Minister of Health clears Air on SMMC

Posted by:  :  Category: Medicare

Running Amok Again by elycefelizFirst of all lets start with getting something straight. The health minister is not as stated a “Dr”. Secondly the benefits of medical tourism and the timeline as given by the minister is not quite accurate. Election is over 2 years away. In the meantime the de weevers positioning their funding with medical tourism. That is very clear. A shift in power is definitely welcomed then the health care services on this island might actually get the attention that is needed. The SMMC needs a overhaul. There is no question about that. What no longer shocks me is that this minister always finds a way to take himself out of the equation. He steps in after and does as if he is cleaning up. The mess ccreated is that of the DP in the first place. If the doctors did not have the needed license because it was submitted late. Once the ministers departments received the documents late they should have checked if those doctors were already functioning. If they were they should have been stopped. That way SMMC would learn to submit on time and the doctors would have had their documents in order. The minister also stated that these doctors would receive the license because they are registered. If a doctor being registered in the Netherlands is all that is needed to practice on St. Maarten then we are in an even worse state. These doctors should be checked for former malpractice cases, performance in the Netherlands and I can go on and on. This should be checked before they butcher people on St. Maarten. The question is did the minister give permission at the end of the day based on a simple registration in the netherlands? was this common practice to allow doctors to practice here while awaiting permission? if this is the practice that the minister has been upholding then again he is at fault and trying to shy away from his lack of functioning as minister of health will not work. Because as said in earlier statements by the inspector general there were previous cases, 7 CASES. The allowing doctors to work knowing of 7 CASES is malpractice by the minister. In the end SMMC still needs that overhaul and so does government.
Source: smn-news.com

Video: 2009 Medicare TV spot for Priority Health Medicare plans – couple RV’ing

Priority Health Launches Medicare Explained

Priority Health has created a new online tool titled “Medicare Explained” to help people understand how Medicare works. As a component of PriorityMedicare.com, this tool breaks down the overwhelming process of choosing a Medicare plan into four simple lessons. VAR:Priority Health Launches Medicare Explained
Source: appspot.com

Priority Health Launches Medicare Explained

Priority Health has created a new online tool titled “Medicare Explained” to help people understand how Medicare works. As a component of PriorityMedicare.com, this tool breaks down the overwhelming process of choosing a Medicare plan into four simple lessons.
Source: com-cure.com

Priority Health Launches Medicare Explained

Priority Health has created a new online tool titled “Medicare Explained” to help people understand how Medicare works. As a component of PriorityMedicare.com, this tool breaks down the overwhelming process of choosing a Medicare plan into four simple lessons.
Source: com-diets.com

The GOP is the Party of Medicare

On the campaign trail, Mitt Romney has declared that it was wrong for Obama to cut Medicare, and promised never to cut the program himself. Now Rep. Paul Ryan, the chief GOP proponent of Medicare reform in Congress and Romney’s running mate, has thoroughly bought into this argument. Ryan’s GOP convention speech tonight went all in on the defense of Medicare. “Medicare is a promise, and we will honor it,” he said. And the reason to repeal ObamaCare is because of the way it upends the existing entitlement structure. “The greatest threat to Medicare,” according to Rep. Ryan,” is ObamaCare, and we’re going to stop it.” 
Source: reason.com

Peter Orszag, Medicare and the health care policy debate

Peter Orszag is Vice Chairman of Global Banking at Citygroup, former Budget Director of the Obama Administration and former Director of the Congressional Budget Office. He is an American economist with substantial credibility across party lines and I think his thesis has been overshadowed by a polarized political environment. For a long time Mr. Orszag has been playing a central role in our health care policy debate, and was one of the architects of the Affordable Care Act.
Source: voxxi.com

Putting the Patient in the Center: Star Ratings Congress for Medicare Advantage Plans

This commitment starts at the very top of an organization, meaning that CEOs and their leadership teams must send a clear message to staff, partners and communities that they hold themselves and their organizations accountable to better experiences of care for their patients.  Higher quality also requires systemic thinking, such as building new systems and processes that support safe, effective, patient-centered, timely, efficient and equitable care.  One aspect of this systemic thinking is building a close relationship between health plans and their provider partners – and once again, putting patients at the center.  A commitment to training and culture growth can pull an entire health care system toward a new organizational DNA – one that is all about better health, better health care and lower costs.
Source: wordpress.com

Medicare regulatory reform effort under way

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 marsmet481“(W)e believe that this change is appropriate because the re-enrollment bar in such circumstances often results in unnecessarily harsh consequences for the provider or supplier and causes beneficiary access issues in some cases. We have learned of numerous instances where the provider’s failure to respond to a revalidation request was unintentional; that is, the provider was not aware of the request due to, for instance, misrouted mail or a clerical mistake,” CMS officials noted in the Federal Register notice for the new rule.
Source: newsfromaoa.org

Video: Enrolling in Medicare

Medicare Enrollment Important Dates

Insurance companies and their agents are allowed to start marketing activities at this time as well. Although plans are made public, companies and their agents are not allowed to accept enrollment applications until the annual Open Enrollment Period begins.
Source: affordablemedicareplan.com

Enrolling in Medicare Advantage

Medicare Advantage. In a nutshell, Medicare Advantage, or Part C, allows you to access your Medicare benefits via a more comprehensive managed care plan. Different companies sponsor different kinds of plans, with varying premium levels and benefit levels to fit a variety of different budgets and needs. They come in the form of health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Each sponsoring company has to provide at least the standard benefits available under Part A and Part B, and every Medicare Advantage carrier must be approved by Medicare to provide benefits.
Source: imms.com

COBRA and Medicare, Part II 

[1] See, e.g., 42 CFR §423.56; also see CMS website at: http://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/index.html?redirect=/CreditableCoverage/. [2] See 29 USC §1162(2)(D)(ii). [3] See Treas Reg §54.4980B-7, Q&A 3, available at: http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=47126146b0c56fbbab9b6b6ebfb7db7d&rgn=div8&view=text&node=26:17.0.1.1.5.0.1.25&idno=26 [4] See Geissal v Moore Med. Corp. (1998) 524 US 74, 141 L Ed 2d 64, 118 S Ct 1869. [5] Note that for individuals who qualify for Medicare because of ESRD and are also entitled to health coverage under an employer plan, the group plan will be the primary payer for a 30-month coordination of benefits period. See 42 USC §1395y(b)(1)(C); 42 CFR §411.162.  This rule applies regardless of whether the individual is a current or former employee and regardless of whether the individual has coverage through COBRA.  Also note that if an individual enrolls in Medicare after electing COBRA coverage, the employer can elect to terminate the COBRA coverage.  [6]  Section 1882(s)(3)(B)(ii) of the Social Security Act; see also “Your Rights to Buy a Medigap Policy” at http://cahealthadvocates.org/medigap/guaranteed-issue.html (site visited May 31, 2012) [7] For a discussion of these plans, see  http://cahealthadvocates.org/medigap/overview.html (site visited May 31, 2012)
Source: medicareadvocacy.org

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

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Video: Medicare Plan Finder at a Glance

New Look for Medicare.gov

Now you can get to the Medicare Part D Plan Finder by clicking on the yellow box labeled “Find Health and Drug Plans” to the left of the picture on the homepage.  This will take you to the familiar Plan Finder.  Once there, if you click on the video to help guide you through the Plan Finder, the first page will look like the older version of the website where you clicked on the blue words “Compare Drug and Health Plans” to get to the Plan Finder. 
Source: retirementeducationplus.com

Medicare Part D Prescription Drug Plan Newsletter

 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: customemployeebenefits.com

Q1Medicare com Now Provides Comprehensive Medicare Part D Drug Pricing Information : e Yugoslavia

“Along with the basic retail price information, we decided to go one step further with our Medicare Part D estimated drug cost matrix and provide the Medicare community with an explanation of how the estimated drug cost is calculated,” notes Dr. Susan Johnson, Technical Director and co-founder of Q1Group LLC. “Many of the cost-sharing calculations are simple, especially for co-payments, but when dealing with the more expensive medications and straddle claims comes into play, many people find it difficult to understand how the pharmacy calculated their point-of-sale cost.”
Source: eyugoslavia.com

Medicare Plan Finder at a Glance

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Source: 247broadstreet.com

Medicare Advantage Plans Part 2

Also, consider the health condition of the individual. A healthy individual could save money initially with a MA Plan due to lower premiums and fewer claims, but what about later in life? Or if currently in poor health? Then Original Medicare with a good supplement may be the way to go. The problem is that once you enroll in certain MA Plans, you can only switch plans under certain conditions. So think hard and plan ahead if at all possible – it could save you or your loved one a lot in the long run.
Source: seniorliving.net

Plans to change Medicare might be easiest political divider

Nationally, too, the Medicare issue helps Democrats, as long as it’s framed around Ryan’s 2010 proposal to reshape the medical insurance program into a voucher plan. (Ryan later modified his plan to allow seniors to opt for traditional Medicare, but they’d still use vouchers to pay for it.) A Pew Research Center poll released last week found that Americans who have heard about the idea tend to oppose it, 49 percent to 35 percent. Opposition is especially strong among those age 65 and older, with 55 percent opposed.
Source: theolympian.com

Sheriff warns of Medicare scammer

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 marsmet481Barker said to be wary of online purchases, although most credit cards offer some type of identity theft protection. He added that if someone calls from a bank or a company asking for personal information, the person should call their bank or the company to verify the information before providing any of their own.
Source: northcoastnow.com

Video: Medicare Supplement Insurance Plans – Where Do I Start?

Medicare: Know Your Rights, Recognize Fraud

“Cold” call or use door-to-door marketing. Insurance agents may contact you about your current plan if you are enrolled in a plan with their company. Insurance companies may contact you for a disenrollment survey if you leave the plan. Insurance companies may contact you if you have given them permission to contact you. (Note: signing up for information at an event or returning a postcard counts as “permission.”) With your permission, an agent may schedule a time to meet with you in your home, but he/she may not come unannounced.
Source: thagroup.org

Does Medicare Call Your House?? Or is this Medicare Fraud?? » Toni Says

I have a problem and I need your help.  I am a 79 year old female who lives alone in Meyerland. Yesterday, a representative from Medicare called me asking all types of personal questions. I told them, I did not give personal information over the phone.  I’m concerned this could be a scam, but then if it was Medicare, I’m concerned I could have made a mistake.  Can you please advise me what I should do or where I could call to see if Medicare is trying to contact me?  Thanks in advance…Alice from Houston,TX
Source: tonisays.com

Medicare Fraud: Cleveland Medicare Fraud Attorney Explains Reporting

You will also need to put in the victim’s name, the date the fraud occurred, and specific details surrounding the incident. If you have additional documentation you can provide, check the applicable box. That information can then be sent to the Medicaid Intake Officer at the Office of the Attorney General’s address.
Source: christophermellino.com

Romney Campaign Keeping Debate Over Medicare on Center Stage

It’s supposed to be the Democrats’ signature issue, but Medicare has risen to the forefront of this year’s presidential race largely because Mitt Romney’s campaign has put it there. On the Sunday political shows, surrogates for the GOP presidential hopeful amplified their attacks on President Obama’s Medicare plans, saying the Democrats’ reforms will gut the popular seniors program leaving it up to Republicans to save it. That twist on the usual Washington refrain – Democrats for decades have accused Republicans of wanting to dismantle Medicare – combined with the aggressive nature of the GOP’s messaging campaign, all but ensure that the issue will remain in the headlines in the run up to election day. In a sense, Republicans have taken a page from Obama’s strategy of attacking the opponent’s core strengths…Republicans now are hoping to duplicate that trick with Medicare, charging full steam ahead with claims that Democrats are threatening seniors’ health and Republicans are racing to the rescue. That strategy was on full display on the Sunday shows, where members of Romney’s camp blasted the Democrats’ Medicare reforms as a threat to a program they’ve championed for years. “In order to pay for ‘ObamaCare,’ he raided the Medicare piggy bank, took $700 billion out of the Medicare program and shifted it to ObamaCare, [and] that’s wrong,” said Eric Fehrnstrom, a top Romney adviser, on CNN’s “State of the Union,” adding that the changes would force thousands of seniors to look for alternative forms of coverage. “There are people out there right now…who are now shopping for new Medicare – or new private healthcare – because their Medicare Advantage program is being cut by this president,” he said. Senior Romney campaign adviser Ed Gillespie was asked by “Fox News Sunday” host Chris Wallace if the focus on Medicare meant other important issues, including the economy, would be overshadowed. “We think a more fulsome debate about the future of Medicare and Romney-Ryan approach is good for us,” said Gillespie. GOP strategist and former George W. Bush adviser Karl Rove piled, saying the Medicare debate is inescapable and the Romney team was served best by going on the offense. “There was going to be a battle about Medicare no matter what. The question was, was it going to be left to what the Democrats traditionally do, which is late night phone calls in the final weeks of the campaign to seniors and scary mail pieces, [or] were we going to have a full-out honest debate,” Rove said on “Fox News Sunday.” Democrats have been quick to push back, arguing that Medicare cuts at the center of the GOP attacks – roughly $700 billion in reductions to projected Medicare growth estimated over the next decade under the Democrats’ 2010 reform law – come largely from eliminating waste, fraud and subsidies to insurance companies, not from cutting health benefits to seniors… Appearing at a campaign stop in The Villages, Florida, on Saturday, Romney’s running mate Rep. Paul Ryan (R-WI) repeated the campaign’s vow to repeal Obama’s healthcare reforms, including the $716 billion in cuts to projected growth. “Medicare was there for my family, for my grandma, when we needed it then, and Medicare’s there for my mom while she needs it now,” Ryan, appearing with his 78-year-old mother, told a crowd largely composed of seniors. “We need to keep that guarantee.” Said Fehrnstrom, “This is the first election cycle I can remember in a long time where Democrats are on the defensive because of Medicare.” READ FULL SOURCE ARTICLE
Source: newmediajournal.us

Contact the Medicare Fraud Hotline

This type of fraud happens when medical institutions such as hospitals or medical clinics add additional hidden charges to the bills of their patients who have Medicare or Medicaid coverage. There are times when the patients are being charged with greater fees as compared to the other patients who do not have any insurance. There are also instances wherein the patients are being charged for drugs or medical procedures that have not been administered. These irregularities are able to push through because the patients are either too busy to check or they do not really care at all. Can you imagine how the money could have been spent on paying for the medical expenses of other people? You can learn more about this type of fraud when you log on to www.whistleblowerlawyers.co.
Source: somascosmx.org

AOA to Congress and Obama administration: Act now to avert looming Medicare pay cut

“The reality is that, in practice, many secondary and tertiary providers rely on primary eye care management provided by optometrists, but top-down policies too often discourage these efficient approaches and transitions developed locally. While optometrists stand ready to provide further help, policymakers would be well-served to not let old biases and misplaced motivations derail overall efforts to increase quality and reduce health care costs,” Dr. Hopping concluded.
Source: newsfromaoa.org

In Your Corner: Medicare card scam

AARP, Elderly, in your corner, kfor, medicare card scam, medicare number, medicare open enrollment, oklahoma insurance department, oklahoma state attorney general, scam artists, Seniors, social security card
Source: kfor.com

Medicare Annual Enrollment Period Approaching

The information provided is straightforward and designed to be a valuable and easy tool that will guide you through the complexities of the Medicare program using simple language that breaks down each part of the program. Each part of the program is discussed in depth and gives you details that will help you to determine the type of supplemental insurance that you will need to ensure that you do not experience unexpected medical costs in the future.
Source: chai-shop.de

Westchester To Offer Free Programs On Medicare Basics

Lewis, an Architectural Lighting expert, explains the flawed process behind a recent City Council decision to approve a $1.5 million expenditure on a new LED Lighting System for the municipal garages at New Roc City and the New Rochelle Transit Center. Lewis urges New Rochelle residents to contact City Council members to reconsider their decision.
Source: newrochelletalk.com

Romney Medicare plan: What he leaves out is more important than what he says

America’s health care problems are not going to be solved by Romney or Obama unless they find solutions that include all Americans. That statement is absolutely correct. Even in Canada Health Care is the number one issue of our time, right after the economy. Even in our so-called “socialist state” (humour) we need a big discussion on escalating costs and government waste. There are some discussions of private delivery through government contracts, opposed by so-called friend of Medicare. One way or the other health care is paid by someone, in Canada primarily through taxes. Yet it takes up approximately 40% of all budgets, federal and provincial. This is not an easy issue. I have heard the arguments in Canada now for some 50 years. No one has found a perfect solution yet and maybe there isn’t one. I can guarantee though that partisan battles aren’t going to solve the problem until the two parties get together and find a workable compromise that works for all Americans. It may be a hot button issue in your election but at the end of the day it is Americans that will decide what they want for health care.
Source: allvoices.com

New York Times Article Highlights Success of Medicare Advantage Plans

Posted by:  :  Category: Medicare

Cassandra Q. Butts by Center for American Progress3rd Party Studies ACOs Admin Costs affordability Age Rating Cadillac Tax cbo Cost-Shift Employers Essential Benefits Exchanges GRP Health Plan Innovations Health Plan Satisfaction House hearings House legislation HSAs KI MA McCarran-Ferguson Medical Prices Medical Tests medicare medigap MedMal MLR Morning Headlines MT Patient Safety premiums Premium Tax Profits Provider Consolidation PWC Quality Rate Review Readmissions Reform RZ Senate hearings Senate legislation Small Business The Link Vilification Waste Fraud and Abuse
Source: ahipcoverage.com

Video: What Is Medicare Advantage?

Ryan and His Panicky Critics

Let’s start with Medicare. Ryan’s critics are beside themselves that the Romney campaign has effectively pinned $716 billion in Medicare cuts on the Obama administration. Two arguments are made to defend the president. First, it is said that Ryan’s own budget cut Medicare by the same amount. But the Ryan budget not only repealed all of Obamacare’s spending, it also doesn’t specify the kinds of Medicare cuts Obamacare does: It calls for the same level of savings but doesn’t spend the money elsewhere and leaves room for Congress to pursue those savings in ways that don’t rely on price controls and the elimination of benefits. Moreover, both Romney and Ryan have said that they, in a Romney administration, would meet their budgetary goals without Obamacare’s Medicare cuts by trimming elsewhere in the budget. And it is certainly the case that Romney and Ryan will have much greater flexibility than Ryan did as House Budget Committee chairman to make cuts wherever they can find them.
Source: wisgop.info

Clearing Out Medicare Advantage Plans Confusion

[…] […] […] […] […] […] […] Medicare Advantage plans are available when you first sign up for Medicare, but after that, you can only join most of the plans from October 15 through December 7. There are a few five-star Advantage plans that have exceptional grades for high quality and these plans can sign up new members all through the year. To see what advantages these plans can give you, read more about the coverage here on our site. You can also listen to or call in and ask questions from leading experts during our free teleseminar.Source: medigapadvisors.com […]Source: medigapadvisors.com […]Source: medigapadvisors.com […]Source: medigapadvisors.com […]Source: medigapadvisors.com […]Source: medigapadvisors.com […]Source: medigapadvisors.com […]
Source: medigapadvisors.com

Medicare Advantage Plans: Preparing For The Future

Health insurance has always been important for me. I always see it as an investment for future health care needs. Although I know some people who don’t believe in paying for plans, I personally know what it’s like to be suddenly hospitalized and without a penny to pay for the bills. Also, no one will ever know if they will be admitted due to some acute or chronic illness. Therefore, I say, it’s always so much better to be prepared. It’s not about waiting to be sick, it’s being armed when the time comes that you acquire any disease or affliction. I was offered with three types of Medicare Advantage Plans and I chose the one which does not require any referral from a certain physician.
Source: eurotrauma2009.org

Private versus public health insurance

Outlook: ?Evidence shows those programs work to improve care for patients and lower health care costs. Our research has done a tremendous amount of work looking at hospital readmissions. We have a readmission crisis in this country. Patients who are discharged from the hospital are not getting appropriate follow-up. In a fee-for-service system, there isn?t an incentive for hospitals and doctors to take steps to prevent that from happening. If patient goes back to the hospital, they get paid again. What private plans have done is they?ve implemented programs ? to make sure patients get appropriate follow-up care to avoid unnecessary, costly trips to ER. Readmission rates in the Medicare Advantage program are 20 to 30 percent lower than the Medicaid fee-for-service program.?
Source: typepad.com

Medicare Advantage Plans With Prescription Drug Coverage: Better Than The Rest

Having health insurance coverage has put my mind at ease. Although preventing diseases is always a top priority in our family, I also make it a point to have immediate assistance should any unforeseen event occur. Compared to other private plans, my parents opted for a Medicare Advantage Plan under the Health Maintenance Organization. In this type, though there is a limited list of accredited physicians only, they are still ensured that those who gave them the much-needed services would be covered with their insurance. What amazed was that the company has continued to improve as time passed by. Their services were notably way better than before. Also, they have expanded benefits and coverage for all their members and beneficiaries. While my parents have chosen HMO, my other siblings went for PPO or Preferred Provider Organization because they could make their own list of network of doctors. However, any incident that involved physicians outside the said network would possibly require higher out-of-pocket expenses for the member and his family.
Source: enviro-center.org

Paul Ryan Medicare Vouchers Vs Medicare Advantage Plans: Which Is Better?

I have no expertise regarding Medicare plans so I will only mention the three basic types. First is the PFFS or Private Fee-for-Service which gives the member the freedom to choose his/her own doctor. However, the said doctor should concede and accept the terms and conditions set by the company and should agree to the specific fees covered by the plan. Second is the HMO or Health Maintenance Organization which only allow their list of accredited doctors and specialists to address the health concerns of the member. Third is the PPO or Preferred Provider Organization wherein, contrary to HMO, the one making the list of chosen physicians or specialists is the member himself. Our plan is HMO but we have no qualms about the list since there are plenty of accredited doctors in our area.
Source: ophiusa.info

Best Aetna Medicare Advantage Plans And Their Perks

We pored over the three types he seriously considered and thought about. Initially, he opted for the Preferred Provider Organization since he has personal acquaintances which were doctors and specialists. However, I informed him that the downside rests on the fact that he should obtain the services of only those in his network if he doesn’t want to incur higher expenses. It may not need referral but his options would then be limited. The Health Maintenance Organizations is composed of a pool of accredited physicians and medical institutes that he could consult and be admitted in. however, referral would be a necessity. In the end, he opted for the last one which was Private Fee-for-Service since it only depended on his chosen physician if the Medicare terms were acceptable.
Source: beatrizcornejo.com

Report: No Area Of U.S. Cheats Medicare More Than S. Fla.

Posted by:  :  Category: Medicare

Insight from Donald Berwick by Gates FoundationSome of those with drug or alcohol addictions were lured from out of state with promises to put a roof over their heads. Once they arrived, with their valuable Medicare cards in hand, they would be squeezed into Broward and Miami-Dade halfway houses and steered to Biscayne Milieu’s purported mental-health programs, according to prosecutors. But if they dropped out of the group therapy sessions, they would lose their housing.
Source: cbslocal.com

Video: Cheryl Bradley lectures on Medicare Billing

Medicare regulatory reform effort under way

“(W)e believe that this change is appropriate because the re-enrollment bar in such circumstances often results in unnecessarily harsh consequences for the provider or supplier and causes beneficiary access issues in some cases. We have learned of numerous instances where the provider’s failure to respond to a revalidation request was unintentional; that is, the provider was not aware of the request due to, for instance, misrouted mail or a clerical mistake,” CMS officials noted in the Federal Register notice for the new rule.
Source: newsfromaoa.org

HHS IG report highlights docs' questionable billing of Medicare

For instance, Medicare paid almost $108 million to some 1,669 physicians who billed the highest possible code for almost all of their visits in 2010, according to the audit. That amounts to a payment of $43 more than the average per service  —even though there was little difference in the ailments they treated or the sickness of their patients, according to the audit.
Source: publicintegrity.org

Report Examines Medicare Billing At Mental Health Centers

At least 90% of more than $200 million in “questionable billing” issues found at Medicare outpatient community mental health centers occurred in states with little or no oversight. “This creates a vulnerability whereby dishonest individuals have an opportunity to establish (the centers) and improperly bill Medicare,” according to the report from Medicare’s inspector general.  (Source: USA Today)  [Read article]
Source: worh.org

Physical Therapy Software: Billing Medicare

Medicare is the standard setter for payers throughout the country and they seem to always be changing and evolving the way that they pay therapists. One question that comes to mind is how can you effectively bill Medicare while still keeping the flow of your system quick and easy to understand? As Medicare creates new rules and gets them set into place, other insurances are quick to follow, so it is necessary to understand how to bill Medicare in the early going or you risk the chance of being left behind. The big question that you need to ask is how can my practice management system help me bill Medicare properly?
Source: rehabsoftware.com

South Florida healthcare fraud prosecution news

Last week, a federal jury convicted eight people for conspiracy to defraud Medicare out of $57 million. The defendants operated a purported mental health clinic like the ones criticized by the HHS report. The clinic apparently offered kickbacks to recruit Medicare patients with substance addictions. Some patients came from out of state because the clinic promised to provide housing. When patients arrived in the Miam area, the clinic put them up in half-way houses. If the patients stopped participating in the clinic’s therapy programs, however, the defendants kicked them out.
Source: miamifederalcriminaldefenseattorney.com

Inappropriate and Questionable Billing by Medicare Home Health Agencies

Data collected and analyzed by the Office of Inspector General (OIG) since 2010, indicate that home health agencies (HHAs) are predisposed to commit Medicare fraud, waste and abuse. In 2010, Medicare inappropriately paid $5 million for erroneous claims submitted by HHAs. With one in four claims being suspect, the OIG established six (6) criteria that identify HHAs submitting potentially fraudulent claims and/or employing questionable billing practices. Primarily, these criteria are based on higher than average payments, visits, late episodes, therapy visits and Medicare payment amounts per beneficiary, as well as a higher than average number of beneficiaries.
Source: hallrender.com

Chika Boom Chika Boom: The Medicare Upcoding Hustle

In other words, almost overnight, people visiting its emergency rooms got a lot sicker. Numerous government reports and whistleblower lawsuits refer to the practice as upcoding. In 2000 HCA paid $840 million – at the time the largest payment for alleged fraud in U.S. history – to settle claims it had overcharged Medicare for upcoding pneumonia patients.While the story focused on one highly visible chain – HCA was founded by relatives of former Senator Bill Frist of Tennessee, was once run by Florida Governor Rick Scott and is currently partly owned by Bain Capital, Mitt Romney’s former firm – the data in the story suggest HCA was hardly alone. Over those same two years, which coincided with an economic slump that curtailed rapid growth in health care spending, the percentage of emergency room patients receiving Medicare’s top two billing codes went from 58 percent to 74 percent – just two percentage points less than at HCA.
Source: hcmatters.com

Texas Medicare Billing Has Biggest Potential for Fraud. Florida Second

Florida ranked second with 25 percent of its home health care agencies filing questionable claims, prompting the HHS Inspector General, Daniel R. Levinson, to call on the Centers for Medicare and Medicaid Services (CMS) to consider capping the number of agencies allowed to bill Medicare.
Source: jameshoyer.com

Community health centers marked by Medicare fraud in Louisiana, other states

Despite the prevalence of Medicare fraud and other forms of health care fraud, it is important for each and every person accused of these crimes to take the steps to protect themselves and claim their rights. Failing to do so can lead to a false or inaccurate conviction and a future of having to deal with the consequences of conviction.
Source: batonrouge-criminallawyer.com

Fraud detection in Medicaid / Medicare

One industry example mentioned in the reports: In one brash scheme, immigrants set up a network of fraudulent medical-supply stores in the Southwest, hoping to cheat Medicaid and Medicare. The gang hired recruiters to bring them innocent patients eligible for Medicaid or Medicare. They then paid off local doctors to prescribe motorized wheelchairs worth $7,500 but instead gave them motor scooters worth just $1,500, pocketing the difference. Investigators shut down the scheme after noticing billings for wheelchairs in Arizona, Texas, and other states scaling into the hundreds of millions of dollars.
Source: analyticbridge.com

Paul Krugman Says All the Evidence Shows Government Controls Health Costs Better than the Private Sector. Here's Some Evidence that Says Otherwise.

What about bureaucracy? A study by consultants at Millman for the Council on Affordable Health Insurance, an industry group, looked at all the ways that Medicare hides its administrative costs, for example by shifting many expenses to other parts of the federal budget. The study found that private insurance administrative costs are actually a lot more competitive than is commonly thought. And taken on a strict per-person basis, rather than as a percentage of the total budget, Medicare’s administrative costs are actually higher than private sector counterparts. No matter what, it’s hard to respect the efficiency and effectiveness of a set of programs — Medicare and Medicaid — that the government’s own watchdogs say blow about $65 billion every year on improper payments, everything from mistaken billing to outright fraud. That’s $65 billion in taxpayer money that these programs are paying out that they shouldn’t.
Source: reason.com

Social Security goes up, but so do Medicare premiums

Posted by:  :  Category: Medicare

Healthcare in America: Who's Paying Who? And Who's Getting What? (g1a2d0014c1) by watchingfrogsboilTo P. D’Antonio, NOT EVERY PENSION PLAN IS THE SAME. MINE WAS FREE WITH THE AIRLINE THROUGH THE UNION. I also suffer with many Esophagus problems and I truly believe all the chemicals I worked with and ulcer in Esophagus from stress from the “Good Old Boys in the Union”. My husband gets a great PENSION as he made very little which co-incided with the city plan as all figured out to a tee as he paid in big monies for his Pension pretty much $200.00 to $400.00 in later years as made more but when he worked overtime and slept all wknd there and removed snow they took $600.00 of his overtime including the reg. month payments for his Pension. You young people know nothing or some older. Every pension plan is different!!! My friend hates it too but her company gives BONUS checks each year which she got a lump sum of $15,000 and others at that same company up to $34,000 per year. I worked for not much for 46 yrs. my hubby got NO Bonuses for Viet Nam. He will not get any Social Security for 30 yrs with City as part of the Pension Plan as he did not pay in unless worked other jobs. He has worked other jobs now for 16 yrs plus his 30 for city. Plus his 4 yrs Marine service plus 6 yrs reserves. He is 65 and still working for Health Ins. Him and I never saw Bonuses!!!!! I don’t get low free flying as quit early because of ulcer and many other throat problems working with so very many chemicals. Get your facts straight about Pensions!!!! I never heard of a 401K plan til 1991 in my whole life and neither did my husband. If they were around earlier must have been for the rich or high up people at jobs! Republicans wanted all the Soc. Sec. to INVEST, remember then we had the stockmarket fall with the Godlman Sacs and Wallstreet. My husband’s Pension almost went broke and had to be transferred to another pension which were still not sure of! If Republicans would of had their way all the Social Security would have been gone then. LOL Stockbroker’s would have taken a big share of soc. sec. How soon we forget Republicans went on and on about people invest their own and let stock people take over Soc. Sec. to invest and they would have lost all of it a long time ago!!! Every company has their perks and some are more generous than others!!!!! LOL
Source: nbcnews.com

Video: Invisible & Insidious Taxes

Daled Amos: Medicare Part D Premiums Expected to Remain Stable

Medicare covers about 47 million seniors and disabled people. And nearly 1 million of those with high drug costs have already received a 50% discount on brand name drugs this year alone due to the implementation of the Affordable Care Act (ACA). The expectation is that as more people fall into the doughnut hole the number who benefit from the savings will increase. In addition, a new study published in the July 2011 issue of the Journal of the American Medical Association suggests that the savings that seniors get from participating in Medicare Part D may extend beyond just the cost of medications. Medicare Part D participants seem to have lower hospital and nursing home bills as well. This may, in part, be due to easier access to the medications that keep them healthy. The Medicare program has reaped the benefits of Medicare Part D as well. Estimates indicate that Medicare Part D has saved the Medicare program an average of $1,200 a year for every senior who had no coverage or inadequate benefits prior to when the program was launched in 2006. Much of the savings was due to the reduction in the need for hospitalization and nursing home stays.
Source: blogspot.com

Paul Ryan’s Health Care Record

Proposed revamping Medicare to, among other things, change it from a defined benefit to a premium-support program. Starting in 2023, Ryan’s budget would give future Medicare beneficiaries (those currently younger than 55) a set amount – a voucher — to purchase either a private health plan or the traditional government-administered program. His proposal also would increase the eligibility age from 65 to 67.
Source: kaiserhealthnews.org

Medicare Advantage Grows; But Not Without Government Help

The net result, encouraging more plans to compete in the Medicare market, is not actually in the best interest of seniors. In a study published last month in Health Affairs, researchers found that too many choices with too little guidance can be overwhelming for Medicare enrollees, especially the growing proportion that is experiencing cognitive difficulties. “Our study suggests that the Medicare Advantage program presents an overabundance of choices for many elderly beneficiaries,” the researchers write. “Medicare Advantage plans currently compete for enrollees through the benefits they offer and the premiums they charge, but elderly beneficiaries with low cognitive function were not responsive to changes in these features.” The implication, according to Health Affairs, is that these “unresponsive” seniors may buy into plans not well suited to their needs, allowing private insurers to profit “by offering less-generous coverage or reducing benefits while still attracting or retaining enrollees with limited cognitive abilities.”
Source: healthbeatblog.com

What Part of My Medicare Costs Are Covered by My Tax Dollars?

Medicare Part A is free to most Americans who have had the Medicare payroll tax deducted from their income for at least ten years. Medicare Part A covers hospital costs, hospice care, home health care and skilled nursing facility stays. The tax rate for Medicare’s Hospital Insurance (HI) is currently 1.45% for both employer and employee. The US government spent $486 billion on Medicare costs in 2011.
Source: seniorcorps.org

Massachusetts Health Stats: Memo to USA Today: Medicare is Freakin’ Complicated

NOTE: I’m going all Medicare all the time until further notice. There’s nothing happening in Massachusetts anyways. The legislature passed its health-care price controls, screwed a few percent of the population, and headed off to their second or third homes in the Berkshires or on the Cape for the rest of the Northern Hemisphere summer. And then they are off to the Democratic convention. Look to the postings list to the left to see what’s new. The Obama Parade of Medicare Lies is never ending. (What would you expect of a guy who lied about his dying mother’s insurance situation to get elected?) Otherwise, whenever, Massachussetts Health Stats is an as-needed look at statistics about the Massachusetts healthcare delivery and insurance market and industry. On both Medicare and Massachusetts health care, this blog overcomes the attempts from those on both the left and right of the political spectrum to use statistics to impose needless changes on one of the best healthcare systems in the world.
Source: typepad.com

Health insurance deduction: Self

[…] […] […] […] […] Prior to 2010, the IRS instructions for Form 1040 specifically said, “Medicare premiums cannot be used to figure the [self-employed health insurance] deduction.” For 2010 and 2011, the instructions were changed to say, “Medicare Part B premiums can be used to figure the deduction.” Now the IRS has clarified that all Medicare premiums qualify for the deduction.Source: bvcocpas.com […]Source: bvcocpas.com […]Source: bvcocpas.com […]Source: bvcocpas.com […]Source: bvcocpas.com […]
Source: bvcocpas.com

Medicare Premiums, Deductibles & Coinsurance: Rates for 2011

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

Medicare premium increases and the PP & ACA Act.

These are Provisions incorporated in the Obamacare Legislation, purposely delayed so as not to confuse the 2012 Re-Election Campaigns. Send this to all Seniors that you know, so they will know who’s throwing them under the bus.
Source: asmainegoes.com

AMAC Says Seniors Will Determine Who Will Be the Next President

Posted by:  :  Category: Medicare

Congressman Kendrick B. Meek by cliff1066™The Association of Mature American Citizens [http://www.amac.us] is a vibrant, vital and conservative alternative to those traditional organizations, such as AARP, that dominate the choices for mature Americans who want a say in the future of the nation.  Where those other organizations may boast of their power to set the agendas for their memberships, AMAC takes its marching orders from its members.  We act and speak on their behalf, protecting their interests, and offering a conservative insight on how to best solve the problems they face today.
Source: amac.us

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

How To Pay Less In An Inpatient Alcohol Treatment

There are specific services in an alcohol inpatient rehab center that the Medicare will not cover. Medicare Part A and B do not cover the cost of a private room unless the treatment program for the client requires it. Extra charges such as television, telephone, private nursing costs or other personal items are not part of the plan. Medicare Advantage may include the cost of both Part A and Part B and may cover the cost of services which are related to the treatment of alcoholism. Coverage provisions may differ since Medicare Advantage can be purchased through various private insurers. It would be advisable that patients who have Medicare Advantage Plans must consult the insurer to ensure the services in the alcohol treatment facilities can be covered by the Medicare. The patients are responsible to pay for the extra payments not included in the insurance coverage. Medicare Part C may have greater insurance coverage when compared with Part A and B. You should check the policy of your insurance provider.
Source: professional-article-marketing.com

Where Can I find Information On Medicare Insurance?

The website www.Medicare.gov is an exceptional resource for finding information about Medicare insurance. At Medicare.gov one can enter a zip code along with any prescriptions one takes, and the system will list the Medicare Advantage plans and Medicare Part D (prescription) plans for the zip code in order of least expensive to most expensive. This allows one to find out how much prescription copayments are for a Medicare Advantage plan or Part D (prescription) plan.
Source: todaysseniors.com

The resource cannot be found.

Description: HTTP 404. The resource you are looking for (or one of its dependencies) could have been removed, had its name changed, or is temporarily unavailable.  Please review the following URL and make sure that it is spelled correctly. Requested URL: /blog/post/2012/08/31/Medicare-Preventive-Services.aspx
Source: soundpathhealth.com

Alliance for Retired Americans Friday Alert, August 31, 2012

Social Security, the platform contends, “is long overdue for major change… to restore trust in the system.” While the actual platform language on Social Security is vague, both Mitt Romney and Paul Ryan have long supported lowering benefits, raising the retirement age, and moving toward a privatized system tied to the stock market.  Also this week, television commentator Pat Robertson said in an interview that the retirement age should be raised to 72, saying that such an idea “would not hurt anybody because people really like to work.”  To see a video of this interview: http://bit.ly/PuV2E8. “This platform is a raw deal for current and future retirees.  Seniors would take all the risks, while Wall Street and health insurers would get all the rewards,” said Alliance President Barbara J. Easterling.  The Alliance’s web site, www.RetiredAmericans.org, has a number of fact sheets current on the debates over the future of Social Security, Medicare, and Medicaid. 
Source: enewspf.com

Romney Medicare plan: What he leaves out is more important than what he says

Posted by:  :  Category: Medicare

Jessica Sundheim by On BeingAmerica’s health care problems are not going to be solved by Romney or Obama unless they find solutions that include all Americans. That statement is absolutely correct. Even in Canada Health Care is the number one issue of our time, right after the economy. Even in our so-called “socialist state” (humour) we need a big discussion on escalating costs and government waste. There are some discussions of private delivery through government contracts, opposed by so-called friend of Medicare. One way or the other health care is paid by someone, in Canada primarily through taxes. Yet it takes up approximately 40% of all budgets, federal and provincial. This is not an easy issue. I have heard the arguments in Canada now for some 50 years. No one has found a perfect solution yet and maybe there isn’t one. I can guarantee though that partisan battles aren’t going to solve the problem until the two parties get together and find a workable compromise that works for all Americans. It may be a hot button issue in your election but at the end of the day it is Americans that will decide what they want for health care.
Source: allvoices.com

Video: DeafLink ASL Update – Show 1 – Medicare Part D Rebate Checks June 15, 2010.wmv

REMINDER: Medicare Part D Notice Due Before October 15th

You may distribute the Notice electronically if you follow the same electronic disclosure requirements that apply to summary plan descriptions (SPDs), except you should inform the participant that he/she is responsible for providing a copy of the disclosure to his/her Medicare-eligible spouse and/or dependents eligible for coverage under the plan (otherwise, you will need to separately send them a hard copy notice) and you must post the Notice on your website (if you have one) with a link on your home page to the Notice.  
Source: jdsupra.com

Temp residents can get refund on Medicare levy 

This certificate must show they were not entitled to Medicare benefits because they were a temporary resident for Medicare purposes, and either they did not have any dependants for that period, or all their dependants were in an exemption category for that period.
Source: com.au

Fort Hays State University

  Academics   Admission   About FHSU   Athletics   Blackboard   Calendar   Hardware/Software   Purchase   Docking Institute   FHSU Foundation   Forsyth Library   Jobs/Careers   Quality   Management/AQIP   Research   Sternberg Museum
Source: fhsu.edu

Medicare and Cash Based Physical Therapy – a Full Overview

Let’s explore an example based on the “Maintenance” scenario above. Once you have determined that the patient will be continuing treatment on a maintenance basis, you need to explain and have them sign the ABN. After the next visit with the (now cash-paying) patient, you will submit a claim to Medicare with a GA Modifier. The GA Modifier tells Medicare that you have an ABN on file for the patient, and also prompts them to automatically deny the claim. After doing this once, you do not need to continue submitting claims for that patient’s non-covered services. (Please note that this paragraph is directed at those practices who have a relationship with Medicare. If you are not enrolled in Medicare with a Provider number, you cannot submit in any bill … even one with a GA Modifier to get a denial.)
Source: drjarodcarter.com

Medicare Spending Growth Slows : South Carolina Nursing Home Blog

CBO Director Doug Elmendorf said at a press conference that the slower growth in Medicare is consistent with slower health care cost growth throughout the economy, which many analysts have observed.  The report also looked at Medicaid. Federal outlays for the program are expected to total only 1.7 percent of GDP next year and 2.4 percent of GDP in 2022 as the program expands under the 2010 health law.  In comparison to its March projections though, the CBO said Medicaid spending would decrease by $325 billion, or 7 percent, from 2013 to 2022. The bulk of that reduction is due to the Supreme Court’s ruling on the health law, which makes optional an expansion of the program that the law essentially required all states to put in place.
Source: scnursinghomelaw.com

DAR File No. 36566 (Section R414

(d) Except for PCN and UPP that are subject to open enrollment periods, the eligibility agency denies an application when the applicant fails to provide all requested verification, but provides all requested verification within 30 calendar days of the denial notice date. The new application date is the date that the eligibility agency receives all requested verification and the retroactive period is based on that date. The eligibility agency does not act if it receives verification more than 30 calendar days after it denies the application. The recipient must complete a new application to reapply for medical assistance;
Source: utah.gov

Paul Ryan’s Plan Will Harm Disabled People

Ryan’s plan is to turn Medicare into a voucher system. The amount of the voucher would be based on the cost of the second-least-expensive health insurance plan that is available. Experts who have studied this are saying that this plan would probably be a plan from a private insurance company that is not offering benefits that are as comprehensive as what people are currently receiving from Medicare.
Source: families.com

Viewpoints: Romney, Ryan Rely On ‘The Magic Asterisk'; Frightening Voters Over Medicare Cuts

JAMA: The Republican Ticket: Mitt Romney, Paul Ryan, And The Magic Asterisk The press has focused a lot on the similarities between Mitt Romney and Paul Ryan. They are both technocratic, they espouse tax cuts, and they believe in a balanced budget. But there is a deeper similarity as well: they both believe deeply in the “magic asterisk.” The magic asterisk was the invention of David Stockman, budget director to Ronald Reagan. Stockman, who needed to show a more favorable budget than the Reagan tax cuts would justify, put in an asterisk and noted “future savings to be identified.” … Since then, the magic asterisk has become a staple of budgets that don’t add up and wishful economic thinking. What Stockman invented, however, Romney and Ryan have perfected (Cutler, 8/29).
Source: kaiserhealthnews.org

American Financial (AFG) Closes Sale Of Medicare Supplement And Critical Illness Businesses

Posted by:  :  Category: Medicare

AFG’s balance supplemental insurance operations consist solely of its run-off long-term care business, which has a book value of approximately $170 million, and which will continue to be based in Austin, Texas. AFG’s Austin-based life and annuity operations will transition to its home office in Cincinnati, Ohio before the end of the year.
Source: istockanalyst.com

Video: Examining Abuses of Medicaid Eligibility Rules

Daily Kos: Medicare Fraud Lawsuit Filed Against Bain Company In Tampa During RNC

These tactics are nothing new for Ameritox: The company has a long and continuing history of offering illegal kickbacks to physicians for referrals. Ameritox’s improper inducements include, but are not limited to, placing personnel in the offices of Ameritox’s customers in violation of state law prohibitions on such placement; providing free or below- market point-of-care testing cups to generate extra revenue for practitioners who use those cups to perform billable testing; and offering other various inducements and kickbacks to practitioners and their medical practices, including gift cards, meals, computers, and office parties.  Ameritox’s fraudulent and illegal practices are pervasive and undertaken as part of a scheme to increase its revenues at the expense of Millennium, other competitors, patients, and the United States. 
Source: dailykos.com

Where Have All the Doctors Gone? The physician shortage in Texas may get worse before it gets better

The interim charges for the Texas House Committee on Public Health prior to the 2013 legislative session include examining the adequacy of the state’s primary care workforce and weighing the impact of an aging population and health care reform as well as the state and federal funding reductions to graduate medical education and physician loan repayment programs. Although the report is not due until this fall, the findings should be obvious: An already-inadequate primary care workforce will buckle further under the aforementioned pressures – not to mention the addition of 5 million new residents this decade. GME and physician loan repayment funding cuts will mean Texas will force its medical school graduates to train – and likely settle – elsewhere and lose its investment in their education. 
Source: healthyatx.org

Research finds Medicare and private insurance spending similar throughout Texas

Variations in health care spending by Medicare and Blue Cross Blue Shield of Texas (BCBSTX) are similar throughout the state despite previous research, which found significant spending differences between the private and commercial sector in McAllen, Texas. The latest research results from the University of Texas Health e Center at Houston (UTHealth), the Commonwealth Fund, and the Brookings Institution are published in the December issue of the American Journal of Managed Care.
Source: sciencecodex.com

The Medicaid expansion gap

The prime directive of the Affordable Care Act could hardly be clearer: affordable health insurance for all. There is no question that those of us who can afford health insurance are paying in part for the uncompensated care that hospitals and ERs deliver to those unable to pay. Not only is an ER a terribly costly primary care option, but also when health insurance is unaffordable, people tend to delay treatment — driving their ultimate health care costs to society even higher.
Source: bankrate.com

State Roundup: Ohio Sets Plan For People On Both Medicaid And Medicare; Minn. Asks Feds For Money

California Healthline: Why Basic Health Plan Failed And Why COOPs May Succeed No one knows exactly what the Basic Health Program would have looked like in California — and now we’ll likely never know. The state Legislature recently shelved the idea by relegating SB 703, by Senate Health Committee Chair Ed Hernandez (D-West Covina), to the “holding committee” in the Assembly Committee on Appropriations. That effectively killed the bill. Meanwhile, another Assembly measure (AB 1846), by Assembly Member Richard Gordon (D-Menlo Park), would establish a legal framework to set up Consumer Operated and Oriented Plans (COOPs). That proposal, like BHP, is an option under the federal health reform law with a lot of questions surrounding it. Unlike BHP, the COOPs bill is a floor vote away from the governor’s desk and appears to have widespread support (Gorn, 8/27).
Source: kaiserhealthnews.org