Brad DeLong: Josh Barro Says Opinions

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 marsmet524The real landscape on Medicare is this: Both parties want to cut Medicare…. There are two key falsehoods in the Democratic message on Medicare. One is Obama’s oft-repeated claim that the Patient Protection and Affordable Care Act “won’t touch your guaranteed Medicare benefits. Not by a single dime.” That’s true only with a tortured definition of “guaranteed Medicare benefits.” PPACA cuts Medicare spending by $716 billion, or about 10 percent over the next 10 years. It achieves these cuts in roughly equal parts by: eliminating subsidies for enhanced, private “Medicare Advantage” plans used by many seniors; reducing reimbursement rates to hospitals; and various other measures, including cutting payments to compensate hospitals for unpaid bills and payment rates for home health providers.
Source: typepad.com

Video: Canvas-CMS1500-HEALTH-INSURANCE-CLAIM-FORM Black Berry.mp4 – Mobile App – GoCanvas.com

“The Basics” Chiropractic Medicare: “The Medicare Claim Tells the Story” ~Newsletter 8/20/12

Many times the carrier will ask for patient S.O.A.P. notes to verify the doctor did in fact adjust vertebrae is specific regions in which they billed Medicare. If you adjust 4 regions on your patient for example, your billing will match the S.O.A.P. notes as to the number of regions you adjusted and billed to Medicare.
Source: blogspot.com

Coding Ahead: How Medicaid Receives Crossover Claims

After providing a service to a dually-eligible recipient, the provider sends a claim to its Medicare carrier or intermediary. After Medicare processes the claim, it sends the provider an explanation of Medicare benefits (EOMB). If Medicare has approved the claim, Medicaid can pay towards the deductible and coinsurance according to Medicaid policy. Medicare crossover claims are submitted to the Medicaid fiscal agent by one of the following methods:
Source: codingahead.com

Follow work expense tax claim rules

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Source: bankrate.com

Daily Kos: Prepare to shed tears: Aetna murders woman by excessive rate hikes

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Source: dailykos.com

Video: How to Lower Your Health Insurance Premiums in Texas Brought to You by Family Financial Services

Laura D'Andrea Tyson: Evidence vs. Ideology in the Medicare Debate

Both Governor Romney and Representative Paul D. Ryan have promised to repeal the Affordable Care Act and with it the reforms behind the $716 billion in Medicare savings (although Mr. Ryan duplicitously counts the savings from these reforms in his deficit-reduction plan). Medicare beneficiaries would be the losers. They would lose the benefits of better care at lower cost. They would lose the plan’s expanded Medicare coverage for prevention benefits and prescription drugs, and they would be forced to pay higher premiums and co-pays as a result of faster growth in Medicare costs.
Source: nytimes.com

Rite Wing TechnoPagan: Medicare’s Administrative Cost — The Last Word, I Hope

In the latest foray, Yuval Levin at NRO argues that Medicare’s administrative costs are underreported in a column responding to Paul Krugman. Although he points out that “fact checking Krugman is rarely worth the time,” he has some good observations. See our own response to the Krugman column as well. In addition to Levin’s case, Tyler Cowan observes that the cost of collecting taxes is 20% or more of each dollar of revenue. Although he doesn’t say so, the critics of U.S. health care almost always include the private insurance cost of selling insurance and collecting premiums, but exclude the cost of tax collection. Austin Frakt chimes in, but in my opinion misses the subtext: Is Medicare less expensive to administer than private insurance?
Source: blogspot.com

Commentary: Michigan Stands Out on High Cost of Car Insurance [Michigan Capitol Confidential]

The reason for this higher cost is not that the share of claimants who seek medical treatment after an accident is appreciably higher in Michigan, but it is that the mix of services is much more costly. Unlimited personal injury protection results in incentives to use the most costly procedures available, since insurance will pay for it, and it creates enormous uncertainty about what the cost of any accident might be. Both of these factors drive up premiums.
Source: michigancapitolconfidential.com

Young People Pay Less For Health Coverage, Older People Pay More, Under Maine’s ‘Market

Insurers can now charge older residents up to three times more than younger ones – twice the spread they were allowed under the state’s old rules, adopted in 1993 to insulate older people from higher costs. Because older people generally have higher medical expenses, however, insurers had charged young policyholders more to make up the difference. Only seven states currently have such “community rating” rules limiting how much they can charge older people. That will change in 2014, when the federal law sets a 3:1 ratio for premium variation based on age, just as Maine’s now does. 
Source: kaiserhealthnews.org

FOCUS ON MEDICARE: Insurance and risk have no place in health care

And that is because a rest of a grown universe adopted, instead of private word plans, variations on inhabitant health care. There is no need to calculate risk: everybody is in a same pool, all is covered. In many countries, people are taxed for this caring according to their income — so everybody can means it. Finally, these countries control their health caring costs, not by shortening advantages a la Ryan/Obama, though by shortening prices. Americans compensate a top prices for health caring in a world. Only a inhabitant supervision has sufficient precedence to revoke these. But that is another op-ed.
Source: com.vn

Chas’ Compilation: Truely Bipartisan Health Care Reform

  In Oregon, for example, 56 percent of seniors currently get all or some of their health coverage from a private plan. (15 percent of Oregon seniors purchase private Medigap policies to supplement their traditional Medicare, while 41 percent of Oregon’s Medicare beneficiaries are enrolled in private health insurance plans through Medicare Advantage.)Wyden-Ryan would allow seniors to continue to choose between the traditional government-administrated Medicare option and privately administered plans.  But instead of maintaining separate programs, Wyden would make those private plans more robust and accountable by forcing them to – for the first time – compete directly with traditional Medicare. Every private plan that participates in the program would be required to offer health benefits that are AT LEAST as comprehensive as those offered by traditional Medicare and premium support payments would be pegged to the actual cost of health care in a given area, determined by an annual competitive bidding process.  Therefore, every senior – whether they get their health insurance from a private plan or the government – will be guaranteed to have the high quality health benefits that has long been Medicare’s promise. How will Wyden-Ryan ensure that private insurance companies don’t take advantage of seniors? All participating private plans will be required to offer benefits that are at least as comprehensive as traditional Medicare, with such standards enforced by the Centers for Medicare and Medicaid Services.  Any plan that is found taking advantage of seniors or providing inadequate care will be kicked out of the system. Cherry picking healthier seniors will be made unprofitable by robust risk-adjustment, and the Medicare Exchange where plans will seek to offer coverage to seniors, will be policed by the federal government. It is worth noting that the Medigap law Senator Wyden authored to regulate the private market for Medicare’s supplemental insurance market has been protecting seniors from unscrupulous insurance practices for more than two decades. How will Wyden-Ryan guarantee that health care will be affordable for all seniors? Isn’t it just a voucher? A voucher suggests giving seniors a fixed amount of money indexed by a set rate of growth that may/may not have anything to do with the actual growth of health insurance costs.  Vouchers would not guarantee that seniors could afford health coverage.  (This is what the last year’s House Republican Budget did.) Wyden-Ryan does not give seniors vouchers.  Instead Wyden-Ryan would guarantee that seniors can afford their health insurance premiums by giving seniors premium support payments, the amount of which will be determined by the actual cost of insurance premiums each year. It would do this through a competitive bidding process in which private insurance plans, wanting to cover Medicare beneficiaries, would submit their benefit packages and the amount they will charge in premiums for the upcoming year.  The amount seniors receive in premium support will be determined by either the cost of traditional Medicare premiums or the second cheapest private plan available on the exchange (whichever is cheaper.)  This process will take place each year, so if health care costs – and therefore insurance premiums — grow dramatically from one year to the next, so will the premiums support payments that seniors get to pay for them – thus ensuring that every senior can afford their health insurance premiums. And again, every private plan in the Medicare exchange will be required to offer benefits that are at least as comprehensive as those offered by traditional Medicare. […] It’s not a “Radical Plan to Kill Medicare”. It actually builds on the Medicare options that already exist, in a way that will both control costs and offer more choices. And it’s a plan we can actually afford! It’s definitely worth reading the whole thing. It’s pretty much the same Medicare plan that Paul Ryan is advocating on his website. In an interview for Human Events, Ryan explains the history of bipartisan support for the reforms he’s advocating.    
Source: blogspot.com

Latest House Republican Budget Threatens Medicare and Shreds the Safety Net

What’s more, private plans could “cherry pick” healthier seniors, driving up premiums for those who remain in traditional Medicare. And private plans would be able to undercut traditional Medicare in other ways, such as by offering free gym memberships or other perks. As a result more and more seniors would gradually shift to private plans over time. This gradual privatization of Medicare does not make sense because traditional Medicare costs less than comparable private coverage. But with fewer beneficiaries Medicare would have less leverage to contain the growth in health care costs.
Source: americanprogress.org

Brad DeLong: The Policy Substance Underlying Today’s Politics

Hey seniors! The Republican platform calls for turning Medicare into a voucher program and for eliminating important benefits for you–they want to reopen the Medicare drug “donut hole”. They would want to raise your Medicare premium by an average of $577/yr a decade from now. Why? Because they seem hell-bent on restoring $716 billion in wasteful Medicare payments to insurance companies and over-treating specialists. We don’t know the full details. They won’t tell us. Republicans’ rhetoric and plans keep shifting as the American people responds with dismay to what Republicans propose. It won’t be good. We do know that two-thirds of Medicaid dollars are used to care for the elderly and the disabled, and that the Republicans have pledged to cut Medicaid dramatically.
Source: typepad.com

Health Law Prompts Review Of Some Medigap Plans; Defining Who Gets Dependent Status

Posted by:  :  Category: Medicare

Your plan and Plan C are the most popular Medigap plans, chosen by nearly two-thirds of beneficiaries. Those are also the policies that provide significant “first dollar” coverage: they pay the deductibles for both the hospital and outpatient portions of the traditional Medicare program (Parts A and B) as well as the 20 percent coinsurance required for doctor visits, and cover other services as well. People with these supplemental plans may pay virtually nothing for medical services beyond their premiums.
Source: kaiserhealthnews.org

Video: Learn About Medigap Plans

GOP Platform Announcement Puts Medicare As Hot Topic For Debate; Sparking New Medigap Coverage Offer from Online Medicare Company

After the GOP published its official platform this week and sited the first two tenets as being saving medicare for future generations and strengthening Medicaid in the sates, showing the issue would clearly be a point of debate in the upcoming presidential election, MostMedicare.com announced a new offer to help older adults with their Medicare issues. The companys new guide will feature professional insight on understanding Medicare so care inside and out and about Medigap insurance that can supplement their original Medicare coverage. The new offer on Medicare advantage plans is being launched so that adults and future generations can have a better understanding of their options no matter what the outcome of the 2012 presidential election is.
Source: cjshl.cn

Using Medigap As A Medicare Supplement

You must currently be enrolled in Part A and Part B of government coverage to buy a Medigap policy. If you want to go back to government insurance when you have an Advantage Plan, you need to apply for a policy before the end of your coverage period. Currently a Medigap policy having the letters E, H, I, and J are no longer being sold. However, individuals can keep these plans as long as the monthly payments continue to be made.
Source: cardealersinsurance.net

Medigap Vs. Advantage plans

All of this makes Medicare Advantage plans sound much more attractive than traditional Medicare, but the reality is lots of people don’t like the access to care they get from Medicare Advantage plans. Researchers from the Commonwealth Fund, a nonprofit foundation that promotes better health care, found that 15 percent of  people with Medicare Advantage policies rated their insurance as fair or poor. That is more than double the number of dissatisfied Medicare/Medigap plan participants — just 6 percent of those with traditional Medicare coverage and Medigap plans rated their coverage as fair or poor.
Source: bankrate.com

Readily Navigate Medicare Supplemental Plans Online

It is not clear as to why Medigap insurance is vital is it. The above states Part A covers the hospital, Portion B covers the physician; what else is there? This can be where Medicare Insurance coverage becomes tricky for quite a few individuals new for the method. For example Medicare Portion A demands patients cover a deductible if admitted into the hospital. Existing estimates state that deductible is near $1500. This deductible only covers care inside a sixty day period. For example, say you might be readmitted on the sixty first day after you had been released you happen to be required to repay the $1500 deductible. It’s not a deductible that is definitely on an annual basis like a lot of prior insurance coverage plans supplied by employers. Portion B leaves a gap for it fails to cover the very first twenty percent of all doctors’ bill and the annual deductible of about $160 which continues to rise every year. It’s evident that extra coverage is needed to fill in the gaps left by the typical Medicare Aspect A and B. This is where the distinct Medicare Supplement Insurance plans come into play. It truly is vital when hunting into each plan that you simply are in a position to compare Medicare Supplemental Insurance plans and compare rates. Medigap, as it is normally identified, is provided for obtain by way of several distinctive private insurance organizations. One particular factor you have to don’t forget is the coverage is equivalent regardless of exactly where it is bought. If you’re comparing rates and plans and decide on Medicare Supplemental Insurance coverage Strategy f from BC/BS it really is exactly the same coverage as you might get with Bankers Fidelity. The distinction lies inside the rate charged for their services. You will need to figure out when you are prepared to pay added for precisely the same coverage as a way to possess a particular insurance provider. For far more info about hospital plans, Read More
Source: fc2.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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

Medigap North Palm Beach Fl

If you don’t do the necessary amount of shopping around, you may end up paying too much for Medicare Supplement Insurance. The different plans are standardized, which means they cannot be changed from one insurance company to another. If you have a supplemental plan in mind, find an insurance company that offers it at the best rate. You can cut the leg-work out of the process by calling an independent Florida Health insurance broker. We shop the various insurance companies for our clients, so they don’t have to. Our multiple company analysis lets clients quickly see which company offers the lowest quote for a particular plan.
Source: floridahealthinsurancebroker.com

MedicareSupplementPlans.com Offer Comparison Shopping Resource for Medicare Supplement Plans

Medicare covers some medical expenses, but it doesn’t cover everything. Medicare leaves gaps in patient coverage, and without a supplementary insurance plan, these gaps must be paid out-of-pocket. For that reason, Medicare supplement insurance plans are becoming a popular way to fill in the gaps left by Medicare coverage. Today, many top insurance providers offer some type of Medicare supplement plans. However, some of these plans are better than others. Some supplement plans might only fill in a few gaps left by Medicare coverage, while other plans comprehensively cover seniors in any circumstance. Some supplement plans are priced affordably, while others are expensive. MedicareSupplementPlans.com has been gaining a lot of attention lately by helping seniors quickly and easily compare any type of Medicare supplement plans. At MedicareSupplementPlans.com, visitors will find information about the best Medicare supplement plans in the country. The website states that these plans – also known as ‘Medigap’ insurance plans – cost far less than what many people expect. A spokesperson for MedicareSupplementPlans.com explained what the site hopes to accomplish: “Our goal is to connect visitors with the best possible Medicare supplement plans for their needs. There are so many different ‘Medigap’ plans available in this country, and finding the right one can be difficult for those who don’t have experience in the industry. That’s why we offer free insurance quotes that can be filled out in just minutes or allow people to be guided by our team of experienced representatives. We want to make it as simple as possible for consumers to select the most appropriate policy at the best possible price.” Using the website, visitors can also discover the specific benefits included in Medigap insurance plans. The website describes the specific types of Medigap plans offered by insurance companies across the states, and plans are identified by the letters A, B, C, D, F, G, K, L, M, and N. Each of these plans is the same for every insurance company. For example, Plan F Medigap from one insurance company will be identical to Plan F Medigap offered by another insurance company. The website features a detailed list that shows what each plan covers in a simple to navigate chart. The information on MedicareSupplementPlans.com is catered to those in California. The website features unique pages for every county in California, and visitors can easily compare California Medicare plans from anywhere in the state. Whether seeking to fill in the gaps left by insufficient Medicare coverage, or simply wanting to learn more about the types of insurance plans available, MedicareSupplementPlans.com allows users to compare the different types of Medicare supplement plans available today. By filling out the free insurance quote form included on the front page, visitors can receive a free quote within hours. About MedicareSupplementPlans.com MedicareSupplementPlans.com educates visitors about Medicare supplement plans, which are designed to fill in the gaps left by Medicare coverage. The website allows users to instantly receive a free insurance quote for insurance in their area. For more information, please visit: http://www.medicaresupplementplans.com
Source: sbwire.com

Hawaii Estate Planning Blog

Posted by:  :  Category: Medicare

ROBERT L. HUFFSTUTTER'S HEALTHCARE PLAN FOR AMERICA by roberthuffstutterThat’s right, the Department of Health and Human Services issued its estimate, and Businessweek reported it in an article titled “Medicare Drug Plan Premiums to Stay at $30 in Coming Year.” According to the estimate and bids from private insurers, the premiums for Medicare drug plans are expected to hold steady at the $30 average, which is where they stand today.
Source: est8planning.com

Video: Rafael del Castillo, Obama Health Care Reform, Medicare and Hawaii, Expectations & Challenges

The Best Hawaii Dentists Behind The Scenes

Finding the best Hawaii dentist isn’t effortless. There is certainly no clear reduce quantitative algorithm to determine who the best dentist in Hawaii is. As well as the very best dentist in Hawaii will differ from family to household. So there are many dentists who can vie for the title of very best Hawaii dentist. Very first off, the best Hawaii dentist really should be a member from the ADA, which stands for the American Dental Association. The ADA will be the most prestigious dental association in the United states of america and all great dentists have to be a member of this organization. The top Hawaii dentist ought to be totally competent, licensed and licensed to practice during the state of Hawaii. All of their licensing and connected paperwork ought to be in order. The State of Hawaii has fairly several rigid demands for dentists practicing here and also the very best dentists will adhere to all of them. Hawaii’s greatest dentist ought to possess a sterling reputation that is certainly completely unassailable. They really should be well esteemed for the high quality of their function along with the care for their patients. They really should have excellent evaluations and testimonials from their past and present patients and you ought to have the ability to see these testimonials the two on the internet and offline, fairly easily. Hawaii’s best dentist should also possess a excellent staff. They should be friendly, courteous and extremely expert. They ought to care to suit your needs as considerably because the dentist does and they really should do their jobs in the highly professional manner dentist qualifications. Their sole concentrate should be on you the individuals. They must not be distracted with private calls and text messages throughout office hours. The personality with the very best Hawaii dentist can also be a essential factor. His character must be warm and engaging and quite caring. He must be comfortable interacting with everybody who walks into his clinic, whether or not they’re a ninety year old grandmother or even a five year old youngster. He ought to be a men and women particular person, who loves spending time with all of his sufferers. He should have a constructive, upbeat frame of mind that makes every single patient feel appropriate in your own home in his workplace. The very best hawaii dentist ought to always place his sufferers first. He should strive to perform precisely what is finest for them and their dental health. His objective must always be to complete what exactly is correct by his patients so that their teeth and gums remain in tip-top form and their smiles will last a lifetime sherman oaks dentist.
Source: bloghi.com

Lingle vs Hirono: An Historically Rare, Important Election

Lingle however, does not believe gays should have the right to marry. She famously vetoed a Hawaii Civil Unions Bill in 2010, two years before a similar measure would be signed into law by her successor, Governor Neil Abercrombie. Lingle favors voter referendums on the issues of gay marriage and civil unions. Such referendums are popular with conservatives, as they often contradict national polling data that shows an increasingly tolerant view of US citizens toward same-sex unions.
Source: mauinow.com

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

Some 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

‘God sent his Son,’ and we have Hawaii birth certificate to prove it!

There also was the development during Obama’s campaign when a website called “Is Barack Obama the Messiah?” captured the wave of euphoria that followed the Democratic senator’s remarkable rise. The site was topped by an Obama quote strategically ripped from a Jan. 7, 2008, speech at Dartmouth College just before the New Hampshire Primary in which he told students, “A light will shine through that window, a beam of light will come down upon you, you will experience an epiphany, and you will suddenly realize that you must go to the polls and vote” for Obama.
Source: itmakessenseblog.com

Barack and Michelle Obama move to Hawaii after White House — already shopping for house

Democrats are already working to locate an acceptable property in Hawaii for the Obamas to live; this land and its complex of buildings must be ready to move-into in January and must meet all the requirements the Secret Service demands since the Obamas will be granted continued protection, by law, for nine years after Barack leaves office. The Reagans, Clintons, and second Bush family all had their post-presidential homes purchased quietly on the side by friends when their times in office were coming to an end. The Obamas are doing the same thing now.
Source: wordpress.com

Public comment sought on Medicaid

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Source: hawaii247.com

Beacon CEO on Paul Ryan’s Medicare proposal

Posted by:  :  Category: Medicare

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Source: beacontn.org

Video: Tennessee Medicare Supplement

Do You Have Access to Affordable Primary Care?

Better Access. Our practice uses modified open-access scheduling (open appointment times for walk-ins), which we find beneficial for several reasons. It gives patients who might otherwise go to urgent care or to the emergency department for non-emergent care an easier access to be seen quickly. Patients appreciate being able to see their primary care provider on a same-day basis, especially when going to an urgent care or emergency department can be much more costly for them. Our accessibility increases patient satisfaction and loyalty. Many patients, who need brief encounters such as flu shots and blood draws, appreciate the short wait time for these services and being able to see their personal healthcare provider that knows their medical history. Because of the time spent with patients, we can ensure continuity and adherence to current treatment guidelines.
Source: tnhealthandwellness.com

Tennessee Guerilla Women: Ronney’s VP Pick: Enemy of Medicare

Let the campaign begin. Romney is announcing Paul Ryan as his VP choice, as I write. In other words, the all male, all white Romney team hopes to slash Medicare and all social safety net programs that are not designed for Romney’s fat-rat buddies. Are you paying attention Florida?
Source: blogspot.com

Tennessee Federal Judge Grants Relator Attorney Fees In Medicare Case

NASHVILLE, Tenn. – A Tennessee federal court judge on Aug. 16 granted the relator’s counsel’s request for attorney fees in a False Claims Act (FCA) case alleging violations of the Medicare Act but reduced the amount requested (United States of America ex rel. Karen J. Hobbs v. Medquest Associates Inc., et al., No. 06-1169, M.D. Tenn.; 2012 U.S. Dist. LEXIS 116056). Full story on lexis.com
Source: lexisnexis.com

Boisterous Medicare debate dominates House races

Republicans have a tight grip on control of the House – 240 seats to 190 for the Democrats with five vacancies. Democrats need a net of 25 seats to reclaim control. But Republicans and Democrats alike see the GOP maintaining control of the House, with Democrats perhaps gaining upwards of 10 seats or Republicans picking up a handful.
Source: wmctv.com

House Calls Nurse Practitioner Tennessee

HouseCalls practitioners conduct in-home health assessments on enrolled Medicare Advantage members.  A HouseCalls practitioner will complete visits on members within a geographic area of responsibility.  The nature of the HouseCalls visit can vary and could include performing an annual health assessment, a post discharge visit, or visiting more complex members more than once per year. 
Source: careers.org

Rep. ‘Kerry’ Keisling doesn’t like Medicare

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Source: bengarrett.net

UNDERDOG: ANDY HOLT ~ DAMAGE CONTROL~ VOTE MADDOX

Romney, the Republican presidential nominee, has endorsed his running mate’s budget that cuts benefits and privatizes Medicare through vouchers. The non-partisan Congressional Budget Office found the Ryan plan would raise health care costs for seniors by $6,400 each year.
Source: blogspot.com

Charging seniors more is not "saving Medicare"

The nonpartisan Congressional Budget Office has estimated that the 2011 Ryan/DesJarlais plan for Medicare would lead to seniors paying an additional $6,300 out-of-pocket annually. The CBO has not evaluated the 2012 budget proposal but said that it too could lead to higher out-of-pocket costs to our seniors. Given the out-of-pocket expenses in the 2011 Ryan/DesJarlais proposal that moves to full privatization of Medicare, there’s no reason to expect anything but increased costs to seniors under their current hybrid-privatization model.
Source: nooga.com

TENNESSEE MEDICARE SUPPLEMENT

Clear plastic retainers have been used for years to help people keep their teeth straight and looking great. Any mouth appliance is going to form a build up of bacteria after a while, and keeping them clean is essential to having a healthy mouth. Instead of toiling away scrubbing and brushing these devices, you can use a product called Retainer Brite. The product comes in individually sealed foil packets that contain a tablet. The tablet is dropped into a cup of warm water and the effervescent effect will clean the retainer to a sparkling shine. The product is specifically made for retainers and other mouth appliances so it has the proper PH rating so as to not do any damage.
Source: tennesseemedicaresupplement.com

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

Posted by:  :  Category: Medicare

Bubbles? Take something like 'Not I! ...item 1.. Wakulla Republicans Protest Against Taxes in the County (September 06, 2011) ... by marsmet552Some 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: Medical Billing Minute – Elimination of Medicare Consultation Codes

Avoid Medicare Fraud Claims by Coding Correctly

You may believe you are beyond reproach if you don’t order a mobile scooter for every patient or dump your patient records in the nearest landfill, but you should exercise caution in these cautionary times: what the feds consider "fraud" is much broader than your definition. E&M coding, for instance is a potential target; the 99213 and 99214 office follow-up codes were the top two CPT codes in terms of both charges and unit volume in 2010. Don’t let your practice be caught up in Medicare’s recovery program. It’s a simple matter to examine your own coding patterns and compare them to national utilization data collected by Medicare. Knowing how you compare to others within your specialty is important in assessing possible exposure to recovery efforts.
Source: physicianspractice.com

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

How much the penalty adjustment payment under ERx incentive program.

How much is the payment? An individual eligible professional may qualify to earn an incentive payment or receive a payment adjustment equal to a percentage of the total estimated Medicare Part B allowed charges for covered professional services furnished by the eligible professional during the respective reporting period. The incentive payments for successful electronic prescribers for each authorized year are displayed in the following table. 2009 2.0% 2010 2.0% 2011 1.0% 2012 and 2013 1.0% In addition to the eRx incentive payment, beginning in 2012 a PFS payment adjustment applies to those who are not successful electronic prescribers for the payment adjustment reporting period. The payment adjustments for eligible professionals who are not successful electronic prescribers for each authorized year are displayed in the following table. 2012 1.0% 2013  1.5% 2014 2.0% An eRx payment is a lump sum payment based upon allowed charges for all covered professional services (paid under or based upon the Medicare PFS only), not just those charges associated with eRx events. It is calculated at the individual eligible professional level using individual NPI data, and (beginning in 2010) for group practices participating in the eRx GPRO, at the group practice level using TIN data. CMS uses the TIN as the billing unit so that individual incentive payments for groups that bill under one TIN are aggregated and paid to the TIN holder of record (regardless of whether the incentive payment was earned by an individual eligible professional or a group practice). Because some individuals may be associated with more than one practice, and CMS makes an incentive payment for each unique TIN/NPI combination, an eligible professional who qualifies for the eRx incentive payment under more than one TIN could receive a separate eRx incentive payment associated with each TIN.
Source: medicalbillingcptmodifiers.com

Healthcare costs and billing

“Privatization is the political preference because private corporations can give campaign contributions and government entities can’t. We are paying ten times the dollars for Blackwater, Bechtel and Halliburton to perform the same functions our troops could be performing in Iraq. Why? Because the US Army cannot give campaign contributions. Get the political money out of the system, and if privatization continues because it makes more sense than creating another government bureaucracy, then fine. But if it continues because political cash is flowing, then it likely wasn’t needed in the first place.” Jack Lohman
Source: moneyedpoliticians.net

Wireless DX Monitoring: CMS

Posted by:  :  Category: Medicare

 Wireless DX Monitoring states it provides cardiac event monitoring.  However CRE has been advised that its services are virtually worthless.  One of our  readers was provided with a unit that had a deficient battery. The battery was replaced but the unit was not providing information to the recording units. The problem—the user was not in a service area serviced  primarily by AT & T.
Source: thecre.com

Video: AT Network Brown Bag on Medicare Competitive Bidding

Brad DeLong: Josh Barro Says Opinions

The real landscape on Medicare is this: Both parties want to cut Medicare…. There are two key falsehoods in the Democratic message on Medicare. One is Obama’s oft-repeated claim that the Patient Protection and Affordable Care Act “won’t touch your guaranteed Medicare benefits. Not by a single dime.” That’s true only with a tortured definition of “guaranteed Medicare benefits.” PPACA cuts Medicare spending by $716 billion, or about 10 percent over the next 10 years. It achieves these cuts in roughly equal parts by: eliminating subsidies for enhanced, private “Medicare Advantage” plans used by many seniors; reducing reimbursement rates to hospitals; and various other measures, including cutting payments to compensate hospitals for unpaid bills and payment rates for home health providers.
Source: typepad.com

Containing costs for Medicare via Competitive Bidding

  Health & Social Technologist, Strategist, Chief Instigator and Co-Founder HealthCamp Foundation. Check out http://healthca.mp – Get involved in your future Health Care now. Socially Empowering Health Care Engagement.
Source: posterous.com

Medicare's Competitive Bidding Confusion Confines Woman to Her Bed

The results of the program are a shortage of providers, which is causing delays in the services that seniors and disabled Medicare beneficiaries need to remain independent and living in their own homes. In addition, the pricing that won the bidding process is for the lowest quality equipment, leaving no opportunity to access new techology that can improve lives.
Source: legacyoxygen.com

Paul Ryan and the Problem With Competitive Bidding

Private corporations all rely on competitive bidding, and it just hasn’t done much to hold down costs. That’s because the real source of America’s high medical costs is the fact that we simply pay more than other countries for everything we get: more for doctors, more for procedures, more for hospital stays, more for drugs, and — yes — more for insurance. If you really want to hold down costs, you have to hold down costs at the source, and Paul Ryan’s Medicare plan has no mechanisms for doing this. It relies solely on competitive bidding, and there’s very little chance that this alone can keep Medicare costs from outpacing his "fallback" growth cap. It’s a near certainty that his growth cap will be the real mechanism for reining in costs.
Source: motherjones.com

Here’s Who Really Benefits When Republicans Change Medicare

The first major emergency endangering the continuance of Medicare occurred in 2008, when President Bush and the Republicans in Congress tried to block Democrats from halting a 10.6% cut, which Bush’s plan forced in the rate-schedule that traditional Medicare paid doctors for their services to their patients under Medicare. This pay-cut to doctors was expected to cause so many physicians to abandon traditional Medicare patients, that the traditional Medicare program would likely collapse. This pay-cut to doctors was scheduled to start on July 15th; but, just days earlier, on 9 July 2008, Bloomberg News bannered “Senate Votes Reversal of Cuts in Medicare Doctor Fees,” and reported that, “The Senate voted final passage of legislation that would halt a 10.6 percent cut in Medicare reimbursements to doctors.”
Source: businessinsider.com

David Brooks Badly Misrepresents the Romney/Ryan Medicare Plan

POSTSCRIPT: It’s worth repeating my assumption that what we’re really talking about here is Paul Ryan’s Medicare plan. The reason for this assumption is that Mitt Romney, almost literally, doesn’t have a plan of his own. If you read through his description, what you learn is that (a) all seniors will get a voucher to buy health insurance, and (b) that’s it. There are essentially no other details aside from the now pro forma assurance that current seniors won’t be affected. It’s really not even possible to assess this plan, let alone suggest that it shows "surprising passion" about reforming Medicare.
Source: motherjones.com

CMS (Medicare) Competitive Bidding Flawed

The two big problems with competitive bidding are: CMS sets the price of products based upon the median of winning bids, and bids are nonbinding. Essentially, that encourages low-ball bids submitted by providers who then withdraw from the process if median bids come in below their cost. Thus, the process “fails to generate competitive prices of goods and fails to satisfy demand,” the study said.
Source: toenrichlives.com

Effect of Medicare Competitive Bidding on Equipment & Supplies

The American Association for Homecare (AAHC) also expressed concern with the program. AAHC officials stated that the group has received “reports from hundreds of Medicare patients about difficulty finding local equipment and service providers, delays in obtaining medically required DME, and fewer choices when selecting equipment and providers.” Medicare officials, on the other hand, attributed only 151 of the calls made to Medicare in the last year to beneficiaries with dissatisfaction with the competitive bidding program that could not be resolved by a call center representative.
Source: ehealthinsurance.com

Educating the educators about Medicare’s competitive bidding program

The petition, signed by dietitians from all over the country, will be sent to key congressional committee leaders who have the ability to push for a Market Pricing Program score and influence change to the competitive bidding system. The signatures will accompany a letter that highlights the need for access to quality diabetic testing supplies and products of choice. It draws from an earlier survey by the American Association of Diabetes Educators that proved Medicare beneficiaries in the Round 1 bidding areas only have access on average to 38 percent of the supplies listed on the Medicare.gov website.
Source: vgm.com

Private Medicare Plans Find Success Despite Democrats’ Warnings

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

TX and OK Home Health Agencies: Beware of Home Health Compliance Risks

Posted by:  :  Category: Medicare

OBAMAS DEATH PANEL------ GUESS WHAT FOLKS IT'S ALIVE AND WELL---"CRAZY PALIN" NOT SO CRAZY NOW by SS&SSDespite the fact that most Texas home health agencies are doing their best to operate within the four corners of the law, there are still a number of providers who are continuing to engage in wrongdoing. Texas home health providers recently received significant negative media coverage for fraudulent and abusive billing practices allegedly committed by agencies within their ranks. As you may have heard, just last week a physician and several home health agency “recruiters” in the Dallas-Fort Worth area were indicted in the largest Medicare fraud scheme in history, allegedly totaling nearly $375 million for home health services either not needed or never provided. Additionally, it was noted that over 75 home health agencies to whom referrals were made have also been implicated in the wrongdoing.  Such an enormous scheme only further demonstrates the fact that fraudulent activity in home health services is continuing, despite the fact that most Texas home health providers are well-meaning organizations, trying in good faith to provide medically necessary services to our nation’s most sick and disabled. Nevertheless, such accusations only increase suspicion and scrutiny of the entire home health industry in this region.
Source: pmimd.com

Video: Rick Perry Hates Social Security, Medicare & Rules For Wall Street

Daily Kos: Slick Rendell lies again

Consider if one or more of these tags fits your diary: Civil Rights, community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don’t fit in any of these tags. Don’t worry if yours doesn’t.
Source: dailykos.com

Medicare rules for seniors leave hospitals in reimbursement limbo. A new program may change that

Currently, if Medicare decides that a hospital has billed it for inpatient treatment of a patient who should have received observation services, the facility can lose its entire payment and is not paid for the cost the observation care. That may prompt hospitals to put too many people in observation care, Medicare says in the rule announcing the pilot program. Under the pilot, the 380 hospitals participating will be able to rebill Medicare for observation services if claims for inpatient care are rejected.  Medicare officials want to see if that takes some of the pressure off hospitals.
Source: medcitynews.com

Viewpoints: Public Seeks Better Campaigns But Politicians Use ‘Schoolyard Rules;’ GOP’s Medicare ‘Flip

The New York Times: For Healthy Aging, A Late Act In The Footlights Many of us look forward to spending retirement expanding our world — traveling, trying what we never had time to do, taking classes that give us new knowledge and skills. These activities are not only desirable in themselves, they help us to live longer and healthier lives. But they are not within everyone’s reach. Absent money and a sense of possibilities, retirement can become more time to fill with television. “We see people without money, who had very hard lives, who are not aware of their own potential,” said Maureen Kellen-Taylor, the chief operating officer of EngAGE ,a program in the Los Angeles area that provides arts and other classes for some 5,000 people — the vast majority of them low-income — living in senior apartment communities (Tina Rosenberg, 8/15).
Source: kaiserhealthnews.org

Medicare Secondary Payer (MSP) Program: Proposed Rules for the Treatment of Funds Intended for Future Medical Expenses 

[1] See 77 Federal Register 35917 (June 15, 2012), [CMS–6047–ANPRM].  [2] See section 1862(b) of the Social Security Act (the Act), 42 U.S.C. §1395y(b)(2)(Medicare Secondary Payer Program) http://www.ssa.gov/OP_Home/ssact/title18/1862.htm. [3] 42 U.S.C. §1395y(b)(2)(B). [4] 42 U.S.C. §1395y(b)(2)(B)(i). [5] 42 U.S.C. §1395y(b)(2)(B)(iv). [6] 42 U.S.C. §1395y(b)(2)(B)(iii). [7] For information about CMS activity related to MMSEA, see http://www.cms.gov/Medicare/Coordination-of-Benefits/MandatoryInsRep/index.html?redirect=/mandatoryinsrep/. [8] See §111, 42 U.S.C. §1395y(b)(8). [9]  See 42 U.S.C. §1395y(b)(8)(B). [10]  See 42 U.S.C. §1395y(b)(7). [11] See, Reporting Workers Compensation case information: https://www.cms.gov/Medicare/Coordination-of-Benefits/WorkersCompAgencyServices/reportingwc.html; set-aside arrangements: https://www.cms.gov/Medicare/Coordination-of-Benefits/WorkersCompAgencyServices/wcsetaside.html; coordination of benefits: https://www.cms.gov/Medicare/Coordination-of-Benefits/WorkersCompAgencyServices/WCMSAP.html. [12] In commenting, please refer to file code CMS–6047–ANPRM. CMS will not accept comments sent via FAX. Comments may be submitted electronically to http://www.regulations.gov; via regular mail (Attention: CMS–6047–ANPRM P.O. Box 8013, Baltimore, MD 21244–8013); express or overnight mail (Attention: CMS-6047-ANPRM, Mail Stop C4-26—5, 7500 Security Boulevard, Baltimore, MD 21244-1850; or by hand or currier (Room 445– G, Hubert H. Humphrey Building, 200 Independence Avenue SW., Washington, DC 20201., telephone (410)-786-1066 in advance of delivery by hand or currier.)
Source: medicareadvocacy.org

IRS provides answers on the new 0.9% Medicare tax

Likewise, if former employees receive group-term life insurance in excess of $50,000, and the resulting income exceeds $200,000, you still don’t have to collect the additional tax from employees. You follow your normal procedure—report the income as wages on your 941 form and make a current period adjustment to reflect the uncollected taxes.
Source: businessmanagementdaily.com

FY 2013 Final Medicare Payment Rules for Inpatient Acute Care Hospitals

Low-Volume Hospital Adjustment – Under the final rule, the preexisting low-volume hospital qualifying criteria and payment adjustment, as implemented in FY 2005, will resume.  As such, in order to qualify for the adjustment, a subsection (d) hospital must be more than 25 road miles from another subsection (d) hospital and have fewer than 200 discharges.  The modified definition of a low-volume hospital and the methodology for calculating the payment adjustment for low-volume hospitals, effective only for discharges occurring during FYs 2011 and 2012, will no longer be applied to payments for a hospital’s discharges beginning on or after October 1, 2012.  By September 1, 2012, a hospital must make its request in writing to its MAC or fiscal intermediary for low-volume hospital status in order to receive the 25 percent low-volume add-on payment.
Source: jdsupra.com

Medicare Issues Proposed Rules on “Future Medicals” : Day On Torts

The Centers for Medicare & Medicaid Services have issued proposed rules to address the issue of how Medicare beneficiaries will protect Medicare’s interest when future medical care is claimed or the settlement or judgment released (or has the effect of releasing) claims for future medical care.
Source: dayontorts.com

How Workers Compensation is Affected by Medicare Set Asides

The Mandell Law Firm, in Northridge, is an aggressive personal injury and wrongful death law firm serving clients throughout the San Fernando Valley, the Greater Los Angeles area, and Southern California. If you or a family member is involved in a workers compensation settlement that might include a Medicare Set Aside, Mara Burnett can help. Experienced and reputable, Mara and the other attorneys at Mandell Law provide hands-on care and a sincere commitment to victims of accidents. Contact Mara Burnett for a free consultation at 818.866.6600.
Source: mandellaw.com

Medicare Launches Pilot Project Relaxing Hospital Payment Rules

A growing number of seniors have been forced to tap into their savings while receiving long term care after a hospital stay because they are classified as observation patients. Under Medicare rules, patients must have at least three days in the hospital as an inpatient to qualify for nursing home care upon discharge.
Source: wordpress.com

Brad DeLong: Josh Barro Says Opinions

The real landscape on Medicare is this: Both parties want to cut Medicare…. There are two key falsehoods in the Democratic message on Medicare. One is Obama’s oft-repeated claim that the Patient Protection and Affordable Care Act “won’t touch your guaranteed Medicare benefits. Not by a single dime.” That’s true only with a tortured definition of “guaranteed Medicare benefits.” PPACA cuts Medicare spending by $716 billion, or about 10 percent over the next 10 years. It achieves these cuts in roughly equal parts by: eliminating subsidies for enhanced, private “Medicare Advantage” plans used by many seniors; reducing reimbursement rates to hospitals; and various other measures, including cutting payments to compensate hospitals for unpaid bills and payment rates for home health providers.
Source: typepad.com

Brad DeLong: The Policy Substance Underlying Today’s Politics

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 marsmet524Hey seniors! The Republican platform calls for turning Medicare into a voucher program and for eliminating important benefits for you–they want to reopen the Medicare drug “donut hole”. They would want to raise your Medicare premium by an average of $577/yr a decade from now. Why? Because they seem hell-bent on restoring $716 billion in wasteful Medicare payments to insurance companies and over-treating specialists. We don’t know the full details. They won’t tell us. Republicans’ rhetoric and plans keep shifting as the American people responds with dismay to what Republicans propose. It won’t be good. We do know that two-thirds of Medicaid dollars are used to care for the elderly and the disabled, and that the Republicans have pledged to cut Medicaid dramatically.
Source: typepad.com

Video: Medicare Supplement Insurance, Medicare Advantage Plans

Medicare and Medicaid Costs (Utility Post)

The go-to source on Medicare Advantage is the official Medpac report (pdf), which currently finds MA plans costing on average 7 percent more than conventional Medicare. This is less than the premium a few years ago; apparently (pdf) because several changes in Medicare policy more or less incidentally put the squeeze on MA plans. So far those plans are still expanding, but time will tell.
Source: nytimes.com

Auditors call for end to Medicare bonus program

Medicare “believes the demonstration supports our national strategy to improve the delivery of health care services, patient health outcomes, and population health,” the Health and Human Services department said in its formal response to the GAO report. “Absent this demonstration, we believe that many plans would not have an immediate incentive to improve the quality of care delivered to (Medicare Advantage) enrollees.”
Source: seattletimes.com

Registration Due for Medicare Seminar

The program, titles “Welcome to Medicare” will be presented by Crossroads’ SHIPP volunteers. The program will cover Medicare Parts A, B, and D, as well as Medicare Advantage plans and Medicare supplemental insurance. Registration for the September 22nd program is required by next Tuesday.
Source: kniakrls.com

IRS provides answers on the new 0.9% Medicare tax

Posted by:  :  Category: Medicare

Likewise, if former employees receive group-term life insurance in excess of $50,000, and the resulting income exceeds $200,000, you still don’t have to collect the additional tax from employees. You follow your normal procedure—report the income as wages on your 941 form and make a current period adjustment to reflect the uncollected taxes.
Source: businessmanagementdaily.com

Video: Medicare Online

Does Paul Ryan Want to Take Medicare Away From Seniors?

The Obama administration’s plan and Romney’s proposal, which is very similar to the proposal introduced by Congressman Ryan and Senator Ron Wyden (D-Ore.) in 2011, both recognize the need for holding down Medicare costs, but each takes a different approach. President Obama’s plan maintains traditional Medicare while seeking to use the power of the federal government to control prices and implement a variety of cost-control provisions aided by various positive and negative inducements. The Republican plan shifts costs from the government to beneficiaries, replacing traditional Medicare with vouchers whose value will grow more slowly than medical costs have been growing.
Source: thelandofthefree.net

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

Readily Navigate Medicare Supplemental Plans Online

It is not clear as to why Medigap insurance is vital is it. The above states Part A covers the hospital, Portion B covers the physician; what else is there? This can be where Medicare Insurance coverage becomes tricky for quite a few individuals new for the method. For example Medicare Portion A demands patients cover a deductible if admitted into the hospital. Existing estimates state that deductible is near $1500. This deductible only covers care inside a sixty day period. For example, say you might be readmitted on the sixty first day after you had been released you happen to be required to repay the $1500 deductible. It’s not a deductible that is definitely on an annual basis like a lot of prior insurance coverage plans supplied by employers. Portion B leaves a gap for it fails to cover the very first twenty percent of all doctors’ bill and the annual deductible of about $160 which continues to rise every year. It’s evident that extra coverage is needed to fill in the gaps left by the typical Medicare Aspect A and B. This is where the distinct Medicare Supplement Insurance plans come into play. It truly is vital when hunting into each plan that you simply are in a position to compare Medicare Supplemental Insurance plans and compare rates. Medigap, as it is normally identified, is provided for obtain by way of several distinctive private insurance organizations. One particular factor you have to don’t forget is the coverage is equivalent regardless of exactly where it is bought. If you’re comparing rates and plans and decide on Medicare Supplemental Insurance coverage Strategy f from BC/BS it really is exactly the same coverage as you might get with Bankers Fidelity. The distinction lies inside the rate charged for their services. You will need to figure out when you are prepared to pay added for precisely the same coverage as a way to possess a particular insurance provider. For far more info about hospital plans, Read More
Source: fc2.com

Chart: Medicare Spending Is Main Cause of Runaway Deficits

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Source: heritage.org