What Is The Best Method For Making A Medicare Supplement Plans Comparison?

Posted by:  :  Category: Medicare

A list of physicians and healthcare professionals, by geographical location, can be found on the official Medicare website: https://questions.medicare.gov/find-a-doctor . This is an easy and convenient method to find participants in local areas. Every year there is an open season when individuals have the opportunity to make a Medicare supplement plans comparison to ensure both providers and services will continue. As with the original Medicare Parts A and B, the monthly fees for Medicare supplement plans are reviewed and adjusted on an annual basis. The Medicare monthly costs for Parts A, B, and D can be found at www.medicare.gov/costs/ . Supplemental insurance carriers will notify participants of any changes in annual fees or altered services during the November to December timeframe. Anyone who wants to change or drop a current insurance carrier can do so during the annual open season, January through March. Comparing costs today will lower individual expenses tomorrow.
Source: seniorcorps.org

Video: Medicare Supplement Comparison

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

Things to know about Medicare Supplement and Health Insurance

Medicare supplement and health insurance is a remarkable resource for individuals of different backgrounds who desire to have financial well being after they retire from their jobs. Supplemental insurance comes into picture along with your regular health insurance plan to fill in the gaps wherever you would or else have to pay through your pocket. Medicare supplement health insurance becomes important for you since your regular medical insurance can take care of nearly 80% of your total medical costs. This leaves a significant 20% cost, which you have to arrange for, from your savings. Having a supplement medical insurance can lower your out-of-pocket expenses significantly without replacing the primary plan. This simply adds to your original plan making you fully covered and filling the gaps. These plans are often called Medigap plans and you have number of options when it comes to choosing the right for you.
Source: wordpress.com

Medigap Quote Comparison: Issues to know about Medicare Supplement and Health Insurance coverage

There are a number of elements that you should be mindful earlier than deciding upon a particular medicare supplement medical health insurance plan. The components that it’s best to bear in mind and understand are how much protection is needed by you and the way a lot does your regular medical health insurance plan cowl for? There are several plans, right from probably the most primary ones to essentially the most detailed ones, so consult your medical care insurance agent whereas selecting an acceptable plan. Primary plans are right for individuals who are effectively off and are able to satisfy high medical costs. You might have nearly ten different plans to choose from the fundamental plans, while detailed plans are the most well-liked plans that decrease your out-of-pocket bills in wake of a medical emergency. This plan significantly lowers your bills for emergency medical providers, offering you a full medical coverage. When selecting essentially the most appropriate medicare supplement plan you could calculate your medical expenses that are not lined by your authentic medical insurance. Choose properly and find out the overall price, varying month-to-month premiums and the benefits. Select a plan which fits your budget and your medical care needs. Discovering the most effective medicare supplement and health insurance supplier, who presents you one of the best plan at the most cheap charge, is significant when you determine on a medicare complement plan. Do a thorough research of all of the medicare complement medical health insurance providers to reinforce your unique plan. Your plan must cowl for all deductible, coinsurance and elevated day by day needs coverage. There are a number of other benefits you can get pleasure from by going for these plans like you’ll be able to proceed to see each physician who accepts medical insurance, you do not need a referral whereas visiting a specialist. Also, you will get full coverage for all of your medical expenses after your retirement.
Source: blogspot.com

The California Medicare Supplement Insurance Carrier Landscape

A similar situation is occurring for 1000’s of California seniors daily these days. As they approach their 65th birthday, the mail starts to get especially thick. You’re now the most popular person in all of the State…with the California Medicare supplement carriers. The shiny brochures and promises why they’re the best create a sheer tidal wave of information coming your way and we’re writing this article to help you narrow a great deal of those offers and really understand the current landscape of California Medigap carriers. So let us begin…before the mail carrier comes by again. First of all, it’s important to understand that even though the California Medicare supplement plans are standardized (a C plan is a C plan regardless of the carrier), health insurance is still regulated and governed at the State level and this applies to California Medigap plans as well. There are some nationwide-type carriers which do business in California (think of Aetna or United Health) but their product offerings in the State will still be tailored to California rules, regulations, and maybe more important, market factors. So, Medicare is Federal while California Medigap carriers and plans are State specific. Let’s jump into the main carriers on the market. First, there’s AARP which most seniors (you may start receiving info from them in your mid 50’s). AARP does not actually underwrite the California Medicare supplement but they partner with a large carrier who does. Currently, it’s United Health which is a respectable, nationwide based health insurance carrier. You will doubtlessly receiving much correspondence from AARP regarding their California Medigap plans and they should be part of the consideration. Next up, you have the Blues. California is unique among the States (aside from various, other reasons) in that Blue Cross and Blue Shield of California are two distinct carriers in our State. You have Anthem Blue Cross and separately, Blue Shield of California…both of which offer California Medicare supplemental insurance plans to State residents. Both have long track records and have been strong promoters of the Medigap plans for decades now so they are also strong contenders. You then have large, multi-State carriers (some health and other’s life) which offer CA Medigap plans. Examples would be Aetna, Humana, Mutual of Omaha and the like. These are also contenders when comparing Med sup carriers in California but outside of a clear pricing advantage (which is not likely compared to AARP and the Blues), the benefit of such a consideration is limited. You may have had one of these carriers prior to Medicare and liked dealing with them which is fine. This is not inconsequential in your decision although the Senior (California Medicare supplement) and pre-65/group divisions of a California carrier can be completely different. Below this rung, you have many smaller carriers, both health and life that jumped into the CA Medigap market. As licensed agents, we would probably stick with the stronger carriers which have longer track records specifically in the Medicare supplement market since this can affect price stability going forward. In another article, we’ll deal with how to compare and quote the various California Medicare supplement carriers so that you get the best value for your premium dollar and this is an important consideration since the pricing models can vary quite a bit. Ultimately, California has one of the most competitive health insurance markets which makes sense considering its size so you are fortunate to have a long list of available carriers to choose from, even if there are really only a few that merit your attention. This works to keep all of them “honest”.

Seniors: Who do you want rationing your Medicare?

Posted by:  :  Category: Medicare

Proposed changes to Medicare, (but not discussed often enough) include raising the Medicare eligibility age; increasing premiums for the wealthier or for everyone; subsidizing premium payments for private health insurance (so-called vouchers); increasing supplemental insurance premiums; hiking deductibles and cost-sharing for such services as home health care; slashing Medicare reimbursements for doctors, hospitals and other health care providers; generating new revenues by increasing the payroll tax rate, and on and on and on. (Check the AARP website for more detailed discussion of the options.)
Source: chicagonow.com

Video: Medicare Part 1: Eligibility and Enrollment

Social Security Disability & Medicare Eligibility

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

Obama v. Romney Election 2012 Fact Check: Medicare and Medicaid

President Obama does not propose fundamental change to Medicare. He’s been attacked for cutting $716 billion from the program, though none of those savings come from reduced benefits for seniors. Instead, that number reflects changes to Medicare Advantage, reduced payments to hospitals, and fees on drug companies. Medicare Advantage is the part of Medicare that lets seniors enroll in private health insurance, and President Obama has proposed limits on those insurance companies’ profits and administrative costs. Such changes could result in fewer private health insurance companies participating in Medicare Advantage.
Source: nationalpriorities.org

How are Social Security and Medicare treated by Ryan and Romney, and are they telling a “half

Net Medicare savings are estimated to total $575 billion for fiscal years 2010-2019. Substantial savings are attributable to provisions that would, among other changes, reduce Part A [hospital insurance] and Part B [outpatient medical services] payment levels and adjust future “market basket” payment updates for productivity improvements ($233 billion); eliminate the Medicare Improvement Fund ($27 billion); reduce disproportionate share hospital (DSH) payments ($50 billion); reduce Medicare Advantage [Part A and B services offered by private insurance companies] payment benchmarks and permanently extend the authority to adjust for coding intensity ($145 billion); freeze the income thresholds for the Part B income-related premium for 9 years ($8 billion); implement an Independent Payment Advisory Board together with strict Medicare expenditure growth rate targets ($24 billion); and increase the HI payroll tax rate by 0.9 percentage point for individuals with incomes above $200,000 and families above $250,000 ($63 billion). Other provisions would generate relatively smaller amounts of savings, through such means as reporting physician quality measures, reducing payments in cases involving hospital-acquired infections, reducing readmissions, refining imaging payments, increasing Part D [prescription drug benefit] premiums for higher-income beneficiaries, and implementing evidence-based coverage of preventive services.
Source: obamavsromneydebateoneconomicgrowthblog.com

What Is Medicare Gap Insurance?

Posted by:  :  Category: Medicare

OOPS I THINK THE SHINE IS OFF THE PEACH ...........IT'S ABOUT TIME by SS&SSA lot of senior citizens do not realize that not all states carry Medicare gap insurance. You can consult an expert on the subject to know if you are eligible for such insurance, and if the state you are in is also carrying such insurance. Different states have different laws when it comes to Medicare supplemental insurance, an example is that some states allow you to apply for gap insurance on a limited window, and if you have already a Medicare part B. Again, it is best to consult with a professional to avoid confusion and headaches, and also speed up the whole process.
Source: seniorcorps.org

Video: Avoid the Donut Hole Coverage Gap in Medicare

Puerto Rico Medicare beneficiaries save $110M under ‘Affordable Care Act’

“In just the last two months, the total amount that Puerto Rico Medicare beneficiaries have saved on prescription drugs has increased by about $15 million, and now totals $111,427,280. In addition, according to a report released this week by HHS, the average person with original, fee-for-service Medicare will save a total of $5,000 from 2010 to 2022 as a result of the ACA. Medicare beneficiaries with high prescription drug costs will save much more — about $18,000 — over the same time period,” said Pierluisi.
Source: newsismybusiness.com

DeMint: Obama, AARP partners in ripping off seniors

“For instance, Jim Messina – then your deputy Chief of Staff, now your re-election campaign manager – asked AARP for ‘immediate robo calls into Nebraska urging Nelson to vote for cloture’ on the bill,” he said. “In December 2009, the White House Office of Public Engagement asked AARP to put out talking points rebutting a Republican amendment related to Medicare.”
Source: humanevents.com

Medicare Part D Coverage Gap

Gary Phillips is a licensed insurance agent based in western North Carolina. He specializes in the senior market and is knowledgeable in multiple insurance lines including Medicare, Medigap, Long-Term Care, Part D Prescription Drugs, Part C Medicare Advantage, Health, Life and Final Expense insurance. He also enjoys writing and helping others. www.bizpartner.homestead.com
Source: seniorliving.net

Daily Kos: I Hate Explaining the Medicare “Donut Hole” (Updated with explanation of donut hole)

I had a chance to talk to Tom Scully, the head of HMS at the time and the creator of Plan D and the donut hole about why he did it. There were two reasons. First, he had a budget of $400 billion over ten years for the program so he had to design something that hit his budget target and he did a great job on that. Medicare Part D is the only government health program where the ten year cost was actually under the budget estimate. I think it came in at $380 billion. The second reason was to make seniors really think about generics and switching from higher priced brand name drugs to lower cost generic substitutes. And that part worked as well. You need to remember that before Part D all prescriptions were out of pocket expenses for seniors on Medicare, so even with the donut hole Part D was a big benefit.
Source: dailykos.com

Medicare EHR Incentive Report Reveals Gap in Payments

Approximately half (50 percent) were specialty practice physicians and over one-third (38 percent) were general practice physicians. Overall, though, general practice physicians were 1.8 times more likely than specialty practice physicians to have been awarded an incentive payment. Professionals who had previously participated in CMS’s electronic prescribing program were almost four times more likely to have been awarded an incentive payment than those who had not participated in the electronic prescribing program. Professionals who had signed an agreement to receive technical assistance from a Regional Extension Center were more than twice as likely to have been awarded an incentive payment.
Source: healthcare-informatics.com

Medicare coverage gap associated with reductions in antidepressant use in study

According to study results, being in the gap was associated with comparable reductions in the use of antidepressants, heart failure medications and antidiabetics. Relative to a comparison group that had full coverage in the gap because of Medicare coverage or low-income subsidies, the no-coverage group reduced their monthly antidepressant prescriptions by 12.1 percent and reduced their use of heart failure drugs by 12.9 percent and oral antidiabetics by 13.4 percent. Beneficiaries with generic drug coverage in the gap reduced their monthly antidepressant prescriptions by 6.9 percent, a reduction attributable to reduced use of brand-name antidepressants, researchers note.
Source: sciencecodex.com

A Season For Medicare Choices

Posted by:  :  Category: Medicare

Americans Support A Public Option by Leader Nancy Pelosi• Get help if you need it. The Medicare.gov website lists all the plans in your area. You can call 1-800-MEDICARE for general information and to enroll in a plan. You can also get a referral for your local State Health Insurance Assistance Program (SHIP). Every state has one, and they provide free counseling and advice to everyone with Medicare.
Source: smmirror.com

Video: Medicare Options – Making Sense of Them All!

Daily Kos: McMahon has ‘all options’ on the table for Medicare

who says “…all options are on the table.” I will not consider murdering the next idiot who says “…all options are on the table.” I will not consider murdering the next idiot who says “…all options are on the table.” I will not consider murdering the next idiot who says “…all options are on the table.” I will not consider murdering the next idiot who says “…all options are on the table.” I will not consider murdering the next idiot who says “…all options are on the table.” I will not consider murdering the next idiot who says “…all options are on the table.” Etc.
Source: dailykos.com

Medicare Open Enrollment Chat with Nicole Duritz

Do you have questions about Medicare?  Open enrollment is the one time each year when you can review your Medicare coverage and change to a different plan if you want to.  Join AARP at 2 p.m. ET on Thursday, Oct. 25, for a live online chat with Nicole Duritz, AARP vice president, Health & Family.  She’ll be taking your questions on Medicare open enrollment, which begins on Oct. 15 and ends on Dec. 7.  If you’re thinking about changing your coverage or have questions about your Medicare options, this free live chat session is for you.  Submit your questions in advance by clicking on the above module! Go to the AARP home page  for tips on keeping healthy and sharp, and great deals.
Source: aarp.org

Things to Think about when You Compare Medicare Drug Coverage

Monthly Premium Most drug plans charge a monthly fee that varies by plan. You pay this fee in addition to the Medicare Part B (Medical Insurance) premium. If you’re in a Medicare Advantage Plan or a Medicare Cost Plan that includes Medicare prescription drug coverage, the monthly premium you pay to your plan may include an amount for prescription drug coverage. Note: What you pay for Medicare prescription drug coverage could be higher based on your income. This includes coverage you get from a Medicare Prescription Drug Plan, a Medicare Advantage Plan, a Medicare Cost Plan, or an employer group Medicare Advantage Plan that includes Medicare prescription drug coverage. If the modified adjusted gross income that you reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain limit, you will pay an extra amount in addition to your plan premium. Usually, the extra amount will be deducted from your Social Security check. If you have to pay an extra amount and you disagree (for example, you have a life event that lowers your income), call Social Security at1-800-772-1213. TTY users should call 1-800-325-0778. For more information, visitwww.socialsecurity.gov.
Source: growingolder.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

Seniors: Who do you want rationing your Medicare?

Proposed changes to Medicare, (but not discussed often enough) include raising the Medicare eligibility age; increasing premiums for the wealthier or for everyone; subsidizing premium payments for private health insurance (so-called vouchers); increasing supplemental insurance premiums; hiking deductibles and cost-sharing for such services as home health care; slashing Medicare reimbursements for doctors, hospitals and other health care providers; generating new revenues by increasing the payroll tax rate, and on and on and on. (Check the AARP website for more detailed discussion of the options.)
Source: chicagonow.com

Learn about Medicare options at two events in Bellingham

The meeting will cover the basics of Medicare and answer questions about such topics as choices in Medicare insurance, company plans vs. Medicare Advantage or Medicare supplement plans, how to choose a new plan, best coverage for prescription drugs, and which plans doctors accept.
Source: bellinghamherald.com

Representative Sanchez Introduces Medicare Adult Day Services Act 2012

“We owe it our seniors to provide them with quality health care, and they deserve to have the full range of care choices,” said Congresswoman Sánchez.    “Adult day care is an important option for seniors who need rehabilitative care or help with daily life tasks, but don’t need around-the-clock care.  This legislation provides a cost-effective Medicare choice by paying adult day care providers 98% of the home health rate.  This bill also provides crucial relief to family caregivers, who often struggle to balance work and caring for their loved ones fulltime.”
Source: nadsa.org

Understanding Your Medicare Options

If you are one of the millions of Americans eligible for Medicare, you probably know that Medicare does not cover all of your health care expenses.  In fact, on average Medicare only covers about 50% of the total health care costs for those covered by Medicare.  There are co-payments for hospitalization and skilled nursing care and most medical expenses are only covered at 80%.  In addition, Medicare does not cover prescription medications.  Understanding your Medicare options will help ensure you have the coverage you need at a price you can afford.
Source: findlocal-insurance.com

Several Companies Ending Medicare Advantage Plans in Wyoming

Option 1: Participants can join another Medicare health plan, if one is available in their area. Most Medicare health plans include prescription drug coverage. If the plan does not have drug coverage, participants under these Medicare Advantage Plans will need to join a separate Medicare prescription drug plan to get prescription drug coverage. Option 2: Participants can change to standard Medicare. Standard Medicare is fee-for-service coverage managed by the federal government. If choosing standard Medicare, participants will need to join a separate Medicare prescription drug plan to get prescription drug coverage. Participants may also want to buy a Medicare Supplement Insurance (Medigap) policy to fill in the gaps in original Medicare coverage.
Source: kgab.com

Continuing Education Options for Seniors: E

E-Learning refers to any type of education which is done electronically, usually online via the Internet.  This can be done in a classroom or outside, but more and more it is being considered as an alternative to traditional classroom lessons.  Some people choose e-learning because they live far from any educational institutions; others have disabilities which prevent them from getting out on a regular basis; yet others study online because it is less expensive than traditional education, and sometimes free.  Whatever your motivation, seniors, it is a viable option, and new opportunities are appearing all the time.  You can take advantage of both formal and informal online learning to acquire new job skills, access a wealth of information, explore a new hobby or just satisfy an intellectual curiosity!
Source: medicareecompare.com

RxAlly to debut Medicare Prescription Drug Plan this season

SmartD Rx has two plan options available: SmartD Rx Saver and SmartD Rx Plus. Both plans offer seniors $0 member co-pays for preferred generic medications and lower co-pays for all medications at Preferred Network pharmacies. Neither plan has a mail-order option, but both offer a 90-day supply of medication at retail pharmacies with a discounted co-pay compared to a 30-day supply. SmartD Rx Plus offers additional options to minimize out-of-pocket costs and greater levels of coverage with no deductible for a higher premium. 
Source: drugstorenews.com

Georgia Medicare Supplement Plans made easy by GAMedicarePlans.com

Posted by:  :  Category: Medicare

admission : waiting by drivebybiscuits1GAMedicarePlans.com makes shopping for Medicare plans easy and simple by giving you all of the information you need. Their skilled agents will stay with you through the entire process. Your confidence level will go up after requesting a quote from them. Georgia Medicare Supplement Plans were designed to fill in the gaps left by traditional Medicare coverage, and GAMedicarePlans.com has made finding your ideal plan that much more simple for you.
Source: release-news.com

Video: Georgia Health Insurance Medicare

Georgia Cancer Specialists Settles with Feds over Medicare Billing

The civil settlement resolves the United States’ investigation into Georgia Cancer Specialists’ practices relating to billing for evaluation and management (E&M) services on the same day as a related procedure. Generally, providers are not permitted to bill both E&M services and a related procedure on the same day under the Medicare program’s regulations. 
Source: patch.com

Prepping for the Fiscal 2013 Wave: Q&A With Greg Damron, CFO of Georgia Health Sciences Medical Center

Question: The federal government’s 2013 fiscal year just started Oct. 1. There is a slew of big changes coming toward hospitals and their Medicare revenue, such as the readmissions program, value-based purchasing and others. How would you describe this upcoming fiscal year for you and your organization, and is it finally time financial officers can put volume-based care in the rear-view mirror? Greg Damron: Ultimately, volume-based reimbursement for care will largely be a thing of the past. In the most immediate term, we need to continue to focus on quality metrics, value-based purchasing and, particularly, readmission rates. In the long term, we need more primary care, preventive care and population management. Since we are Georgia’s only public academic health center, we have to ask, “How do we get out into the state and reduce the incidence of disease before it becomes problematic and requires acute care?” For instance, in our most recent negotiations with the managed care plans, insurers have been much more interested in paying for quality instead of having a traditional negotiation over rate. Overall, the work plan is toward more global payments, capitation [fixed payment remitted at regular intervals to a medical provider by a managed care organization for an enrolled patient], accountable care organization models and the like. Q: You mentioned capitation. Do you see that type of pursuit failing like it did in the early 1990s? GD: We are in a much more data-rich environment now, and there is a much higher occurrence of hospital employment of physicians. This wasn’t the case then. [Hospitals and physicians] were misaligned and literally fighting over that capitated dollar back then. We’re beginning to see more alignment through employment or other mechanisms because everyone realizes the old model is unsustainable. Q: What financial issues worry you most going into the next year, and conversely, what trends are encouraging? GD: The most immediate danger is the upcoming sequestration, if it goes through. That wasn’t part of the healthcare reform conversation, but that will have to be faced first. Longer term, as an academic health center, we’re most concerned about things like reimbursement for medical education. Another piece that is not [Medicare-related] — Georgia Health Sciences Medical Center is the state’s second-highest provider of Medicaid services, and that’s a more immediate issue given both the state’s fiscal condition, as well as the fact that we are starting at reductions to [disproportionate share hospital] payments due to healthcare reform. And right now, we’re in position where the state doesn’t seem to be inclined to expand Medicaid, which would have offset some of that reduction through expanded coverage. This year will be a continuation of trying to take costs out of our system. Last year, at this time, we were uncertain about how the Affordable Care Act would land in the Supreme Court, but you had to anticipate whatever would happen over the long term would require a reduction in payments to providers. Between the federal deficit and state budget issues, there is going to be less money for healthcare services in the future than there is today. We are taking costs out through whatever means we can. We are looking at overhead and supply chain, and we are trying to be as efficient as we can at the highest level of quality — for example, in terms of patient throughput. In terms of encouraging trends, that’s a tough one. [Laughs] While Georgia doesn’t plan to expand Medicaid, they are looking to redesign the program. As one of largest providers in the state, we are actively involved in this process. We have the second-largest children’s hospital in the state, so there is much work to be done around the pediatric population as well. But those types of changing models and getting everyone aligned are encouraging — they are just very challenging. Q: Conversations about the legitimacy of tax exemptions for non-profit hospitals and health systems have hit a fever pitch within the past year or so. Do you eventually see tax exemptions fading away for hospitals as more people become insured in the coming years, assuming charity care then goes down? GD: I think there will always be a place for hospital tax exemption. There’s more to it than just the provision of charity care. There are a lot of other benefits for communities to have a not-for-profit hospital or health system in their area. As an academic center, there are also ancillary benefits that would not necessarily exist with a profit motive and shareholders. For example, there’s involvement with other community organizations, research and the public health aspect. The biggest difference is that we reinvest whatever margins we have back into community benefit programs like these. Think about it this way: A for-profit entity is going to have facilities in markets where it can be profitable. A hospital can’t be profitable in every community. That’s part of why having a not-for-profit provider is a plus. It’s getting harder, of course, for standalone facilities to maintain their presence in their communities. There are lots of different combinations, for-profits taking over not-for-profits, for example, and that’s a trend that will be interesting to watch. Q: You said Georgia’s Medicaid program is a major part of Georgia Health Sciences Medical Center and other safety-net institutions. What other specific issues in Georgia are you following with utmost attention? GD: We’re sensitive to whatever happens to the Medicaid program in Georgia. That’s probably our number one concern currently. As an academic health center, while we’re not owned by the university system, we’re still a component of it. Other state budget cuts that affect the university will impact us in tangential ways. The economy and unemployment situation in Georgia is also a concern. At least in our immediate service area, the central Savannah River area, our unemployment rate is still persistently above the national average despite the fact we have many government employers. Many of those employers are military, like Fort Gordon, and assuming sequestration comes to pass, that will adversely affect those organizations. That has obvious impacts on safety-net hospitals having to take care of folks without coverage or those who become unemployed. Q: Do you have any final thoughts or recommendations on how other hospital CFOs like you can best prepare for the upcoming fiscal year? GD: You always have to guard your balance sheet. That is key. A strong balance sheet will protect you during a downturn. For example, another major local hospital system with a very strong balance sheet has been able to weather a lot of change due to reimbursement reduction and reinvestment needs — investments into the clinical and financial information systems and a changing reimbursement outlook. They are able to weather that because they have a strong balance sheet. For some, that’s one of the many reasons they are partnering [with other organizations] because of a lack of liquidity or access to capital. Those go hand-in-hand.
Source: beckershospitalreview.com

Georgia voters oppose Romney

Georgians are sour on the direction of both the country and the state. Self-identified independent voters are especially skeptical of our national and state progress. Only 24 percent of independents believe Georgia is headed in the right direction while 66 percent say things have gotten off on the wrong track.  Their views on the country mirror these numbers with only 21 percent saying the country is headed in the right direction and 77 percent believing things have gotten off on the wrong track.
Source: bettergeorgia.com

Hospitals Against Norquist; For Renewal Of Bed Tax

The bed tax goes to pay for Medicaid which is kids, seniors and special needs. We already know that close to 75% of unwed teenage mothers end up using the service at one point in time. The combination of birth control policy and abortion rights would be major contributors to the problem of needing the tax revenue. Norquist is against both insurance companies required to allow women to have the choice about using birth control if their employer said no, and is against abortion. In my book it would be rather hypocritical to be against both policies and take away tax revenue for Medicaid. What am I missing? BTW if you really want to lower abortion how can you be against promoting contraception, especially in schools with high teenage pregnancy rates?
Source: peachpundit.com

Experts debate future of Medicare in AARP event

In the videoconference, Stuart Butler of the Heritage Foundation and Henry Aaron of the Brookings Institution agreed on at least a couple of points: that Medicare beneficiaries should have a cap on their out-of-pocket spending, and that high-income seniors should pay higher premiums than lower-income people.
Source: georgiahealthnews.com

Georgia Medical Practice Settles Case with DOJ For $4.1 Million

The civil settlement resolves the United States’ investigation into Georgia Cancer Specialists’ practices relating to billing for evaluation and management (E&M) services on the same day as a related procedure. Generally, providers are not permitted to bill both E&M services and a related procedure on the same day under the Medicare program’s regulations. In specific circumstances, providers can avoid this prohibition by submitting their claims marked with modifier 25, which tells Medicare to pay both the procedure and the E&M service. Here, the U.S. Attorney’s Office alleged that Georgia Cancer Specialists applied modifier 25 to claims that did not qualify for its use, leading to overpayments by Medicare.
Source: midsouthtriallawyer.com

Houston Hospital Head Accused Of Medicare Fraud

In Houston, authorities arrested Earnest Gibson III, son Earnest Gibson IV and five others. The indictments accused the group of participating in a scheme to pay kickbacks to Medicare beneficiaries enrolled in programs that allowed the hospital to bill Medicare for millions.
Source: cbslocal.com

Medicare Fraud Strike Force Charges 91 Individuals for Approximately $430 Million in False Billing

Seven individuals are charged in Houston for their participation in a fraud scheme at a hospital which led to $158 million in fraudulent billing for community mental health center services. According to court documents, the defendants who served as administrators at the hospital paid kickbacks – in the form of cigarettes, food and coupons redeemable for items available at the hospital’s “country stores” – to Medicare beneficiaries in exchange for those beneficiaries’ attendance at the hospital’s partial hospitalization programs (PHP). Allegedly, beneficiaries watched television, played games and engaged in other non-PHP activities rather than receiving the services for which the hospital billed Medicare. Previously, on Feb. 22, 2012, the assistant administrator of the hospital, Mohammad Kahn, pleaded guilty to conspiracy to commit health care fraud and paying kickbacks related to $116 million worth of fraudulent claims submitted to Medicare. After his guilty plea, an additional $42 million in fraudulent claims were discovered that are included in today’s totals.
Source: batonrougetoday.com

Leading Oncology Practice to Pay $4.1 Million to Settle False Claims Act Investigation

ATLANTA—The United States Attorney’s Office for the Northern District of Georgia announced today that it has reached a settlement with Georgia Cancer Specialists I PC, which agreed to pay $4.1 million to settle claims that it violated the False Claims Act by billing Medicare for evaluation and management services that were not permitted by Medicare rules. Georgia Cancer Specialists is one of the largest private oncology practices in the country with 27 offices located throughout the Atlanta metro area. Sally Quillian Yates, United States Attorney for the Northern District of Georgia, said, “Health care providers should be on notice that if they inflate their billings, we will aggressively seek to recover not only the overcharges but also significant penalties under the False Claims Act.” Ricky Maxwell, Acting Special Agent in Charge, FBI Atlanta Field Office, stated, “The FBI continues to do its part in ensuring that federal funds appropriated to Medicare are spent appropriately and today’s settlement is an example of those efforts. The FBI urges anyone with information related to overbilling or fraudulent billing of our Medicare programs to contact their nearest FBI field office.” “Today’s settlement sends a clear message to health care providers across the country that they will be held responsible if they misrepresent the services they bill to Medicare,” said Derrick L Jackson, Special Agent in Charge of the United States Department of Health and Human Services, Office of Inspector General for the Atlanta region. “The Office of Inspector General will continue to work closely with our law enforcement partners to stamp out fraud, waste, and abuse within the Medicare system.” The civil settlement resolves the United States’ investigation into Georgia Cancer Specialists’ practices relating to billing for evaluation and management (E&M) services on the same day as a related procedure. Generally, providers are not permitted to bill both E&M services and a related procedure on the same day under the Medicare program’s regulations. In specific circumstances, providers can avoid this prohibition by submitting their claims marked with modifier-25, which tells Medicare to pay both the procedure and the E&M service. Here, the United States Attorney’s Office alleged that Georgia Cancer Specialists applied modifier-25 to claims that did not qualify for its use, leading to overpayments by Medicare. Because of widespread abuse of the use of modifier-25, the United States Department of Health and Human Services, Office of Inspector General, has targeted the use of modifier-25 in its yearly work plans. The yearly work plans outline the current focus areas of the OIG and lead to increased scrutiny by the OIG of those areas. The focus on the abuse of the use of modifier-25 was prompted because prior OIG work has shown that improper use of the modifier resulted in inappropriate payments to Medicare providers. This resolution is part of the government’s emphasis on combating health care fraud under the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover more than $9.2 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are over $12.8 billion. This case was investigated by special agents of the Federal Bureau of Investigation and Health and Human Services, Office of Inspector General. The civil settlement was reached by Assistant United States Attorney Christopher J Huber. The claims settled by the settlement agreement are allegations only; there has been no determination of liability. For further information please contact the United States Attorney’s Public Information Office at USAGAN.Pressemails@usdoj.gov or (404) 581-6016. The Internet address for the HomePage for the United States Attorney’s Office for the Northern District of Georgia is www.justice.gov/usao/gan. Reported by: FBI
Source: 7thspace.com

DeMint: Obama, AARP partners in ripping off seniors

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SS“For instance, Jim Messina – then your deputy Chief of Staff, now your re-election campaign manager – asked AARP for ‘immediate robo calls into Nebraska urging Nelson to vote for cloture’ on the bill,” he said. “In December 2009, the White House Office of Public Engagement asked AARP to put out talking points rebutting a Republican amendment related to Medicare.”
Source: humanevents.com

Video: Choosing a Medicare Supplement Policy in 2011

APPRISE Medicare Counseling Information Sessions

 (1) Medicare 2013 will explain the options that will be available next year for persons who have (or are considering) a Medicare Advantage plan, and those who are currently enrolled in, and those considering enrollment in a Medicare managed care plan (typically, HMOs). Usually, these plans include Part D prescription drug coverage as part of the package.
Source: wordpress.com

Georgia Medicare Supplement Plans made easy by GAMedicarePlans.com

GAMedicarePlans.com makes shopping for Medicare plans easy and simple by giving you all of the information you need. Their skilled agents will stay with you through the entire process. Your confidence level will go up after requesting a quote from them. Georgia Medicare Supplement Plans were designed to fill in the gaps left by traditional Medicare coverage, and GAMedicarePlans.com has made finding your ideal plan that much more simple for you.
Source: release-news.com

How to Effectively Compare Medicare Supplement Insurance Plans

When comparing insurance policies, it is important to find out whether the premiums are ‘community-rated’ or ‘attained-age-rated’. Essentially, community-rated insurance premiums are not set based on age, meaning that age is not a factor when calculating premiums. Attained-age-rated premiums increase as one gets older, meaning that over time, a policy with an initially low premium may end up costing policyholders more as they get older.  This may not be an issue for some, especially those who do not plan to be part of the Medicare system for a long period of time. So this is not necessarily something to avoid completely.
Source: insurancewithatwist.com

Medicare Supplement or Medicare Advantage

That is correct, Jeff!!  If your group prescription drug plan is not as good as Medicare’s standard prescription drug plan, which means has a $321deductible or more for 2012.  Or if your company and/or your insurance company states that the plan is not creditable, then you should enroll in a Part D plan to keep from having a 1% per month penalty which goes back to the month your Part A started, when you do enroll in a prescription drug plan. Read page 90 of the
Source: tonisays.com

Greenbelt Explorations Unlimited Explores Medicare Supplements

On Friday, Sept. 21, Explorations Unlimited welcomes Mr. Greg Markomanolakis, who will be talking about the differences in Medicare plans and pricing, Medicare Extra Help and the Maryland Senior Prescription Drug Assistance Program that a lot of seniors aren’t aware of. He will also touch briefly on the importance of having burial plans established through an irrevocable funeral trust that is Medicaid waived.
Source: patch.com

Medicare Supplement Insurance Texas Agencies Offer Is Helpful To Certain Clients

The federal government allows private agencies to sell supplemental policies to customers. These policies help individuals to pay for the things that their original insurance does not cover. Companies that sell such policies must comply with very strict federal and state laws and regulations. They are standardized according to guidelines created by the United States government and all such policies must provide the same coverage, regardless of the agency from which the coverage is obtained. However, each agency is allowed to charge different rates for the coverage.
Source: myglobalseattle.org

Things you should know about Medicare Supplement Insurance at Maximum Performance Begins With A Healthy Body

If you already have Medicare Part A or Part B, you can also buy medigap cover because it provides coverage for coinsurance, co-payments, and deductibles. In this arrangement, original medicare policy pays for the approved amount for health care cost. The medicare supplement policy will supplement your coverage by providing its share afterwards. However, there are few things that are not covered by Medigap policies. Dental and vision care, glasses, hearing aids, private nursing services, and long-term nursing facilities are not covered by Medigap.
Source: procureperformance.com

Today’s Influence Ads: AARP Medicare Supplement, Shale Gas Production

A slew of new ads are out today as Congress embarks upon its last week before the elections. AARP and UnitedHealthCare have a new ad today promoting AARP Medicare Supplement Insurance Plans as the only standardized Medicare supplement plan that AARP  endorses. American Clean Skies Foundation has a new ad pushing for the production of shale gas in the United States. The government of Panama’s new ad promotes the country as a good place for American businesses to invest. And Across the Aisle Foundation has a new ad inviting senior House and Senate staffers from both parties to an October event to discuss how the new Congress should tackle its first 100 days. Others with new ads, per Kantar Media’s Washington Eye, include: American Petroleum Institute, American Sugar Alliance, American Veterinary Medical Association, Consumer Electronics Association, Employee Freedom Act Committee, Fair Search, Lockheed Martin, McDonald’s, Neustar and Radiation Therapy Alliance. Those with continuing ad include: Altria, American Cancer Society, American Council of Life Insurers, American Hospital Association, AT&T, Beirut Families, Boeing Company, BP, Chevron, CIT Group, CME Group, Hologic, Honda, Huntington Ingalls Industries, Lockheed Martin, Mars Chocolate, Northern Dynasty Minerals, Nuclear Energy Institute, Pfizer, Pharmaceutical Research Manufacturers of America, Southern Company, United Soybean Board, Univision, WellPoint, WTOP and Zurich.
Source: nationaljournal.com

The California Medicare Supplement Insurance Carrier Landscape

A similar situation is occurring for 1000’s of California seniors daily these days. As they approach their 65th birthday, the mail starts to get especially thick. You’re now the most popular person in all of the State…with the California Medicare supplement carriers. The shiny brochures and promises why they’re the best create a sheer tidal wave of information coming your way and we’re writing this article to help you narrow a great deal of those offers and really understand the current landscape of California Medigap carriers. So let us begin…before the mail carrier comes by again. First of all, it’s important to understand that even though the California Medicare supplement plans are standardized (a C plan is a C plan regardless of the carrier), health insurance is still regulated and governed at the State level and this applies to California Medigap plans as well. There are some nationwide-type carriers which do business in California (think of Aetna or United Health) but their product offerings in the State will still be tailored to California rules, regulations, and maybe more important, market factors. So, Medicare is Federal while California Medigap carriers and plans are State specific. Let’s jump into the main carriers on the market. First, there’s AARP which most seniors (you may start receiving info from them in your mid 50’s). AARP does not actually underwrite the California Medicare supplement but they partner with a large carrier who does. Currently, it’s United Health which is a respectable, nationwide based health insurance carrier. You will doubtlessly receiving much correspondence from AARP regarding their California Medigap plans and they should be part of the consideration. Next up, you have the Blues. California is unique among the States (aside from various, other reasons) in that Blue Cross and Blue Shield of California are two distinct carriers in our State. You have Anthem Blue Cross and separately, Blue Shield of California…both of which offer California Medicare supplemental insurance plans to State residents. Both have long track records and have been strong promoters of the Medigap plans for decades now so they are also strong contenders. You then have large, multi-State carriers (some health and other’s life) which offer CA Medigap plans. Examples would be Aetna, Humana, Mutual of Omaha and the like. These are also contenders when comparing Med sup carriers in California but outside of a clear pricing advantage (which is not likely compared to AARP and the Blues), the benefit of such a consideration is limited. You may have had one of these carriers prior to Medicare and liked dealing with them which is fine. This is not inconsequential in your decision although the Senior (California Medicare supplement) and pre-65/group divisions of a California carrier can be completely different. Below this rung, you have many smaller carriers, both health and life that jumped into the CA Medigap market. As licensed agents, we would probably stick with the stronger carriers which have longer track records specifically in the Medicare supplement market since this can affect price stability going forward. In another article, we’ll deal with how to compare and quote the various California Medicare supplement carriers so that you get the best value for your premium dollar and this is an important consideration since the pricing models can vary quite a bit. Ultimately, California has one of the most competitive health insurance markets which makes sense considering its size so you are fortunate to have a long list of available carriers to choose from, even if there are really only a few that merit your attention. This works to keep all of them “honest”.

Top 10 Proposals for the Future of Medicare – Part 1 of 3

Posted by:  :  Category: Medicare

ILGWU senior female members and retirees holding placards urging "fair play for the aged", "hands off social security", "don't mess with medicare", "keep your promises Mr. President", and more. by Kheel Center, Cornell UniversityBHM Healthcare Solutions is a healthcare management consulting firm which offers a breadth of services including: physician advisor services, accreditation, compliance, financial analysis, revenue cycle, denials management, quality management, clinical improvement, executive recruitment/interim staffing, and training. We have achieved URAC accreditation for both our IRO and PCHCH services. We have a 100% success rate with assisting our clients in achieving accreditation. We have a state of the art physician review portal system for peer reviews. Our team of healthcare management consultants are all experts in their areas, are always current on the latest trends and regulations, and ready to assist you with any of your healthcare consulting needs. Please visit our site http://www.bhmpc.com to learn more about us. Please call us at 1-888-831-1171 today to schedule your free consultation. We look forward to working with you.
Source: bhmpc.com

Video: Romney Campaign: ‘WILL Raise Age for Medicare’

Should The Eligibility Age For Medicare Be Raised?

Maya MacGuineas, president of the Committee for a Responsible Federal Budget, makes the case for raising the eligibility age. Arguing to leave it unchanged is Aaron E. Carroll, the associate director of Children’s Health Services Research at Indiana …
Source: newamerica.net

More on raising the Medicare age

As a stand-alone policy, there is no doubt that raising the Medicare eligibility age this is a bad one. And doing so assumes the implementation of exchanges under the ACA. However, I am open to raising the Medicare age in a manner that equalizes it with the Social Security retirement age as part of a broader political deal that either brings about federally-guaranteed universal catastrophic coverage or an agreement to move ahead with implementation of the ACA that makes reform the responsibility of both parties. For many Conservatives, a move such as this one is a strong signal of seriousness in addressing long range health care cost problems. As I say, I don’t think they are correct, but there is a policy logic of increasing the age along with Social Security increases given that they have been linked for so long. In the end, I would potentially agree to this, so long as what is gained in return is consequential enough.
Source: samefacts.com

Caldwell Guardian: There Is No Cure For Old Age, Medicare Mills Sell False Hope

There is no cure for old age and most of us are in denial about our looming demise.  Medicare costs are going to force decisions a lot of people will not agree with as more and more people move onto Medicare rolls.  I watched with a lot of disdain for how my own father made really bad end of life decisions and vowed to not do the same as I move closer to the end my of life.  For example, my father called me when he was 91 years old about his scheduled surgery to have both knees replaced.  Mind you he was taking no pain meds for his knee issues.  I asked him why he had opted for surgery over taking a few pills to control his knee pain.  I was not ready for his answer:  He was worried about the “long term” consequences of taking pills to control pain!  I countered his objection to taking meds and asked what his view of “long term” meant in his mind.  I won’t go into the details of this discussion but it is a very good example of why we need some serious oversight of Medicare.  (Note: My father died two weeks after he turned 92 from congestive heart failure.) The Republican Congress wants to raise the age for Medicare eligibility and ditto for Social Security.  I would offer the real opportunity lies on the back end and all of the bad decisions that may extend life but at what cost and quality of life.  Medicare and his Part B coverage stood ready to pay the bills for my father for his knee surgery and never mind that he was suffering from Congestive Heart Failure and only had about 20% of he heart capacity.  At age 66, I am well into what I call the last quarter of my life.  I want Social Security and Medicare to be there for younger people so they can retire and enjoy a few years of what life they have left to live.  However, we have to get a system in place to address the fact we all get old and we all get to die at some point in time.  The options offered to my father as well as others when they are near the end of their lives have to undergo some cost benefit analysis.  Many health care options made by people today make no sense and cost Medicare billions of dollars. There is no cure for old age and we owe it to our survivors to make a graceful exit.  Good decisions about our health care and when to recognize our time is up will be necessary to keep Social Security and Medicare solvent for future generations.  Life is short no matter how long we live.
Source: blogspot.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

Medicare Pricing Released for Most Flu Vaccine Codes

90656 Influenza virus vaccine, trivalent, preservative free, when administered to individuals 3 years and older, for intramuscular use (Use for Medicare flu shots using the vaccine Fluarix) (Medicare reimbursement $12.39) single dose syringe
Source: managemypractice.com

Daily Kos: Romney/Ryan will raise Medicare eligibility age for current seniors

If the increases in eligibility age are raised now because of the fiscal “crisis” and those under 55 are supposed to be dumped altogether, what guarantee is being offered that a further “crisis” caused by counter-productive Republican policies won’t prompt them to reduce eligibility further?  If their solution hastily offered now is to cut eligibility, why would that not be their preferred option during the next manufactured “crisis?”  The Republicans have already let it be known that they will never look at increasing revenues through upward changes in the tax rates, so any total revenue increases must come disproportionately from increases in the national economy, except they’ll have already cut taxes further reducing revenues.  Why should they get a third shot at dynamic scoring for revenue increases when the prior experiments under Reagan failed and Bush II totally cratered the economy?  
Source: dailykos.com

New Medicare, Health Law Ads Emerge In Congressional Races Across The U.S.

National Journal: Chamber Expands Ads Into New York, Utah And Georgia The U.S. Chamber of Commerce will launch a new round of advertisements in nine House districts beginning tomorrow, including on behalf of six New York Republicans and two conservative Democrats seeking re-election this year. The Chamber’s new advertising will focus on President Obama’s health care law. Advertisements are running against Reps. Tim Bishop, Bill Owens and Louise Slaughter and ex-Rep. Dan Maffei, four New York Democrats who voted for the law; Rep. Kathy Hochul, who entered Congress after the law passed; and Democratic candidate Sean Patrick Maloney, who is running against Republican Rep. Nan Hayworth. But lest someone accuse the Chamber of only backing Republicans, the group is launching its first advertising on behalf of a few conservative Democrats. Both Reps. Jim Matheson (D-Utah) andJohn Barrow (D-Ga.) — both of whom voted against the health care law — will get advertising on their side… Now, a Democratic source sends along the totals of the buys so far, which add up to about $1.9 million. (Wilson, 10/4).
Source: kaiserhealthnews.org

ONLY ON 3 UPDATE: Injured man on Medicare is able to stay in hospital to await surgery

Posted by:  :  Category: Medicare

Harry Reid, Health Care narrow by Truthout.orgTom, I know portions have kicked in, like the part that removed the lifetime cap on benefits. This alone saved us from financial ruin when my wife came down with cancer. I am sure more provisions will be forthcoming. What gets me is all these people have moaned and groaned for years about having to foot the medical bills for those who choose not to carry insurance. Obama did something about it and they are still whining. Probably most of those who are complaining the most are the ones that will have to slack off on their Marlboros, cheap beer, tattoos and piercings and use that money to buy insurance.
Source: wwaytv3.com

Video: David Rouzer: Ending Medicare, Outsourcing Jobs

Open Enrollment for Medicare Part D : Hoke County, North Carolina

The Hoke County Health Department Board of Health will hold an open meeting on Monday, October 8, 2012 at 7:00 PM in the Conference Room at the Hoke County Health Department, 683 East Palmer Road, Raeford, NC. Please follow the signs to the meeting room. The public is invited to attend. For further information, please contact the Hoke County Health Department at 910-875-3717.
Source: hokecounty.net

North Carolina Medical Society

Palmetto Government Benefits Administrators (GBA) has announced their 2012 Fall Tour Workshop series to discuss Medicare coverage and billing updates, as well as clinical and documentation information affecting Medicare healthcare professionals. The target audience includes Part A hospital and skilled nursing facility (SNF) professionals and all Part B specialties.
Source: ncmedsoc.org

White House: Medicare cuts to cost $11B

Under the Budget Control Act of July 2011, a supercommittee was charged with trimming $1.2 trillion over the next decade or else automatic cuts, split between domestic and defense programs, would go into effect, The Washington Post reported. Stalled by a political gridlock, the first round of automatic cuts is scheduled for January, only a few months away.
Source: msochealth.com

Romney confronts Ryan's Medicare question in N.C. rally

 I personal do not beleive mr romney about what he is saying with regards to the issue of their passing medicare cuts to the current budget with the help of the democrats not a true democrat anyway maybe with the help of some right winged winged nut of a democrat that is already so closely alinged with the repbulcians that he /she had may as well be a republican in the first place .  just another republican elephant posing as a donkey/ democrat by surely not a true democrat the democratic party in this state is better off with members of this nature for sure. they need to truely change their real registration to  reflect the actuakl way they feel an vote an stop posing as our current governor did as a democrat whenin fact they are republcians in the first place thank you
Source: newsobserver.com

Killing Medicare is just an appetizer

At a time of extreme inequality – with the top 1 percent capturing a staggering 93 percent of all income gains in 2010 – Republicans would dramatically lower taxes on the wealthiest Americans, and by definition raise them on working families.They don’t actually admit to that, of course. But they lower top income tax rates and sustain lower rates on wealth (capital gains, dividends) while claiming their reforms will raise as much money (be revenue neutral) by eliminating unspecified loopholes and tax breaks. That means they must go after the biggest deductions – either limit the mortgage deduction for middle class homeowners or cut the tax benefits for employer provided health care, both reforms that would directly hit working families. With health care costs soaring and employers cutting back on health insurance benefits, the Republican budget would add millions to the rolls of the uninsured by eliminating the health care reforms, with no program in its place. With boomers headed into retirement and soaring Medicare and Medicaid the essential cause of projected deficits, Republicans address the problem not by limiting health care costs, but by requiring seniors to pay more. They would turn Medicare into a voucher or “premium support” program that would not keep up with health care costs, forcing seniors to pay thousands more out of their own pockets. Worse, they would cut Medicaid support drastically for the most vulnerable – the impoverished, the disabled, and the terminally ill. With the U.S. spending almost as much on its military as the rest of the world combined, Republicans demand that we raise, not pare, Pentagon spending. With our basic infrastructure – from roads to schools to sewage systems – in dangerous decline, the construction industry flat on its back, and interest rates near record lows, Republicans call for spending less, not more, on rebuilding America, rendering our economy less competitive and our streets less safe. With global corporations growing ever more adept at using transfer pricing and overseas tax havens to avoid taxes here at home, Republicans would make the entire world outside the U.S. a corporate tax haven, encouraging companies to move jobs and book profits abroad. With college tuition soaring and more and more being priced out of the education they have earned and need, Republicans solve the problem by cutting back on student loan programs. Today every element of the American dream – a secure job with American wages and benefits, an affordable home, a good education and affordable college for the kids, a secure retirement, health care for the family – is growing out of reach for more and more Americans.
Source: bluenc.com

Butterfield Commemorates the 47th Anniversary of Medicare and Medicaid

“As we reflect on the success of Medicare and Medicaid, we are constantly reminded that there are forces threatening to cripple these critical programs that sustain so many Americans.  This year, the House Republicans approved a Budget Resolution for Fiscal Year 2013 that calls for significant reductions to Medicaid funding and place at risk access to healthcare for 47 million Medicare beneficiaries.  In North Carolina’s First Congressional District alone, 14,000 children rely on Medicaid and 121,000 seniors are eligible for Medicare.  The so-called ‘Ryan Budget’ is an unacceptable proposal that would undermine the future of Medicare and Medicaid while drastically burdening seniors and low-income families with higher healthcare costs.  Ryan’s budget proposal would place families’ health at the mercy of health insurance companies that are focused on profits and not individuals’ health.  I challenge my colleagues to work together to strengthen Medicare and Medicaid so millions of American households continue to have access to lifesaving healthcare.”
Source: homeinhenderson.com

Impact of Medicare Sequester v. Medicaid expansion on providers

Interestingly, the impact of the Sequester on health care providers is beginning to get some news coverage in North Carolina, but there has been very little discussion of the Medicaid expansion choice along the same lines, in the media or in the campaigns for Governor and General Assembly. I assume this means that the Republicans know that we will do the expansion in N.C., and they have wisely not boxed themselves in. It is not as clear to me why none of the Dems running are talking about this issue.
Source: samefacts.com

YOU DECIDE: What’s the best approach to Medicare?

The amount of subsidy would depend on the cost of the insurance plan chosen by the Medicare recipient. The government would establish a benchmark plan with certain features and reasonable costs. Seniors choosing a more costly plan would receive a smaller subsidy and likely have to pay more out of pocket, while seniors choosing a less costly plan would receive a larger subsidy and maybe even a cash rebate. Additionally, all financial assistance would be calibrated to the medical condition of the senior, meaning the sickest seniors would receive higher subsidies.
Source: ncsu.edu

How to Effectively Compare Medicare Supplement Insurance Plans

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSWhen comparing insurance policies, it is important to find out whether the premiums are ‘community-rated’ or ‘attained-age-rated’. Essentially, community-rated insurance premiums are not set based on age, meaning that age is not a factor when calculating premiums. Attained-age-rated premiums increase as one gets older, meaning that over time, a policy with an initially low premium may end up costing policyholders more as they get older.  This may not be an issue for some, especially those who do not plan to be part of the Medicare system for a long period of time. So this is not necessarily something to avoid completely.
Source: insurancewithatwist.com

Video: Understanding Medicare Supplemental Insurance

The California Medicare Supplement Insurance Carrier Landscape

A similar situation is occurring for 1000’s of California seniors daily these days. As they approach their 65th birthday, the mail starts to get especially thick. You’re now the most popular person in all of the State…with the California Medicare supplement carriers. The shiny brochures and promises why they’re the best create a sheer tidal wave of information coming your way and we’re writing this article to help you narrow a great deal of those offers and really understand the current landscape of California Medigap carriers. So let us begin…before the mail carrier comes by again. First of all, it’s important to understand that even though the California Medicare supplement plans are standardized (a C plan is a C plan regardless of the carrier), health insurance is still regulated and governed at the State level and this applies to California Medigap plans as well. There are some nationwide-type carriers which do business in California (think of Aetna or United Health) but their product offerings in the State will still be tailored to California rules, regulations, and maybe more important, market factors. So, Medicare is Federal while California Medigap carriers and plans are State specific. Let’s jump into the main carriers on the market. First, there’s AARP which most seniors (you may start receiving info from them in your mid 50’s). AARP does not actually underwrite the California Medicare supplement but they partner with a large carrier who does. Currently, it’s United Health which is a respectable, nationwide based health insurance carrier. You will doubtlessly receiving much correspondence from AARP regarding their California Medigap plans and they should be part of the consideration. Next up, you have the Blues. California is unique among the States (aside from various, other reasons) in that Blue Cross and Blue Shield of California are two distinct carriers in our State. You have Anthem Blue Cross and separately, Blue Shield of California…both of which offer California Medicare supplemental insurance plans to State residents. Both have long track records and have been strong promoters of the Medigap plans for decades now so they are also strong contenders. You then have large, multi-State carriers (some health and other’s life) which offer CA Medigap plans. Examples would be Aetna, Humana, Mutual of Omaha and the like. These are also contenders when comparing Med sup carriers in California but outside of a clear pricing advantage (which is not likely compared to AARP and the Blues), the benefit of such a consideration is limited. You may have had one of these carriers prior to Medicare and liked dealing with them which is fine. This is not inconsequential in your decision although the Senior (California Medicare supplement) and pre-65/group divisions of a California carrier can be completely different. Below this rung, you have many smaller carriers, both health and life that jumped into the CA Medigap market. As licensed agents, we would probably stick with the stronger carriers which have longer track records specifically in the Medicare supplement market since this can affect price stability going forward. In another article, we’ll deal with how to compare and quote the various California Medicare supplement carriers so that you get the best value for your premium dollar and this is an important consideration since the pricing models can vary quite a bit. Ultimately, California has one of the most competitive health insurance markets which makes sense considering its size so you are fortunate to have a long list of available carriers to choose from, even if there are really only a few that merit your attention. This works to keep all of them “honest”.

Medicare Fraud Charges Brought Against Miami Doctors, Nurses

Posted by:  :  Category: Medicare

Healthcare solution >> more doctors by / // /The announced cases are being prosecuted and investigated by Medicare Fraud Strike Force teams comprising attorneys from the Fraud Section of the Justice Department’s Criminal Division and from the U.S. Attorneys’ Offices for the Southern District of Florida, among others, and agents from the FBI, HHS-OIG and state Medicaid Fraud Control Units, with assistance from the Justice Department’s Civil Division and the IRS.
Source: kcrlawyers.com

Video: Medicare Solutions

Feds stop Medicare payments after 91 arrests for alleged false billings

Seven people in Houston allegedly participated in a hospital fraud scheme that led to $158 million in false billing for community mental health center services. Hospital administrators allegedly paid kickbacks, in the form of cigarettes, food and coupons redeemable for things available at hospital stores, to Medicare beneficiaries. In exchange, the beneficiaries attended the hospital’s partial hospitalization programs, according to court documents.
Source: ifawebnews.com

Opinion: The facts about Medicare spending debate

Kaiser Health News reports that, under that proposal, traditional Medicare would remain in place for current enrollees. However, for those 55 and younger, Medicare eligibility would eventually increase to age 67 and the program would be converted into a premium-support system where the government would provide a set amount of money annually that could be used to purchase private insurance or enroll in the traditional Medicare program. The government would pay the full premium for the private plan with the second-lowest bid, or for traditional Medicare, whichever is lower.  If costs should rise faster than the size of the annual subsidy, then seniors would have to pay the difference or move to a cheaper and possibly less comprehensive plan. Over time, that could shift more of the cost burden to seniors.
Source: healthpolicysolutions.org

Medicare Part D Creditable/Non

Plan sponsors that offer prescription drug coverage must provide notices of creditable or non- creditable coverage to Medicare-eligible individuals before each year’s Medicare Part D annual enrollment period. Many plan sponsors fulfill this obligation by including the notices in their annual enrollment materials or in separate mailings in the fall. Whether plan sponsors use the model notices provided by the Centers for Medicare & Medicaid Services (CMS) or other notices that meet prescribed standards, they must provide the required disclosures no later than October 14, 2012.
Source: sheakleyhrsolutions.com

Medicare Fraud Strike Force presses billing charges

“Today’s arrests put criminals on notice that we are cracking down hard on people who want to steal from Medicare,” said Health and Human Services (HHS) Secretary Kathleen Sebelius.  “The health care law gives us new tools to better fight fraud and make Medicare stronger.  In addition to the arrests made today, HHS used new authority from the health care law to stop future payments to many of the health care providers suspected of fraud, saving Medicare resources and taxpayer dollars from being lost to fraud in the first place.”
Source: ehrintelligence.com

Turning 65? 5 Things Every Senior Should Know About Medicare

The free Extend Health guide, Understanding Your Medicare Options, offers a clear explanation of the benefits and requirements of the various parts of original Medicare, including Part A (hospital coverage) and Part B (physician and outpatient coverage). The guide also explains what original Medicare does not cover and how to fill those gaps by explaining private Medicare coverage options, including Part C—known as Medicare Advantage, Part D—prescription drug coverage, and Medigap plans.
Source: naturalsolutionsmag.com

91 Charged in Alleged $430 Million Medicare Fraud

Seven individuals are charged in Houston for their participation in a fraud scheme at a hospital which led to $158 million in fraudulent billing for community mental health center services.   According to court documents, the defendants who served as administrators at the hospital paid kickbacks – in the form of cigarettes, food and coupons redeemable for items available at the hospital’s “country stores” – to Medicare beneficiaries in exchange for those beneficiaries’ attendance at the hospital’s partial hospitalization programs (PHP).   Allegedly, beneficiaries watched television, played games and engaged in other non-PHP activities rather than receiving the services for which the hospital billed Medicare.   Previously, on Feb. 22, 2012, the assistant administrator of the hospital, Mohammad Kahn, pleaded guilty to conspiracy to commit health care fraud and paying kickbacks related to $116 million worth of fraudulent claims submitted to Medicare.   After his guilty plea, the government says, an additional $42 million in fraudulent claims were discovered that are included in today’s totals.
Source: financialfraudlaw.com

What to Do About New Medicare Taxes: Kitces at FPA Conference

The new Medicare taxes will apply to earned income, including wages and self-employment, as well as unearned income, which mean dividends and capital gains. The increases will apply to individuals making more than $200,000 a year, or $250,000 for married couples. According to estimates from the Tax Policy Center, about 4 million households will initially be affected by the increase and in 10 years that number will more than double.
Source: advisorone.com