Business: Air Ambulance Medicare Coverage: The Basics

Posted by:  :  Category: Medicare

Deal 3, Table 7: Initiation enter Trick A~ contract taker leads King of Risks by KevinHutchins314It is of much importance here to note that Medicare caters to emergency medical transportation only under certain circumstances: if the patient’s location is not easily accessible by land transportation, if the patient is in an intensive care situation and the use of other means of transportation would endanger his/her life, and finally if speediness of the means of transportation is a significant factor in the person’s welfare. In each of the scenarios described here, air would be the most appropriate medium to use in order to avoid congestions that would have been experienced if ground transportation were used.
Source: blogspot.com

Video: Medicare Fundamentals

New E.M.T. Coverage Debuts Tonight in Holiday City

The EMT service will come at no cost to taxpayers, unlike MONOC paramedics, who billed residents separately for their services. The new EMT service will bill Medicaid for the cost of answering calls. Residents will not have to pay above and beyond what Medicare pays, township officials have said.
Source: patch.com

Number of Americans with Insurance Coverage Up in 2011

According to new data by the U.S. Census Bureau, the percentage of people with health insurance in the U.S. increased for the first time since 2007, moving to 260.2 million insured people in 2011 from 256.6 million in 2010. That means that the percentage of people with health insurance grew from 83.7 percent in 2010 to 84.3 percent in 2011. Not all states saw increases in their rates – 18 states saw a decrease in the percentage of their population covered by insurance from 2010 to 2011 while 29 states saw an increase and three saw no change.
Source: csg.org

The Best Home Health Care: Five Things To Consider When Integrating Your Home Health Care With Medicare

Medicare can be perplexing, all the more so when you combine complex health issues and the need for medical aids such as oxygen or hospital beds. While the insurance maze can be difficult to traverse, an estimated 47.5 million people received this program in 2010, which is more than a sixth of the nation’s population. Here is a brief overview and some answers to some commonly asked questions regarding Medicare and home health care. 1. Who qualifies? Medicare is a national health insurance program provided by the U.S. government for those who are: – 65 and older – Under 65 with certain disabilities – Diagnosed with End Stage Renal Disease (ESRD), a form of permanent kidney failure requiring dialysis or a kidney transplant 2. What types of services does Medicare cover? Medicare has four different coverage sections: Part A, B, C, and D. “Original Medicare” consists of Part A & B, while Part C is known as “Medicare Advantage Plan”. These four parts are summarized briefly: – Medicare Part A: Hospital Insurance * Part A covers care while in hospital as well as health care in skilled nursing facilities, home health care, and hospice. – Medicare Part B: Medical Insurance * Part B covers doctor’s visits as well as visits to other health care providers. Additionally, Part B covers hospital outpatient care, durable medical equipment (like intravenous infusion devices), and home health care services. Part B also covers specific types of preventative services, such as getting certain vaccinations. – Medicare Part C: Medicare Advantage * Part C combines health plan options you purchase from other private insurance companies approved by Medicare. Part C also integrates Medicare Prescription drug coverage (Part D) and can be tailored to include extra benefits at an extra cost. – Medicare Part D: Medicare Prescription Drug Coverage * Part D covers the prescription of Medicare-approved prescription drugs and can lower the cost of other medications. Similar to Part C, Medicare-approved private insurance companies also run Part D. 3. Why do I need to choose between Medicare plans? The choice of “Original Medicare” (Parts A & B) entails payment of monthly premiums for part B and may necessitate additional coverage to pay deductibles and coinsurance to see physicians, hospitals, and other providers who accept Medicare. If you require Prescription drug coverage, you must pay a monthly premium to join the Medicare Prescription Drug Plan (Part D). The “Medicare Advantage Plan” (Part C, which covers Part A & B), also requires the payment of monthly premiums in addition to the Part B premium & a copayment for in-plan doctors, hospitals. If prescription medications are not covered by your supplemental coverage, you have the option of joining the Medicare Prescription Drug Plan (Part D). As with prescription medications, you can purchase supplemental coverage to cover services not covered by Medicare. The “Original Medicare” plan allows for the option of buying Medicare Supplement Insurance (Medigap), while the “Medicare Advantage Plan” does not. It is prudent to always check if you can take advantage of other additional coverage through your employer or union, military, or Veteran’s benefits. 4. Is home health care covered by Medicare? The Medicare website states, “Medicare only covers home health care on a limited basis as ordered by your doctor”. As reviewed earlier, Parts A & B are the Medicare options which cover the home health care services specified by Medicare. Coverage of home health care by Medicare in New Mexico stipulates you must meet the following criteria: – You are currently receiving regular services from a physician. This physician must also maintain a care plan unique to you, which is reviewed regularly. – Your physician must certify a “need” for specific medical services such as requirements for intravenous medication therapy, physical therapy, occupational therapy, respiratory therapy, or speech-language pathology services. – The home health care agency providing you services must be Medicare-certified (for more details see below). – Your physician must certify your health status as homebound, which is indicated by the following: * Your health condition limits you from leaving the house. * You are unable travel from home without help (i.e. transportation assistance such as aids or individuals). * Leaving your home takes considerable effort and may be detrimental to your health condition. 5. My home health company does not take Medicare, why is this? The Medicare-approval process is lengthy and costly, so while it may appear that many companies may not take Medicare, they may actually be in the process of becoming Medicare certified. Furthermore, the Medicare criteria for individual qualifying to receive home health care are very strict; the reality is that many people who may apply for coverage by Medicare for their approved home health company services will not actually receive coverage. Currently, Medicare pays only about half of all health care costs to seniors. Medicare very often denies payment due to not meeting criteria, so it is essential to be aware if you meet these criteria prior to restricting yourself exclusively to Medicare-approved home health care companies.
Source: blogspot.com

Rep. Henry Waxman Discusses Obamacare, Medicare, Medi

There was a lot of misinformation about death panels, which the Tea Party people and the Republican organization argued was part of this bill, and it’s not. There’s a lot of misconception because a lot of misinformation has been given about the legislation and people get nervous when there’s going to be something new and something big. They don’t like the idea of the whole bill, but if you ask people what they think of all the parts of the legislation, it’s wildly popular. People support the idea of giving heath care insurance availability to people with pre-existing conditions and stopping the insurance companies from discriminating. People support all of these different elements of the bill.
Source: patch.com

Does Medicare help with transportation costs?

Transportation costs are considered allowable expenses under Medicare Part B. Knowing the facts can be both a timesaver and money saver when it comes to meeting your medical needs. There are tips to help with transportation costs, things you should know about your coverage and the ways to find transportation that is covered under Medicare. It is important to know that Medicare does help with transportation costs if you know where and how to look for these resources.
Source: todaysseniors.com

Medicare Part D Notice of Creditable Coverage

If you are an employer that provides prescription drug coverage to employees and their dependents as part of your employer-sponsored health insurance plan, you must notify all of your Medicare-eligible employees and dependents of their options regarding Medicare Part D prescription drug coverage.  Since it is difficult to know for sure who among your employees and their dependents may be Medicare eligible, we recommend sending this notice to all participants in your employer-sponsored health insurance plan.
Source: holdenagency.com

Medicare Policies Continue To Claim Campaign Trail Attention

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSThe Washington Post’s The Fact Checker: Romney’s Medicare Remarks: Would He Pass Costs On To Seniors Or Not? GOP presidential candidate Mitt Romney faced questions about his policy proposals during an interview that aired Sunday on NBC’s “Meet the Press.”… The Ryan plan would eventually cap government payments toward Medicare and provide future generations of seniors with premium-support payments …  to purchase coverage through traditional Medicare or on the private market. (David) Gregory asked Romney: “If competitive bidding in Medicare fails to bring down prices, you have a choice of either passing that cost on to seniors or blowing up the deficit. What would you do?” … Romney pointed to Medicare Advantage and Medicare Part D as proof that competitive bidding works to bring down costs. Let’s look at how those entitlement programs impact federal spending and determine how much they really compare to the Ryan plan (Hicks, 9/13).
Source: kaiserhealthnews.org

Video: Shop and Compare Medicare Insurance Plans

Getting answers to your Medicare questions

With Medicare open enrollment season coming up (it runs from Oct. 15 to Dec. 7), you may be thinking about joining a Medicare health or drug plan, or switching from one plan to another. SHIP can help you choose a plan that best meets your needs in terms of cost, coverage and convenience. A counselor can sit down with you and help you compare various plans until you find the right one. They also can help you enroll in that plan.
Source: thisisreno.com

The Senior Insider: Are all Medicare Advantage Plans the same?

It pays for you to take a close look at the information you will soon be receiving in the mail about your Medicare Advantage or Prescription plan. You’ll want to compare your plan’s benefits and premiums to last year’s. Also, double check to make sure the doctors, hospitals and other medical facilities you prefer are still included in your plan.
Source: blogspot.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

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

California Medicare Supplement Plans Blue Shield

each month for 12 months on your Medicare Supplement Plan rates.To qualify, you must be age 65 or older, and Blue Shield must receive your application within six (6) months of the date you first enrolled for benefits under Medicare Part B. Savings will be effective for the first twelve 12 months of your plan dues.The Welcome to Medicare Rate Savings is available for all Medicare Supplement Plans that Blue Shield of California offers. You can also take advantage of our two-party rates and Easy$Pay
Source: mattlockard.net

New Study: Dems’ Brutal Medicare Cuts to Pay For ObamaCare Hit Your Hometown

“We are concerned that, by removing Congressional authority over the Medicare payment system and placing such unprecedented authority in an unelected body, quality care for our patients will be jeopardized.  We are equally concerned with the potential that physicians may be subjected to a double jeopardy in  Medicare payments if IPAB cuts  are  coupled with those projected under the current sustainable growth rate (SGR). The current instability and inequities in Medicare physician payments is hindering access to care for millions of Medicare beneficiaries.  IPAB would only exacerbate this problem.” 
Source: nrcc.org

Brutally Honest SWAG (Scientific Wild

USA Today: It’s no surprise that Medicare has become a big campaign issue — it is somewhat surprising that the Republicans are pushing it. GOP presidential candidate Mitt Romney, running mate Paul Ryan, and other Republicans are stressing $716 billion in cuts to Medicare that are part of President Obama’s health care plan. That attack has forced Obama and company to play defense, even as they emphasize that Romney and Ryan want to turn Medicare into a voucher program that will cost seniors thousands of dollars a year.
Source: blogspot.com

Medicaresupplementalplans.com: Medicare Supplemental Insurance @ SEOValidator.Net

Medicare Supplemental Insurance, California, Medicare Supplemental Comparison, Medigap Insurance, Medigap Insurance Plans, Medicare Supplemental Plans, Medicare Insurance, Best Medicare Plans, Medicare Plans, Supplemental Medicare, Anthem Blue Cross, Blue Shield, AARP, Health Net, Aetna, Mutual of Omaha
Source: seovalidator.net

'''''Medigap Rates Age 65 and Older

Our Macon female can purchase Medicare supplement plan N for as little as $71 per month but she will not be able to purchase that plan from Mutual of Omaha or Gerber. You may know friends or relatives who bought these plans in the past but these carriers no longer offer plan N and have targeted current policy holders for significant ongoing rate increases, in some cases as high as 40%.
Source: georgia-medicareplans.com

Medicare Supplement Insurance

When you go out on the net searching for the perfect strategy, that you are probably to land on internet websites that have only 1 target and that may be to collect your individual details. Why do they want to do this? You can find plenty of insurance coverage agency who do not know how to find new company, so naturally, they have to buy leads from somebody who does. Quite a few of those businesses make it look like they are selling medicare supplement insurance, but in reality, they may be only promoting your name and number to a bunch of agents.
Source: aifomd.org

GRAY MATTERS: Things to know about the Medicare Enrollment Period

Medicare beneficiaries will be receiving mail in September from their current insurance company. Most important is the annual notice of change that will outline what the changes are for them for 2013. Beneficiaries can review the information to make sure their current plan will be a good choice, or may want to see if changing to another plan might offer better coverage and save them money for 2013.
Source: times-standard.com

Medicare Prescription Drug Coverage Is Here!

Posted by:  :  Category: Medicare

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Source: drillkey.com

Video: The National Medicare Training Program: Medicare and Immunosuppressive Drug Therapy. Part 1 of 2

Medicare Prescription Drug Coverage Is Here!

above ground pool accessories above ground swimming pools advertisers analysis argan oil hair article buy here chiropractic coaching chiropractic marketing click here consumers division follow us on twitter go here go there human resources manager ibs treatment investing in real estate jump button like i said megan fox biography more information new york web design next official link open in a new browser patent pending payday loans principles read this real estate investing training remove frames return to site site site preview swimming pools above ground tell us what you think the best this month this page is not affiliated TM via visit link web design new york worth reading
Source: darkandrich.com

Getting answers to your Medicare questions

With Medicare open enrollment season coming up (it runs from Oct. 15 to Dec. 7), you may be thinking about joining a Medicare health or drug plan, or switching from one plan to another. SHIP can help you choose a plan that best meets your needs in terms of cost, coverage and convenience. A counselor can sit down with you and help you compare various plans until you find the right one. They also can help you enroll in that plan.
Source: thisisreno.com

Maximizing Medicare Prescription Drug Coverage

Medicare beneficiaries take an average of 29 prescriptions per year, spending approximately $1,300 on medications annually.[1] Individuals with chronic conditions such as heart failure often pay more than double that amount.[2]   Fortunately, there is a voluntary program called Medicare Part D that helps beneficiaries pay for their prescription drugs. Beneficiaries can access prescription drug coverage either from a stand-alone Part D prescription drug plan or from a Medicare Advantage plan that bundles coverage of medical, hospital and prescription drug benefits in one plan.   Enrolling in Part D prescription drug coverage is one way beneficiaries can help manage their prescription drug costs, but they should be aware that all Part D plans include a coverage gap, which is often called the “donut hole.” In the coverage gap, beneficiaries’ out-of-pocket costs on their prescription drugs increase significantly.   Summer is the time of year when many beneficiaries enter the coverage gap, making this an opportune time for beneficiaries with Medicare Part D to remind themselves of the following tips that may help them save money on their prescription drugs and make the most of their benefits.    1. Get Help with Managing Multiple Medications Beneficiaries who have a chronic condition that requires them to take multiple medications every day should consider enrolling in a Medicare Advantage Chronic Special Needs Plan. These specialized Medicare Advantage plans combine Medicare coverage with additional support services, some of which are designed to help ensure that members are able to afford their medications and understand how to take them as directed. Many Special Needs Plans also offer personalized pharmacist counseling and drug formularies designed for Medicare beneficiaries with complex health care needs.    2. Understand How the “Donut Hole” Works All Part D plans include a coverage gap. After spending $2,930 in out-of-pocket costs on their drug coverage, beneficiaries will reach the coverage gap. Currently, beneficiaries in the gap pay 50 percent of the cost of their brand-name prescriptions and 86 percent of the cost of generic drugs. In an effort to prepare for the increased expenses while in the gap, beneficiaries should monitor their plan’s Evidence of Coverage statement to get a clear sense of their drug expenditures and see how close they are to reaching the gap.   3. Apply for “Extra Help” with Drug Costs  For beneficiaries with limited income and resources, Extra Help is a federal program that provides an average of $4,000 of additional assistance with prescription costs. According to the Social Security Administration, many beneficiaries who qualify for this program don’t know they are eligible. Medicare beneficiaries must apply for this program, and the amount of assistance is based on annual income and assets. For more information about the Extra Help program, contact the Social Security Administration at 1-800-772-1213.   4. Take advantage of cost-savings on prescription drugs. Beneficiaries enrolled in a Medicare Advantage plan that includes drug coverage should check their plan details to see if they could save money on their prescriptions, such as by using mail-order pharmacy benefits, switching to generic or lower-tier drugs, or taking advantage of special programs available with some plans.   5. Explore “PAP” Programs Several pharmaceutical manufacturers sponsor Patient Assistance Programs (PAPs) that may reduce prescription drug expenses. Some companies offer financial assistance or free products, but all manufacturers have their own rules and grant assistance on a case-by-case basis. For more information, contact the Partnership for Prescription Assistance program at 1-888-477-2669.   For more information about Medicare Part D, contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day, seven days a week. The Arkansas State Senior Health Insurance Information Program (SHIIP) provides free counseling and support to help beneficiaries understand their Medicare coverage options, including prescription drug coverage. To contact the SHIP office in Arkansas, call 1-800-224-6330.    Ray Morris is the community outreach manager for Care Improvement Plus in Arkansas. Care Improvement Plus is a UnitedHealthcare Medicare Solution providing specialized Medicare Advantage coverage for underserved and chronically ill beneficiaries throughout Arkansas.  
Source: thecitywire.com

Medicare Prescription Drug Coverage Is Here!

. Appear for enrollment events in the area. Over the next handful of months, you are going to be able to get aid with your drug plan alternatives at dozens of areas throughout your community, like schools, senior centers, clubs, faith-based organizations, and your pharmacy. Or you can speak with pals and loved ones or contact your local office on aging for help. For the telephone number, check out www.eldercare.gov on the Web. The Eldercare Locator can help you discover locations to go to get personalized assistance.
Source: topreviews123.com

No Medicare Drug Plan Cost Increases For Seniors In 2013

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

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

Pitfalls in Billing Pharmaceuticals to the Medicare Program

It is clear there are multiple pitfalls for the compliant billing of pharmaceuticals to Medicare Part B. Hospitals need to ensure, to the extent possible, that their pharmacy CDM is accurate with correct HCPCS and revenue codes, that unit conversion modules or tables are set up correctly, that self-administrable drugs have been identified as such and revenue code fields are set to toggle between 637 and 250 based on bill type. Noncovered drugs should be billed to the patient, not Medicare. Drugs integral to the procedure should be set up as supply items, not billed as noncovered. Nursing documentation, including that on an electronic medication administration record, should indicate date, time and nurse responsible for administration and the amount of drug given—and wasted—if any. Only wasted drugs in single-dose vials can be billed to the program and only if documentation in the medical record meets the requirements. 
Source: bkd.com

Unitedmedicarerx.com:

united medicarerx, united healthcare, medicare rx plan, prescription drug plan, medicare part d, medicare plan part d, medicare prescription drug plan, medicare drug coverage, medicare drug plans, medicare eligibility, medicare enrollment, medicare part d
Source: seovalidator.net

Issue Worth Exploring: Raising the Medicare Eligibility Age May Harm Minorities

Posted by:  :  Category: Medicare

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Source: reportingonhealth.org

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

View from the Valley: Health district offers vaccine clinics

AETNA, Anthem Blue Cross/Blue Shield, ConnectiCare and Medicare Part B if it is the primary insurance plan. Clinic attendees should bring all of their insurance cards to better verify their eligibility for flu vaccine coverage by their insurer. Medicare HMO’s, United and Oxford Health Care will not be accepted this year. The cost of the flu vaccine for those with other forms of insurance is $20, payable by cash, check, Visa or MasterCard. All clinic attendees should wear loose fitting clothes with short sleeves.
Source: blogspot.com

Maximizing Medicare Prescription Drug Coverage

Medicare beneficiaries take an average of 29 prescriptions per year, spending approximately $1,300 on medications annually.[1] Individuals with chronic conditions such as heart failure often pay more than double that amount.[2]   Fortunately, there is a voluntary program called Medicare Part D that helps beneficiaries pay for their prescription drugs. Beneficiaries can access prescription drug coverage either from a stand-alone Part D prescription drug plan or from a Medicare Advantage plan that bundles coverage of medical, hospital and prescription drug benefits in one plan.   Enrolling in Part D prescription drug coverage is one way beneficiaries can help manage their prescription drug costs, but they should be aware that all Part D plans include a coverage gap, which is often called the “donut hole.” In the coverage gap, beneficiaries’ out-of-pocket costs on their prescription drugs increase significantly.   Summer is the time of year when many beneficiaries enter the coverage gap, making this an opportune time for beneficiaries with Medicare Part D to remind themselves of the following tips that may help them save money on their prescription drugs and make the most of their benefits.    1. Get Help with Managing Multiple Medications Beneficiaries who have a chronic condition that requires them to take multiple medications every day should consider enrolling in a Medicare Advantage Chronic Special Needs Plan. These specialized Medicare Advantage plans combine Medicare coverage with additional support services, some of which are designed to help ensure that members are able to afford their medications and understand how to take them as directed. Many Special Needs Plans also offer personalized pharmacist counseling and drug formularies designed for Medicare beneficiaries with complex health care needs.    2. Understand How the “Donut Hole” Works All Part D plans include a coverage gap. After spending $2,930 in out-of-pocket costs on their drug coverage, beneficiaries will reach the coverage gap. Currently, beneficiaries in the gap pay 50 percent of the cost of their brand-name prescriptions and 86 percent of the cost of generic drugs. In an effort to prepare for the increased expenses while in the gap, beneficiaries should monitor their plan’s Evidence of Coverage statement to get a clear sense of their drug expenditures and see how close they are to reaching the gap.   3. Apply for “Extra Help” with Drug Costs  For beneficiaries with limited income and resources, Extra Help is a federal program that provides an average of $4,000 of additional assistance with prescription costs. According to the Social Security Administration, many beneficiaries who qualify for this program don’t know they are eligible. Medicare beneficiaries must apply for this program, and the amount of assistance is based on annual income and assets. For more information about the Extra Help program, contact the Social Security Administration at 1-800-772-1213.   4. Take advantage of cost-savings on prescription drugs. Beneficiaries enrolled in a Medicare Advantage plan that includes drug coverage should check their plan details to see if they could save money on their prescriptions, such as by using mail-order pharmacy benefits, switching to generic or lower-tier drugs, or taking advantage of special programs available with some plans.   5. Explore “PAP” Programs Several pharmaceutical manufacturers sponsor Patient Assistance Programs (PAPs) that may reduce prescription drug expenses. Some companies offer financial assistance or free products, but all manufacturers have their own rules and grant assistance on a case-by-case basis. For more information, contact the Partnership for Prescription Assistance program at 1-888-477-2669.   For more information about Medicare Part D, contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day, seven days a week. The Arkansas State Senior Health Insurance Information Program (SHIIP) provides free counseling and support to help beneficiaries understand their Medicare coverage options, including prescription drug coverage. To contact the SHIP office in Arkansas, call 1-800-224-6330.    Ray Morris is the community outreach manager for Care Improvement Plus in Arkansas. Care Improvement Plus is a UnitedHealthcare Medicare Solution providing specialized Medicare Advantage coverage for underserved and chronically ill beneficiaries throughout Arkansas.  
Source: thecitywire.com

Is Medicare Health Insurance?

Medicare coverage is broken down into four parts identified simply as Part A, Part B, Part C and Part D. Part A involves hospital stays and sometimes rehabilitation following hospital discharge. Regular medical coverage like doctor’s visits for check-ups or sickness are issued through Part B as well as certain equipment needs, like wheelchairs. These perform much like other health plans with monthly premiums and co-pay per visit. Part C is also referred to as Advantage Plans which are contracts with private insurance companies and include PPO networks and the like. Part D is the prescription drug plan which, again, works very much like any other insurance where you pay a small co-payment at the pharmacy.
Source: seniorcorps.org

Low Cost Health Insurance Plans and Companies: Tackling Rising Health Care Costs

This week, the New York State Health Foundation (NYSHealth) released a report by the Medicare Rights Center detailing our contributions towards creating a new, more streamlined Medicaid application process for people in New York State. In addition, the report outlines steps other states can take to implement improved eligibility and enrollment systems. Under the Affordable Care Act (ACA), states are required to build a new, simplified Medicaid enrollment system that will make it easier and quicker for a segment of the Medicaid-eligible population to enroll. The mandate does not, however, extend to dual-eligibles, or people with both Medicare and Medicaid. In some states, this oversight may result in a bifurcated Medicaid program: a streamlined enrollment system for most people with Medicaid, and an antiquated, more onerous process for dual-eligibles.   The report explains how creating a bifurcated Medicaid system would be costly to both states and dual-eligibles. Duals would be more likely to lose their coverage or be denied coverage solely because of a complicated enrollment process.   With the support of NYSHealth, Medicare Rights worked with state and federal partners to ensure that New York will establish a single Medicaid enrollment system for all Medicaid beneficiaries, including dual-eligibles. In addition, in part due to Medicare Rights’ advocacy efforts with federal policymakers, federal guidance now moves all states in the direction of a uniform Medicaid program and prohibits states from using federal funds to maintain two enrollment systems.    To assist other states in building an improved Medicaid enrollment system by 2014, Medicare Rights developed a set of recommendations that can make these systems more responsive to people with Medicare. The recommendations include simplifying the application and renewal processes for all Medicaid applicants, including duals, and utilizing electronic data sharing to verify eligibility, thereby reducing the burden on beneficiaries to prove information that may already be available to states.    “Creating a single system not only ensures dually eligible beneficiaries have access to a simpler, more streamlined application and enrollment process, but it also saves state dollars by operating one system, rather than two,” said Doug Goggin-Callahan, Director of Education and NY State Policy at Medicare Rights. “By creating a single system, states achieve both equity and cost-savings.”   Read the NYSHealth report, “Lessons from New York: Building a Better Medicaid Eligibility and Enrollment System for Duals.”
Source: blogspot.com

New Study: Dems’ Brutal Medicare Cuts to Pay For ObamaCare Hit Your Hometown

Posted by:  :  Category: Medicare

Providence RI Tax Day Teabagging event by kd1s“We are concerned that, by removing Congressional authority over the Medicare payment system and placing such unprecedented authority in an unelected body, quality care for our patients will be jeopardized.  We are equally concerned with the potential that physicians may be subjected to a double jeopardy in  Medicare payments if IPAB cuts  are  coupled with those projected under the current sustainable growth rate (SGR). The current instability and inequities in Medicare physician payments is hindering access to care for millions of Medicare beneficiaries.  IPAB would only exacerbate this problem.” 
Source: nrcc.org

Video: Senate Hearing: Medicare.avi

Hospital Receives Extra $1.3M in Medicare

The final regulation, issued on August 1, 2012, establishes a new hospital wage index for the Newport, Kent, South County, and Westerly Hospitals, which have consistently been reimbursed based on a lower wage index than every other hospital in the state.  Due to Rhode Island’s size, this has resulted in a severe payment disparity among hospitals located in close proximity to each other.  This new wage index will help ensure that patients in Kent, Newport, and Washington counties continue to have access to high quality health care services and that these hospitals remain a source of sustainable jobs in the state.
Source: patch.com

9 R.I. hospitals penalized for hospital re

Quinlan said that while the issues of hospital re-admissions and penalties were important, he hoped that CMS would change its methodology and establish an accountability of care for the continuum of care. “Hospitals are now held accountable for any break in that continuum,” he said. “Any break in the discharge planning for patients [could cause a re-admission], but only the hospitals are now being penalized.”
Source: pbn.com

DownWithTyranny!: Who Will Stand Up To The Boehner

Boehner and Obama have a bridge they want to sell you after the election… but before the new Congress is sworn in. It should be pretty ugly and we need to wonder who’s going to stick up for any citizens out there who can’t afford to hire lobbyists. Will a strange bedfellow coalition of Progressives and Teabaggers be strong enough in the House. How about a filibuster led by Rand Paul (R-KY), Mike Lee (R-UT), Jeff Merkley (D-OR) and Bernie Sanders (I-VT) in the Senate? And, if I read David Atkin’s post at Digby’s place right on Monday, maybe Sheldon Whitehouse (D-RI) will be joining them as well. he and Dante sat down with Whitehouse in Charlotte and asked him about protecting Social Security and Medicare, particularly about the Obama/Boehner plans for a Grand Bargain which looks like quite a bargain for the rich and the shaft for working families. Whitehouse felt, like many progressives, that the fatal flaw in Simpson-Bowles is how the right wants to use this to get at Social Security. Fatal is a good word next to flaw in this instance, but Obama wants this bad and he’ll probably fight harder and smarter to wreck Social Security for Wall Street than Bush did after he won his second term. White House says Social Security cannot be rolled into the equation and that the Defending Social Security Caucus will fight. There are 15 members and at least two of them, Schumer and Menendez are total Wall Street puppets and will probably cause more harm inside the caucus than if they weren’t part of it. The other members are Dan Akaka (D-HI), who’s retiring, Richard Blumenthal (D-CT), Barbara Boxer (D-CA), Sherrod Brown (D-OH), Maria Cantwell (D-WA), Tom Harkin (D-IA), Frank Lautenberg (D-NJ), Jeff Merkley (D-OR), Barbara Mikulski (D-MD), Jack Reed (D-RI), Bernie Sanders (I-VT), Debbie Stabenow (D-MI) and Whitehouse. Whitehouse: Social Security has a $2 trillion surplus. It contributes virtually not at all to our national debt and deficit. It has long been kind of a bogeyman to the Republican Party that we have Social Security. They want to get rid of it, they want to privatize it, they never liked it. We cannot use this debt and deficit discussion as an excuse or vehicle to go after Social Security which is a separate discussion. It’s sound until 2027, I think, at this point. It has got a huge surplus, and we need to make sure there is airspace between our debt and deficit discussion and Social Security. That’s one of the reasons I helped found the Defending Social Security Caucus, and one of the things I think has happened in the Senate, not invisibly perhaps as it might have, but visibly to those of us who are there, setting Simpson-Bowles aside, the discussion about using Social Security to solve the deficit, has really gone away. And I think in part it’s because I believe we’re up to thirty Senators who have signed on and said, “No way. No way. Not going to happen.” And we make a blocking minority that makes that very difficult for the White House. They’ve backed off, everybody has backed off. And I think that’s an important line. We have a success so far. But when you look at $2 trillion that Wall Street would love to get its hands on, and privatizing Social Security that Wall Street would love to do, this is a fight that’s not going to go away. We’re in a good position on it now, we should not give in, and we need to be alert really for the rest of our lives to protect against those efforts to encroach on it. …Atkins: Thrilled about your answer on Social Security and thank you for all your activism on that. In terms of the other major issue which is, of course, Medicare, I guess a lot of plans have come out and I’m surprised there hasn’t been more of a push for raising the caps as opposed to making earned benefit cuts. What is going on there, and what do you expect to see happen during the lame duck session? Whitehouse: Well, either in the lame duck session or assuming we do a continuing resolution in March when we have the sort of big budget discussion, I think those are issues that are going to be on the table. I’d love to raise the cap on Social Security, so that someone who is making $100 million isn’t paying the same amount into Social Security as someone making $100,000. That just doesn’t make to me any logical sense. If Social Security could use the support in way out years, why not get started now when it’s an easier foundation to build? I think the Medicare discussion is one that we need to grab a hold of and win. And we need to do two things: one is to point out that there’s a difference between savings in the Medicare system that come from making a better healthcare system for people, and cutting people’s benefits and giving them less access to the healthcare system. And there’s a clear distinction between those two strategies, and the Republicans have worked very hard to blur those two, and to say that the $716 billion in savings in the Affordable Healthcare Act is actually a cut. It’s not. Unless you’re a big insurance company or a provider. Then maybe it’s a cut to you, but it’s a signal to get more efficient and deliver the care better. And to kind of get that morphed into the plan for the Republicans to take Medicare and get it turned into a voucher program is something we’ve got to be really, really clear on. And the last point I would make, even though this gets a little bit techy and geeky, is that there really is a huge savings potential not in Medicare per se but in our healthcare system from better healthcare delivery, more primary care, more prevention, less administrative overhead, electronic health records, paying doctors for results and keeping patients healthy rather than procedures and treating them when they’re sick, that whole arena of activity is estimated to saving between $700 billion a year and $1 trillion a year in American healthcare, and that needs to be a Democratic issue. That is how you bring down the cost of Medicare and veterans’ care, and TriCare, and Blue Cross and United and all of it, in a way that people in the country can see difference in their lives in better care that costs less because you’re not getting sick, you’re not taking drugs that react badly with each other because nobody kept track that they do react badly with each other and you prescribe both of them. I mean, that’s an arena we need to put light into and we need to own. It’s good policy, it’s innovation, it’s high tech, it’s all the things that we’re for. We need to strengthen the Members of Congress who are willing to hold the line for working families. In the House, we’ve found 16 candidates from every part of the country using the Prosperity Economics framing as a way for campaigning against Ryan’s and Romney’s and Wall Street’s toxic Austerity Agenda. And, of course, in running for the crucial Massachusetts and Wisconsin Senate seats are two stalwarts for economic justice issues, Elizabeth Warren and Tammy Baldwin. Brother, if you can spare a dime, spare it now.
Source: blogspot.com

Raging Grannies Protest Forbes, Hinckely Event

Mr. Hinckley is also on record supporting plans to turn Medicare into yet another entitlement program for the 1% by transforming Medicare into a voucher system as of 2022. This will leave seniors at the mercy of private insurers. His plans would do for Medicare what has already been accomplished for the health care insurance industry, where 20 cents of every premium dollar goes toward administrative costs and profit, so that only 80 cents is left to pay for actual health care. Medicare, by comparison, currently pays out more than 98 cents of each premium dollar for actual health care. The difference between the current corporate health care system, on the one hand, and Medicare For All, if it existed, on the other, costs every single one of us about $2,000 per year.
Source: rifuture.org

Doherty raps Cicilline, seizes on the trust issue

“End the guarantee of Medicare, roll back rights for women’s reproductive health, provide subsidies for big oil, undermine the middle class, and I think what Rhode Islanders are ultimately going to decide is, who do they trust to go to Washington and fight for them and fight for their families.”
Source: wordpress.com

How Social Security is Funded

Posted by:  :  Category: Medicare

When Social Security was created in the 1930s, retirees could not start collecting benefits until age 65. But in 1956, eligibility rules were changed to allow women to begin collecting at age 62. In 1961, the rule was changed for men as well. Today, 62 is the most common age of retirement. With a typical 62-year-old likely to live to age 83, an individual now spends roughly one-third of his adult life in retirement. Neither immigrants nor anyone else is able to collect Social Security benefits without someone paying Social Security payroll taxes into the system. However Social Security is often confused with the Supplemental Security Income (SSI) program. SSI is a federal welfare program and no contributions, from immigrants or citizens or anyone else, is required for eligibility. Under certain conditions, immigrants can qualify for SSI benefits. The SSI program was an initiative of the Nixon Administration and was signed into law by President Nixon on October 30, 1972.
Source: taxspeaker.com

Video: Excellus BCBS Medicare plan travels with you

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

How to Protect Your Company From Criminal Health Care Enforcement

In an unprecedented move, DOD criminally prosecuted Laura Stevens, in-house counsel for GlaxoSmithKline (GSK), for obstruction of justice and false statements. The U.S. Attorney’s Office for the District of Maryland refused to participate in the criminal prosecution, which is especially telling. The evidence against Ms. Stevens centered on her failure to ensure that GSK produced certain documents in response to an informal letter request from the Food and Drug Administration relating to off-label marketing practices. At the conclusion of the government’s case, the judge dismissed the case, and made a blistering statement on the record which rebuked the government prosecutors for bringing the action (and vindicated the U.S. Attorney’s opposition). The prosecutors who handled the case have since restated their intent (and DOJ’s) to prosecute similar cases.
Source: pharmacompliancemonitor.com

At least Paul Ryan was going to wait a few years before killing Medicare. Barack Obama, on the other hand…

ever since reagan was president, i’ve been resigned to the possibility that someone would get around to destroying medicare and social security before i could get any benefit from them, but i’ve always thought my parents were probably safe. now it’s looking like maybe not. they’re in reasonably good physical, mental and financial health for now, but they’re not rich and if something really bad were to happen, there’s no way i could help them out of anything like this.
Source: correntewire.com

Biggert Senior Fair Serves 200 People in Bolingbrook

 “Whether they had questions on Medicare prescription drug coverage, the RTA reduced fare program, or property tax assistance, the event gave seniors the chance to put government to work for them.  And that’s the way it should be.  I place a high priority on constituent services and I value the input of area seniors who encouraged me to continue fighting to safeguard and strengthen Medicare for years to come.” 
Source: plainfieldonline.com

New England Complex Fluids Workshop at Brandeis Sept 21

In addition to taking questions from the floor, the panel will address questions such as  what kind of training and education do industrial labs seek in job applicants? What (scientific) knowledge should applicants possess? experience? skills? creativity? business knowledge? What should the universities do to better prepare students for a career in industry? What opinion do the industrial scientists and managers have on the research being done at universities? And how does research done in industry compare to that done in universities?  How common are collaborations between industry and academic researchers? What makes a successful collaboration? When does industry use academic consultants?
Source: brandeis.edu

Free seminar to probe Medicare changes in light of Supreme Court ruling, 10/2

“Our goal is to give journalists, who sometimes are thrown into the beat with limited resources and research budgets, an intensive Medicare basics course so they can hit the ground running when it comes to Medicare reporting,” EJ Mitchell, managing editor of The Medicare NewsGroup, said in a statement. “We hope the journalists who participate will feel more informed about the topic, and will become more comfortable writing articles and analyses on the program and the politics surrounding it.”
Source: sabew.org

RAIL ROAD MEDICARE REQUESTS FOR PROVIDER’S PTAN#

Posted by:  :  Category: Medicare

Medical Billing Solution, Medical Billing Training Program, About Outsourcing Services, Medical Billing Process and Concept, Tips to Medical Biller, Specialist. Medical Insurance Billing Denial Guidelines. Medical Billing Training Articles and Software Review. Medicare Billing CPT code ,ICD-9 DX Code Update.
Source: whatismedicalinsurancebilling.org

Video: YouTube Videos matching query: medicare ptan lookup

Provider idenification Numbers 

NPI Number-National Provider Identifier Number was created in order to simplify all the different ID number for each insurance.  Effective May 23, 2007  all providers had to have an NPI number to bill insurance and also to identify themselves as referring physicians.  A new uniform billing form was created to accommodate these new NPI numbers.(see Uniform Billing Forms).  The doctor or group associated with the NPI will be the address in box 33 a of the CMS form/ or for a facility box   of the UB-04 form.  that is who will receive the insurance payment.
Source: survivinghealthinsurance.com

Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline, CPT Code Billing: Chest X

Denial Reason, Reason/Remark Code(s) M-80, CO-18 – Duplicate Service(s): Same service submitted for the same patient, same date of service by same doctor will be denied as a duplicate CPT codes: 93010, 71010, 71020 Resolution/Resources First: Verify the status of your claim before resubmitting. You can determine the status of a claim through the Palmetto GBA Online Provider Services (OPS) tool or by calling the Palmetto GBA Interactive Voice Response unit (IVR). Online Claim Status Verification through OPS
Source: medicarepaymentandreimbursement.com

NGHP Section 111 Reporting Mid Year Review :Gould & Lamb

Posted by:  :  Category: Medicare

DC Voting Rights by dbkingEarlier this year, the Department of Health and Human Services (DHS) issued a Medicare Learning Center ‘News Flash’ advising Medicare fee for service providers on proper procedures for identifying primary payers and making correct and timely billing submissions to Medicare. Despite this notification and training of CMS contractors, there remain widespread reports of injured parties contacting insurers or their agents seeking remedy for affected Medicare treatment and services disrupted by NGHP Section 111 reporting. Along with the administrative burden on the industry, there is frustration over the inability to affect resolution.
Source: themedicarecomplianceblog.com

Video: Consumer Financial Protection Efforts: Answers Needed (Part 1 of 2)

The Official Medicare Set Aside Blog And Information Resource: MMSEA Section 111 Reporting Updates

MEDVAL, LLC provides pre-settlement and post-settlement services for high exposure workers’ compensation and liability claims that require Medicare’s interests to be protected pursuant to 42 USC 1395y(b)(2). As the first firm in the country to provide a fully integrated, one-stop solution for the Medicare Set-Aside process, we can recommend Medicare Set-Aside arrangements, submit them to the Centers for Medicare and Medicaid Services (CMS) for approval, provide annuity and lump sum funding options, provide post-settlement medical trust administration, and pharmacy benefit management to our clients all under one umbrella.
Source: medicaresetasideblog.com

Asbestos Trusts and Medicare Liens:Medicare Wants its Money Back

And how is “exposure after Dec. 5, 1980” defined? The burden is on you or, in our example, Mr. Jones, to establish that the exposure ended before Dec. 5, 1980. All of the exposure. This is a difficult burden to meet, especially in light of the trouble many people have remembering exactly when and where exposure occurred. Trying to recall facts from 20, 30 or 40 years ago is difficult. Sure, most folks know when certain milestones occurred in their lives, like marriage, entry into military service or where you were when President John F. Kennedy was assassinated. But try to remember exact dates or circumstances; it can often be difficult to recall the the “who, 
Source: motleyrice.com

CMS Extends Section 111 Reporting Deadline and Dollar Thresholds

Bradley v. Sebelius CDC Centers for Medicare and Medicaid Services CMS COBC Conditional Payments Coordination of Benefits Contractor David Korch GAO HHS liability LMSA Mandatory Insurer Reporting MARC Medicaid Medicare Medicare Secondary Payer Medicare Secondary Payer Act Medicare Secondary Payer Recovery Contractor Medicare Secondary Payer Statute Medicare Set-Asides Medicare Set Aside Medivest MIR MMSEA MSA MSP MSPRC NAMSAP ORM RREs SCHIP Section 111 settlement SMART Act Social Security The Centers for Medicaid and Medicare Services TPOC US Department of Justice US v. Hadden US v. Harris US v. Stricker WCMSA WCRC workers’ compensation
Source: medivest.com

Medicare Section 111 Reporting Requirements

Group health plans must report to the Centers for Medicare and Medicaid Services (CMS) Social Security Numbers or Medicare Insurance Claim Numbers for employees and their covered family members who might have Medicare coverage in addition to coverage under the employer group health plan.  Many employers with fully-insured health plans have been contacted by their insurers to collect SSNs and HICNs for their participating employees.  Self-funded plans may have their own reporting requirements.  The reporting, required under Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007, helps CMS identify Medicare-covered individuals with group health plan coverage that should pay claims primary to Medicare.
Source: basusa.com

CMS Updates Section 111 Implementation Timeline

There have also been some changes relating to the TPOCs. The CMS has now determined that the Section 111 reporting will not include the reporting of TPOC amounts with dates prior to January 1, 2010. If a TPOC amount dated on or after January 1, 2010 falls below the threshold amount, the RRE is to add all associated TPOC amounts dated on or after January 1, 2010 in determining if the reporting threshold is met. Any associated TPOC amount occurring prior to January 1, 2010 should not be considered when calculating the TPOC amount for purposes of the reporting threshold. However, The CMS has also stated within this memo that although RREs are not required to report TPOCs where the applicable TPOC date is prior to January 1, 2010, a record will not be rejected based upon a TPOC date before January 1, 2010.
Source: medivest.com

MMSEA Section 111 Mandatory Insurer Reporting Updates : Life Sciences Legal Update

Second, CMS has posted revised guidance pertaining to liability insurance (including self-insurance) responsible reporting entities (RREs) where the claims involve exposure, ingestion, and implantation issues. In the guidance, CMS explains its policies for claims involving exposure, ingestion, and implantation. Specifically, CMS discusses when Medicare will, and will not, assert a recovery claim against the settlement, judgment, award, or other payment, and when the MMSEA, Section 111 mandatory reporting rules must (or need not) be followed. CMS also provides examples of various factual scenarios involving exposure, ingestion, and implantation, and discusses how its policies will be applied to each.
Source: lifescienceslegalupdate.com

New York Tightens Protections on Social Security Numbers : Workplace Privacy, Data Management & Security Report

New York takes another step toward safeguarding Social Security Numbers (SSN), this time limiting certain entities, including employers, from requiring a person to disclose or furnish his or her SSN for any purpose. Signed into law by Gov. Andrew Cuomo on August 14, 2012, the new law (A.8992-A / S.6608-A) adds a new section 399-ddd to the General Business Law of the Empire State, that becomes effective 120 days from enactment (December 12, 2012). Businesses will need to revisit their practices with employees, customers and other individuals in situations where all or a part of the Social Security Number is involved. 
Source: workplaceprivacyreport.com

Section 111 Medicare Secondary Payer Reporting Update

The Centers for Medicare and Medicaid Services (“CMS”) announced an option which will allow for payment of a simple fixed percentage on small dollar liability insurance or self-insurance settlements for physical trauma-based injuries. Effective November 7, 2011, in cases where the settlement is $5,000 or less, a Medicare beneficiary may opt to resolve Medicare’s recovery claim by paying Medicare 25% of the total settlement instead of using the standard recovery process.
Source: dritoday.org

Putting the Medicare Cards On the Table: Court Rules That L

However, from the author’s review of CMS’ statements (both oral and written) on the issue, the question may not necessarily be “is an L-MSA required?” That answer is seemingly “no”— even from CMS’ perspective. Id. Rather, the “issue” may more appropriately be: “Is there an obligation to protect Medicare’s ‘future interests’ as part of a liability settlement?” or, from a more practical position, “Does CMS believe there is an obligation to protect Medicare’s ‘future interests’ as part of a liability settlement?” See id; and Charlotte Benson, CMS Memorandum: Medicare Secondary Payer: Liability (Including Self Insurance) Settlements, Judgments, Awards, or Other Payments and Future Medicals, September 30, 2011. As part of this, consideration should also be given to the fact that recent versions of the MSP manual have included references to both L-MSAs and no fault Medicare Set-Asides. Also, at the time of this article’s publication, CMS has advised that it is in the process of developing regulations surrounding Medicare Secondary Payer compliance regarding future medicals. See pending rule; “Medicare Secondary Payer and ‘Future Medicals’ (CMS-6047-ANPRM),” May 3, 2012. Thus, while CMS may acknowledge that L-MSAs, are not “required,” this other evidence would seem to suggest that on some level, to some extent, and in some manner, the agency believes there is some obligation to consider Medicare’s interests with respect to certain liability settlements, with the “MSA” being just one vehicle or option available toward that end. Assuming that this in fact CMS’ position, the question would then become; “are they correct legally?”
Source: lexisnexis.com

60 Days to Pay – Has Medicare Reached the Point of No Return?

“The rising cost of medical care, and particularly of hospital care, over the past decade has been felt by persons of all ages. Older persons have larger than average medical care needs.  As a group they use about two-and-a-half times as much general hospital care as the average for persons under age 65, and they have special need for long term institutional care. Their incomes are generally considerably lower than those of the rest of the population, and in many cases are either fixed or declining in amount. They have less opportunity than employed persons to spread the cost burden through health insurance. A larger proportion of the aged than of other persons must turn to public assistance for payment of their medical bills or rely on ‘free’ care from hospitals and physicians. Because both the number and proportion of older persons in the population are increasing, a satisfactory solution to the problem of paying for adequate medical care for the aged will become more rather than less important. In our society the existence of a problem does not necessarily indicate that action by the Federal Government is desirable. The basic question is: Should the Federal Government at this time undertake a new program to help pay the costs of hospital or medical care for the aged, or should it wait and see how effectively private health insurance can be expanded to provide the needed protection for older persons?”[24]
Source: garnerhealthcare.com

New Efforts To Improve Medicaid in California, Colorado

Posted by:  :  Category: Medicare

The Lund Report: Governor Kitzhaber Seeks To Expand Coordinated Care Organizations With coordinated care organizations – better known as CCOs — in full swing for the Medicaid population, Governor John Kitzhaber is setting his sights on the next targets – people on Medicare, the state’s public employees and the private business sector. “The biggest challenge with Medicare is that it’s not a sustainable model,” the governor told Beaverton residents last week at a town hall meeting hosted by Sen. Mark Hass (D-Beaverton). Why not allow people on Medicare to participate in a CCO on an “experimental basis,” he suggested (Lund-Muzikant, 9/12).
Source: kaiserhealthnews.org

Video: AT Network Training on AT and Medicare

New Study: Dems’ Brutal Medicare Cuts to Pay For ObamaCare Hit Your Hometown

“We are concerned that, by removing Congressional authority over the Medicare payment system and placing such unprecedented authority in an unelected body, quality care for our patients will be jeopardized.  We are equally concerned with the potential that physicians may be subjected to a double jeopardy in  Medicare payments if IPAB cuts  are  coupled with those projected under the current sustainable growth rate (SGR). The current instability and inequities in Medicare physician payments is hindering access to care for millions of Medicare beneficiaries.  IPAB would only exacerbate this problem.” 
Source: nrcc.org

California Medicare Supplement Plans Blue Shield

each month for 12 months on your Medicare Supplement Plan rates.To qualify, you must be age 65 or older, and Blue Shield must receive your application within six (6) months of the date you first enrolled for benefits under Medicare Part B. Savings will be effective for the first twelve 12 months of your plan dues.The Welcome to Medicare Rate Savings is available for all Medicare Supplement Plans that Blue Shield of California offers. You can also take advantage of our two-party rates and Easy$Pay
Source: mattlockard.net

Herding dual eligibles into low quality plans

Looking at Medicare evaluations, two of the plans selected have received a notice of non-compliance from the Medicare program. One of those has been marked as a low-performing plan for three consecutive years and is at risk for termination of its Medicare contract. Another plan was recently sanctioned by Medicare as a result of beneficiary access problems. Medicare continues to restrict enrollment of dual eligibles into that plan. All eight proposed demonstration plans were found to be low-performing on a least one composite Medicare quality measure.
Source: pnhp.org

Report: Budget cuts could cost thousands of Arizona healthcare jobs

1. California 50,785 2. Florida 35,827 3. Texas 32,172 4. New York 31,801 5. Pennsylvania 24,201 6. Ohio 20,175 7. Illinois 19,593 8. Michigan 17,639 9. North Carolina 15,912 10. New Jersey 14,126 11. Georgia 13,271 12. Virginia 12,208 13. Massachusetts 11,284 14. Tennessee 11,279 15. Indiana 10,718 16. Missouri 10,667 17. Washington 10,388 18. Arizona 9,863 19. Wisconsin 9,703 20. Alabama 9,010
Source: cronkitenewsonline.com

Are Medicare’s incentives large enough to cause real behavior change?

The program is part of a major shift for Medicare, which historically has paid hospitals and doctors based on the nature of services they provided to patients without taking into account how good a job they did. Medicare has already launched several trial programs that are intended to reward hospitals based on performance, but those are voluntary; the value-based purchasing program is the first one that will be applied to nearly all acute care hospitals regardless of whether they want to participate. It kicks in at the same time that 2,211 hospitals will also begin losing money because of high readmission rates, another program created in the health law.
Source: medcitynews.com

Getting answers to your Medicare questions

With Medicare open enrollment season coming up (it runs from Oct. 15 to Dec. 7), you may be thinking about joining a Medicare health or drug plan, or switching from one plan to another. SHIP can help you choose a plan that best meets your needs in terms of cost, coverage and convenience. A counselor can sit down with you and help you compare various plans until you find the right one. They also can help you enroll in that plan.
Source: thisisreno.com

Do You Have Questions About Medicare Eligibility?

If a person receives Social Security benefits, they are automatically signed up for Medicare. However, if you are 65 and delay receiving Social Security, you may still sign up for Medicare, but this will not be done automatically. You will need to personally contact the Social Security Administration to receive this benefit. You are also not automatically signed up when your spouse is eligible or signed up for benefits. You must sign up for Medicare coverage individually and this may be done online, or by making an appointment and visiting your nearest Social Security office.
Source: todaysseniors.com

Court: You Can Appeal Medicare Decisions About Hospice Services

That’s a victory of sorts, because it makes it clear that beneficiaries have the right to challenge a hospice provider’s refusal to provide a service that a doctor deems necessary, Mr. Deford said. But it’s disappointing because it doesn’t ensure that people receive a notice of their right to appeal when they enter hospice care, or that any mechanism exists for expedited appeals – an important protection for people who are dying.
Source: nytimes.com

Joe’s Health Calendar 9/15/12 Walk More Eat Less

Starting Oct. 1 (Monday) 6 p.m. lighting ceremony: October is National Breast Cancer Awareness Month, so Mark Twain St. Joseph’s Hospital in San Andreas is once again promoting Pink in The Night to emphasize the importance that early detection of breast cancer, followed by prompt treatment, saves lives. The entire community is invited to participate in the Pink in the Night opening ceremony at The Terrace Center, 1906 Vista Del Lago Drive, Valley Springs (at Highway 26). All survivors and participants will be able to light a candle in tribute to those that are currently battling breast cancer, or in remembrance of those that bravely lost their battle, and ones that have survived the disease. Businesses are encouraged to “pink up” their businesses with a strand of pink lights available at one of the hospital’s five Family Medical Centers in Angels Camp, Arnold, Copperopolis, San Andreas or Valley Springs. Through the “Every Woman Counts” program, women can obtain free cancer screening health care services such as cancer screening pap smears, breast screening exams including digital mammography and diagnostic imaging reading from the radiologist. Women that are California residents can qualify to meet the income guidelines that pertain to those that do not have health insurance, or are underinsured with high deductibles and high co-pays. Those women that may be unable to afford to cover these costs may be able to immediately qualify for free services through the Every Woman Counts program. Any women desiring these services can call (209) 754-2968 to make an appointment through the MTSJH Family Medical Center in Arnold. For information on picking up lights or the ceremony, contact Nicki Stevens at (209)754-5919.
Source: esanjoaquin.com

Blue Cross & Blue Shield of NC Shows High Blue Medicare Ratings

Posted by:  :  Category: Medicare

[…] affordable BCBSNC blue advantage Blue Cross blue cross nc blue options Blue Options HSA coinsurance compare copay deductible dental blue dental insurance article dental insurance guide dental insurance information dental insurance tips finance health Health care health insurance health savings account Health Savings Accounts help with prescriptions high deductible health plan insurance Life Cover life insurance life insurance article life insurance guide life insurance information life insurance tips long term care insurance article long term care insurance guide long term care insurance information long term care insurance tips medicare NC North Carolina out-of-pocket ppo premiums rx help savings Term Life InsuranceSource: richdayhealthplans.com […]
Source: richdayhealthplans.com

Video: Is Freedom Blue PPO a Medicare Supplement?

California Medicare Supplement Plans Blue Shield

each month for 12 months on your Medicare Supplement Plan rates.To qualify, you must be age 65 or older, and Blue Shield must receive your application within six (6) months of the date you first enrolled for benefits under Medicare Part B. Savings will be effective for the first twelve 12 months of your plan dues.The Welcome to Medicare Rate Savings is available for all Medicare Supplement Plans that Blue Shield of California offers. You can also take advantage of our two-party rates and Easy$Pay
Source: mattlockard.net

CrummeyService.com Accepts Equity Investment

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

Lewis Insurance / Nationwide Insurance

Health insurance plans come in all shapes and sizes. That’s why it’s important to assess your needs before you choose an insurance plan. First, determine what kind of coverage you need, for example, a major medical insurance plan or a temporary insurance plan. A major medical insurance plan usually renews on a yearly basis and does not expire until you decide to terminate the policy or discontinue paying premiums. On a temporary insurance plan, you can decide if you want coverage from one to six months at a time, for a maximum of 12 months. Major medical insurance plans usually offer an optional dental plan. The dental plan is only offered along with the health insurance plan – it cannot be purchased alone. Additional services that could be included with a health insurance plan are preventive care, prescription drug coverage and vision coverage. It is important to do research so you can find the insurance plan that provides the best coverage and services for you.
Source: blogspot.com

Health Insurance in NYC and Area: Empire Blue Cross Senior Product Specialist

I am appointed and certified to help anyone receiving Medicare benefits or those aging in to Medicare with any of the plans offered by Empire Blue Cross Blue Shield in the New York City area including Westchester, Nassau and Suffolk counties. To research the plans available, just visit my personal agent portal to Empire BC/BS, Just click here Empire Sales Agent Kirk Devereux Empire has a variety of Medicare Advantage options to choose from such as HMO and PPO plans.  Each plan has unique features that I would be happy to help you understand. Empire has Medicare supplement plans as well to help pay for costs not covered with Original Medcare Parts A and B. Fill out the contact request located in my agent portal link and I will contact you and we can arrange to meet and go over all your options and choose the right plan for YOU. Empire Sales Agent Kirk Devereux  
Source: blogspot.com

Blue Cross and Banner Health to offer insurance for seniors

The new plan, which will be marketed during Medicare enrollment this fall, will be called Blue Cross Blue Shield of Arizona Advantage. The plan will assume Banner Health’s existing 22,000-member Medicare Advantage plan, called the Banner MediSun Medicare health plan. It will be available to Medicare-eligible residents in Maricopa County and parts of Pinal County.
Source: azcentral.com

Dave Fluker’s California Health Insurance Blog: Blue Shield CA Reaches Contract Agreement with University of California (UC)

Blue Shield of California finalized negotiations with University of California and signed new agreements with the providers at each campus. UC San Siego, UC Irvine, UC San Francisco and UC Davis remain in the Blue Shield network. UCLA providers will return to the network effective September 1, 2012. The new, long-term agreement runs through June 30, 2015. Product impact as follows:
Source: blogspot.com

Blue Cross Blue Shield of Michigan Offers New Medicare Plans

HMO’s (health maintenance Organizations) let you select a primary care physician from the BCBS provider network and this PCP manages your overall care. He or she will refer you to a specialist or to a selected hospital for care should you need additional services beyond his scope of practice. Referring yourself to an outside provider will cause a forfeit of benefits and out-of-pocket costs. The four BCBSM HMO products, formerly known as Options 1, 2, and 3, will now be known as BCN Advantage Elements, Classic , and Prestige. The Blues Care Network will also continue to offer the BCN Advantage Basic Plan.
Source: emaxhealth.com