HEAT) HH CAHPS Hilda Solis HIPAA ICD-10 In-Home Aides-Partners in Quality Care Independence at Home Demonstration Kathleen Sebelius Lisa Remington Marco Rubio Marilyn Tavenner Medicare Fraud Strike Force MedPAC National Association for Home Care & Hospice National Private Duty Association Office of the Inspector General Open Door Forum Palmetto GBA Pam Bondi Patient Protection and Affordable Care Act PECOS Rick Scott Super Committee Supreme Court
Source: hcafnews.com

Limiting the Medicare rebate for genital surgery is a good move

Posted by:  :  Category: Medicare

SCOTUS Obamacare Decision Makes Individual Mandate A Fact & Universal Healthcare Coverage A Fiction by watchingfrogsboilWhile western women are increasingly turning to the knife and having the size, shape and appearance of their labia enhanced, feminists and activists continue the campaign to end the practice of female genital mutilation affecting millions of women living in parts of Africa, Asia, and the Middle East. Female genital mutilation is a procedure that intentionally excises genital tissue leading to problems such as frequent bladder infections, childbirth complications and the risk of later surgery. The World Health Organization estimates that there are 100 to 140 million women who have had their lives damaged by FGM.
Source: wordpress.com

Video: Medicare rebate – Nick Xenophon

Plibersek Verifies Medicare Rebate for e

Ms Plibersek has verified this but it was further added that once the patients get registered to the services, "patients will be able to go online to view their record and add a range of basic health information, including emergency contact details, the location of their advanced care directives, any allergies they have or medication they’re on".
Source: topnews.us

Provinces must stand together on drug purchases

Some pharmaceutical companies also employ another tactic, commonly known as “whip-sawing.” Companies secure a PLA with one province, say Ontario, by offering the province the largest rebate possible.  They then pressure other provinces to list the product through a PLA offering at a much lower rebate. The other provinces have little choice than to pay the higher price because patient advocacy groups will accuse it of offering sub-standard treatment compared to Ontario.
Source: umanitoba.ca

Medicare Part D $250 Rebate: The Donut Hole Coverage Gap

I reached the Medicare donut hole in April of this year and have yet to receive that so called $250 rebate. My Humana Medicare Advantage Plan tells me they are not responsible for informing Medicare who is in donut hole so how is Medicare supposed to know who to send checks to? As usual one hand does not know what the other is doing in these government programs. No one wants to take responsibility and Obama just wants to look like he is doing something to help but his programs have no accountability to the taxpayers.
Source: suite101.com

Claiming a Medicare rebate: :: Centred MGP

Every woman is entitled to have a midwife, unfortunately if you see your GP you don’t get to see a midwife until you go for your hospital visit at 19/20 weeks. This means you have missed out on vital information and building a valued relationship. This is regretable because it is beneficial for women to see a midwife from the moment she is pregnant or at least between 8 – 10 weeks. A midwife gives the woman unbiased information allowing the woman to choose different options of care, rather than the straight route to an obstetrician because she has private cover. Now with midwives having a Medicare provider number, this means that a pregnant woman can see a private midwife to discuss options of care and claim for a refund just like going to the doctors. Midwives work in collaboration with doctors and midwives are all to happy to refer the woman when it is required and the woman wishes to do so.
Source: centredmgp.com

Medicare Rebate for Counselling in Brisbane

Is male ‘menopause’ real? Is it fair to compare this to what happens for women when their hormones drop off very rapidly at menopause? Gradual decline in testosterone / androgen is normal in males aged over 30 years. On average, by the time we get to 45 we’ve lost about 15% of our male hormones, and by 60 we’ve lost over 30%. At 70 we are at about 50% of where we were when younger. So, in this respect male hormone loss with aging is … …
Source: visionpsychology.com

NBN promises "Ferrari" speed telehealth

Dr Ash Collins, a GP based in Temora in regional NSW, said that his practice had been using telemedicine over the last 18 months over a 100 kbps link. Although this was already delivering benefits, and had saved patients about 160 500 km round trips to see specialists in major metropolitan areas, higher internet speeds would improve the quality of care. He said that he was recently in Japan and Korea where 100 Mbps network connections are available and that “the quality was fantastic.” He said that in Australia while existing network speeds did allow telehealth services to be delivered it was; “Like driving a Toyota and expecting a Ferrari.” Dr Collins said that access to higher speed internet would allow a higher quality image to be displayed, which could improve the quality of care. Howeverwith regard to the cost of the NBN rollout he acknowledged that “You’ve got to look at your pocket to see if you can afford a Ferrari.”
Source: itwire.com

Doughnut Hole Rebate Checks Fuel Medicare Fraud & Insurance Scams

Missouri Attorney General Chris Koster (also the name of the website) comments on the types of Medicare scams taking place across the nation. The article can be found in the Attorney General’s News Release titled, "Attorney General Koster Warns Seniors About Medicare Rebate Fraud Schemes" (June, 2010). According to the author (name not given), "[Koster] said a common scam related to the $250 donut hole checks was for individuals to convince seniors that the rebate check needed to be transferred to a third party or used to cover specific prescription drug payments."
Source: suite101.com

MEDICARE REBATE: Review Your Health Insurance Before June 30.m4v

With the Federal Government bringing in legislation to means-test the Medicare rebate as of July 1, 2012, now is the time to review your health insurance needs for the coming financial year. In this Skype interview, Tim Andrew from SplitIt.com.au outlines in simple terms what the legislation means and tiers of income the government will be means-testing; he also touches on why paying your health i
Source: babichforcongress.org

Franken's health care reform rebate provision kicks in on Wednesday

The Center for Medicare and Medicaid Services predicts more than 123,000 Minnesotans are among those getting rebate checks, averaging $160 per household, which is right around the national average. Most of that ($8.4 million of the nearly $9 million in rebates for Minnesotans) will be funneled through individuals’ companies, though a business that receives the rebate is required to give it back to employees through rebate checks, premium offsets or other means.
Source: minnpost.com

The Econ Student: Is the medicare rebate middle class welfare?

I should start by saying this piece is more of debate about ideology rather than economics. The medicare offset known commonly as the medicare rebate can be seen as a subsidy of 30% to the holders of private health insurance. These people are mostly middle class or in a high income bracket. However, many people, especially those with health issues choice to purchase a private health insurance policy despite not having a high income. Alternatively, the policy could be seen as a way of giving health consumers choice. In that if people decide to insure themselves privately they can at least claim a deduction on their tax for the cost of the policy allowing them to pay with their gross income rather than net. How a tax offset differs from a deduction is that a deduction reduces a persons reportable income on their tax return and results in a reduction of tax of whatever the top marginal tax rate the consumer was paying. So assuming the person who bought the policy was earning 200k the deduction would be 45% plus a reduction in of the medicare levy making a total tax deduction of 46.5% of the policy cost. This would mean that the wealthy would get a bigger deduction for purchasing health insurance than people not paying the top marginal tax rate. An offset instead is a blanket 30% of the policy cost regardless of who buys it. It’s for this reason and to reduce the cost of the policy the Howard Government would have chosen to have an offset rather than a deduction. This with the fact its commonly known as a rebate has seen this policy portrayed as  middle class welfare. This with the private vs public school debate really comes down to the question should people be able to opt out of government provided services? Clearly in health people still continue to benefit partially by the public system and will still continue to receive benefits from it, but should people who choose to partially seek healthcare through the private market be made to pay the full cost of the public system that they now are far less likely to use. Many people have the view yes, if people choose to use private services than they should still contribute 100% to the public system and receive no assistant/deduction for their private expenditure. Another argument that is often used is the claim that people should pay their fair share. Too often a person’s fair share is their share and about four other peoples share and then are to be told they can’t access the service they paid for becomes of a means test. It’s apparent that the expansion of middle class welfare in the late Howard years was a response to the fact the middle class felt they were paying taxes into a system that wasn’t interested in helping them or their family. As a libertarian I believe in a perfect world much more of the health system would be left to the private market with competitive pressures rather than a system that helps line the pockets of the medical profession. (I believe we do need a public helathcare system, probably similar to what Queensland had pre Medicare) However, we do not have that system, we probably will never have that system as the average person does not under that government funding of many medical services in the long run raises the price of those services. So as a next best solution those people who do not want take a chance with government waiting lists is to allow them to choose to access services through the private market. By allowing a 30% rebate of private health insurance means the individual gets a small deduction of their tax as an incentive, while they still continue to pay the medicare levy and a significant proportion of their taxes still goes towards funding the system.
Source: econstudent.org

Two Medicare Accountable Care Organizations Approved in Connecticut

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSAt last Connecticut has two medical groups that have been approved to participate in Medicare’s Accountable Care Organization (ACO) program.  The two groups are:  MPS ACO Physicians in Middletown and PriMed of Shelton.  The ACO program is part of many efforts being undertaken to change how health care is both delivered and paid for; moving from a system that rewards volume to a system that rewards quality care and better outcomes. 
Source: universalhealthct.org

Video: **Jim Himes – How To Fix Social Security & Medicare** Westport, CT July 1, 2012

Affordable Health Care Act may impact Medicaid and Medicare patients

Author Sandra Decker, PhD, an economist at the National Center for Health Statistics of the US Centers for Disease Control and Prevention (CDC) noted that the findings serve as a useful baseline from which to measure the anticipated impact of Affordable Care Act provisions that could increase Medicaid payment rates to primary care physicians in some states while boosting up the number of individuals with healthcare coverage. She reported a low acceptance rate of new Medicaid patients of 40.4% in New Jersey and a high of 99.3% in Wyoming. In general, acceptance rates generally were higher in states with higher Medicaid fee-for-services rates, expressed as a percentage of Medicare’s rates in 2008. For example, Medicaid rates in Wyoming in 2008 were close to 150% of the reimbursement for a Medicare patient; this marked the nation’s highest rate. In contrast, New Jersey’s Medicaid rates were the nation’s lowest: 37% of Medicare. Nationwide, the average Medicaid-to-Medicare fee ratio is 74.2.
Source: emaxhealth.com

My Left Nutmeg:: Emily's List claims Esty "protecting" Social Security and Medicare? Really?

Powered By – SoapBlox Connecticut Blogs – Capitol Watch – Colin McEnroe – Connecticut2.com – Connecticut Bob – ConnecticutBlog – CT Blue Blog – CT Energy Blog – CT Local Politics – CT News Junkie – CT Smart Growth – CT Voices for Civil Justice – CT Voters Count – CT Weblogs – CT Working Families Party – CT Young Dems – Cool Justice Report – Democracy for CT – Drinking Liberally (New Milford) – East Haven Politics – Emboldened – Hat City Blog (Danbury) – The Laurel – Jon Kantrowitz – LieberWatch – NB Politicus (New Britain) – New Haven Independent – Nutmeg Grater – Only In Bridgeport – Political Capitol (Brian Lockhart) – A Public Defender – Rep. David McCluskey – Rep. Tim O’Brien – State Sen. Gary Lebeau – Saramerica – Stamford Talk – Spazeboy – The 40 Year Plan – The Trough (Ted Mann: New London Day) – Undercurrents (Hartford IMC) – Wesleying – Yale Democrats CT Sites – Clean Up CT – CT Citizen Action Group – CT Democratic Party – CT For Lieberman Party – CT General Assembly – CT Secretary of State – CT-N (Connecticut Network) – Healthcare4every1.org – Judith Blei Government Relations – Love Makes A Family CT CT Candidates – Chris Murphy for Senate – Susan Bysiewicz for Senate – John Larson for Congress – Joe Courtney for Congress – Rosa DeLauro for Congress – Jim Himes for Congress – Chris Donovan for Congress – Elizabeth Esty for Congress
Source: myleftnutmeg.com

Sox Put Padilla On Disabled List

BOSTON (AP) _ The Boston Red Sox placed right-handed reliever Vicente Padilla on the 15-day disabled list with arm tightness and promoted right-hander Clayton Mortensen from Triple-A Pawtucket before their game against Texas on Wednesday.
Source: cbslocal.com

AARP wants your input on changes to Social Security, Medicare :: East Haddam Today

AARP is a nonprofit, nonpartisan organization with a membership that helps people age 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates… AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. We have staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.
Source: htnp.com

Roundup: Ky. Judge To Hear Christians

HealthyCal: Got Docs? A new county health plan for low-income residents, Riverside County Health Care, created in January 2012, was expected to ease the economic burden and address health disparities. So far, however, it’s falling short of expectations. The plan promises a full range of medical services: primary care, mental health services and access to specialists. The idea is that an up-front investment in comprehensive care will have a long-term payoff in fewer emergency room visits and hospital stays. Riverside County, as well as 46 other counties in California, are in the process of rolling out new health plans for the poor—essentially an expansion of Medicaid—in anticipation of the full implementation of the federal Affordable Care Act in 2014 (Urevich, 8/6).
Source: kaiserhealthnews.org

Daily Kos: President Obama’s remarks at Westport, CT, campaign event, private residence

And the great privilege of being President is you interact with people from every walk of life, from every corner of the country.  And what you discover is the faith that I brought into this office in the American people — their core decency and their values and their resilience and their fundamental fairness — they have never disappointed me.  And I’m confident that they won’t this time either, despite the fact that we’ve got all these negative ads raining down on our heads, and super PACs running around with folks writing $10 million checks — because when the American people focus and are paying attention, their instincts are sound and they know what makes this country great.
Source: dailykos.com

Anthem Medicare Advantage Plans: Offering Affordable Freedom of Choice

Posted by:  :  Category: Medicare

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

Video: Excellus BCBS Medicare: What’s included in my Medicare Advantage Plan?

Things To Keep in mind When Selecting A Medicare Complement Strategy

Medicare Portion D is administered via private insurance coverage businesses such as Humana, Wellcare, BCBS, United Healthcare, Healthsprings, and several other people. They are county particular, and their costs vary tremendously from program to prepare and from area to location. All ideas carry a regular monthly premium. Also consider be aware of whether or not the plan has a deductible. Deductibles are typical in Component D programs. The crucial factors when deciding the finest drug prepare for you is to think about the expenses, formulary, and your pharmacy decision. A formulary is a record of medication that is coated by the plan as effectively as their amount of protection or Tier.
Source: artyapt.com

Arkansas BCBS Extends Relationship With Healthways

“As part of their mission, Arkansas Blue Cross offers products and services designed to create high customer value, confidence, peace of mind and an improved quality of life. By continuing to offer SilverSneakers to its Medi-Pak Advantage and Medi-Pak members, Arkansas Blue Cross is demonstrating its ongoing commitment to its older adult members through a time-tested, proven solution that provides a unique combination of exercise and social support to improve members’ health and overall well-being,” said Ben R. Leedle, Jr., Healthways president and chief executive officer.
Source: distilnfo.com

Medicare plans, compare Medicare plans, Medicare Insurance,Medicare advantage plans

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Source: pressreleasesworld.com

CrummeyService.com Accepts Equity Investment

Posted by:  :  Category: Medicare

State of the World - May 7 2006 by yonghokimIn order for a gift to a trust to qualify for the annual gift tax exclusion, currently $13,000 per beneficiary, the IRS requires trust beneficiaries to be given formal written notice of their right to withdraw the gifted amount if they choose to do so (Crummey v Commissioner, 397 F.2d 82 (9th cir 1968)). CrummeyService.com technology reminds the grantor to make the gift to the trust, notifies the beneficiaries of their right to withdraw the gifted amounts, and provides an independent third-party record of the entire process.
Source: lifesourcedirect.com

Video: EHR: Medicare Incentive Program Attestation Webinar for Eligible Professionals

Medicare Eligible? Resources at Mature Health Center Online

While you do not have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. In 2011 the monthly premium for Part B is $96.40 for most with incomes under $85,000 (single) and $170,000 (married). However, the monthly Part B premium for 2011 will be $115.40 for people enrolling in Medicare for the first time in 2011. It is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of the above payments, Medicare sends you a bill for your Part B premium every 3 months.
Source: stewardshipmatters.net

Who is eligible for Medicare? Who is eligible for Medicaid?

Medicare is for those who are 65+ but there are exceptions for people with disabilities. Medicaid covers a broader range of people (children, low-income families, pregnant women and etc.) for more information on the two, take a look at the links below:
Source: enotes.com

HITECH and HIPAA: Applications for all Dentists

The American Recovery and Reinvestment Act (ARRA), of which the HITECH Act is a part, established additional Health Insurance Portability and Accountability Act (HIPAA) requirements. These include 1) privacy and security extended to business associates, 2) breach notification, 3) health information privacy education, 4) withholding of protected health information from insurance carriers if patients pay out of pocket, 5) authorization for patient requested audit trails, 6) prohibited sale of protected health information, and 7) patient authorization for marketing and fundraising activity. All HIPAA covered dentists should stay abreast of HITECH changes that impact requirements for security and privacy policies through their professional associations.
Source: dentalsoftwareadvisor.com

Illinois, Federal, Dual Eligible Reform Too Fast?

Illinois has been moving forward on an aggressive timeline to implement a Dual Alignment Initiative project. The Dual Alignment Initiative is currently in the processing of reviewing applications from managed care organizations and will be announcing contracts in August 2012. Successful contracts will be awarded and held between the managed care organization, HFS and the federal Centers for Medicare and Medicaid Services (CMS). The tentative start date for enrollment through the Dual Alignment Initiative in Illinois is April 2013. Despite the Dual Eligible population tending to be more costly as a result of having more complex conditions, there is concern that the goal of achieving cost-savings is eclipsing the need for real health reform.
Source: typepad.com

Basics of Medicare by Don Meyer

Part B (Doctors Insurance) Part B of Medicare helps cover the costs for medically-necessary services, like doctors’ services, outpatient care, durable medical equipment and other medical services.  For Medicare approved expenses, Medicare is the primary insurance and covers 80% of the costs.  You, the Medicare beneficiary, are responsible for the remaining 20% as well as the yearly deductible.  Unlike Part A, there is a premium for Part B, which in 2012 is $99.90 per month for most people.  If you are already receiving Social Security benefits when you turn 65, you will get Part B automatically.  However, for people that continue to work past 65 and stay on their employer’s group coverage, it is critical that you meet with a licensed insurance agent.  You might be paying too much and could be at risk for high out-of-pocket expenses that can be avoided with proper planning.  Timing is also a crucial issue with Part B.  Making a mistake could result in a life-time premium penalty from Medicare.
Source: clearontop.com

TORT TALK: More Decisions Regarding Impact of Medicare Liens on Finalization of Settlements

Below are summaries of two recent federal court decisions regarding the impact of potential Medicare liens on the finalization of a settlement of a third party action: Carty v. Clark, Civil Action No. 11-6083 (E.D.Pa. June 14, 2012 Rueter, Mag. Judge)(Order by Robreno, J.) In Carty, the Plaintiff agreed in a Release that defense counsel could hold settlement amount in escrow until Plaintiff produced Final Demand Letter from the Centers for Medicare and Medicaid Services. The Plaintiff thereafter produced a Final Demand Letter and the defense counsel refused to release settlement amount citing fears that an unpaid medical bill might be paid by Medicare in the future and would have to be added to the lien. The Court granted Plaintiff’s Motion to Enforce settlement citing the clear terms of the Release which stated that, once the Final Demand Letter was produced by the Plaintiff from Medicare, the settlement proceeds were to be released to the Plaintiff.  The Plaintiff’s request for sanctions were denied as it did not appear to the court that the defense had acted in bad faith. To view Federal Magistrate Rueter’s Report and Recommendation, click HERE. To view the Eastern District Court Order issued by Judge Eduardo C. Robreno adopting Judge Rueter’s Report and Recommendation, click HERE. I send thanks to Attorney Bill Mabius of the Pennsylvania Association of Justice for bringing this case to my attention. Sipler v. Trans AM Trucking, Inc., et al, No. 10-3550(DRD)(D.N.J. July 24, 2012 DeBevoise, S.J.) Although the Sipler case is a Federal District Court of New Jersey decision that was marked by that court as “NOT FOR PUBLICATION,” a number of Pennsylvania litigators are pointing to the case for its persuasive authority on the issue of the impact (or more appropriately, the non-impact) of Medicare issues on personal injury settlements. In the District of New Jersey case of Sipler, the parties settled a personal injury action arising out of a motor vehicle accident.  The parties were unable to finalize the settlement due to disagreements over the terms of the Release, which dispute included issues over release terms pertaining to Medicare matters.  The Plaintiff brought the matter before the court by way of a Motion to Enforce Settlement. After thoroughly reviewing the applicable law pertaining to Medicare and the potential for Medicare liens, the court in Sipler noted that, while the Plaintiff was Medicare eligible, there was no evidence that Medicare had paid for any of the Plaintiff’s accident-related treatment. Based on the demands of the defense in this matter in terms of the requested provisions of the release, one of the issues in this case became whether the Medicare Secondary Payer statute required language in the release provisions of the plaintiff’s settlement agreement specifying (1) the plaintiff’s obligation not to seek such payments from Medicare, and (2) that a portion of the settlement amount would be set aside for future medical expenses arising out of the accident. The court in Sipler noted that, while set-aside agreements were common in workers’ compensation matters, “no federal law requires set-aside arrangements in personal injury settlements for future medical expenses.”  Op. at p. 6. The court went on to note that personal injury settlements should not be required to have such set-aside agreements because “to require personal injury settlements to specifically apportion future medical expenses would prove burdensone to the settlement process and, in turn, discourage personal injury settlements.”  Id. at p. 7. In a footnote, Judge DeBevoise also stated “Indeed, it would be particularly discouraging if litigants were required to obtain Medicare’s approval of a settlement.”  Id. at p. 7, n. 1. Accordingly, the court held that “the parties in this case need not include language in the settlement documents noting [the Plaintiff’s] obligations to Medicare or fashion a Medicare set-aside for future medical expenses.”  Id. at p. 7. To view the Sipler decision online, click this LINK. I thank several attorneys for pointing this decision out to me including, but not limited to, Attorney Andrew Bigda of the Wilkes-Barre, PA law firm of Rosenn, Jenkins & Greenwald, and Attorney Thomas Foley, Jr. of the Scranton, PA Foley Law Firm. To review, other Tort Talk posts (as well as my July of 2012 Pennsylvania Law Weekly article) on this issue of the interaction of Medicare lien issues and personal injury settlements, click this LINK.
Source: torttalk.com

Daily Kos: Old Waitress says, “Don’t Raise Medicare Eligibility Age!”

ginabroom, Ed in Montana, Joe Bob, pundit, tmo, Paleo, Laura Clawson, Jackson L Haveck, Bendygirl, Nina Katarina, Outsourcing Is Treason, Emerson, Debby, Shockwave, SanJoseLady, Stein, rhubarb, polecat, HootieMcBoob, elfling, SallyCat, Matilda, opinionated, Zinman, wonkydonkey, annrose, DaleA, bluesteel, boadicea, roses, someRaven, Clues, bwren, jalbert, Major Tom, splashy, antirove, revsue, NMRed, tidalwave1, scorpiorising, dejavu, figbash, 2laneIA, draghnfly, lcrp, MagentaMN, alizard, bwintx, Diana in NoVa, VerbalMedia, zerelda, ybruti, WV Democrat, solesse413, Josiah Bartlett, murrayewv, Gowrie Gal, sb, libnewsie, Treg, TexasTom, el dorado gal, elsaf, lilypew, newfie, Independent Musings, chimene, PBen, offred, Blue Jean, dewtx, dancerat, Brooke In Seattle, YucatanMan, madmommy, Dem Beans, where4art, ladybug53, Burned, rlochow, Bob B, Arsenic, huttotex, mightymouse, kathny, splashoil, third Party please, Nance, BlueInARedState, Themistoclea, Dvalkure, sleipner, dougymi, blueoasis, triv33, global citizen, gooderservice, Preston S, AmBushed, fiddlingnero, Stripe, ms badger, theark, Thinking Fella, seabos84, pale cold, One Pissed Off Liberal, Cronesense, redheadgeek, grelinda, ColoTim, Positronicus, FishOutofWater, terabytes, NoMoJoe, artisan, millwood, gchaucer2, RudiB, fallina7, Neon Mama, MKinTN, KLS, Amor Y Risa, also mom of 5, poligirl, elwior, lineatus, monkeybrainpolitics, Calamity Jean, tofumagoo, davekro, envwq, mofembot, temptxan, SmileySam, CitizenJoe, KrazyKitten, aigeanta, DixieDishrag, MizC, priceman, rodentrancher, David Futurama, GrannyOPhilly, vmdairy, legendmn, prettygirlxoxoxo, bluemoonfever, Florene, ImABlondOK, Lura, lostinamerica, Pariah Dog, lapidarygal, bamjack, CamillesDad1, zaka1, TheOpinionGuy, kevinpdx, sfarkash, porchdog1961, cassandraX, Amber6541, smileycreek, rb137, p gorden lippy, flitedocnm, ColoradAnne, melpomene1, manyamile, pixxer, ItsSimpleSimon, beverlywoods, Oh Mary Oh, cany, not4morewars, dot farmer, Mike08, allenjo, mama jo, msazdem, La Gitane, Boris49, yakimagrama, Arkieboy, pbgv23, deeproots, ciaomama, muddy boots, Coastrange, evilgalblues, seattlebarb, LSmith, Grandma Susie, chira2, PhilJD, Sunspots, stlsophos, Regina in a Sears Kit House, Mathazar, DawnN, SuWho, jacey, jeopardydd, MNGrandma, Kiterea, Cordyc, Heart n Mind, anodnhajo, oblios arrow, Williston Barrett, Jakkalbessie, wordfiddler, Eric Nelson, oldcrow, orangecurtainlib, swampyankee, FloridaSNMOM, Horace Boothroyd III, Mr Robert, deweyrose, hotheadCA, oldflowerchild, Arahahex, BusyinCA, MartyM, burnt out, doroma, Grabber by the Heel, miningcityguy, NCPSSM, GAladybug, Spirit of Life, George3, DarkLadyNyara, Sue B, allensl, Metta, Dancun74
Source: dailykos.com

Social Security Disability & Medicare Eligibility

If you have health insurance coverage already, you need to figure out how Medicare works with your health insurance. Many health insurance policies state that Medicare is to provide the primary coverage. Thus, your present health insurance may pay only for what Medicare does not cover. You need to check with your health insurance company when you get your Medicare card.
Source: disabilitydenials.com

Information on Medicare Part 1: Finding Medical Help for Seniors

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 marsmet524There are many ways that information about Medicare coverage can be obtained online, several are fraudulent or unreliable. We only use information from government websites and simplify it to help you find reliable resources for seniors. In this post, we will only be using information from the government website and putting it in an easy to understand and simplified manner for you.
Source: elderhelpers.org

Video: Medicare Supplement Plans | Questions about Medicare Supplement Plans

Q1Medicare com Provides More Information on How 2013 Medicare Part D Prescription Drug Plans Will Impact Seniors : e Yugoslavia

Because of the slight increase in the Medicare Part D base premium, Medicare beneficiaries who have accrued a late-enrollment penalty (or LEP) will notice that their 2013 monthly penalty payment will be slightly higher. The late-enrollment premium penalty is assessed to any Medicare beneficiary who is without some form of creditable prescription coverage for more than 63 days and does not qualify for the low-income subsidy. The penalty is calculated as an additional monthly payment of 1% of the annual base Medicare Part D premium accumulated for each month that a person is without prescription coverage. For example, a person who has been without creditable prescription coverage for five years (or 60 months) will pay a 2013 monthly penalty of $18.70 or 60% of the 2013 base premium of $31.17. Annual changes in the base premium used to calculate the late-enrollment penalty can be found at: Q1Medicare.com/LEP.
Source: eyugoslavia.com

Medicare Part D Information « Insurance News from Crowe & Associates

 It depends on when you need your Medicare prescription plan coverage to begin.  Initially, you have a seven (7) month window of time to join a Medicare Part D or Medicare Advantage plan.  So if you enroll in a Medicare Part D plan within the three (3) months before the month that you become eligible for Medicare (for example, the 3 months before you turn 65), your Medicare plan coverage will start on the first day of your birthday month (or Medicare eligibility month).  If you join a Medicare plan during your birthday (or eligibility) month, your prescription drug coverage will start on the first day of the next month.  Finally, if you join a Medicare plan during the three (3) months after your birthday (or eligibility) month, your drug coverage will start the first day of the month following the month when you enroll.
Source: croweandassociates.com

What is the Medicare Advantage maximum out pocket?

The insurers who offer Medicare Advantage benefits must follow rules set by Medicare. However, each Medicare Advantage plan can charge different out-of-pocket costs and have different rules for how care is provided. For example, they can determine whether or not you need a referral to see a specialist or if you have access to a specific network of doctors and hospitals. These rules can change from year to year.
Source: ehealthinsurance.com

2013 Medicare Drug Plan Premiums Will Be Similar To This Year — On Average

“Some folks won’t have access to plans at this price,” said Joe Baker, president of the Medicare Rights Center, a consumer advocacy group. “The bigger issue is that seniors have too much choice, or too much non-meaningful choice.” Seniors, he said, “tend to go for lower premiums, which look more affordable, but they can be surprised when their drug isn’t in the formulary.”
Source: kaiserhealthnews.org

All the Fuss about Medicare Readmission Rates Overlooks State

I asked a former Medicaid director—Sandeep Wadhwa, MD, CMO at 3M Health Information Systems—why states would prefer a different approach. He explained that Medicare model focuses on only three conditions that are common in elderly patients. “Children and their caregivers do not have high rates of these conditions,” he said. “Readmissions related to asthma, GI conditions or obstetrics are of much more interest to a Medicaid program.” The states are targeting broader sets of conditions, allowing providers to better focus quality initiatives and operational improvement.
Source: wordpress.com

No Medicare Drug Plan Cost Increases For Seniors In 2013

Posted by:  :  Category: Medicare

Press Conference on Benefits of Health Insurance Reform to Seniors by Leader Nancy PelosiThe Associated Press: Gov’t: Medicare Drug Plan Premiums Stable For 2013 It’s an economic indicator of sorts for seniors: The Obama administration says the average premium for basic Medicare drug coverage will stay the same next year, $30 a month. That’s the third year in a row of little or no change. In addition, Medicare recipients with high prescription costs are saving an average of $629 apiece thanks to a provision of the new health care law that gradually eliminates a coverage gap called the “doughnut hole.” There is a caveat on premiums. Because the number is an average, some beneficiaries may see their monthly cost go up, while others get a decrease (8/6).
Source: kaiserhealthnews.org

Video: Rep. Paul Ryan: The health care law remains a budget buster and bad for jobs

Medicare Private Health Insurance

When 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

TAMHSC News & Information—August 2012 President’s Corner

For example, when stumping for Medicare – a plan to provide health security for those over the age of 65, President Lyndon Baines Johnson said, “….There is a…program where you and I must stand together today. We must unite in passing a bill in Congress to help our older citizens secure decent medical aid under Social Security. Inadequate hospital care is an indecent penalty to place on old age….All we are asking for is a program under Social Security which will let the worker put in about $1 a month from his average lifetime earnings. The average manufacturing earnings in this country are now $100 a week. We ask $1 per month when he enters the labor market from the employee and $1 per month from his employer and the Government does not put in a single cent. But under this plan all Americans, not just the rich and affluent Americans, all Americans can face the autumn of life with dignity and security. Twenty-four dollars a year, if you enter the labor market at 20 and stay until you are 65 – 45 years at $24 – makes a little over $1,100, multiplied by the formula 3.75, and you have almost $4,000 when you are 65 in your account to take care of your hospital needs.” (President Johnson before the 50th Anniversary Convention of the Amalgamated Clothing Workers convention May 1964)
Source: tamhsc.edu

Getting Answers To Your Health Coverage Questions

Health coverage can be confusing. Over the past decade, the number of coverage choices has increased. Television, mail, and the Internet now bring us an overwhelming amount of information, and it’s not always reliable. So where can you turn for personalized, unbiased help with health insurance problems? Fortunately, there are free resources in every community that can provide you (or a loved one) with individualized counseling and assistance.
Source: smmirror.com

Low cognitive ability impairs enrollment in Medicare supplemental plans

Because traditional Medicare leaves substantial gaps in coverage, many people obtain supplemental coverage to limit their exposure to out-of-pocket costs. However, some Medicare beneficiaries may not be well equipped to navigate the complex supplemental coverage landscape successfully because of their lower cognitive ability or numeracy—that is, the ability to work with numbers. We found that people in the lower third of the cognitive ability and numeracy distributions were at least eleven percentage points less likely than those in the upper third to enroll in a supplemental Medicare insurance plan. This result means that many Medicare beneficiaries do not have the financial protections and other benefits that would be available to them if they were enrolled in a supplemental insurance plan. Our findings suggest that policy makers may want to consider alternatives tailored to these high-need groups, such as enhanced education and enrollment programs, simpler sets of plan choices, or even some type of automatic enrollment with an option to decline coverage.
Source: pnhp.org

Is the Fact that I Am a Woman Considered a Pre

Americans are nowhere near ready for anything that looks like overt rationing. Refusing to pay for services, tests, procedures and drugs that either don’t work or cost more than they’re worth is not rationing though. Fixed budgets for hospitals would probably result in rationing. With over 5,000 hospitals in the U.S. from large urban teaching hospitals to small rural community hospitals with very different cost structures, I don’t know how such a budgeting approach would work. Some areas are growing in population while others are stable or falling. It would be a nightmare in such a large, diverse and complex country like the U.S. Besides, we have lots of other strategies that we can try first and that have a lot of potential to mitigate cost growth. We should try them and I’m pretty sure we will. We do have overt rationing for organ transplants but that’s because there aren’t enough organs for every patient that could benefit from one and we’ve developed elaborate protocols to determine who gets them and who doesn’t. That’s acceptable because there is no viable alternative.
Source: thehealthcareblog.com

Best places to Hunt for Medicare supplemental insurance Quotations?

Medicare health insurance gain programs just like a PPO as well as The hmo are methods to obtain advantages of Medicare health insurance whereas Medigap guidelines only product the benefits of Medicare health insurance coverage. Even though, sold plus advertised by way of confidential corporations, Medigap guidelines have to stick to legal guidelines made by Federal and state federal government.
Source: ciker.org

Penobscot Community Health Care joins effort to improve health of Medicare patients — Health — Bangor Daily News — BDN Maine

The site will still be viewable but certain elements might display incorrectly. In order to enjoy all the features of our site, we recommended you upgrade to a newer, more secure browser. Read more ». If you don’t have administrator privileges for your computer, you can still take action. Google has developed a free plugin for Internet Explorer called Google Chrome Frame. You can install it on any computer, even if you can’t install applications, and it will ensure your computer stays secure and that you can still visit our website. Enable Google Chrome Frame now »
Source: bangordailynews.com

How Will Health Reform Affect Medicare? Part D, Donut Holes, Limits, and More

If you select “Keep me signed in on this computer”, every time you visit WebMD.com you won’t have to type your email address and password. This means that a cookie will stay on your computer even when you exit or close your browser which may reduce your levels of privacy and security. You should never select this option if you’re using a publicly accessible computer, or if you’re sharing a computer with others. Even if you select this option there are some features of our site that still require you to log in for privacy reasons.
Source: webmd.com

Many Years Young: No Increase In Medicare Drug Costs For Seniors

HHS attributed the low premiums to President Barack Obama’s healthcare reform law, known as the Affordable Care Act, which includes some measures to lower the cost of medications for seniors. Last year, HHS also attributed the low premiums to increased competition and greater use of cheaper generic drugs.
Source: manyyearsyoung.com

No Medicare Drug Plan Cost Increases For Seniors In 2013

Posted by:  :  Category: Medicare

Standing Up for Seniors and Women by Senator BoxerThe Associated Press: Gov’t: Medicare Drug Plan Premiums Stable For 2013 It’s an economic indicator of sorts for seniors: The Obama administration says the average premium for basic Medicare drug coverage will stay the same next year, $30 a month. That’s the third year in a row of little or no change. In addition, Medicare recipients with high prescription costs are saving an average of $629 apiece thanks to a provision of the new health care law that gradually eliminates a coverage gap called the “doughnut hole.” There is a caveat on premiums. Because the number is an average, some beneficiaries may see their monthly cost go up, while others get a decrease (8/6).
Source: kaiserhealthnews.org

Video: Mitt Romney May Not Need Medicare, But Seniors Do

Many Years Young: No Increase In Medicare Drug Costs For Seniors

HHS attributed the low premiums to President Barack Obama’s healthcare reform law, known as the Affordable Care Act, which includes some measures to lower the cost of medications for seniors. Last year, HHS also attributed the low premiums to increased competition and greater use of cheaper generic drugs.
Source: manyyearsyoung.com

Kuster Marks Medicare Milestone with Local Seniors

Kuster has spent years speaking with New Hampshire seniors about issues like aging and healthcare. In 2004, Kuster and her mother, Susan McLane, co-authored “The Last Dance: Facing Alzheimer’s With Love & Laughter,” which chronicles her family’s experience coping with her mother’s diagnosis.
Source: patch.com

MEDICARE MARKS 46TH YEAR, HOCHUL PRAISES ACHIEVEMENT AND URGES FURTHER IMPROVEMENT

“Over the last 46 years, Medicare has transformed the way people get the care they need,” said Hochul. “With close to half a million Medicare beneficiaries in Western New York, it has provided the security our seniors deserve in their health care. But despite delivering low cost, high quality health care for nearly fifty years, Medicare is under attack.  Many in Washington would force seniors to pay thousands more for their health care, and use that money to give tax breaks to millionaires and billionaires. As I have in the past, I will continue to fight to preserve Medicare while we seek out ways to eliminate fraud and abuse, and work to lower costs.”
Source: kathyhochul.com

Rim Country Gazette: 97% of AZ seniors on Medicare

AARP is a nonprofit, nonpartisan organization with a membership that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, the definitive voice for 50+ Americans and the world’s largest-circulation magazine with nearly 35 million readers; AARP Bulletin, the go-to news source for AARP’s millions of members and Americans 50+; AARP VIVA, the only bilingual U.S. publication dedicated exclusively to the 50+ Hispanic community; and our website, AARP.org. AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. We have staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.
Source: blogspot.com

Reductions in Medicare Advantage Payments: The Impact on Seniors by Region

At MediBid, we restore market forces to medical care. Doctors get to set their own rates based on their training, experience, and outcomes, and patients get to shop for medical care across state lines and international borders. Many times with MediBid, you will find procedures that are more effective than procedures allowed, or covered by health plans. Transparency and competition are the only way to achieve reasonable costs. Many of our employer clients offering group health insurance through MediBid save $5,000 per employee per year. Those are substantial savings. Patients are saving an average of 48% vs. insurance discounted rates, or 80% vs. retail. Contact us for more information.
Source: medibid.com

Presidential Race Deadlocked Among Over

A new AARP poll of voters over 50 finds President Obama and Mitt Romney are tied at 45% with the group. However, Obama gets just a 42% to 49% approval rating among them. As First Read notes, 91% believe “Social Security is critical to the economic security of seniors” and “the next president and Congress need to strengthen Social Security so that it is able to provide retirement security for future generations.” (That includes about three-quarters of Romney voters.) And on Medicare: 95% say “Medicare is critical to maintaining the health of seniors” and 88% say the next president and Congress “need to strengthen Medicare so that it is able to provide health coverage in retirement for future generations.”
Source: politicalwire.com

WSYX ABC6 On Your Side Top Story

Posted by:  :  Category: Medicare

Rally at Todd Akin's office  by joetta@sbcglobal.netCOLUMBUS, Ohio (AP) — Ohio Gov. John Kasich’s administration says it’s on track to convert the state Medicaid office into its own agency by next July.    In an announcement Friday, Governor’s Office of Health Transformation Director Greg Moody said the office will move out of the Ohio Department of Job and Family Services. The move is the next step in the administration’s efforts to improve the performance of Ohio’s nearly $19 billion Medicaid program. The switch will be complete July 1, 2014.    Moody said the change was recommended by two different study commissions in 2005 and 2006, and so it’s overdue.    Removing Medicaid from the state’s social services agency will allow Job and Family Services to better focus on welfare benefits programs. ————————————— Web Producer: Ken Hines
Source: abc6onyourside.com

Video: John Russell Explains “Medicare For All” To Protester Rep. Kathy Castor’s Office 21 August 2009

ACP Internist: QD: News Every Day

Slightly more than two-thirds of physicians accept new Medicaid patients, reports a survey that establishes a baseline for whether better reimbursement provided under the Affordable Care Act might prompt more doctors to enroll recipients onto their patient panels. Nationally, 69.4% of physicians accepted new Medicaid patients, compared to self-pay (91.7%), Medicare (83.0%) or privately insured patients (81.7%), reported a study that appeared in the August issue of Health Affairs. While Medicaid reimbursement will equal Medicare reimbursement for the years 2013 and 2014, one internist spelled out why he’s not changing his practice management habits. Robert Maro Jr., MD, ACP Member, practices in Cherry Hill, NJ, the state with the lowest Medicaid acceptance rate among doctors (40.4%). He told Kaiser Health News why the Medicaid bump won’t change his mind about not accepting new patients: “Robert Maro Jr., a Cherry Hill internist, said he had not accepted new Medicaid patients for 15 years because of low pay. He said the state reimburses him only $23.50 for a basic office visit, less than half of what he gets from Medicare or private insurers. “Maro said he treats Medicaid patients in the hospital and in nursing homes, but would lose money treating them in the office, where his administrative costs are higher. “He said he would start seeing new Medicaid patients only if knew the pay hike under the health law would continue beyond 2014. Otherwise, he worries he would take on new patients only to see rates fall back to the old levels in 2015, and then he would be required legally and ethically to keep treating them.” An ACP survey tracks closely with the numbers reported in the Health Affairs study. In the survey, among 3,109 U.S. members (no students or associates) practicing entirely or primarily outpatient medicine who responded, 34.1% were no longer accepting Medicaid patients. Other items of note in the Health Affairs report: –Physicians in solo practice were 23.5 percentage points (34% relative difference) less likely to accept new Medicaid patients than physicians in offices with at least 10 other physicians; –Primary care physicians were 7.3 percentage points (11%) less likely to accept new Medicaid patients; –Physicians outside of Metropolitan Statistical Areas were 12.9 percentage points (19%) more likely than others to accept new Medicaid patients; –Physicians in the Midwest were 8.2 percentage points (12%) more likely than those in the Northeast to accept new Medicaid patients; and –Physicians practicing in counties where at least 15% of the population was under the federal poverty level were more likely by about 8.4 percentage points (12%) than others to accept new Medicaid patients.
Source: acpinternist.org

Understanding Medicare Secondary Payer

It is important to understand Medicare billing requirements which can be somewhat complex. Consider attending training events and opportunities. Providers must ensure that those responsible for preparing and submitting claims to Medicare are aware of proper submission guidelines and regulations. Knowing the answers to the following questions can help your billing process a lot easier.
Source: about.com

Law needs refining on Medicaid

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Source: thedailyreview.com

Study: Nearly A Third Of Doctors Won’t See New Medicaid Patients

New Jersey Medicaid officials acknowledge the lack of physician participation is a problem, but said the recent move to enroll nearly all Medicaid recipients into private managed care plans “should reverse the trend,” said Nicole Brossoie, spokeswoman for the New Jersey Department of Human Services which oversees Medicaid.
Source: kaiserhealthnews.org

CMS Opens Medicare Fraud Command Center

5010 AARP 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 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

Social Security, Medicare Preservation Group Endorses Kuster [VIDEO]

Posted by:  :  Category: Medicare

Exactly Reggie, HHS Secretary Sebelius testified before Congress in May 2011. The administration is trying to "double count" the 500 Billion. Critics of the new health-care law are ridiculing Health and Human Services Secretary Kathleen Sebelius for essentially admitting a key GOP contention: that the administration has been "double counting" Medicare savings by saying the same $500 billion would be used both for extending the life of the current program and for funding its new mandates.
Source: patch.com

Video: The Rest of Us: Seniors’ Edition

Kuster Marks Medicare Milestone with Local Seniors

Kuster has spent years speaking with New Hampshire seniors about issues like aging and healthcare. In 2004, Kuster and her mother, Susan McLane, co-authored “The Last Dance: Facing Alzheimer’s With Love & Laughter,” which chronicles her family’s experience coping with her mother’s diagnosis.
Source: patch.com

Who’s Romney’s VP Pick? There’s an App for That

Right you are essay, Mr Rubio is a very articulate and knowledgeable politician who is well versed on the issues of the day and is always up to date and knowledgeable on any given subject. Which is why his excuse about getting the date of his parents emigration from Cuba wrong just doesn’t wash. He attempted to gain sympathy from anti-Castro Cubans and American conservatives by portraying his family as being political refugees when nothing could be further from the truth. His family left Cubea freely years before Castro ever came to power, this is fact and very well documented. Of course all that pales in comparison to being a multi-millionaire USA citizen who didn’t pay a dime in taxes for ten years thanks to shell companies, tax shelters and Swiss bank accounts.
Source: patch.com

NH ambulance service paid almost $4M to settle overbilling claims

Department officials have said that the maximum amount AMR can charge is around $600 per trip, though many patients have reported being billed for more than double this amount. Under the city contract, the base amount AMR is authorized to charge is $578, not including charges for additional services and mileage. This figure, however, is the maximum one can be charged out-of-pocket, Campasano said. The typical insurance rate AMR charges is $1,630 per trip. If an insurer doesn’t cover the entire bill, a patient can’t be personally billed for more than $578.
Source: ems1.com

Two NH providers agree to standards for Medicare, Medicaid

Two groups of medical care providers that serve New Hampshire were among 89 nationally selected to participate in a new federal program aimed at improving health care quality and reducing costs, the Obama administration said Monday.
Source: 2lk.info