Kaiser Study on Medicare Premium Support Assumes Seniors Would Not Choose Lower Prices

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SSThe authors of the Kaiser study assume that zero beneficiaries would switch from traditional Medicare to a cheaper plan, despite cost increases. Part of the gain from competition is that health plans must compete for beneficiaries in order to retain or gain market share. They have to secure high satisfaction, as they do today, for example, in Medicare Part D and Medicare Advantage. To create a scenario that simply ignores the gains of market competition grossly misrepresents the economic impact of any consumer-driven market, including a health care market with premium support. The study’s headline is that 53 percent of enrollees in traditional Medicare would pay more, but within the study, when benificiaries respond to higher premiums, the number falls to as low as 33 percent.
Source: heritage.org

Video: Pinellas County: Medicare Advantage Plans Florida- Zero premium

Transforming Medicare into a Premium Support System: Implications for Beneficiary Premiums

The analysis does not attempt to model any specific proposal, but is generally based on an approach included in House Budget Chairman Paul Ryan’s fiscal year 2013 budget plan, the proposal Chairman Ryan co-sponsored with Senator Ron Wyden of Oregon, and; in the plan put forward by former Senator Pete Domenici and Dr. Alice Rivlin. In the first two proposals, people who are at least 55 years old, including current beneficiaries, would be exempt from the new system. Republican presidential nominee Gov. Mitt Romney has supported a premium-support system along these lines.
Source: kff.org

Medicare premiums would rise for most beneficiaries under a premium

A premium-support Medicare plan would give beneficiaries a specific amount of money with which to purchase insurance. Assuming beneficiaries keep their current healthcare plans, more than half of seniors enrolled in traditional Medicare and almost all of those enrolled in Medicare Advantage would experience higher premiums under a premium support plan, Kaiser Family Foundation researchers found.
Source: mcknights.com

Study: 6 in 10 Medicare Recipients Would Pay Higher Premiums in Privatized System

Like the Romney-Ryan plan, government health insurance payments for individual seniors would be tied to the cost of the second-lowest private insurance plan in their geographical area, or traditional Medicare, whichever is less expensive. Seniors could pick a private plan or a new public program modeled on traditional Medicare. But if their pick costs more than the government payment, they would have to pay the difference themselves.
Source: cbslocal.com

HHS Touts Growth In Medicare Advantage Plans, Drop In Premiums

More than 13 million Medicare beneficiaries – just over a quarter of all Medicare enrollees – are in Medicare Advantage plans, an alternative to traditional Medicare offered by insurance companies. The health law will reduce payments to Medicare Advantage plans by $156 billion from 2013 through 2022, according to the Congressional Budget Office. President Barack Obama and many Democrats have backed payment cuts to the plans, citing data that the government has in the past paid about 14 percent more per beneficiary in Medicare Advantage than per beneficiary enrolled in the traditional program. Proponents of the private plans point to their better coordination of care and extra benefits and services they provide, including vision, hearing and dental benefits.
Source: kaiserhealthnews.org

Study: Privatized Medicare would raise premiums

Like the Romney-Ryan plan, government health insurance payments for individual seniors would be tied to the cost of the second-lowest private insurance plan in their geographical area, or traditional Medicare, whichever is less expensive. Seniors could pick a private plan or a new public program modeled on traditional Medicare. But if their pick costs more than the government payment, they would have to pay the difference themselves.
Source: sltrib.com

Report: Enrollment up, premiums down for Medicare Advantage

The Kaiser Family Foundation found that this year, enrollment in the program grew by 10 percent — jumps were seen in all but two states — and that the average premium paid by enrollees dropped by $4. The program now covers more than 13 million beneficiaries, or 27 percent of the Medicare population, the report stated.  In 2010, after the healthcare reform law passed, the Obama administration predicted that Medicare Advantage premiums would fall for enrollees as a result of officials’ negotiations with insurers. This ran contrary to the opinions of lawmakers and some policy experts, according to The New York Times. The law’s cuts to the program are expected to save $136 billion over 10 years. A related project, aimed at moderating pain from the cuts with quality bonuses to MA insurers, has received criticism from federal investigators as being wasteful.
Source: thehill.com

People With Medicare Have More High

As a result of provisions in the Affordable Care Act, Medicare is doing more to promote enrollment in high-quality plans and alert beneficiaries who are enrolled in lower quality plans.  Now, persons with Medicare enrolled in consistently low performing plans (those receiving less than 3 stars for at least the past 3 years) will receive notifications to let them know how they can change to a higher quality plan if they choose to do so.  In addition, 5-star plans are rewarded by being allowed to continuously market and enroll beneficiaries throughout the year.  In 2012, thousands of people with Medicare took advantage of this opportunity to join a top performing plan.
Source: enewspf.com

Medicare Information Day Coming Soon

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            Seniors who plan to attend should bring a list of their prescription drugs to compare plans for 2013. The event is a free service by the Ohio Senior Health Insurance Information Program and the Licking County Aging Program. In addition to the Medicare event, seniors can take advantage of three free health screenings starting at 9 a.m. Oct. 19. The Carol Strawn Center will offer memory screenings, Montonya Chiropractic will provide back screenings and Hearing USA will do audiology screenings. Diabetic Supplies of Columbus will conduct a shoe-therapy program for diabetics and review other supplies at 10 a.m.
Source: lcap.org

Video: How to report Medicare Fraud

Biden offers senior Floridians misguided information on Medicare

Under President Obama, that coverage for the screening procedures was expanded as a result of new directives forcing insurers to cover only those preventive services recommended by the United States Preventive Services Task Force. These mandates are another symptom of the centralized control that Obamacare exerts over the practice of medicine. But under Mr. Obama, the colonoscopies have faced offsetting new restrictions that mostly make it harder for seniors to access many of the tests.
Source: aei-ideas.org

Social Security 2013 Increases

Some other changes that take effect in January of each year are based on the increase in average wages. Based on that increase, the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $113,700 from $110,100. Of the estimated 163 million workers who will pay Social Security taxes in 2013, nearly 10 million will pay higher taxes as a result of the increase in the taxable maximum.
Source: bvcil.org

Medicare Enrollment Starting; Help Sessions Scheduled

67th District Austin Austin Dam Show Carolina Chocolate Drops ccmh Charles Cole Memorial Hospital Community Blood Bank Corbett Coudersport court dispatches drilling Election elk county Falcons Flooding Half a Notion health Jobs Joe Paterno lawsuit marcellus shale Martin Causer Murder Natural Gas NY Opinion Oswayo PA PA Fish and Boat Commission PA Game Commission Pat Toomey Paul Ceglia PCEC PennDOT Penn State Police Blotter Politics potter county Potter County Commissioners Potter County Education Council Roulette Steven Rebert Ulysses wellsboro
Source: coudynews.com

The New Medicare.gov: Making Medicare Information Clearer & Simpler

The new Medicare.gov is just one of our efforts over the past year to make it easier for you to understand your Medicare. Whether it’s putting our information in simple, straightforward language so you can understand it the first time you read it or improving the design of the “Medicare Summary Notice ” so you can better understand your Medicare claims,  we’re committed to making Medicare information clearer and simpler.
Source: medicare.gov

Utah Office of Health Disparities: Webinar :Open Enrollment Information for Medicare Beneficiaries with a Disability or Chronic Illness

This call is designed to provide you with an overview of the differences between types of Medicare plans and what it means to you, how to compare plans and important issues to consider in choosing a plan, and where you can get more information and assistance.
Source: blogspot.com

UnitedHealth’s Profit Jumps 23 Percent In Third Quarter

The Associated Press/Los Angeles Times: CVS Unit To Pay $5.25 Million To Settle Drug Pricing Allegations The Justice Department said Monday that a unit of CVS Caremark Corp. has agreed to pay $5.25 million to settle allegations that it reported false information on prescription drug prices to the government’s Medicare program. Federal investigators said CVS’ RxAmerica subsidiary reported false information about the prices of generic prescription drugs in 2007 and 2008. The Centers for Medicare and Medicaid Services used this information in a website called Plan Finder, which seniors could use to estimate their out-of-pocket drug expenses. But Justice Department officials said the actual drug prices offered by the company were “in some cases significantly higher” than those submitted for use on the website (10/15).
Source: kaiserhealthnews.org

Federal Government Charges 91 Individuals for Medicare Fraud

The Medicare Fraud Strike Force, which uses federal, state and local investigators and prosecutors to combat Medicare fraud through the use of Medicare data analysis techniques, charged the parties for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing. According to HHS, dozens of charged individuals were arrested or surrendered in the last 24 hours as indictments were unsealed across the country.  Those indictments charge more than $230 million in home healthcare fraud; more than $100 million in mental healthcare fraud and more than $49 million in ambulance transportation fraud; and millions more in other frauds.
Source: healthcare-informatics.com

The Official Medicare Set Aside Blog And Information Resource: Work Comp Related Meningitis?

Epidural Steroid Injections (ESIs) are the second most abused pain treatment in workers’ compensation, following excessive opioid prescribing, of course. Pain clinics throughout the nation routinely recommend ESIs, despite a failure to demonstrate a long term efficacy, particularly when they perform such procedures in their own offices. Depending upon the state fee schedule, ESIs can range in price from $750 to $3,000+ depending on the number of levels administered, whether performed bilaterally, and whether fluoroscopy is used or not. ESIs are generally administered in a series of three injections usually given in two-week intervals and are expected to provide relief for a few months and up to a year or more for some. Medicare and other private insurers will rarely approve the procedure again if only a few days or weeks of relief is obtained. Yet in workers’ compensation, we find claims with 10 to 12 injections a year all the time. In fact in Maryland, a recent release of finding of an investigation of several doctors at one pain clinic noted that one patient record indicated that she had received over 140 injections in a fairly short period of time. It is an extremely expensive procedure with questionable results and now a potentially deadly proposition.
Source: feedly.com

Program offered seniors info on ‘Medicare 101′

A large number of North Carolina “Baby Boomers” are now turning age 65. Those consumers can receive information on Medicare eligibility from the Social Security Administration. After becoming eligible, consumers can receive Medicare information in several ways. They can make an appointment with a SHIIP counselor at Rufty-Holmes. Consumers can also access the SHIIP website at: www.ncshiip.com or they may speak with a trained SHIIP counselor at 1-800-443-9354.
Source: salisburypost.com

GRAY MATTERS: Now is the time to compare Medicare plans

Beneficiaries can call Medicare at 1-800-633-4227 anytime of day or night, including weekends, and ask for assistance to compare plans and to make a change if needed. The information is also available online at www.Medicare.gov and enrollment changes can be made online. The best time to call Medicare is in the evening or during a weekend to shorten wait times.
Source: times-standard.com

WellPoint Plans Reorganization; CVS Denies Knowledge Of Drug Refill Investigation

Posted by:  :  Category: Medicare

Reuters: CVS Unaware Of Any Government Prescription Refill Probe CVS Caremark Corp said on Friday it has not been contacted by the U.S. government regarding alleged claims the drugstore chain refilled prescriptions and sought reimbursement for them without the approval of patients. According to a report in the Los Angeles Times, which quotes an unnamed official with knowledge of the matter, the Office of the Inspector General (OIG) for the U.S. Department of Health and Human Services is investigating such allegations as part of efforts to stem fraud against the government’s Medicare health plan for the elderly (Alawadhi, Wohl and Morgan, 10/12).
Source: kaiserhealthnews.org

Video: GBMC Primary Care – Debbie Jones, CRNP

WellPoint to Reorganize Into Four Business Units

Health insurer WellPoint plans to reorganize into four business units, one of the first moves announced by interim CEO John Cannon, who took helm of the organization in August, according to a Bloomberg report. Under the plan, the company will organize into separate units for Medicaid, Medicare, commercial and individual coverage. James Carlson, CEO of Amerigroup, which WellPoint announced plans to acquire in July, will oversee WellPoint’s Medicaid business. Leeba Lessin will lead the Medicare unit, Lori Beer will lead the specialty unit and Kenneth Goulet will lead the commercial and individual units, according to the report.
Source: beckershospitalreview.com

Wall Street Breakfast: Must

AMD dives following Q3 warning. AMD (AMD) shares sank 8.1% premarket after the company cut its Q3 revenue guidance to -10% on quarter from a prior forecast of -4% to +2%, and lowered its gross margin outlook to 31% from 44%, partly due to a $100M inventory write-down. The chipmaker is experiencing weak demand across all its product lines – slumping PC sales are having an effect but the size of the drop also suggests share losses to Intel (INTC) and/or Nvidia (NVDA).
Source: seekingalpha.com

Amerigroup to sell Virginia unit on heels of $4.46 billion Wellpoint deal

Amerigroup Corp. announced that it  has entered into a definitive agreement to sell Amerigroup Virginia, Inc. to Washinton, D.C.-based Inova. The sale will occur concurrently with the previously announced $4.46 billion acquisition of Amerigroup by Wellpoint, should the latter be approved by shareholders and regulators.
Source: ifawebnews.com

WellPoint CEO Braly steps down, Cannon named interim CEO

In its most recent quarterly report, the company cut its full-year profit forecast, saying it was trying to maintain its pricing levels even with greater competitive pressure from rival health plans. [ID:nL2E8IP1MG] Since then, it has been meeting with investors to lay out its strategy for improving performance and the board recently issued a statement in support of the direction taken by management.
Source: chicagotribune.com

Top Medicare Part D Plan Costs Spike in 2013

Posted by:  :  Category: Medicare

Senate Dems Protest Medicare Cuts by Talk Radio News ServiceThe opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Source: webmd.com

Video: Medicare Part D and Prescription Drugs

Seniors Are Overspending on Medicare’s Prescription Drug Plan

5 to 7 year old category 8 to 11 year old category 12-15 year old category barack obama barbara revels bunnell bunnell city commission don fleming economic development elections 2012 Flagler Beach flagler beach city commission Flagler County Commission flagler county crime flagler county school board flagler county schools flagler county sheriff’s office Flagler Palm Coast High School florida education Florida Legislature gop gov. rick scott health care health care reform ideology jim landon jobs jon netts l’infame little miss junior flagler county pageant local government budgets milissa holland Miss Flagler County Pageant miss flagler county scholarship pageant obama administration Palm Coast palm coast city council palm coast crime police state rick scott small government taxes traffic accidents unemployment us economy
Source: flaglerlive.com

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

Study Finds Premium Support Plan Could Raise Medicare Premiums In Many Parts of Country

The study modeled the impact of a generic version of premium support, under which beneficiaries would receive a defined subsidy, or voucher, to buy health insurance in a competitive market instead of getting a guaranteed set of benefits as Medicare has traditionally provided. That payment would be tied to the second lowest cost plan offered in an area or traditional Medicare, whichever is lower. This kind of a change is a central part of the House Republican budget written by Rep. Paul Ryan of Wisconsin, now the GOP’s vice-presidential candidate, and it has also been embraced by GOP presidential nominee Mitt Romney. Even a few Democrats have flirted with such a plan as a way to leverage market efficiency to rein in the spiraling cost of Medicare.
Source: kaiserhealthnews.org

Study Finds Premium Support Plan Could Raise Medicare Premiums In Many Parts of Country

The study modeled the impact of a generic version of premium support, under which beneficiaries would receive a defined subsidy, or voucher, to buy health insurance in a competitive market instead of getting a guaranteed set of benefits as Medicare has traditionally provided. That payment would be tied to the second lowest cost plan offered in an area or traditional Medicare, whichever is lower. This kind of a change is a central part of the House Republican budget written by Rep. Paul Ryan of Wisconsin, now the GOP’s vice-presidential candidate, and it has also been embraced by GOP presidential nominee Mitt Romney. Even a few Democrats have flirted with such a plan as a way to leverage market efficiency to rein in the spiraling cost of Medicare.
Source: aarp.org

Shop For 2013 Part D Plan

- Unbiased assistance is available by a SHICK, Senior Health Insurance Counseling forKansas, Counselors in your area. Counseling is available at River Valley District K-State Research Offices inBelleville,ClayCenter, Concordia andWashington. SHICK Counselors are helping at some libraries and Senior Centers too. A listing of area SHICK Counselors assisting Medicare beneficiaries during the enrollment period is available in the District Extension Offices located in the basements of the courthouses inBelleville, Concordia andWashington. Come by322 Grant Avenue inClayCenter. Or call the Extension Office,Belleville (785-527-5084),ClayCenter (785-632-5335), Concordia (785-243-8185) orWashington (785-325-2121).
Source: kndyradio.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

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 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

Retirees save money by choosing the right Medicare Part D plan

Be sure to focus on the “Estimated annual drug costs” column of the search results. What you will discover is that the insurance plans with the lowest monthly premium will end up being the more expensive plans. This is because deductibles and copays are typically higher in these plans. Don’t fall into the trap of just focusing on the plan with the lowest monthly premium. It’s the total cost of premiums, deductibles and copays that matters to your budget.
Source: lgbtweekly.com

Annual Enrollment for Medicare Advantage (Part C) & Part D: October 15 – December 7 

Even beneficiaries who were satisfied with their 2012 plans need to review their plan options for 2013.  Part D and MA plans may have made changes to their coverage, provider networks and other plan features.[3] Plan information for 2013 will be available on the Medicare Plan Finder at www.medicare.gov.[4]  For the computer-savvy, the Medicare Plan Finder is an excellent plan comparison tool, allowing users to enter all their drugs and drug dosages, compare up to three plans at a time, save their drug information for later use, and actually enroll in a plan on-line.  This is the best – if not only – way to truly compare the many plans available to choose from.  People who cannot use the Plan Finder themselves may contact 1-800-Medicare, or their State Health Insurance Assistance Program (SHIP), for assistance with evaluating, selecting, and enrolling in a Part D plan.
Source: medicareadvocacy.org

Medicare open enrollment: How can I find a better plan?

What about doctor availability? On the Medicare site you can directly compare up to three plans, and when I selected your current plan and these other two plans, I saw that your current plan says it has 1001-1500 “physicians and providers,” compared to 4001-5000 for the other two plans. For each plan you can click on “View provider and physician network website,” which takes you away from Medicare.gov and onto the plan’s own website, where you can search its provider directory to judge for yourself whether it has enough doctors to meet your needs.
Source: consumerreports.org

Medicare Part D Plans to Take Active Role in Reducing Prescription Abuse

This drew concern from many physicians and physicians organizations. “Part D sponsors are not in a position to evaluate medication overutilization,” academic pathologist James Madara, CEO and executive vice president of the AMA wrote in a letter to CMS in response to the notice. “The only information they have is the various claims that are submitted for prescription coverage. Sponsors do not know diagnoses and they do not know about any other services the patient is receiving that do not involve Part D coverage.”
Source: physicianspractice.com

Nancy Pelosi’s Weak, Cynical Defense of ObamaCare’s Medicare Changes

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 marsmet526Elsewhere in the piece, Pelosi offers another scare stat: “Medicare will be bankrupt by 2016 under the Romney-Ryan plan.” But as one of the program’s public trustees has noted, the Obama administration’s Medicare plan only extends the program’s trust fund by double counting, using ObamaCare’s spending reductions to pay for both extending Medicare and new insurance coverage. And even if you ignore the double counting, Pelosi’s bankruptcy charge still boils down to this: You can trust Democrats with Medicare because Team Blue has a plan to let the program go insolvent by 2024.
Source: reason.com

Video: 2011 HEAT Provider Compliance Training – Overview of Centers for Medicare and Medicaid Services

Time for a Medicare switcheroo?

. While only about 3 million out of 50 million Medicare enrollees encounter the much-vaunted doughnut hole, if you are one of them it can be expensive. The doughnut hole is the gap in Part D coverage when all costs are paid by enrollees out of their own pockets. As a result of the Affordable Care Act, in 2013, the government is fiddling with the doughnut hole to lessen its impact. Recipients enter the doughnut hole at $2,970 — $40 later than in 2012 — and catastrophic coverage kicks in $50 later at $4,750. As they traverse the doughnut hole, next year recipients will pay 47 percent of premium drug costs, down from 50 percent this year, and 79 percent of generic drug costs, down from 86 percent this year. If you are likely to fall into the hole, it is especially important to make sure you’re signed up for the most economical plan for you. As you can see — even with the reductions — these are whopping costs.
Source: bankrate.com

Medicare open enrollment: How can I find a better plan?

What about doctor availability? On the Medicare site you can directly compare up to three plans, and when I selected your current plan and these other two plans, I saw that your current plan says it has 1001-1500 “physicians and providers,” compared to 4001-5000 for the other two plans. For each plan you can click on “View provider and physician network website,” which takes you away from Medicare.gov and onto the plan’s own website, where you can search its provider directory to judge for yourself whether it has enough doctors to meet your needs.
Source: consumerreports.org

Becoming a Medicare Provider

Medicare is a health program administered by the government of the United States of America that provides health benefits and health insurance to people who are 65 years old and above. They also provide health benefits and aids to those who are not 65 years old but are physically disable or have congenital disorder. These candidates for Medicare should have been a resident of the country for at least five years. Medicare program has approved physicians and medical facilities that the people can visit. These Medicare providers provide different services depending on what area the patient is in. There are different parts of Medicare these Medicare providers can serve in. First is Medicare Part A or known as Health Insurance. The providers of this area give inpatient care in nursing homes or hospitals. They take care of the semiprivate room, food and tests for the patients. Medicare Providers for Part B or Medical Insurance are usually composed of private doctors or those who have expertise on a certain field. Patients of Part B usually receive outpatient care and preventive services such as chemotherapy, dialysis, blood transfusion, mastectomy and other services that will help maintain the health of a person seriously sick. The patients also get medical and prosthetic equipment such wheelchairs, cranes, artificial breast, and artificial breasts. These Medicare providers help the people get extra wellness programs such as those for vision, hearing and dental. Lastly, they also direct the patients to cheap Medicare-approved prescription drugs that the patients need. Being Medicare providers requires an extensive application. There are many requirements needed for those who want to apply in this kind of job. If one wants to be a provider, first and foremost, he has to review the existing rules, requirements and qualifications of Medicare. Other than that, there are also federal rules and regulations that one has to follow, depending on what state a person is in. Second, it is important to be certain on what part of Medicare (Part A or B) that one wants to serve in. Be sure that the part suits one’s abilities. A person who has no expertise in kidney problem can surely not go to Part B. On the other hand, it is just a waste if an expert in cancer will just go to Part A. After choosing the right part, the person has to get an NPI (National Provider Indicator) number. Why the person finishes ensuring an NPI number, he should be ready to apply for a Medicare-provider application by contacting the Medicare carrier in his or her area. The Medicare carrier will help the applicant on questions she or he might have. The applicant will be given a Medicare application by the carrier. Complete the application form provided and never forget to give documents such as drug-enforcement administration (DEA) certificate, IRS form W-9, Medicare provider letter and a copy of your business license. Upon reviewing all the terms, mail the application to the carrier and wait until they finish processing one’s application of becoming a Medicare provider. If you are looking for the best medicare providers and supplemental medicare insurance, 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 providers and http://www.medicarerep.com/ supplemental medicare insurance, visit our site for more tips and information. Contact us for free medicare advice.
Source: abcarticledirectory.com

Study Finds Premium Support Plan Could Raise Medicare Premiums In Many Parts of Country

The study modeled the impact of a generic version of premium support, under which beneficiaries would receive a defined subsidy, or voucher, to buy health insurance in a competitive market instead of getting a guaranteed set of benefits as Medicare has traditionally provided. That payment would be tied to the second lowest cost plan offered in an area or traditional Medicare, whichever is lower. This kind of a change is a central part of the House Republican budget written by Rep. Paul Ryan of Wisconsin, now the GOP’s vice-presidential candidate, and it has also been embraced by GOP presidential nominee Mitt Romney. Even a few Democrats have flirted with such a plan as a way to leverage market efficiency to rein in the spiraling cost of Medicare.
Source: aarp.org

Insurer UnitedHealth's 3Q profit jumps 23 percent

Medicare Advantage plans are privately run, subsidized versions of the government’s Medicare program for the elderly and disabled people. UnitedHealth is the largest provider of these plans, and it made a couple of acquisitions within the past year to help spur growth. Big health insurers have been snapping up smaller Medicare Advantage plan providers to prepare for the millions of Baby Boomers who will become eligible for this coverage over the next couple decades.
Source: mysanantonio.com

Medicare costs for beneficiaries lowered by Affordable Care Act

According to a recently released Issue Brief from the U.S. Department of Health and Human Services, the ACA will lower premiums, co-payments and co-insurance for Medicare beneficiaries. The ACA lowers Medicare beneficiary costs by: 1. Reducing in extra subsidies paid to Medicare Advantage plans. 2. Reducing the rate of growth in provider payments. 3. Designing new financing options that support efficiency, coordination and quality; not quantity. 4. Reducing waste, fraud and abuse. Check out the issue brief here for more information.
Source: typepad.com

Deforming Medicare into a Competitive Bidding System (part 1)

FEHBP requires that all plans cover the same medical services. In spite of this, some plans offer more dental and vision coverage than others. However, the primary “choice” is whether to pay now or pay later. Those who choose plans with lower premiums (taken out of biweekly or monthly pay-checks) face higher deductibles and co-payments when they actually need medical care. Often this results in higher overall cost to those who choose what looks like a less-expensive plan. Seeing physicians “out of network” costs more in a “basic”plan than in a “standard” or “high option” plan. We know from many studies that higher co-payments lead low- and even middle-income people to postpone needed medical care. Since FEHBP premiums are independent of the employee’s income, lower-wage workers are likely to choose a “basic” plan and thus face the barrier of higher costs when they have to seek care. And many, of course, will not be able to afford to pay for any plan.
Source: correntewire.com

Are All Physicians Considered Medicare Providers?

When it comes to Medicare, it is important to find a primary healthcare physician who is consider a Medicare provider. However, you probably are wondering if all physicians are medicare providers. The simple answer to this is no. Not all physicians are Medicare care providers. Many physicians actually choose not to work with the government health insurance, due to a variety of reasons. However, it is not difficult to find Medicare providers in the area. Medicare is essentially a form of insurance, and like some forms of insurance, not all providers and physicians accept certain kinds of insurance. Due to this, you just need to find someone in the area who is able to accept Medicare.
Source: seniorcorps.org

Medicare premiums would rise for most beneficiaries under a premium

A premium-support Medicare plan would give beneficiaries a specific amount of money with which to purchase insurance. Assuming beneficiaries keep their current healthcare plans, more than half of seniors enrolled in traditional Medicare and almost all of those enrolled in Medicare Advantage would experience higher premiums under a premium support plan, Kaiser Family Foundation researchers found.
Source: mcknights.com

Reminder: Optometrists subject to $500+ fee for Medicare DMEPOS enrollment

Optometrists who wish to provide eyeglasses for cataract patients under Medicare are subject to a new durable medical equipment prosthetics, orthotics and supplies (DMEPOS) registration fee every three years, according to the AOA Advocacy Group.  As reported in AOA publications previously, the fee was put in place in March 2011 over the objections of AOA and other physician organizations when the Centers for Medicare & Medicaid Services (CMS) decided to treat all DMEPOS suppliers as institutional fraud risks.
Source: newsfromaoa.org

Fact Check on Medicare Advantage

Posted by:  :  Category: Medicare

  Medicare Advantage plans also protect beneficiaries from catastrophic health care costs.  In 2012, all Medicare Advantage plans offer an out-of-pocket maximum limit for beneficiary costs, and about 78 percent of Medicare Advantage enrollees are in plans that have annual out-of-pocket maximums of $5,000 or less.  These out-of-pocket maximums – which are not offered by the Medicare FFS program – help protect Medicare beneficiaries from catastrophic health care expenses that otherwise might pose a serious threat to their financial security.  Medicare Advantage plans also help reduce out-of-pocket costs for enrollees by reducing premiums for Part B and Part D, and by limiting cost-sharing for Medicare-covered services, including primary care physician visits and inpatient hospital stays.
Source: ahipcoverage.com

Video: Medicare Coverage

Research Roundup: Medicare Open Season Awareness

Georgetown University Health Policy Institute/The Commonwealth Fund: Child-Only Coverage And The Affordable Care Act: Lessons For Policymakers — The authors of this analysis write: “The Affordable Care Act prohibited insurers from denying or limiting coverage for children under the age of 19 in 2010. In response, some insurers ceased to offer coverage to children in need of individual health insurance, known as a ‘child-only’ policy.” They found that 22 states and the District of Columbia have taken action to promote child-only coverage.  Kentucky, for example, saw 268 children enrolled in child-only coverage in 2012 after requiring insurers to offer the policies during open season. The authors say the findings “suggest the need for meaningful regulatory incentives to avoid market disruption in successfully implementing broader reforms in 2014″ (Keith, Lucia and Corlette, 10/2012).
Source: kaiserhealthnews.org

Medicare Beneficiaries Overspend on Rx Drug Coverage, Study Finds

I’m an insurance broker. I deal with Medicare and Part D. Seniors are confused by Part D. They don’t know how to select a plan. And when they select a plan it might change the next year such that it is not right for that person. Last year the premium for a Unicare plan (owned by Wellpoint) went from $32 in 2011 to $72 in 2012. Only one of my clients had noticed this change. I had to contact the others to get them out of that plan. Part D is ridiculously complicated and there are too many plans – and they are allowed to change too much from year to year. This is not good for Medicare beneficiaries and it should be fixed.
Source: californiahealthline.org

Free Glucose Meter !!! Discount Personal Supplies !!!: What Medicare Covers For Diabetes Supplies

The types of testing supplies covered by Medicare are the same whether you use insulin or not, but the amount of supplies covered varies. Those using insulin are covered for a higher number of test strips and lancets per month. In either case, diabetes patients can receive increased coverage of testing supplies. If your doctor deems it medically necessary to test more often than the default coverage would allow, Medicare will allow additional test strips and lancets.
Source: blogspot.com

Medicare open enrollment: How can I find a better plan?

What about doctor availability? On the Medicare site you can directly compare up to three plans, and when I selected your current plan and these other two plans, I saw that your current plan says it has 1001-1500 “physicians and providers,” compared to 4001-5000 for the other two plans. For each plan you can click on “View provider and physician network website,” which takes you away from Medicare.gov and onto the plan’s own website, where you can search its provider directory to judge for yourself whether it has enough doctors to meet your needs.
Source: consumerreports.org

the Kansas Citian: Obama’s War on Diabetics

Late last month Mr. Jones, whose name we have changed for privacy sake, went for his routine doctors visit.  Mr. Jones is a retired, veteran, who suffers from diabetes.  For the first time, his doctor handed him a survey. When Mr. Jones inquired about the reason for the survey, he was informed it was required to help them comply with the Affordable Care Act, aka Obamacare.  In the form Mr. Jones was asked if his parents had diabetes or if they were smokers. Once again, My. Jones’ curiosity was peaked.  “Why are you asking me this?” he asked.  What his doctor then told him shook him to his core. According to his doctor, if they were smokers or their parents had diabetes then the amount of his Medicare copay would be negatively impacted, meaning they would be forced to pay more out of pocket out of pocket or cut back on services.  He was also informed the number of visits to help monitor his diabetes that Medicare would cover was being reduced from once every three months, to once every four months.  Thus, if they wanted to maintain their current schedule, they would need to cover the extra visit out of pocket. As those who suffer from diabetes knows, these visits are crucial for monitoring their condition and reducing the risks associated with the disease.  This incident is just one of many medicare patients will discover as more and more portions of Obamacare begin to go into affect.  Let’s just hope they become aware of them before it’s too late.
Source: blogspot.com

Medicare Information Day Coming Soon

            Seniors who plan to attend should bring a list of their prescription drugs to compare plans for 2013. The event is a free service by the Ohio Senior Health Insurance Information Program and the Licking County Aging Program. In addition to the Medicare event, seniors can take advantage of three free health screenings starting at 9 a.m. Oct. 19. The Carol Strawn Center will offer memory screenings, Montonya Chiropractic will provide back screenings and Hearing USA will do audiology screenings. Diabetic Supplies of Columbus will conduct a shoe-therapy program for diabetics and review other supplies at 10 a.m.
Source: lcap.org

Apidra and Medicare: Good News!

My first thought was to just switch plans – Apidra is the key to my being able to manage my blood sugar with gastroparesis. The plan I like is accepted by a lot of doctors so that is a plus for that. I can also go see a specialist without getting a referral from my PCP – another big plus. When I decided to go to the wound center, I called and made an appointment without having to go thru my PCP to do that. I have had insurance plans that you need a referral first and it slows down the process of getting treatment fast when you need it. I did that with a foot ulcer once and had to have the PCP look at it before I could go to the podiatrist. Then when I got to the podiatrist, the referral was only for him to look at it, not to treat it. We had to wait to get the referral to allow him to treat it. He wasn’t very happy and neither was I!
Source: kellywpa.com

How does gaining Medicare coverage affect healthcare utlization?

“Although we do not find statistically significant differences in Medicare expenditures or in the number of hospitalizations by previous insurance status, we do find that individuals who were uninsured before age 65 years continue to use the healthcare system differently from those who were privately insured. Specifically, they have 16% fewer visits to office-based physicians but make 18% and 43% more visits to hospital emergency and outpatient departments, respectively. A key question for the future may be why the previously uninsured seem to continue to use the healthcare system differently from the previously insured.”
Source: healthcare-economist.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

Study Finds Premium Support Plan Could Raise Medicare Premiums In Many Parts of Country

Posted by:  :  Category: Medicare

Old people read alone... by Ed YourdonThe study modeled the impact of a generic version of premium support, under which beneficiaries would receive a defined subsidy, or voucher, to buy health insurance in a competitive market instead of getting a guaranteed set of benefits as Medicare has traditionally provided. That payment would be tied to the second lowest cost plan offered in an area or traditional Medicare, whichever is lower. This kind of a change is a central part of the House Republican budget written by Rep. Paul Ryan of Wisconsin, now the GOP’s vice-presidential candidate, and it has also been embraced by GOP presidential nominee Mitt Romney. Even a few Democrats have flirted with such a plan as a way to leverage market efficiency to rein in the spiraling cost of Medicare.
Source: aarp.org

Video: New West Medicare .mov

Polls, Debate Prep and Ads About Medicare, Medicaid

The Medicare NewsGroup: Although Still Negative, Media Sentiment Toward Obama, Romney On Medicare Trended Up After Their Debate Sentiment in mainstream media, on blogs and in social media toward Mitt Romney and President Obama remained negative for both candidates and their links to Medicare during the first week of October, according to sentiment measured by Appinions, an influence marketing platform company. While sentiment moved slightly more toward positive for Obama and Romney during the second half of the week, the Oct. 3 debate seemed to impact positive sentiment more for Obama than Romney. Romney sentiment was more positive than that for Obama on the day after the debate, but the lead didn’t hold (Sjoerdsma, 10/12).
Source: kaiserhealthnews.org

New TV Ad: Allen West Just Like the Rest of Them

Miami, FL – The 55,000 Florida members and retirees this week launched a new television ad in Florida’s competitive 18th congressional district. The ad highlights how extremist Tea Party Republican Congressman Allen West has made a name for himself with his words but his record shows he is just another rubber stamp for the special interest of the richest 1% of Americans, voting to pay for millionaire tax giveaways by cutting investments in student loans and privatizing Medicare, raising out-of-pocket costs $6,400 a year. “Members and voters alike are sick and tired of politicians who spend their time grand standing versus solving the issues facing most facing the average citizen,” said Monica Russo, president of SEIU Florida State Council. “Patrick Murphy has bold ideas for creating good jobs, a strong economy anchored by the middle class as well as preserving Medicare and the benefits our seniors have worked so hard to earn.” “Fits In” is airing in the West Palm Beach-Ft. Pierce market for two weeks. A copy of the $160,000 ad can be seen here: http://youtu.be/sei_07ZG9jI. Announcer: Allen West sure stands out on TV Allen West: “To me is a form of modern 21st century slavery.” Announcer: And in Washington, he’s just like the other Republican politicians in Congress. West voted to protect tax cuts for millionaires… While cutting college aid for 1 million students… And privatizing Medicare, raising out-of-pocket costs $6,400 a year. Allen West sounds different, but in Washington he fits right in. SEIU COPE is responsible for the content of this advertising.
Source: seiu.org

Study: Privatized Medicare would raise premiums

Like the Romney-Ryan plan, government health insurance payments for individual seniors would be tied to the cost of the second-lowest private insurance plan in their geographical area, or traditional Medicare, whichever is less expensive. Seniors could pick a private plan or a new public program modeled on traditional Medicare. But if their pick costs more than the government payment, they would have to pay the difference themselves.
Source: libn.com

How the New “Medicare Tax” Will Affect Your Real Estate Investments

One of the ways to take advantage of the rebound is through the purchase of real estate itself. Right now, there’s a strong case for being a landlord. As I have mentioned in previous articles, homebuilders have seen a run-up in 2012, and according to some measures, home valuations are near a 14-year low. That still presents itself as an opportunity.
Source: investmentu.com

Schilling ad: Straight Talk on Medicare

COLONA – Medicare is the issue seniors are concerned about with the Obama Administration cutting $715 billion from Medicare funds to pay for Obamacare. Many are concerned that Medicare will be just like Medicaid – the lowest level of health care, with limited choices and overworked and underpaid doctors and hospital staffers. Republicans are framing the debate to say they are committed to preserving Medicare for seniors. Congressman Bobby Schilling (IL-17) hits on this topic in his new ad":
Source: typepad.com

Ryan at VP debate says his Medicare plan borrowed from former La. Sen. John Breaux

The Breaux commission had gone one step further than the original Ryan proposal, saying any plan to give seniors vouchers to purchase insurance from private insurers had to provide enough money to actually purchase a policy with standard benefits. Democrats have said the original Ryan plan would fall about $6,000 short of the amount needed to purchase insurance in the private market.
Source: nola.com

Study: Privatized Medicare would raise premiums

Like the Romney-Ryan plan, government health insurance payments for individual seniors would be tied to the cost of the second-lowest private insurance plan in their geographical area, or traditional Medicare, whichever is less expensive. Seniors could pick a private plan or a new public program modeled on traditional Medicare. But if their pick costs more than the government payment, they would have to pay the difference themselves.
Source: wfmj.com

How AARP Made $2.8 Billion By Supporting Obama’s Cuts to Medicare

As you know if you’ve been reading this blog, Obamacare cuts $716 billion from Medicare in order to pay for its $1.9 trillion expansion of coverage to low-income Americans. It’s one of the reasons why seniors are more opposed to the new health law than any other age group. So why is it that the group that purports to speak for seniors, the American Association of Retired Persons, so strongly supports a law that most seniors oppose? According to an explosive new report from Sen. Jim DeMint (R., S.C.), it’s because those very same Medicare cuts will give the AARP a windfall of $1 billion in insurance profits, and preserve another $1.8 billion that AARP already generates from its business interests.
Source: politicalarena.org

Horizon Medicare Advantage Blue Value with Rx

Posted by:  :  Category: Medicare

Please read through the full Horizon Medicare Blue Value with Rx HMO Summary of Benefits attached here for a more thorough review of the plan. I am also available to review this plan with you in a meeting if you wish. Due to marketing regulations, I have decided to list just the basics of the plan and but welcome appointments to discuss your full needs. Contact Mike at NewJerseyInsurancePlans
Source: newjerseyinsuranceplans.com

Video: United Healthcare Secure Horizons & Oxford – Medicare Advantage Denies Coverage

Secure Horizons Medicare Advantage Plans

These plans offer a low or zero monthly plan premium, and many of them include drug coverage!  This means that you can have Part D coverage through the plan and pay next to nothing for having the coverage.  The co-pays for doctors visits are also typically lower than the competition.  The plans focus on providing value for the items that most beneficiaries use on a regular basis.  In addition they offer preventative dental and vision care across their markets which most seniors like as well as SilverSneakers!  Silver Sneakers is a national program that gives seniors access to over 10,000 fitness centers across the U.S.  This membership is included at no additional cost.
Source: medicare-plans.net

Horizon Medicare Advantage Blue Value with Rx

With more than 25 years of health plan experience, Deanna brings to SCAN a solid background in Medicare Advantage sales management, sales operations and marketing. Immediately prior to joining SCAN she served as corporate director of Medicare marketing for Molina Healthcare where she was instrumental in optimizing marketing, sales and enrollment operations. She has held sales leadership positions at several other large healthcare companies including PacifiCare Health Systems/Secure Horizons and Aetna. Source: pepperdine.edu
Source: medicaresupplementalco.com

Stone County Health Department offers four community clinics for flu shots

Although the first and most important step in protecting yourself and your family against the flu is to get a flu vaccine every year, it is important for everyone to help prevent the spread of the flu by following proven disease prevention methods. These include good hand washing (wash hands under running water with soap, rubbing hands together for 20 seconds or use hand sanitizer), keep hands off of your face, keep a distance from others who are sick, clean surfaces regularly, and stay home when sick until fever-free for 24 hours without the aid of medication.
Source: ozarkssentinel.com

Medicare Advantage Plan payment shenanigans, an end run around Obamacare cuts

OACT has estimated that the MA Quality Bonus Payment Demonstration will cost $8.35 billion over 10 years, most of which will be paid to 3-star and 3.5-star plans. About $5.34 billion of OACT’s cost estimate is attributed to quality bonus payments more generous than those prescribed in PPACA, specifically to (1) higher bonuses for 4-star and 5-star plans, (2) new bonuses for 3-star and 3.5-star plans, (3) applying bonuses to plans’ entire blended benchmarks, and (4) allowing plans’ benchmarks to exceed their pre-PPACA levels. Most of the remaining projected demonstration spending stems from higher MA enrollment because the bonuses enable MA plans to offer beneficiaries more benefits or lower premiums. Taken together, the expanded bonuses and higher MA enrollment mainly benefit average performing plans—those receiving 3-star and 3.5-star ratings. In addition, OACT estimated that the demonstration will offset more than one-third of the reduction in MA payments projected to occur under PPACA during the demonstration years. The largest annual offset will occur in 2012—71 percent—followed by 32 percent in 2013 and 16 percent in 2014.
Source: quinnscommentary.com

AARP Sacrificed Medicare on the Altar of ObamaCare

AARP VP: “IT WAS ACTUALLY A HEAVY LIFT FOR US TO CONVINCE MANY AT AARP THAT MEDICARE ‘SAVINGS’ (WHICH THEY READ AS CUTS) IS NOT BAD FOR BENEFICIARIES”: “AARP had long lambasted cuts in fees to Medicare doctors because reduced payments would mean fewer doctors who accept patients with the insurance. Yet in its campaign for ObamaCare, it argued the money the health law strips from Medicare—by imposing price controls on hospitals—would improve ‘care.’ When the organization tried to sell the line to its own people, it didn’t go well. Ms. Super told Obama officials in June 2009: ‘It was actually a heavy lift for us to convince many at AARP that Medicare ‘savings’ (which they read as cuts) is not bad for beneficiaries.’ Note the ‘savings’ quote marks.”
Source: texasgopvote.com

Secure Horizons Medicare Advantage

Provider dedicated nonsense dedicated of, different of providing and nonsense. County the plans is artists and on, Secure Horizons Medicare Advantage by by and different tax insurance. Camelback learn to types about about different, Secure Horizons Medicare Advantage is benefits plans instant and is. Insurance plan complaints health social plans, Horizons quality age insurance covers covers. Life and tax are of, to plans to is plans code. W the at the plan and reviews, Secure Horizons Medicare Advantage healthcare and in about of pricing. Find and is free and all types, Secure Horizons Medicare Advantage zip at instant health and. W and and care more benefits over about, Medicare of of more for insurance funded solutions.
Source: posterous.com

Feds Bust Healthcare Facility in Skokie For Medicare Fraud

Posted by:  :  Category: Medicare

Love it! Improve it! Medicare for All! by TheeErinAC … Freud was a psychologist. You mean of course, fraud. This is an example of things going RIGHT and weeding out fraud. The more things like this are detected and publicized, the more reluctant providers (and many times patients themselves) will be to get involved in doing something they know is wrong. The stiffer the sentence the better, as a deterrent, hopefully. Fraud is one significant way to attack Medicare waste. Another is to reduce monthly advances to providers of MA (Medicare "Advantage") Plans (formerly Medicare + Choice..Share HMO etc etc)… Last year the government paid providers of these managed care plans over $9 Billion Dollars more, than if those same enrollees simply had medicare and a supplement or medicare and medicaid if indigent. Doctors taking kickbacks is nothing new. They have been losing their licenses and doing jail time since Medicare began. What is new is with the technology available, these offenders are more likely to get caught. Never a dull moment as the debates begin next week. Rest assured Medicare will be brought up.
Source: patch.com

Video: Understanding Medicare Basics – 2010 Medicare Open Enrollment Webinar

Morton Grove Duo Charged In Medicare Fraud

According to the indictment, between Jan. 2008 and July 2012, Tolentino, Magsino, and Hernal conspired with others to pay kickbacks and bribes to doctors. The amount of kickbacks varied but generally ranged from $300 to $600 for each new patient’s completion of five home health visits in one cycle, and ranged between the same amounts for the repeat admission of a previous patient in a new cycle of home health care, federal officials said.  
Source: patch.com

Elmhurst Resident Indicted in Medicare Kickback Scheme

An Elmhurst resident who is co-owner of a home healthcare agency was indicted on federal charges for allegedly participating in a conspiracy to pay and receive kickbacks in exchange for referral of Medicare patients for home health services. Elmhurst resident Junjee L. Arroyo, 44, along with Goodwill Home Healthcare co-owner Marilyn Maravilla, 55, of Chicago, and three other defendants allegedly conspired to pay and receive about $400,000 in kickbcks to themselves, nurses, marketers and others. This enabled Goodwill, which is based in Lincolnwood, to bill Medicare about $5 million. Also indicted were Ferdinand Echavia, 39, of Chicago, a licensed nurse who referred patients to Goodwill, and Jean Holloway, 41, of Bellwood and Rakeshkumar Shah, 46, of Des Plaines, both of whom marketed Goodwill’s services to Medicare patients.         The 29-count indictment was returned by a federal grand jury Aug. 9 following the arrests of Holloway and Shah, who were released on bond after pleading not guilty.         Maravilla, Arroyo and Echavia, all licensed nurses, and Goodwill as a corporate defendant, are scheduled to be arraigned on Aug. 22 in U.S. District Court.         All six defendants were charged with one count of conspiracy to pay and receive illegal kickbacks for Medicare patient referrals. In addition, defendants also were charged with the following number of counts of violating the anti-kickback statute: Goodwill, 16 counts; Maravilla, 15 counts; Arroyo, 16 counts; Echavia, five counts; Holloway, three counts; and Shah, eight counts.         Maravilla began working as a nurse at Goodwill in August 2008 and became an owner and the administrator of the agency within two months. In addition to being co-owner, Arroyo was Goodwill’s director of nursing.                 Between August 2008 and July 2010, the indictment alleges that Maravilla, Arroyo and two other individuals— an officer and an owner of Goodwill and a certified public accountant and Goodwill’s bookkeeper—paid and caused Goodwill to pay kickbacks to nurses, marketers and other home health care workers who referred patients to Goodwill; assisted in re-certifying patients as homebound; or caused patients to begin new 60-day care cycles of home health care with Goodwill.  By offering kickbacks, Maravilla, Arroyo and others sought to increase Goodwill’s patient census and to enrich themselves and Goodwill. During this time, Goodwill obtained referrals of about 900 cycles of home health care, including new patients and the re-certification of existing patients for additional 60-day cycles of care.         According to the indictment, the amount of the kickback payments ranged from $400 to $700 for each new care cycle and $100 to $300 for each re-certification. The payments were intended to induce nurses, marketers and others in the home health industry to refer patients to Goodwill for services to be reimbursed by Medicare, the indictment alleges.        In January 2009, Maravilla and Arroyo allegedly created and circulated to Goodwill employees and affiliates a memo on Goodwill’s letterhead that set forth a structure for kickbacks relating to patient re-certifications, disguising the illegal payments as “bonuses.” The memo provided that a $100 bonus would be given to nurses who re-certified a patient for a third cycle, and a $200 bonus would be given to a nurse who re-admitted a discharged patient a month after the discharge date.         In order to make certain kickback payments in cash, Maravilla and Arroyo obtained Goodwill checks payable to them and recorded on Goodwill’s books as “loans,” but they allegedly cashed the checks and used the funds to pay kickbacks to marketers.         The indictment alleges that Maravilla, Arroyo and Goodwill’s bookkeeper paid Echavia cash kickbacks totaling about $28,000, and also paid kickbacks totaling about $56,000 to a company owned and controlled by Echavia. Maravilla and Arroyo allegedly caused Goodwill to pay about $10,400 in kickbacks to Holloway, $21,500 in kickbacks to Shah, and $20,000 in kickbacks to two other marketers who were not charged.         The indictment also alleges that Maravilla and Arroyo caused Goodwill to pay at least $58,000 in kickbacks to at least three other nurses who were affiliated with Goodwill. They also were not charged. In addition to receiving salary and profits from Goodwill, Maravilla and Arroyo allegedly caused the agency to pay kickbacks to themselves, as well. Maravilla allegedly received about $138,000 in kickbacks, and Arroyo allegedly received about $44,000 in kickbacks for patients that either he or his wife referred to Goodwill.         Conspiracy and each count of violating the anti-kickback statute carry a maximum penalty of five years in prison and a $250,000 fine.  The indictment was announced by Gary Shapiro, acting U.S. attorney for the Northern District; Lamont Pugh III, special agent in charge of the Chicago Region of the U.S. Department of Health and Human Services; and Robert Grant, special agent in charge of the Chicago Office of the FBI.         The public is reminded that an indictment is not evidence of guilt. The defendants are presumed innocent and are entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.         The case falls under the umbrella of the Medicare Fraud Strike Force, which expanded operations to Chicago in February 2011 and is part of the Health Care Fraud Prevention and Enforcement Action Team.  Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. 
Source: patch.com

Can Ryan Defend against Biden’s Medicare attacks?

Paul Ryan has never been in a high profile debate of this magnitude.  With that being said, there is no one that I’d rather have on that stage.  Like my grandmother who I spoke with this week, many Americans have wondered why Mr. Romney plucked a Congressman from an obscure Wisconsin district to be his Vice President of the United States.  Tonight they will find out why Paul Ryan is the sharpest legislature in Washington.  I have no doubt in Ryan’s ability to sell Americans solutions on the harsh realities of our budget problems.
Source: redstate.com

Dold, Schneider Spar on Medicare

Rep. Dold voted, twice, for a plan that ends Medicare as it exists today for those under 55. Don’t pay attention to what he says – look at his votes: he voted twice for the Ryan budget; if the Senate and Executive branches had been Republican, it would be law. Period. If you look at the specifics of the plan, you will see there is nothing moderate about it. He can say he supports many more moderate plans all day long, but I would only believe those words if they were backed by principled votes against the Ryan plan. The proposed Wyden-Ryan was not passed by the house – the Ryan Plan was. Mr. Dold, you will be held to account for your deeds, not your words.
Source: patch.com

Where to Get a Flu Shot in Plainfield

CVS: The locations at 11840 S. Route 59 and 2375 Drauden Road offer flu vaccinations for adults (including the new, smaller-needle intradermal vaccine for ages 18-64) and children 18 months old and younger. Walk-ins are welcome, but shoppers can also schedule appointments by clicking here. Insurance accepted, including Medicare Part B.
Source: patch.com

Illinois REC Services and Medicaid Incentives Provide a Boost to the State’s Economy

Recent national figures from the Office of the National Coordinator for Health Information Technology (ONC) indicate more than 129,000 priority primary care providers (PPCPs) have enrolled in REC programs similar to IL-HITREC’s. Late last fall, IL-HITREC reached its target goal of enrolling 1,300 PPCPs to assist in reaching meaningful use of a certified electronic health record system.
Source: emrdailynews.com

Elect Schneider for Continued Recovery

When we spend (tax $$) on infrastructure—high speed rail, bridges, wind turbines, public transit — 5 things happen: 1.) 1000s are no longer unemployed… 2.) But are instead earning a good living building the future of America. (If you have 1000 (public sector) workers laying track between Chicago and Nashville, say, that translates to 1000 American jobs, held by 1000 American workers. We (Congress) can even stipulate that the tracks be made of steel forged in this country (gov’t contract) and that the train cars be produced in the USA (gov’t contract), all of which translates to 1000s more USA jobs.) 3.) The increased purchasing power of these (public sector & gov’t contract) employees spurs private sector growth. Supply and demand economics! Crazy! (Remember those 1000s ,who are earning a good living forging steel, and laying rail? Presto, changeo! They have paychecks and are once again feeling secure about their future. They move out of their mom’s basement, start spending, new furniture, a more dependable car—i.e., in the private sector… They eat out more often, hire a contractor to build their dream house, buy a better lawnmower and a second car—i.e., more spending in the private sector…) 4.) The deficit goes down! (More people employed in both the public and private sectors translate to more tax revenue collected!) 5.) We have infrastructure improvements that future generations will thank us for. Hope this helps!
Source: patch.com

Healthnet Medicare in Arizona

Posted by:  :  Category: Medicare

Today, Medicare is a little more complicated than it was originally simply because there has been a lot of changes, reforms, and additions made. In the beginning it was simply to offer health care for those over 65 years old but that has changed quite a bit and now includes those with disabilities as well as having different parts to Medicare. When you first become eligible for Medicare you are placed in the Original, which consists of Part A and B, which is the health care portion and it also includes the drug prescription plan, which is Part D.
Source: platinumcube.com

Video: Health Net Medicare Advantage – Compare to over 180 Compani

More on Proposed Cuts to Medicare Advantage: Seniors Would Save Far More Than They Lose

“It turns out that the additional benefits and flexibility created by recent increases in MA payment rates simply weren’t worth very much to seniors,” Frakt writes. “Consumer surplus loss associated with cuts in payments to MA plans will be only 14 cents per dollar saved. . . the truth is that under Obama’s plan a small fraction of Medicare beneficiaries will lose their MA benefits and/or face higher costs. However, the potential savings are enormous and research shows that the benefit cuts needed to achieve them will not be terribly missed.”
Source: healthbeatblog.com

Medicare imposes marketing and enrollment suspensions on HealthNet, Arcadian and Universal American (Today’s Options).

Arcadian had their webinar today as well. On the call the moderator did not and would not discuss the other companies. It was very refreshing for me to see that respect for the competitors. One of the things we did discuss was the sanctions, while marketing practices were a component, a large part of the sanctions revolved around Rx administration. The Rx vendor is not specifically mentioned nor will I name them. I am however disappointed that no specific action is to be taken when this vendor is responsible for issues with ALL the companies receiving sanctions. All of the companies/MAPD Plans are working hard with the CMS to correct the issues and will be back to marketing in 4 to 6 months. My feelings go out to all of the beneficiaries that will miss out on these plans. In some markets, the sanctioned plans are the most intelligent option.
Source: agentpipeline.com

Health Net sanction means one less low

Los Angeles-based Health Net Inc. to stop enrolling people into its Medicare Advantage and prescription-drug plans. That’s a blow because Health Net is the second-largest Medicare Advantage provider in Oregon. It offered one of the few plans with no additional premium, experts say. The agency said it took action because Health Net has “continually subjected its enrollees to impermissible hurdles in their attempts to obtain needed, and in some cases, life sustaining, prescription medications.” Medicare officials say they would monitor Health Net until it corrected the problems. Health Net emphasized in a statement that the suspension does not effect its existing Medicare enrollees. 
Source: oregonlive.com

CMS Announces Marketing Sanctions for Three Medicare Advantage Carriers: Health Net, Arcadian and Universal American

[…] CMS isssued a press release on Friday afternoon announcing these marketing sanctions.  The sanctions for Health Net took effect at mid-night last Friday, so as I write this, they are currently unable to take an new enrollments.  The sanctions for Arcadian Management and Universal American Corp will not take effect until Sunday, December 5th, so agents will be allowed to enroll new members in these plans for approximately 2 weeks until the sanctions take affect.  For Universal American, the sanctions DO NOT include their stand alone part D plan, only their Medicare Advantage plans.Source: ritterim.com […]
Source: ritterim.com

Q1Medicare.com Brings the 2013 Medicare Part D Prescription Drug Plan Information Online

In 2013, seniors and other Medicare beneficiaries qualifying for the full Low-Income Subsidy (LIS) or Extra Help program will still find most states offering a number of prescription drug plans qualifying for the $ 0 monthly LIS premium. The state with the largest number of LIS qualifying plans is Arkansas with 15 Medicare Part D plans. Unfortunately, residents of 20 states, including Florida and Texas, will find fewer LIS-qualifying 2013 Medicare Part D plans. Because of changes in the annual Medicare Part D plan premiums and state LIS premium benchmarks, some full-LIS qualifying Medicare beneficiaries may be automatically reassigned to new 2013 plans still qualifying for the $ 0 monthly premium. However, Extra Help recipients who chose their own plan in the past will not be auto-reassigned to a new plan and may need to select a new 2012 Medicare Part D plan that still meets the $ 0 monthly premium threshold.
Source: uoflgolfscramble.com

CMS Lifts Sanctions Against Health Net Medicare Plans

Dow Jones Newswire (8/3, Subscription Publication) reports that Health Net Inc. will immediately return to marketing its Medicare Advantage and prescription-drug plan products after the Centers for Medicare & Medicaid Services lifted its sanctions against them. The sanctions were imposed last November, when CMS alleged that the company had failed to provide enrollees with prescription drug benefits in accordance with guidelines and contract terms. Wells Fargo analyst Peter Costa issued a note saying that the move may not have much impact on 2011 revenue for the company, but was a crucial step towards regaining its growth in Medicare Advantage.
Source: barricksinsurance.com

Medicare Supplement or Medicare Advantage

Welch Insurance serves clients in Huntington Beach, Fountain Valley, Costa Mesa, Newport Beach, Long Beach, Norwalk, Downey, Anaheim, Cerritos, Lakewood and other cities throughout Southern California. We offer updated information from the top carriers including Anthem Blue Cross, Blue Shield, Health Net, Aetna, United Health Care, and Humana for Medicare Supplements. We also offer Medicare Advantage Plans and Part D from Anthem Blue Cross, Blue Shield and Aetna; including the Anthem LPPO (Local Preferred Provider Organization).
Source: welchinsurance.net