Debate 2012: Obama’s Dubious Medicare “Voucher” Claim

Posted by:  :  Category: Medicare

Eliminate medicare advantage - Health care reform rally at San Francisco City Hall by Steve RhodesThe president accused Governor Mitt Romney of favoring a “voucher” program for Medicare, by citing, ironically, a plan previously supported by Romney’s running mate, Representative Paul Ryan. The voucher label can be politically toxic, but bears little resemblance to Ryan’s actual Medicare proposal (in its most recent iteration).
Source: capoliticalreview.com

Video: California Medicare Supplement Insurance Plans 1-800-243-8100

FONTANA: Senior Center offers Medicare and Medi

Arrowhead United Way art big bear buck McKeon business California State University San Bernardino Cal State San Bernardino Claremont Coachella Valley Women’s Business Center colton congress Corona csusb EDA education featured featured_business fontana inland empire Inland Empire Center for Entrepreneurship Inland Empire Small Business Development Center Inland Empire Women’s Business Center Jerry Lewis joe baca marketing Mark Gutglueck Music Ontario Palm Desert Public Affairs Rancho Cucamonga redlands riverside Salvation Army San Bernardino San Bernardino County Museum SBDC Sentinel Small Business Temecula U.S. Small Business Administration UCR University Enterprises Corporation University of Redlands Workshop
Source: inlandempire.us

Dave Fluker’s California Health Insurance Blog: Blue Shield CA Medicare Plan Changes Coming

Blue Shield CA will be adding two new Medicare Supplements to their portfolio. Additions will include High Deductible Plan F and Plan N. The current $20 per month “new to Medicare” discount will be reduced to $15 per month for those enrolling in Medicare Part B for the first time. As always, Blue Shield of California Medicare Supplement Plans include the Silver Sneakers health club membership at no additional cost. For more information about Blue Shield Medicare products, visit my web site. 
Source: blogspot.com

Daily Kos: Congressman John Garamendi Takes on Fox News on Medicare (CA

John Garamendi: I was the Insurance Commissioner of California for eight years and I can tell you, once you begin to divide future beneficiaries from the existing beneficiaries, the existing program will fail and those — that’s an actuarial fact that will happen. And it is clear in the 2012 – as well as the 2011 – Romney/Ryan Republican budget – and Mr. Romney has bought into the Ryan budget – that it will terminate the guarantee of Medicare for future beneficiaries. And, because of the nature of insurance, the existing beneficiaries will see an … ever increasing increase in their share of the cost of Medicare. That’s not my talk, that’s talk by every analysis that has been done of the issue. And so what you have here is a situation in which the Medicare guarantee, which has been available to every person who turns 65, that guarantee ends. Yes, they’ll be given a voucher, a voucher that overtime and, initially and overtime, will be insufficient to pay for medical care. And let’s understand, the population that’s 65 and over is a very, is a population that has the highest health care cost. And so if you’re given a voucher that doesn’t keep pace with the cost as well as the incident of illnesses, then you’re going to find a shifting of costs from the Medicare program to the individual as well this a situation which … that program will fail. I am so happy to see Congressman Garamendi taking the struggle to save Medicare into difficult territory. As I’ve written about previously, John Garamendi is a “better Democrat.” His will be a voice in Congress that we can all be proud to having representing Democrats and our true blue values – no compromise on issues like ending the war in Afghanistan while making sure that returning veterans receive the help and benefits they need to get back on their feet, immigration reform and the DREAM act, equality for the LGBT community including marriage equality. Seriously, he’s as good as Democrats get. I wish there were more like him across the nation!
Source: dailykos.com

Medical Background NOT Needed: Medicare’s New Price Control Board

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Source: capoliticalnews.com

Executive Jobs, Executive Director, Senior Management, Vice President Jobs

McAfee  is a name that some of you may be very familiar with, but for those of you who are not here is a look at how the company chooses to describe itself, “McAfee is the world’s largest dedicated security technology company. Delivering proactive and proven solutions and services that help secure systems and networks […]
Source: execcrossing.com

Kaiser Permanente Northern California Among Top 10 Commercial and Medicare Health Plans In The Country

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to   improve the health of our members and the communities we serve. We currently serve more than 9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery   and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/newscenter.
Source: patch.com

Medicare for all CA Bus tour: In West Covina Tonight SiCKO ‘Sisters’ Reunite

Today in West Covina, the California Nurses Association summer 2012 Medicare for all bus tour will come to a close.  After visiting 18 other California cities since June 19, the nurses will wrap up this run with a bang and with clarity.  Three of the subjects of Michael Moore’s 2007 documentary film SiCKO will be on hand to help lead others in sharing their stories of struggle and frustration with the broken healthcare system. 9/11 first responder Reggie Cervantes and Dawnelle Keys, the mother whose toddler died because she was denied treatment at an out-of-network hospital, will join me at this final stop where the nurses will perform health screenings from 3 – 6 p.m. and then we’ll have a town hall meeting from 6:30 – 8 p.m.  My husband and I lost everything we had worked a lifetime to achieve when we got sick even though we always carried health insurance.   Five years ago, when SiCKO was released, the nurses of CNA went to Sacramento with Michael Moore to call attention to the pain Californians were needlessly suffering at the hands of the dysfunctional system.  On this fifth anniversary of the film’s release, this West Covina reunion of some of the American SICKOs will help highlight how far we have yet to go and what these women have to say about the current healthcare law – the Affordable Care Act – just upheld by the Supreme Court and the subject of so much political gamesmanship.  These SiCKO patients will share what it means to real people, real Californians.  And that’s what this tour has been all about. Don’t come planning to sit unengaged through a lengthy program.  Come ready to become a part of what moves California and the nation to a place where there are no more SiCKOs like me or Reggie or Dawnelle.  See you in West Covina.  And don’t think because this tour is almost a wrap that the nurses are finished.  They won’t be done until every patient is treated under a system that includes a single standard of high quality care for all – a guaranteed, improved Medicare for all system.
Source: nationalnursesunited.org

Medicare: the Fierce Democrats

On one hand, you have the Republicans riding on the crest of Rep. Paul Ryan’s proposal to save Medicare and Medicaid through a detailed budgetary masterplan that is hoped to ensure the long-term sustainability of socialized health care institutions in the USA. On the other hand, Democrats declare that the Republican solution to save Medicare and its future is merely all about shifting the costs to the taxpayer—basically raising the costs for seniors and those with disabilities, reducing the benefits they get, and letting private insurance companies sit on the driver’s seat as far as seniors’ health care is concerned. From a scientific perspective, it is difficult to say at this point which party—the Republicans or Democrats—really have a fail-proof solution, as even the most sophisticated governmental plans have to deal with the problem of uncertainty—that no one can ever be a hundred percent sure with anything. In any case, the debate continues to heat up, and it’s only a matter of months before America sees the outcome after the smoke has cleared.
Source: rescuealertofca.com

FREE (MEDICARE SEMINARS) SENIOR HEALTH PLANS …

FREE Medicare Senior Health Plan Coverage Seminars Discussing Parts: A, B, C, & D and how they work When: Thursday September 27, 5:00 p.m. Where: 1451 W. Center St. Stonegate Apartments Clubhouse Manteca When: Wednesday October 3, 4:00 p.m. Where: 1451 W. Center St. Stonegate Apartments Clubhouse Manteca When: Saturday October 6, 8:00 a.m. Where: 305 N. Union Road Chez Shari, Manteca Golf Course When: Saturday October 13, 3:00 p.m. Where: 305 N. Union Road Chez Shari, Manteca Golf Course RSVP: Odetta Rodriguez 209-825-4456 Hosted by: V.G. Capital Insurance Services CA Lic.# 0G72989
Source: pennysaverusa.com

DeBord Report : Vice presidential debate: 5 (and a half) economic battles Biden and Ryan will fight

Taxes. The deficit will come in a minute. Ryan will argue that the Obama plan to increase taxes on wealthy Americans will crush job creation and take money out of the hands of the people who are going to invest in the country’s future growth. Biden could counter by arguing that when the wealthy have their taxes cut, they tend to save the gains rather than spend them, so whatever job creation Romney and Ryan expect is an article of faith rather than anything that rests on sound economic fundamentals: “Cut them and they will spend.” Biden and Ryan could wind up agreeing about cutting corporate taxes, which are pretty high by global standards in the U.S. Corporations are also sitting on a huge pile of cash right now — around 11 percent of U.S. GDP, or $1.7 trillion. A tax cut could induce big companies to spend, rather then relying on tax cuts for the rich to trickle down into the economy.
Source: scpr.org

CA Medical Equipment Supplier Sentenced To Prison For Medicare Fraud Scheme

In February 2010, Ademefun pleaded guilty to health care fraud.  As part of his plea, Ademefun admitted that from January 2006 to his arrest in October 2009, he owned and operated Jamef Medical Supply, a fraudulent durable medical equipment (DME) supply company, which he used to submit almost $1 million in false claims to Medicare.  Ademefun admitted he paid illicit kickbacks to co-conspirators for medical prescriptions and other documents he needed to defraud Medicare.  Ademefun focused his fraudulent billings on power wheelchairs, which were among the most expensive DME that a Medicare provider could bill to Medicare.  In fact, Ademefun admitted that approximately 95 percent of all the claims he submitted to Medicare were for power wheelchairs.  Ademefun admitted he supplied these power wheelchairs to Medicare beneficiaries who were illegally solicited by patient recruiters or “marketers” for medical equipment they did not want or need.
Source: sandiegocountynews.com

Medicare for all CA Bus tour: In West Covina Tonight SiCKO ‘Sisters’ Reunite

Today in West Covina, the California Nurses Association summer 2012 Medicare for all bus tour will come to a close.  After visiting 18 other California cities since June 19, the nurses will wrap up this run with a bang and with clarity.  Three of the subjects of Michael Moore’s 2007 documentary film SiCKO will be on hand to help lead others in sharing their stories of struggle and frustration with the broken healthcare system. 9/11 first responder Reggie Cervantes and Dawnelle Keys, the mother whose toddler died because she was denied treatment at an out-of-network hospital, will join me at this final stop where the nurses will perform health screenings from 3:00-6:00 p.m. and then we’ll have a town hall meeting from 6:30 – 8:00 p.m.  My husband and I lost everything we had worked a lifetime to achieve when we got sick even though we always carried health insurance. Five years ago, when SiCKO was released, the nurses of CNA went to Sacramento with Michael Moore to call attention to the pain Californians were needlessly suffering at the hands of the dysfunctional system.  On this fifth anniversary of the film’s release, this West Covina reunion of some of the American SICKOs will help highlight how far we have yet to go and what these women have to say about the current healthcare law – the Affordable Care Act – just upheld by the Supreme Court and the subject of so much political gamesmanship.  These SiCKO patients will share what it means to real people, real Californians.  And that’s what this tour has been all about. Don’t come planning to sit unengaged through a lengthy program.  Come ready to become a part of what moves California and the nation to a place where there are no more SiCKOs like me or Reggie or Dawnelle.  See you in West Covina.  And don’t think because this tour is almost a wrap that the nurses are finished.  They won’t be done until every patient is treated under a system that includes a single standard of high quality care for all – a guaranteed, improved Medicare for all system.
Source: michaelmoore.com

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

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98Hoke County Health Center’s Annual MaternityFair will be held on Wednesday, October 17, 2012, from 5:30 – 8:30 PM at the Hoke County Senior Center (Old Armory), 423 E. Central Ave. Don’t miss out on the FREE FOOD and GREAT DOOR PRIZES! Example prizes include car seats, strollers, free dinner coupons, baby items, & much, much more! The community is invited! No registration required. For more information contact the Health Education Office at (910) 875-3717 Ext: 2104. For expectant and 6 months postpartum mothers
Source: hokecounty.net

Video: Medicare Supplement Plan, Cary, Raleigh, Durham, Chapel Hill, Greensboro, Charlotte, NC

North Carolina Medical Society

For almost a year, CMS has been revalidating the enrollment of participating health care professionals enrolled in Medicare prior to March 25, 2011 as required by the Patient Protection and Affordable Care Act (ACA). Since the revalidation process is being phased in and scheduled for completion by 2015 this call will be useful to find out the latest information about the revalidation effort, including how improvements to the PECOS system make it easier to submit revalidated enrollment information electronically. As the completion date nears the medical community should learn what to expect and how to prepare for this process. 
Source: ncmedsoc.org

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

Senate Leaders Working On Post

CQ HealthBeat: Grassley Scrutinizes North Carolina Hospitals’ Use Of Medicare Outpatient Drug Program The Senate Judiciary Committee’s top Republican, Charles E. Grassley, is pressing North Carolina hospitals to answer questions about whether they are abusing the 340B Medicare outpatient drug program, which is intended to lower drug prices for the uninsured poor. Grassley, of Iowa, wrote to Carolinas Medical Center, Duke University Health System and the University of North Carolina Hospital after newspaper reports said they were inflating prices on chemotherapy drugs. The investigation by The News & Observer in Raleigh and The Charlotte Observer found that hospitals “mark up prices on cancer drugs two to 10 times or more over cost,” according to a Sept. 22 article (Adams, 10/1).
Source: kaiserhealthnews.org

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

Daily Kos: Poll: Medicare Propels Obama Into the Lead in Florida

Biden’s father had been very well-off earlier in his life, but had suffered several business reverses by the time Biden was born, and for several years the family had to live with Biden’s maternal grandparents, the Finnegans. When the Scranton area went into economic decline during the 1950s, Biden’s father could not find enough work. In 1953, the Biden family moved to an apartment in Claymont, Delaware, where they lived for a few years before moving to a house in Wilmington, Delaware. Joe Biden Sr. then did better as a used car salesman, and the family’s circumstances were middle class. He took a stand against injustice at an early age. Biden attended the Archmere Academy in Claymont…During these years, he participated in an anti-segregation sit-in at a Wilmington theatre. People like to portray him as a bumbling avuncular man, but he’s had one hell of a career, too. When Biden took office on January 3, 1973, at age 30 (the minimum age to become a U.S. Senator), he became the sixth-youngest senator in U.S. history…
Source: dailykos.com

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

Tom, 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

Keeping an eye on Social Security and Medicare

When elected officials talk about the future of Social Security and Medicare, it’s usually a lot of “Washington-speak.” AARP is working to change that by making sure everyone in North Carolina understands what’s being discussed in Congress and has opportunities to express personal points of view. We’ve enlisted a broad range of experts from all political views to share their ideas so you can understand the pros and cons of leading proposals on the table in Washington.
Source: bluenc.com

Tampa doctor builds billion

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ... More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524(The investors took the company public and its growth was impressive until late 2007, when federal officials made public charges of Medicaid fraud against the company and its former executives. The company paid $80 million in May 2009 and reached a civil settlement with the Department of Justice for $137.5 million in 2010. In 2011, a federal judge approved a $200-million class-action settlement. Criminal charges are still pending against three former executives.
Source: healthnewsflorida.org

Video: Medicare Advantage Plans Orlando : For the disabled – Florida

MEDICARE ADVANTAGE PLAN PROBLEMS

Giving up Medicare Part A and Medicare Part B is necessary, because it allows the person to sign up with the insurance company that is selling the Medicare Advantage plan. This is a potentially dangerous sacrifice, considering the insurance company is not obligated to renew their contract with Medicare each year. If the insurance company did drop out of their Medicare Advantage contract, you would be dis-enrolled from that Medicare Advantage Plan and would have to start over looking for another one that met your needs adequately.
Source: floridahealthinsurancebroker.com

Is Florida Medicare Insurance Different From Other States?

Florida Medicare Insurance differs because many seniors have trouble paying out-of-pocket co-pays and deductibles after their Florida Medicare Insurance Part A and B pays their share. Currently, Floridians have the highest insurance rates in the country. And, the amount they pay for their Florida Medicare Insurance depends on the county they live in.
Source: seniorcorps.org

Looking for Information on Florida

I am considering whether or not to get additional health care coverage for myself; I am already on medicare at this point in time, but I am not sure whether or not it is enough coverage for me. As such, I am currently looking into florida blue medicare advantage plans, and I am trying to figure out if it is something that I need. I would really be upset if I were ever to be in a medical emergency, and not have enough health insurance to cover the expenses, so I will need to figure out what is most prudent for me to do at this point in time, considering my risk of certain health problems in the future, and other factors as well.
Source: rogervelasquez.com

Heritage: 10 Questions for the Vice Presidential Debate

A former U.S.Marine, he is the Creator of The Minority Report Network. He is also the Founder and Managing Editor of the Network’s flagship site, www.theminorityreportblog.com, Former Director of New Media for Liberty.com, Former Director of New Media for Liberty First PAC, and the Former Chief Managing Editor of 73Wire.com. Steve is a well respected national conservative blogger who’s dedicated the past several years of his life advancing conservatism online. Recently Steve was instrumental in the development of Liberty.com, Liberty First PAC, The Patriot Caucus, the national campaign trail and grassroots news site73wire.com.
Source: theminorityreportblog.com

Karl Rove Targets Tammy on Medicare

The section of the ACA that sets up the board specifically declares: “The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums . . . increase Medicare beneficiary cost-sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria.”
Source: progressive.org

The Disadvantages of Medicare Advantage Plans

  Therefore, it is not shocking to expect that the Medicare beneficiary will get less benefits in the end when they are now managed by health insurance companies with higher overhead than Medicare, getting less money from Medicare to cover the same patients, and being expected to make a profit (spend less on patient care). Some of the plans are only paying for 85% of the wholesale drug costs. For example, on a drug like Lucentis or Eyelea for Wet Macular Degeneration, this would be a gap of $300 dollars that would be a loss to the caring physicians that purchase the drugs from the pharmaceutical companies then bill the insurance companies. This makes caring for patients in plans like these impossible. The Medicare Rights Center recently published a report Too Good To Be True: The Fine Print in Medicare Private Health Care Benefits. The report was based on thousands of beneficiary calls to the Medicare Rights Center and listed nine common problems with Medicare Advantage plans.
Source: retinaassociatesflorida.com

The Florida Medicare Advantage and FL Medicare plans

The Florida Medicare Advantage, FL Medicare plans allows every insurer to gain access to a wide network of health care services .In some cases where in the people are suffering from chronic illness or being hospitalized in institutions they qualify for “dual eligible” scheme that covers most of their expenses. Call up a reliable FL agent to know more about the Florida Medicare Advantage or FL Medicare plans /supplementary plans today!
Source: wordpress.com

Coventry Expands Healthways SilverSneakers® Fitness Program to Its Medicare Advantage Beneficiaries in 13 States

Healthways (HWAY) is the largest independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities. We provide highly specific and personalized support for each individual and their team of experts to optimize each participant’s health and productivity and to reduce health-related costs. Results are achieved by addressing longitudinal health risks and care needs of everyone in a given population. The Company has scaled its proprietary technology infrastructure and delivery capabilities developed over 30 years and now serves approximately 40 million people on four continents. Learn more at www.healthways.com or www.silversneakers.com.
Source: gymrat-fitness.com

Health care could swing voters

Posted by:  :  Category: Medicare

SAM_2063 by TakeDownCravaackAnother issue that has emerged during the 2012 campaign is that of placing substantial new limits on the availability of abortion services. Abortion was found to be the top issue for 4 percent of likely voters. The general public is divided, with more people favoring restrictions on abortion. About half (52 percent) say that abortion should be illegal in all circumstances or legal in only a few circumstances; 44 percent believe abortion should be legal under any or most circumstances. However, a large majority (83 percent) of the public believes abortion should be legal when the pregnancy was caused by rape or incest. Among likely voters who said abortion would be the most important issue in the presidential voting choice, 61 percent said they were much more likely to vote for a candidate who favored placing substantial new limits on abortion services, a position similar to that held by Romney; 24 percent said they were much less likely to vote for such a candidate.
Source: harvard.edu

Video: 2011- 4/19 MEDICARE PATIENTS HAVE SHORTER HOSPITAL STAY AFTER HIP REPLACEMENT BUT

President Obama Releases Ad Blasting VP Hopeful Paul Ryan’s Stance On Medicare [VIDEO]

Now that Mitt Romney has announced  Congressman Paul Ryan as his running mate, President Obama has honed in on the aspiring vice president’s short comings. Ryan has been criticized for his stance on Medicare which he believes should no longer be offered by the government, but adjusted in the form of a stipend given to senior citizens to purchase their own health care.
Source: hiphopwired.com

Medicare Part D Exclusion of Benzodiazepines and Fracture Risk in Nursing Homes

Following the enactment of Medicare Part D, Tennessee was the only state to forgo supplemental coverage for benzodiazepines; when benzodiazepine prescriptions declined, nursing home residents in Tennessee experienced more falls and hip fractures.Benzodiazepines are controversial sedatives. Enacted in 2006, Medicare Part D excluded reimbursements for benzodiazepines. However, most state Medicaid programs continued to provide supplemental coverage for benzodiazepines.
Source: rwjf.org

Hip Fracture Surgery Experience In Phoenix, Arizona (My Medicare Father at Banner Thunderbird Hospital, 2012)

I have taken care of many patients with broken hips over the years.  Hip fracture carries an incredibly high morbidity and morality. Mobility is the absolute key to survival.  If hip fracture patients cannot ambulate again, they can expect a life filled with recurrent complications.  Add on the risks associated with Parkinson’s and I fear for my father’s life from any number of complications from  aspiration pneumonia and bowel impaction to ileus and pulmonary embolism.  The human body was built to move.  His key to survival will be acceptance of  any limitations, prevention of all  falls all the time  and continued aggressive physical therapy,  without dropping  him. Sometimes, it’s best for patients to swallow their pride and accept a walker as their best friend.
Source: blogspot.com

Daily Kos: New Obama KILLER Medicare Ad! VICTIMS!

to what I’ve been saying.  I was saying that he may have blown the debate because he was fighting for SS and Medicare cuts rather than fighting for you and me and progressive causes when he failed to fight back against Romney on the issue of SS and Medicare in the debates.  Again, I’m obviously speaking speculatively here, but this is what I think most likely happened now.  He’s wed himself to the Grand Compromise and wouldn’t unwed himself long enough to make categorical statements defending SS and Medicare, two programs which are not just progressive, but popular with conservatives in polling as well.  As it is, he stood there at the podium and said:
Source: dailykos.com

Ever Wonder How Much Medicare Pays for Hip and Knee Replacement

Between 1998 and 2007, the Medicare reimbursement rate decreased 21 percent for total hip arthroplasty and 20 percent for total knee arthroplasty, according to the report. The researchers surveyed 1,120 patients in an outpatient office setting, asking patients what they thought orthopedic surgeons should receive for total joint arthroplasty and how much they thought Medicare actually paid surgeons. Patients were also asked the same questions about cardiac surgeons who perform open heart coronary bypass surgery and surgeons who perform appendectomy.
Source: nicholascappello.com

Hip Suburban White Guy: I Just Got Off The Phone With My Mom

My mom is 78 years old. Her only income is Social Security. She lives in Section 8 housing. Her only health insurance is Medicare which pays 80% of her health care costs, and a Medicare Supplement plan that pays the difference and costs her $9.00 a month out of her Social Security check. She called tonight complaining about her health care and the fact that the Medicare Supplement only closes the gap on what Medicare already covers. She thought her $9.00 a month would pay for the stuff that Medicare doesn’t cover. She thinks she’s getting ripped off. She is going to shop around for insurance policies that she thinks she can get on the open market that will provide a 78 year old woman who has preexisting conditions that include losing a breast to cancer, high blood pressure, degenerative myopia and mild dementia with coverage better than Medicare for less money. She doesn’t realize that what she thinks she can do is impossible.  But there is no shortage of unscrupulous insurance sales reps who get paid on commission who will be only too happy to feed on her fear, sell her a policy she can’t afford, send her to a collection agency and leave her without any health care at all when she can’t pay.  Because that’s how the unregulated free market economy works. In the future, if Republicans like Paul Ryan have their way, my mom wouldn’t get jack shit other than a fixed amount voucher, a URL and a “Good luck! Go figure it out for yourself. Because we don’t give a fuck.” Throwing American senior citizens under the bus, letting them curl up and die if they get sick because they couldn’t figure out how to make enough money so that in their retirement they could afford to make rich young doctors richer isn’t my idea of America. Is it yours? If it is, vote for Romney and hope you will wind up like him with millions of dollars in ill-gotten gains stashed in offshore tax havens. But if you truly think that America at least aspires to be the greatest nation on Earth, then vote for Obama and the party who thinks EVERY AMERICAN deserves to grow old with dignity and good health without bankrupting their friends and family.
Source: blogspot.com

MHS Indiana Helpful Tips for Billing HIP

Physical therapy / occupational therapy / situational therapy claims, when billed with the Revenue codes 042X, 043X, and/or 044X, need to be billed with appropriate CPT codes and modifiers. You will need to follow Medicare guidelines when billing for these services. For example, the Revenue Code 0420 would need to be billed using the appropriate CPT and the appropriate modifier, such as GP.
Source: mhsindiana.com

Booker Rising: Rep. Allen West: “What Paul Ryan Must Do In Tonight’s Debate”

From Newsmax, about the conservative Republican Congressman from Florida: “West, a frequent guest on Fox News programs, said he believes the debate coming up on Thursday night between Vice President Joe Biden and GOP vice presidential nominee Paul Ryan will show voters once again just out wrong Obama administration policies have been for the country. He said the administration’s failure to address the Medicare and Social Security issues is just one of the failures he expects Ryan to highlight.” The article continues: “‘All I want Paul Ryan to do is to tell the truth,’ West told [Greta] Van Susteren. ‘I want Paul Ryan to say that the actuaries of Medicare and Social Security have said that in 2024, Medicare goes bankrupt. And Joe Biden can sit up and try to criticize Paul Ryan, but to do nothing means that we lose the Medicare program for our seniors.’ ‘ Rep. Allen West ain’t done yet: “‘So Paul Ryan just needs to talk about the facts and watch Joe Biden run scurrying like rats off the Titanic,’ West added.”
Source: bookerrising.net

Getting outpatient therapy? Be sure you know Medicare’s limits

You may qualify to get an exception so that Medicare will continue to pay its share for your services after you reach the therapy cap limits. Your therapist must document your need for medically-necessary services in your medical record, and your therapist’s billing office must indicate on your claim for services above the therapy cap that your outpatient therapy services are medically necessary.
Source: medicare.gov

Cataract surgery may prevent efficiently hip fractures in elderly which is huge cost for Medicare 10bn$/yr @FLAHAULT @drsilenzi

Results  There were 1 113 640 US Medicare beneficiaries 65 years and older with a diagnosis of cataract between 2002 and 2009 in the 5% random sample; of these patients, 410 809 (36.9%) received cataract surgery during the study period. There were 13 976 patients (1.3%) who sustained a hip fracture during the study period. The most common fracture-related comorbidity was osteoporosis (n = 134 335; 12.1%). The most common ocular comorbidity was glaucoma (n = 212 382; 19.1%). Compared with 1-year hip fracture incidence in patients with cataract who did not have cataract surgery, adjusted OR of hip fracture within 1 year after cataract surgery was 0.84 (95% CI, 0.81-0.87) with an absolute risk difference of 0.20%. Compared with matched subgroups of patients who did not receive cataract surgery, patient subgroups that experienced lower odds of hip fracture after cataract surgery included patients with severe cataract, patients most likely to receive cataract surgery based on propensity score, patients 75 years and older, and patients with a CCI score of 3 or greater.
Source: wordpress.com

Mitt Romney and the 47 percent, joined at the hip

. He has the cluelessness — or maybe it’s gall — to boast about not deducting some of his charitable contributions, in order to boost his effective tax rate to 14 percent. Give me a break. People earning less than $110,100 pay an effective rate of 15.3 percent in just Social Security and Medicare tax on every penny of salary they make (including the employer’s portion, which analysts say comes out of workers’ pockets.) Plus in many cases, they pay income tax, too. So forgive me for not being impressed by Romney’s 14 percent effective rate. The fact that he could have paid only 10 percent, perfectly legally, is pretty appalling.
Source: mbcalyn.com

The American Spectator : AARP Stands by as Obama Gets Mugged by Reality

As I have written previously, this conflict of interest was not lost on the House Ways and Means Committee. Last year, it conducted hearings for the purpose of “getting to the bottom of how AARP’s financial interests affect their self-stated mission of enhancing senior’s quality of life. It is important to better understand how AARP’s insurance business overlaps with its advocacy efforts and whether such overlap is appropriate.” This didn’t require much digging. AARP derives only about 20% its annual revenue from membership dues. Meanwhile, the organization earns more than $1 billion per year by endorsing various products, including “Medigap” insurance policies that pay medical charges not covered by traditional Medicare.
Source: spectator.org

Fix the Eye and Save the Hip?

ACA accountable care organizations Affordable Care Act cancer diabetes doctors doctors and patients Educate the Young Elaine Waples electronic health records exercise Georgetown University School of Medicine GoozNews health healthcare health care reform health insurance health reform hospitals innovation Jane Sarasohn-Kahn Klepper Lisa Suennen maggi cary margaret cary MD medical education Medicare Merrill Goozner mHealth Michaeli nutrition Obamacare obesity other patient engagement patient safety Paul Levy PPACA primary care RUC Salber Type 2 diabetes Venture Valkyrie weight loss
Source: thedoctorweighsin.com

grab yer’ pitchforks, it’s witch hunt season … as usual

just when i thought that these guys couldn’t go any lower … now this … it’s bad enough that these traitorous grifters have stopped EVERY initiative that came along that might help the jobs situation for the american people, but even when there is good news they try their best to dirty it or just kill it outright … and it was insane and sleazy enough when faux noise and their band of idiot followers jumped all over the recent announcement on the unemployment rate dropping to 7.8%, but now the “jobs, jobs, jobortion” gang on the hill has decided to further the right wing fanatic’s conspiracy theories with an “investigation” … or, at least that’s what issa, boehner, mcconnell and cantor, et al will call their latest witch hunt/smear campaign against obama … really? … this is going to help the country how? … it really is time that these recalcitrant mofos be tossed from office forever … they are, and have been all along, willing to sacrifice the economy, the country’s credit rating, and the well being of their fellow americans for nothing other than pure partisan advantage … it’s sickening, and treasonous …
Source: wordpress.com

Trends and Regional Variation in Hip, Knee and Shoulder Replacement

The rate of hip, knee, and shoulder replacements for Medicare patients is growing rapidly, and there is widespread variation in how likely patients are to undergo this surgery, depending on where they live and their race, according to a new report from the Dartmouth Atlas Project. This new analysis of Medicare data found a 15 percent increase in the overall rate of hip replacement, a 48 percent increase in the overall rate of knee replacement and a 67 percent increase in the overall rate of shoulder replacement from 2000-2001 to 2005-2006. Meanwhile, the rate of shoulder replacement was 10 times higher in some regions than others during 2005-2006, and the rates of hip and knee replacements were four times higher. Researchers said the patterns suggest both overuse and underuse of these procedures. Some patients who could benefit from joint replacement may not be offered the procedure, while others may be receiving a procedure that they might choose to forego if they had received balanced information on risks and benefits.
Source: rwjf.org

In CD 7 scrap, Lance targets Obama while Chivukula goes after Tea Party Congress

Posted by:  :  Category: Medicare

Chivukula kept jabbing at Lance over what he identified as the congressman’s morph from leafy-burgh moderate to fire and brimstone Paul Ryan ally since he left state politics and went to the federal level. “He had the option to vote for the American Jobs Act,” Chivukula said. “This Congress has put forward no legislation to create jobs.”
Source: politickernj.com

Video: New Jersey Delegates Happy With Paul Ryan’s RNC Speech

NJ Court: Federal Law Does NOT Mandate Medicare Set

This Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.
Source: wordpress.com

Campaign Buzz: Obama, Romney Vie For Swing Voters

CQ HealthBeat: The Medicare Conundrum The future of Medicare lines up with the economy as one of the hottest topics in this year’s presidential campaign. Republican nominee Mitt Romney accuses President Obama of stealing money from the program to pay for parts of his 2010 health care law. Obama says the GOP plan would “end Medicare as we know it.” … The two men are courting voters 65 and older with essentially the same message: “The other guy wants to change your Medicare. I won’t do that. Vote for me.” In fact, both candidates do want to change Medicare, recognizing that something needs to be done to address the financial crisis facing the half-century-old health care program for the elderly and disabled. At the same time, neither wants to mess with the benefits so dear to the hearts of a demographic group that has a reputation for showing up at the polls (Ethridge, 10/9).
Source: kaiserhealthnews.org

“Medicare Hot Topics” Professional Seminar

Rothkoff Law Group is committed to helping seniors and their families with life care planning, medicaid planning, asset protection planning, estate planning, elder care law, nursing home law, veteran’s benefits and medicaid applications in southeastern Pennsylvania and Southern New Jersey.
Source: rothkofflaw.com

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

Medicaid oversight saved taxpayers $500M, N.J. comptroller says

An annual report released by state Comptroller Matthew Boxer detailed how fraud-prevention efforts kept $402 million from being paid out and how the agency worked to get another $102 million in improperly paid Medicaid funds returned to the state and federal governments.
Source: theridgewoodblog.net

Racist ‘Obama Witch Doctor’ Display Creates Controversy In NJ Town

That sign is not racist you Communist piece of garbage. Obama is of the ancestry of the Negro African witch doctors, and because of the greatest country that ever was, i.e. America, a Negro of the ancestry of the witch doctor had the opportunity to learn English, become civilized and go on to be a U.S. Senator and the President. But that does not give Obama or anyone else of African ancestry or any ancestry the authority to pass or sign unconstitutional legislation. Obama care is repugnant to the U.S. Constitution.
Source: inquisitr.com

Republican Hopeful Frelinghuysen Comes to Nutley

Rodney Frelinghuysen, the longtime Republican congressman for the 11th District, met with local party activists and supporters Wednesday in Nutley, where he spoke cordially about President Obama but still drew sharp distinctions with him on health care, foreign policy and other issues. “I’m damn excited about getting 270,000 new voters in 14 towns,” said Frelinghuysen, whose legislative district has grown to include Nutley, some of Bloomfield and other parts of Essex and Passaic counties after the state’s congressional districts were redrawn late last year. Frelinghuysen faces Democrat John Arvanites in the November election. Speaking at the Diamond Spring restaurant, Frelinghuysen, who has served nine terms in the House of Representatives, stressed bipartisanship, stating that Obama deserves respect as the commander-in-chief and referring to fellow Rep. Bill Pascrell as “a friend” with whom he’s worked on environmental issues affecting the Passaic River. Pascrell represented Nutley and other areas that become part of the new 11th District as a result of redistricting. But he also spoke strongly in favor of the top of his ticket, Mitt Romney and vice presidential nominee Paul Ryan, whom Frelinghuysen described as “the new generation” of Republican leadership. “I think we’re all aware that all is not well,” Frelinghuysen said. “Far too many people are out of work, or working more than one job. Too many young people are still living at home, who don’t have a job and bring nothing to the table but college debt.” Following brief remarks, Frelinghuysen then took questions from the audience, where he outlined some of his positions on major issues, including:
Source: patch.com

OIG Issues Memo Regarding Excluded Individuals : New Jersey Healthcare Blog

If an individual employed by a provider is excluded under a federal program, including Medicare and Medicaid, the federal government will not pay the employer for services provided by the excluded individual.  The federal government has previously indicated that this applies not only to individuals who provide clinical services, but also to individuals who provide administrative services, such as billing and claims processing.  Thus, a provider who employs an excluded individual is not entitled to reimbursement for services provided by the excluded individual, including claims for clinical services provided by the individual, but also claims on which the individual only provided billing services.  In addition, a provider who employs an excluded individual may face civil monetary penalties.
Source: njhealthcareblog.com

Report: Private Insurers Cost Medicare Billions In Excess Payments

Posted by:  :  Category: Medicare

KNOW WHO YOUR CZARS ARE --ENOUGH TO MAKE YOU SICK ---ONLY OBAMA COULD CREATE POSITIONS FOR THESE INCOMPENTENT COMMUNISTS AND SOCIALISTS by SS&SSBlogger, CommonHealth Rachel Zimmerman worked as a staff reporter for The Wall Street Journal for 10 years, most recently covering health and medicine out of the paper’s Boston bureau. Rachel has also written for The New York Times, the (now-defunct) Seattle Post-Intelligencer and the alternative newspaper Willamette Week, in Portland, Ore., among other publications. Rachel co-wrote a book about birth, published by Bantam/Random House, and spent 2008 as a Knight Science Journalism Fellow at MIT. Rachel lives in Cambridge with her husband and two daughters. View all posts by Rachel Zimmerman
Source: wbur.org

Video: Medicare Supplement Insurance in New Mexico by 1 800 MEDIGAP

‘No Debate,’ Cleveland Clinic’s Great. But How To Replicate?

But Romney’s right that the Clinic’s own history is one of independent physicians recognizing an opportunity to deliver better care, even at the expense of their own profits. And Obama’s suggestion that the ACA’s cost-cutting board, the Independent Payment Advisory Board, would somehow help other hospitals become Cleveland Clinics of their own is mistaken, Thomas Burton and Louise Radnofsky wrote on the Wall Street Journal’s “Washington Wire.” Specifically, IPAB may give providers incentives to more effectively practice medicine, but it is focused on controlling Medicare payments, not shaping how care is delivered.
Source: californiahealthline.org

E&M Services Now Under Review by the Recovery Audit Contractors (RACs)

administrative complaint Administrative Hearing attorney audit Centers for Medicare & Medicaid Services CMS dea defense attorney department of health Department of Health and Human Services doctor doh drug enforcement administration emergency suspension order ESO false claims act florida fraud prevention fraud schemes government health programs health care fraud health law hipaa investigation legal representation licensing and regulatory medicaid medical license medicare medicare audit Medicare fraud Medicare investigation Medicare overbilling nurse nurses overbilling pain clinics pain management pharmacies pharmacist pharmacists pharmacy physician physicians whistleblower
Source: wordpress.com

Obama still up by 11 in New Mexico

With Obamacare 4,000,000 true Americans lose Senior advantage care and the folks supporting the program at Lovelace and Pres will lose their jobs. Also anyone on medicare in this state will see their medicate monthly payment triple. So everyone have another bowl of stupid in the morning and vote for this community organizer
Source: watchdog.org

New Mexico Politics with Joe Monahan

It looks like Governor Martinez and Jay McCleskey are making a credible move to take on a relatively safe Democrat seat and potentially swing the balance in the state House. The mailer seems to be targeting weak voters and unreliable Democrats. That piece was sent to a family member of mine, who is a Democrat, but an irregular or “weak” voter. That piece should have been sent to reliable voters and strong Democrats, such as myself and another family member, who vote regularly.  .  Navajo voters seem to be very “forgiving” and elect flawed politicians, such as the current group of Shiprock Chapter officials, including some current and previous leaders who were involved in the multi-million dollar BCDS scandal, another chapter official who misused funds to buy a motorcycle (money was paid back), or how another Shiprock Chapter official was re-elected twice to his current position, despite being a convicted felon. Is the “Reform New Mexico Now” attack piece a one-hit-wonder that will be forgotten? Or is McCleskey and Governor Martinez going to bring more heat to bear in the District 4-San Juan race?  The Alligators say Martinez and Jay will have to apply a lot of heat. Getting direct mail into voting Navajo households is notoriously difficult. Unless Begaye takes another big hit, he remains favored to keep his seat.   SHOUT OUT We shout it out for this–$140 million in bonds that voters will decide this election. $120 million will go for improvements to higher education buildings. It’s a prod for the construction industry here–stuck in a long-term depression. WAITING FOR IT You know, if there is not a really good campaign against the proposal to raise the ABQ minimum wage to $8.50 an hour (from $7.50), it just might pass Nov. 6. The news: About 40,000 Albuquerque workers, or one-seventh of the city’s workforce, would receive a raise if the city’s minimum wage is increased to $8.50 an hour, a study on the issue released Tuesday said. Raising the minimum wage from $7.50 to $8.50 an hour would generate $29 million in additional wages, put $18 million into the economy and create 160 jobs in the city, said the report by New Mexico Voices for Children, a health care advocacy group in Albuquerque. Biz interests have raised money and a campaign against the minimum wage boost is coming, but it appears they are missing out on these first early voting days. A FIFTY PERCENT MAYOR? Paperwork has been filed that could lead to an election to decide if ABQ should increase the percentage a mayor needs to be elected. Right now, if a candidate gets 40% of the vote, he takes the office. If no candidate crosses that threshold, there is a run-off between the top two contenders. Under the proposed change, a candidate would have to get 50%, making a run-off more likely. Mayor Barry got elected with over 40% in the first round in 2009 in a three-way race. The change would increase the chances of a run-off. Union groups wanting this change will have to gather over 12,000 petition signatures to force a special election. RED MEAT TIME No one serves up a serving of red meat like southern GOP Congressman Steve Pearce. Here he can be seen in fine form bashing Dem Martin Heinrich who is the favorite to win this year’s US Senate race: He’s not a not a good fit for southern New Mexico, he’s not a good fit for anyone,” said Pearce. “He was not very active when we were losing military missions. That’s a very big job creator in his area. He’s not very active in supporting the minerals industry, oil and gas, and mining. Again, in fact, he’s probably on the opposite side of that. So, people have to ask if Martin Heinrich is elected (U.S. Senator), where they’re going to get their jobs? Because New Mexico has a lot of jobs in the resources industry. That’s the biggest question, I think, that faces us this election. Don’t worry, Martin, if you win the Senate seat you can have him over for lunch and serve him some of that elk meat you sock away from your hunting trips. Just remember: no vegetables. Heinrich’s latest TV ad is up in which he tries to carve up some red meat of his own over Social Security and Medicare. He says Heather will harm the programs. (Okay, he might ask Pearce for some advice on how to really hit). A HEFTY CHEST How this money is spent on Dem legislative candidates is going to be a major story for the remainder of the campaign. The Patriot Majority New Mexico PAC reported $780,000 in cash on hand. It received much of its cash from national unions. That will be the primary war chest to counter Reform NM Now PAC run by Guv political adviser Jay McCleskey. His Reform New Mexico Now PAC raised $85,250 and spent $277,421 in the past month. Jay had about $113,000 in the bank to spend in the final month. That’s a big difference in cash on hand between the two committees. Will Reform NM be outgunned or is that $277,000 it already reports spending giving it a head start? ALLIGATOR PUNISHMENT
Source: blogspot.com

New Mexico State Senator Dede Feldman’s Blog: Majority of N.M. Better Off Under ObamaCare

A lot of the controversy about the “individual mandate” is misplaced. Once reform goes fully into effect, about two Americans out of every 100 may still not buy health insurance through work, Medicaid or Medicare, or by using new tax credits. This tiny sliver will be subject to a small tax fine, so uninsured people cannot just go to the emergency room and shift the cost onto the rest of us. Opponents of reform are trying to make voters believe that most people will be subject to higher taxes for ObamaCare. That is simply not true. The vast majority of New Mexicans will save money or gain benefits – and families earning less than $50,000 a year will gain the most, to the tune of $2,000 to $3,000 a year.
Source: typepad.com

Upcoming CMS Jurisdiction JH Medicare Contractor Change

The Centers for Medicare and Medicaid Services (CMS) has awarded the Medicare Administrative Contractor (MAC) Jurisdiction JH contract to Novitas Solutions. The clearinghouse is currently working with Novitas to obtain transition details and will send additional notifications as soon as they are available. Providers must be aware of the following: CPID: 1449 Payer Name: Colorado Medicare – Professional Transition Date: 11/19/2012 Current MAC: TrailBlazer Health Enterprises, LLC Old Payer ID: 04102 New Payer ID: 04112 CPID: 1457 Payer Name: New Mexico Medicare – Professional Transition Date: 11/19/2012 Current MAC: TrailBlazer Health Enterprises, LLC Old Payer ID: 04202 New Payer ID: 04212 CPID: 1458 Payer Name: Oklahoma Medicare – Professional Transition Date: 11/19/2012 Current MAC: TrailBlazer Health Enterprises, LLC Old Payer ID: 04302 New Payer ID: 04312 CPID: 1449 Payer Name: Texas Medicare – Professional Transition Date: 11/19/2012 Current MAC: TrailBlazer Health Enterprises, LLC Old Payer ID: 04402 New Payer ID: 04412 Contractor number (Payer ID) changes: Providers only need to include the CPID (not Contractor Number) in the claim. The clearinghouse will manage the Contractor Number changes for our customers. Contractor Enrollment information: Provider claim re-enrollment is not required. Provider electronic remittance advice (ERA) re-enrollment is not required. CMS-588 EFT Agreement Required for CMS Jurisdiction JH Medicare Contractor Change: All CMS-588 EFT Authorization Agreement (05/10 version) received and processed by TrailBlazer, on or after May 29, 2012 for Part B providers, will be forwarded by TrailBlazer to Novitas Solutions, Inc. as part of the transition. No further action is needed. Providers who receive their payments through Electronic Funds Transfer (EFT) from the current contractor TrailBlazer Health Enterprises, LLC (TrailBlazer) should have received a letter from Novitas Solutions, Inc. requesting a CMS-588 EFT Authorization Agreement so that Novitas Solutions, Inc. can issue EFT payment to you after the cutover. Please read the Novitas Solutions, Inc. letter carefully for instructions for completing and returning the CMS-588 EFT Authorization Agreement. Failure to complete and submit the CMS-588 EFT Authorization Agreement may result in a delay or interruption of your Medicare payments. All affected Colorado, New Mexico, Oklahoma, and Texas providers should have received their letter from Novitas Solutions, Inc. in late July 2012. Note: Should you have questions or need assistance, call Novitas at 1-877-235-8073. Please identify yourself as a JH provider to expedite the handling of your call. For additional information you can go to the following websites: https://www.novitas-solutions.com/transition/jh/index.html https://www.novitas-solutions.com/transition/jh/info-alerts.html Action Required: Providers that are enrolled for EFT will need to complete a CMS-588 EFT Authorization Agreement. Failure to complete and submit the CMS-588 EFT Authorization Agreement may result in a delay or interruption of your Medicare payments. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

Poll: Voters Nationwide, In Swing States Prefer Obama Over Romney To Handle Medicare

The poll shows that 51 percent of voters across the country prefer Obama to preside over the nation’s health care system for senior citizens, while 43 percent prefer Romney.  Voters in swing states give the nod to Obama on Medicare by a similar margin, 50 percent to 44 percent.  Gallup’s swing state sample includes voters in Colorado, Florida, Iowa, Michigan, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Pennsylvania, Virginia and Wisconsin.    
Source: talkingpointsmemo.com

Medicare Recipients Overspend By Not Choosing The Cheapest Prescription Plan

Posted by:  :  Category: Medicare

meds: it's obscene by fallsroadImplemented in 2006, Medicare prescription drug benefit (Part D) spent $65.8 billion for prescription drugs in 2011, according to the Congressional Budget Office. But Medicare beneficiaries are overpaying by hundreds of dollars annually because of difficulties selecting the ideal prescription drug plan for their medical needs, an investigation by the University of Pittsburgh Graduate School of Public Health reveals.  Their work also could be useful in designing health insurance exchanges, which are state-regulated organizations created under the Affordable Care Act (“Obamacare”) to offer standardized health care plans. Only 5.2 percent of beneficiaries chose the least-expensive Medicare prescription drug benefit (Part D) plan that satisfied their medical needs in 2009, overspending on Part D premiums and prescription drugs by an average of $368 each per year. The evaluation took a national look at how well beneficiaries were making plan choices in the fourth year of the Medicare Part D program and could help guide changes to health insurance programs. Their solution, unfortunately, is even more government employees to counsel recipients, which may cost a lot more than $368 per year.  “In particular, government officials could recommend the three most appropriate Part D plans for each person, based on their medication history,” said co-author Yuting Zhang, Ph.D., associate professor of health economics at Pitt Public Health. “Alternatively, they could assign beneficiaries to the best plan for them based on their medication needs, while offering them the option to choose another plan instead. In designing health insurance exchanges, models with more active assistance would be more helpful than models with large numbers of plans and information. For example, health insurance exchanges could actively screen plans on quality and negotiate premiums to reduce the number of plans.” The researchers looked at the difference in a patient’s total spending, including the plan premium and out-of-pocket payment for the prescriptions filled, between the plan the patient chose and the cheapest alternative option in the region that would satisfy the patient’s medication needs. The study looked at data for 412,712 people, with an average age of 75. Beneficiaries tend to overprotect themselves by purchasing plans with more generous features, such as generic drug coverage in the coverage gap. A few other trends emerged: As beneficiaries aged, they increasingly chose more expensive plans, with people older than 85 overspending by $30 more than people 65 to 69 years old. Blacks, Hispanics and Native Americans chose less expensive plans than whites.  People with common medical conditions, such as diabetes and chronic heart failure, were not significantly more likely to choose more expensive plans. People with cognitive deficits or mental health issues, such as Alzheimer’s disease, tended to choose less expensive plans, spending an average of $10 less than those without such conditions. The researchers could not determine if those people had assistance from caregivers. As the number of plan options increased in a region, the amount of overspending increased by $3.20 for every additional plan available. “A previous study showed that in 2006, beneficiaries could have saved nearly 31 percent of their total drug spending by switching to the lowest cost plan,” said lead author Chao Zhou, Ph.D., a post-doctoral associate at Pitt Public Health. “Since our results are similar, this suggests people are not learning to reduce overspending.” One possible explanation for these consistent results over time is the impact of inertia and bias toward maintaining the status quo, she noted.  “When Medicare Part D started in 2006, the majority of beneficiaries did not choose the least expensive plan,” said Zhou. “Over time, they may have simply stuck to their original plan and never switched to a better one. Beneficiaries might not spend much time researching and adjusting their plan choices based on changes in their medication needs and in plan options.”  Findings from the private health insurance market support the authors’ conclusion that people keep their current plan instead of spending time researching and optimizing their plan choices based on their insurance use and prescription spending in the previous year. Published in Health Affairs
Source: science20.com

Video: 2012 Medicare Part D Drug Coverage Updates

Comparing Medicare prescription drug plans

Also, be aware that if you’re a low-income beneficiary and your annual income is under $16,755 or $22,695 for married couples living together, and your assets are below $13,070 or $26,120 for married couples, you may be eligible for the federal Low Income Subsidy known as “Extra Help” that pays Part D premiums, deductibles and copayments. For more information or to apply, call Social Security at 800-772-1213 or visit socialsecurity.gov/prescriptionhelp.
Source: pomeradonews.com

Medicare annual enrollment starts soon

There are also programs that can help with Medicare costs. The Low-Income Subsidy and Medicare Savings Programs can provide varying levels of assistance depending on the beneficiary’s income. There are still many Douglas County residents who may qualify for these programs but not even know it. Individuals with gross monthly income less than $1396, and couples with less than $1891 could be eligible for extra help. Certain asset limits apply.
Source: superiortelegram.com

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

Survey: Most Medicare Beneficiaries Satisfied With Rx Drug Coverage

I wonder where the money is coming from to finance the added coverage? It has to come from somewhere. Consider: drug companies have to offer rebates in order to have their drug covered by Medicare part D. Do you think they just absorb the decreased profit margin they had before and accept lower earnings? I rather doubt it. Could it be they simply have increased the charges that non Medicare payers (commercial health plans) pay for these drugs? If they do, that is simply transferred to those who are covered by these health plans…. i.e all of us not on Medicare. For every added benefit, there is a cost borne by someone.
Source: californiahealthline.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

Will Growing Familiarity With Medicare’s Private Choices Make Seniors More Open To Premium Support?

CQ HealthBeat: Could Seniors’ Familiarity With Private Medicare Choices Lead Them To Accept Premium Support? A Kaiser Family Foundation survey released Wednesday said that 73 percent of seniors are aware there’s an open enrollment period during which they can choose among private plan alternatives to the traditional fee-for-service Medicare. That could be a sign that many seniors would be comfortable with a Medicare approach that relies more heavily on private plan choices, a Kaiser brief speculated. Whether seniors could accept such an idea is one of the hottest issues in the presidential race between Republican Mitt Romney and Democratic President Obama (Norman, 10/11). (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation)
Source: kaiserhealthnews.org

Put it on your fall checklist: Medicare Open Enrollment

If your parents want to go online and sort through the details, they can get an early start, and you can help them navigate the process if needed. We’ve already made sure that the Medicare Plan Finder is fully updated with all new 2013 cost and benefit information for health and drug plans and is ready right now. All your parents need to do is start by entering the drugs and checking on the doctors and pharmacies they want to use. A few more steps will get them a personalized list of their plan choices and help them compare.
Source: medicare.gov

Medicare Part D Notice Required Before October 15

This is a reminder that the deadline to distribute the Annual Notice of Creditable Coverage required under Medicare Part D is less than a week away. This notice informs participants whether the prescription drug coverage offered under your health plan constitutes creditable or noncreditable coverage. As the Medicare Part D annual enrollment period now runs from October 15 to December 7, you must distribute the notices before October 15. Employers who sponsor a health plan offering prescription drug benefits must provide an annual notice to all Medicare-eligible participants that explains whether the prescription drug benefits offered under the plan are at least as good as the benefits offered under the Medicare Part D plan. The only employers exempt from this requirement are those that establish their own Part D plan or contract with a Part D plan. The Centers for Medicare and Medicaid Services (CMS) has posted forms and instructions for providing this notice. The forms were last updated in 2011. They are available, both in English and Spanish, through the following links:
Source: jdsupra.com

AHIP Statement on New Survey Showing 90 Percent of Seniors Satisfied with Prescription Drug Coverage

3rd Party Studies ACOs Admin Costs affordability Age Rating Cadillac Tax cbo Cost-Shift Employers Essential Benefits Exchanges GRP Health Plan Innovations Health Plan Satisfaction House hearings House legislation HSAs KI MA McCarran-Ferguson Medical Prices Medical Tests medicare medigap MedMal MLR Morning Headlines MT Patient Safety premiums Premium Tax Profits Provider Consolidation PWC Quality Rate Review Readmissions Reform RZ Senate hearings Senate legislation Small Business The Link Vilification Waste Fraud and Abuse
Source: ahipcoverage.com

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

Report: Most top Medicare drug plans hiking premiums

President Barack Obama’s health care law does not appear to be the cause of the increases. The law actually is improving the prescription benefit by gradually closing a coverage gap called the “doughnut hole,” which catches people with high drug costs. Instead, the price hikes appear to be driven by market dynamics, and some insurers are introducing new low-premium options to gain a competitive advantage on plans that are raising their prices.
Source: sltrib.com

Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

Posted by:  :  Category: Medicare

New Online Rx System Makes UM Student 'Top Entrepreneur' Finalist by University of Maryland Press ReleasesThis paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries comprise many of the poorest and sickest people covered by either program, and they account for a disproportionately large share of Medicare and Medicaid spending. As an outgrowth of the Affordable Care Act, CMS is reviewing proposals from states to test two new models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries with the goal of delivering better coordinated care and reducing costs.
Source: kff.org

Video: Turning 65 Becoming Eligible for Medicare – 2011

People Eligible For Medicare 2011

Medicare 2011 is a government-sponsored program managed by the state which offers health coverage to persons from sixty-five years old and above. This is also available for persons below age sixty-five and are physically disabled or to individuals under other special considerations indicated. Generally, all people who are sixty-five years old and over who have been living legally in the United States as citizens for at least five years are qualified to register under Medicare 2011. Persons who are physically incapacitated and under sixty-five years old may also qualify if they obtain their payroll tax-funded federal insurance program or SSDI benefits. Certain medical health concerns may also be advantageous to persons to become qualified to register under Medicare. Individuals become eligible for Medicare coverage at the same time Medicare Part A payments are all put aside if they are of qualified ages and are American citizens. They have to be living in the country continuously for at least five years and one of the family members has provided payments for taxes incurred through Medicare for at least ten years. If they do not quite reach the age of eligibility, are physically incapacitated, and have been in receipt of SSDI benefits or retirement disability benefits for at least two years from their initial disability payment. People who are receiving dialysis services for a certain severe illness or in need of organ or kidney transplant are eligible for Medicare. They can enrol under Medicare if they are qualified for SSDI and have Lou Gehrig’s disease. Individuals who are sixty-five years and older should provide regular payments on a monthly basis to stay enrolled when they have not provided payment for Medicare taxes for ten years while still working. Individuals who are physically disabled will no longer be qualified for Medicare once they discontinue getting SSDI. The two-year exclusion denotes that individuals who turn out to be incapacitated have to wait for twenty-four months before obtaining medical coverage from the government. This happens not unless they have one of indicated medical conditions or they will be qualified for Medicaid. A lot of individuals may be eligible for both Medicare and Medicaid or dual-eligible. With other states, for people who have earnings below a particular level of income, it is Medicaid which will provide payment for their Part B payments. Majority of recipients have been in the workforce long enough and do not have Part A premium. Medicaid will also provide support for medications or drugs that Part D does not cover. Enrolment for Medicare 2011 is estimated to reach seventy-eight million by year 2030. This is the period when the age group of baby boomers will be totally registered. The proportion of the workforce who provides payment for Medicare taxes to persons who are on retirement in receipt of benefits is diminishing. While the cost of healthcare services is going up. At the present time, there are an estimated four workers providing payments for taxes in Medicare for each elderly obtaining Medicare services. When baby boomers retire in twenty years, that estimation is anticipated to diminish to 2.4 of the workforce who will pay for every beneficiary. The expenses of Medicare s anticipated to increase by approximately seven percent per annum for the following decade. If you are looking for the best medicare forms and medicare cost, visit our site for more tips and information. Contact us for free medicare advice. If you are looking for the best http://www.medicarerep.com/ medicare forms and http://www.medicarerep.com/ medicare cost, visit our site for more tips and information. Contact us for free medicare advice.
Source: abcarticledirectory.com

Baby Boomers and Medicare Myths

enroll in Medicare any time after you turn 65, without penalty – Medicare has a seven month “Initial Enrollment Period” (IEP) when people first become eligible to enroll into Medicare Part A and B, either based on a disability or when they “age in” to Medicare at age 65. IEP starts 3 months prior to the month of Medicare eligibility and ends 3 months after the month of eligibility. There are some exceptions, for instance, if you’re still working and covered by an employer. But, generally people who miss the IEP could be required to pay late enrollment penalties.
Source: ehealthinsurance.com

Who is Eligible in Medicare Supplemental Insurance? at Maximum Performance Begins With A Healthy Body

Not everybody needs a policy of Medicare supplement. If you encompass some other kinds of health coverage, your Medicare coverage gaps might already be covered. You may possibly not require insurance of Medicare supplement if: • You encompass group health insurance via a former employer or an employer, comprising military or government retiree plans. • You encompass a plan of Medicare Advantage. • Medicaid or the QMB (Qualified Medicare Beneficiary) Program disburses your other out-of-pocket costs and Medicare premiums. Qualified Medicare Beneficiary is one of numerous Medicare Savings Programs, which help disburse coinsurance, copayments, deductibles, and Medicare premiums. You ought to ask your organization or agent what advantages you have.
Source: procureperformance.com

Medicare Advantage In Limbo?

Most people are unaware that the recent health insurance reform legislation, the Patient Protection and Affordable Care Act (PPACA), made significant changes to how Medicare Advantage Plans are reimbursed by the federal government.  While the intent behind the legislation is to ensure that private health insurers are providing the highest possible quality of care to those enrolled in their plans, the result will likely be that beneficiaries experience reduced benefits and higher premiums over the next few years, leading many to opt out of the program in favor of traditional Medicare and/or Medigap.  For the time being, however, Medicare Advantage enrollment is up and premiums are down due to quality bonus payments due to private health insurers.  Medicare beneficiaries can take advantage of the lower premiums for now, but should be aware that things may change over the next year or two.
Source: advocator.com

Are You Eligible for Medicare Yet Still Working? How Does This Affect Your Medicare Coverage?

Medicare Part B, which is doctor and outpatient coverage, does charge a premium.  For the year 2012, the premium starts at $99.90 per month with increasing premiums for people with higher incomes.  Many people who are still working and have group health coverage delay enrolling in Part B in order to postpone paying this premium.  Also, the Medicare Part B benefits may be of limited value to you as long as your group health plan is the primary payer of your medical bills.
Source: medicareecompare.com

Ask The Experts: Retirement

First, please review previous Q&As to see if your question already has been answered. If you cannot find the answer, submit your question to our Retirement expert at fedexperts@federaltimes.com PLEASE NOTE! Do not submit ANY questions via the Comments form. Questions submitted via the Comments form will NOT be answered!
Source: federaltimes.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

More Adults Eligible For Medicare Than Ever Before

On January 1 of 2011, the oldest members of the Baby Boomers turned 65 years old. That was just the kick off of a 20 year, history-making turn of events. Every single day, until 2031, at least 10,000 baby boomers will celebrate their 65th birthday. Such a large number of older people have never existed in the United States (or the world, for that matter). This means that never before have so many Americans also been on the verge of becoming eligible for Medicare.
Source: gohealthinsurance.com

Canadians want Parliament to make medicare top priority, poll finds

Posted by:  :  Category: Medicare

Newsweek Magazine (February 16, 2009) ... Lenders Add Bigger Fannie, Freddie Fee – Thanks to Payroll Tax Cut (January 15, 2012) ...item 2.. Dupuy: GOP trying to sell pyrmaid scheme to voters (September 3, 2012) ... by marsmet526But several months after winning the election, the Harper government announced there would be no negotiations. Instead, federal health-care transfers will continue to increase by six per cent until 2016-17. After that, increases will only be tied to economic growth including inflation – currently roughly four per cent – and never fall below three per cent.
Source: canada.com

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

Priority Health Launches ‘Medicare Explained’ Web Site

Each page includes key Medicare information, a short video and a quiz designed to accommodate a number of different learning methods. These are supplemented with “extra credit” articles that include detailed information about Medicare topics, options and Priority Health plans. The Medicare Explained educational tool helps people learn how Medicare works, determine what type of plan they need and find the right Priority Health Medicare plan for their needs and their budget.
Source: cbslocal.com

Election Will Decide Fate of Obama's Health Law

When Americans go to the polls next month, they will cast a vote not just for president but for one of two profoundly different visions for the future of the country’s health care system. With an Obama victory on Nov. 6, the president’s signature health care law — including the contentious requirement that most Americans obtain health insurance or pay a tax penalty — will almost certainly come into full force, becoming the largest expansion of the safety net since President Lyndon B. Johnson pushed through his Great Society programs almost half a century ago.
Source: realclearpolitics.com

Priority Health Adds Medicare Advantage Plan and Seven Counties.

Medicare is available to individuals age 65 and older as well as to some people with disabilities. Medicare recipients may enroll between November 15 and December 31, 2010. To learn more about Priority Health’s Medicare plans, premiums by county and participating health care providers, call Priority Health toll-free at 888 389-6676, visit a Priority Health Medicare Information Center in Holland, Grand Rapids, Kalamazoo or Traverse City (opening November 1) or go to prioritymedicare.com. Priority Health’s Medicare Advantage health plans are available in 38 counties: Allegan, Antrim, Barry, Benzie, Cass, Charlevoix, Clare, Crawford, Emmet, Grand Traverse, Hillsdale, Ionia, Jackson, Kalamazoo, Kalkaska, Kent, Lake, Leelanau, Livingston, Manistee, Macomb, Mason, Mecosta, Missaukee, Monroe, Montcalm, Muskegon, Newaygo, Oakland, Oceana, Osceola, Otsego, Ottawa, Roscommon, St. Clair, Washtenaw, Wayne and Wexford.
Source: blogspot.com

David Brooks on Drugs and Medicare | MyFDL

To start, in dismissing the idea that governments can be successful in designing policies that contain costs, Brooks ignores all the evidence from every other wealthy country. All of them have much greater involvement of the government in their health care system (in some countries like the United Kingdom and Denmark they actually run the system) yet their average cost per person is less than half as much as in the United States. And they have comparable health care outcomes, with all enjoying longer life expectancies. If health care costs in the United States were comparable to those in any other wealthy country we would be looking at long-term budget surpluses, not deficits. (We could look to trade to reduce costs, but policy debates in the United States are dominated by ardent protectionists in the area of health care.)
Source: firedoglake.com

Why Do Women Suddenly Like Mitt Romney?

You could say that women, as a group, have a bigger stake in a community-oriented view of society–one that supports Head Start, family leave, public schools, college aid, government-run health care, and other social programs and protections for the disadvantaged–as opposed to the macho, go-it-alone ethic and economic policies of the Republican ticket.
Source: progressive.org

Minister of Health clears Air on SMMC

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

Don’t forget your veterans benefits

“VA does not recommend Veterans cancel or decline coverage in Medicare (or other health care or insurance programs) solely because they are enrolled in VA health care. Unlike Medicare, which offers the same benefits for all enrollees, VA assigns enrollees to priority levels, based on a variety of eligibility factors, such as service-connection and income. There is no guarantee that in subsequent years Congress will appropriate sufficient medical care funds for VA to provide care for all enrollment priority groups. This could leave Veterans, especially those enrolled in one of the lower-priority groups, with no access to VA health care coverage. For this reason, having a secondary source of coverage may be in the Veteran’s best interest. In addition, a Veteran may want to consider the flexibility afforded by enrolling in both VA and Medicare. For example, Veterans enrolled in both programs would have access to non-VA physicians (under Medicare Part A or Part B)”
Source: bankrate.com

For Voters It’s Still the Economy

In addition, while the budget deficit remains a very important issue for most voters, there continues to be broad agreement that the best way to reduce the budget deficit is with a combination of tax increases and cuts in major programs. In the new survey, fully 69% of registered voters say the best way to reduce the federal budget deficit is with a combination of tax increases and spending cuts; just 16% say the focus should be mostly on cutting major programs and just 6% say the deficit should be reduced mostly by increasing taxes.
Source: people-press.org

Making Patients the Priority

Aurit also demonstrates his commitment to continuous improvement by providing his employees with opportunities to advance and continue learning. With company support, Gateway pharmacists and technicians can pursue programs in areas ranging from diabetes management to public speaking. One hundred percent of Gateway Health Mart pharmacists and technicians belong to the North Dakota Pharmacists Association (NDPhA), where Aurit served as the 2011 president. The NDPhA actively works to advance the pharmacy profession and is vital “in advocating the role of the pharmacist as an essential provider of healthcare.”
Source: mckesson.com

Medicare Reform Using Part D Model Is Advocacy Priority For PhRMA – Castellani :: “The Pink Sheet” :: Elsevier Business Intelligence

For PhRMA, supporting a move toward privatizing Medicare is a tactic that may help avoid the establishment of new price controls in the system, like the often-discussed mandated drug rebates in Part D.
Source: elsevierbi.com

Kuster: ‘It’s All Political Theater’

In contrast, Obamacare will negatively affect the Medicare of seniors regardless of whether they are currently over 55 or volunteer for anything. Politifact agrees that Obamacare would cut over $700 billion from what Medicare spending would otherwise be; their quibble ("half-truth") is based on whether these can be called "cuts" in the context of a program that is growing each year. Democrats also like to claim that there are no "cuts" with their plan because Medicare won’t be covering fewer procedures, they will just be paying doctors and hospitals less for each procedure! Given that many hospitals and doctors are already losing money on Medicare patients, and refusing to take new Medicare patients, this is a bogus distinction. It also rests on a dubious assertion: Once the 15-member cost panel is in place there likely will be treatments rejected, that is after all the whole point of the panel.
Source: patch.com

How Will Medical Change Impact Medicare Health Insurance _

How Will Medical Change Impact Medicare Health Insurance ? How will healthcare change have an effect on treatment ? This is really a problem which is weighty priority of those that rely on treatment protection for his or her healthcare requires. Men and women frequently consider prescription medications once they consider treatment , but it covers more options than treatments. Some people never perhaps decide in the doctor prescribed drug strategy and alternatively utilize protection pertaining to items like all forms of diabetes assessment products ; canes, walkers , electric wheelchairs and mobility scooters ; adaptable bedrooms and lift recliners ; medical professional expenditures and stay in hospital expenses which includes assessment and diagnosis ; and also other gear and products such as lift recliners included in Medicare. Sweeping adjustments across treatment will have an effect on what sort of protection performs and just how significantly the idea expenses over the returning 10 years. And even though a lot of people understand this kind of , they aren’t confident in regards to the distinct adjustments. Simply because healthcare change is at the beginnings , there are many potential adjustments that’ll be needed to meet up with price range cuts that will never have perhaps been recently designed nevertheless. However there are many adjustments which were validated contained in the popular change that may have an effect on treatment. Will our benefits be cut ? The very good news is a lot of the sweeping cuts-it’s approximated that will treatment and also other federal applications will have their own devices tightened to the beat around $450 trillion dollars-won’t have an effect on the treatment strategy the slightest bit that one could observe. The medical doctors that will take care of you might notice the adjustments given that they will not be able to expenses for similar quantities , however your basic benefits will not alter. The only actual gain cuts inside software are certainly not throughout treatment , however a new subset associated with treatment referred to as treatment edge which offers extra insurance policy and protection more than standard treatment. Men and women with this strategy must actually view a fee frost nova however some other distinct adjustments haven’t been defined nevertheless. Those in treatment may also get an extra gain starting next season. Men and women previously have a free of charge check-up once they join , nevertheless the strategy will become spending money on a health and fitness check-up hoping associated with protecting against a lot of conditions and issues. The biggest Change The biggest customize the govt covers any time talking about treatment and healthcare change may be the change to the doctor prescribed drug software. Although it most likely are not the greatest alter general , it’s the one that the covered , as opposed to the medical doctors and nursing homes , will likely be almost certainly to get noticable. rIght this moment , people that have doctor prescribed drug protection are near risk associated with slipping in to Medicare’s donut opening. It is a protection distance that will retreats into influence every person’s drug expenses achieve $2,seven-hundred every year. nExt sum , anyone accounts for the price of each of their drug treatments right up until
Source: pdfcast.org

Priority Health recognizes four Michigan senior volunteers

About Priority Health Priority Health is an award-winning health plan nationally recognized for creating innovative solutions that impact health care costs while maximizing customer experience. It offers a broad portfolio of products for employer groups and individuals including Medicare and Medicaid beneficiaries. As a nonprofit company, Priority Health serves more than 600,000 people and continues to be rated among the best health plans in the nation by the National Committee for Quality Assurance.
Source: co.za

Medicare Part D: A First Look at Part D Plan Offerings in 2013

Posted by:  :  Category: Medicare

The analysis, is the first in a series of planned reports examining the private plan choices available to Medicare beneficiaries for 2013. It is authored by researchers at Georgetown University, the Kaiser Family Foundation and NORC at the University of Chicago.
Source: kff.org

Video: Medicare Part D and Prescription Drugs

Survey Finds Seniors Satisfied With Medicare Part D

Politico Pro: Survey: High Satisfaction With Medicare Part D The debate may be raging over Medicare in the race for the White House — but a new survey points out that one part of it, Medicare Part D, has both positive results and bipartisan support. And health experts from Third Way, the Galen Institute and the Healthcare Leadership Council say the program’s success means that during sequester negotiations lawmakers should keep their hands off the Medicare prescription drug benefit. David Kendall, senior fellow for health and fiscal policy at Third Way, said on a call with reporters that the Medicare prescription drug benefit was a key example of successful bipartisanship because it was “enacted by Republicans and perfected by Democrats” (Smith, 10/3).
Source: kaiserhealthnews.org

Medicare Part D Notice Required Before October 15

This is a reminder that the deadline to distribute the Annual Notice of Creditable Coverage required under Medicare Part D is less than a week away. This notice informs participants whether the prescription drug coverage offered under your health plan constitutes creditable or noncreditable coverage. As the Medicare Part D annual enrollment period now runs from October 15 to December 7, you must distribute the notices before October 15. Employers who sponsor a health plan offering prescription drug benefits must provide an annual notice to all Medicare-eligible participants that explains whether the prescription drug benefits offered under the plan are at least as good as the benefits offered under the Medicare Part D plan. The only employers exempt from this requirement are those that establish their own Part D plan or contract with a Part D plan. The Centers for Medicare and Medicaid Services (CMS) has posted forms and instructions for providing this notice. The forms were last updated in 2011. They are available, both in English and Spanish, through the following links:
Source: jdsupra.com

Medicare Recipients Overspend By Not Choosing The Cheapest Prescription Plan

Implemented in 2006, Medicare prescription drug benefit (Part D) spent $65.8 billion for prescription drugs in 2011, according to the Congressional Budget Office. But Medicare beneficiaries are overpaying by hundreds of dollars annually because of difficulties selecting the ideal prescription drug plan for their medical needs, an investigation by the University of Pittsburgh Graduate School of Public Health reveals.  Their work also could be useful in designing health insurance exchanges, which are state-regulated organizations created under the Affordable Care Act (“Obamacare”) to offer standardized health care plans. Only 5.2 percent of beneficiaries chose the least-expensive Medicare prescription drug benefit (Part D) plan that satisfied their medical needs in 2009, overspending on Part D premiums and prescription drugs by an average of $368 each per year. The evaluation took a national look at how well beneficiaries were making plan choices in the fourth year of the Medicare Part D program and could help guide changes to health insurance programs. Their solution, unfortunately, is even more government employees to counsel recipients, which may cost a lot more than $368 per year.  “In particular, government officials could recommend the three most appropriate Part D plans for each person, based on their medication history,” said co-author Yuting Zhang, Ph.D., associate professor of health economics at Pitt Public Health. “Alternatively, they could assign beneficiaries to the best plan for them based on their medication needs, while offering them the option to choose another plan instead. In designing health insurance exchanges, models with more active assistance would be more helpful than models with large numbers of plans and information. For example, health insurance exchanges could actively screen plans on quality and negotiate premiums to reduce the number of plans.” The researchers looked at the difference in a patient’s total spending, including the plan premium and out-of-pocket payment for the prescriptions filled, between the plan the patient chose and the cheapest alternative option in the region that would satisfy the patient’s medication needs. The study looked at data for 412,712 people, with an average age of 75. Beneficiaries tend to overprotect themselves by purchasing plans with more generous features, such as generic drug coverage in the coverage gap. A few other trends emerged: As beneficiaries aged, they increasingly chose more expensive plans, with people older than 85 overspending by $30 more than people 65 to 69 years old. Blacks, Hispanics and Native Americans chose less expensive plans than whites.  People with common medical conditions, such as diabetes and chronic heart failure, were not significantly more likely to choose more expensive plans. People with cognitive deficits or mental health issues, such as Alzheimer’s disease, tended to choose less expensive plans, spending an average of $10 less than those without such conditions. The researchers could not determine if those people had assistance from caregivers. As the number of plan options increased in a region, the amount of overspending increased by $3.20 for every additional plan available. “A previous study showed that in 2006, beneficiaries could have saved nearly 31 percent of their total drug spending by switching to the lowest cost plan,” said lead author Chao Zhou, Ph.D., a post-doctoral associate at Pitt Public Health. “Since our results are similar, this suggests people are not learning to reduce overspending.” One possible explanation for these consistent results over time is the impact of inertia and bias toward maintaining the status quo, she noted.  “When Medicare Part D started in 2006, the majority of beneficiaries did not choose the least expensive plan,” said Zhou. “Over time, they may have simply stuck to their original plan and never switched to a better one. Beneficiaries might not spend much time researching and adjusting their plan choices based on changes in their medication needs and in plan options.”  Findings from the private health insurance market support the authors’ conclusion that people keep their current plan instead of spending time researching and optimizing their plan choices based on their insurance use and prescription spending in the previous year. Published in Health Affairs
Source: science20.com

Medicare Part D Premiums Holding Steady

Thanks to the marvels of medical science, our parents are living longer than ever before. Adults over age 80 are the fastest growing segment of the population; most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children. In The New Old Age, Paula Span and other contributors explore this unprecedented intergenerational challenge. You can reach the editors at newoldage@nytimes.com.
Source: nytimes.com

Comparing Medicare prescription drug plans

Also, be aware that if you’re a low-income beneficiary and your annual income is under $16,755 or $22,695 for married couples living together, and your assets are below $13,070 or $26,120 for married couples, you may be eligible for the federal Low Income Subsidy known as “Extra Help” that pays Part D premiums, deductibles and copayments. For more information or to apply, call Social Security at 800-772-1213 or visit socialsecurity.gov/prescriptionhelp.
Source: pomeradonews.com

Appeal to protect and preserve Medicare Part D

Medicare Part D has provided a lifeline to millions of beneficiaries. The personal result is improved health outcomes for America’s seniors. The financial result is overall Medicare savings through reduced doctor and hospital visits, prevention of acute illness, and avoidance of other costly health issues. The potential results of mandatory budget cuts to Medicare Part D are reduced options for treatment and medications, considerably increased out-of-pocket costs, and the suffering of Part D beneficiaries who can no longer afford the healthcare they need.
Source: thesomervillenews.com

Karl Rove Targets Tammy on Medicare

The section of the ACA that sets up the board specifically declares: “The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums . . . increase Medicare beneficiary cost-sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria.”
Source: progressive.org