Business owners report business health improving, but no plans to spend

Posted by:  :  Category: Medicare

it has all of the GOVERNMENT OPTIONS, but will they really tax the CADILLAC health plans? by roberthuffstutterWhile business owners may not be able to control or predict the future of health care, many are turning to wellness programs to improve employee health and reduce risks. Nearly two-thirds of those surveyed (64 percent) offer some form of wellness benefit to their employees. Among businesses that offer wellness benefits, 32 percent have experienced lower health insurance costs. Business owners report wellness programs have contributed in other ways:
Source: lifehealthpro.com

Video: The 6 Minute Muscle Building Meal Plan – Healthy Dinners

Celticare Health Plan CeltiCare Health Plan Receives NCQA Accreditation

About CeltiCare Health Plan of Massachusetts Founded in 2009, Boston-based CeltiCare Health Plan of Massachusetts is a managed care organization that provides high-quality, cost-effective health insurance to Massachusetts residents. CeltiCare is committed to helping its members achieve better health outcomes by providing high-quality benefits, services and wellness education. Backed by parent company Centene Corporation, CeltiCare offers a new form of local managed care that is tailored to the needs of Massachusetts’ progressive healthcare system.
Source: celticarehealthplan.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

Romney health plan would cost US, group says

If and when in the distant future we feel a need to enroll in Tricare and take advantage of the benefits I earned while serving, we will, but as of now we both feel it is more important that we don’t and let those who honestly need it be able to have it. We have discussed this several times and when we hit Medicare age we would then use it. For now we just don’t need it. Why take from a system we really do not need to take from? To us that isn’t fair to those who actually need it. We both make more than enough money to fund our own way. We both take good care of ourselves and are in perfect health. We both have successful companies and are not hurting financially. A simple principle to our life is self sufficiency and saving intelligently for a rainy day, not rely on others to pay our way when we can provide for ourselves. Even though we could have afforded a much larger and more expensive house and cars we didn’t feel it was necessary. The more people take the less their is to give. We have tens of thousands of vets who need the most from those programs and for us to take from it means less to them. I recently read a story about a soldier who needed a powered wheelchair and the one thing that was holding it up is the cost. So some private donors stepped up to the plate and got this wounded warrior what he needed. They also renovated his house for him so he could get around it easier. This guy served and sacrificed but the gov couldn’t take full care of him because of cost. Stories like this formed our decisions. Our country is broke in case you haven’t heard already. When I enlisted in 1983 I did it for the love of my country and not to squeeze every nickle and dime I could from it. I certainly did benefit greatly from my time served thru education and opportunities provided to me. That doesn’t mean I feel ill will towards those of you who do use your military medical benefits (Tricare, DEERS, and VA), you earned it. For us it isn’t necessary yet.
Source: nbcnews.com

Poll: How healthy is your health insurance plan?

Kellie Lunney covers federal pay and benefits issues, the budget process and financial management. After starting her career in journalism at Government Executive in 2000, she returned in 2008 after four years at sister publication National Journal writing profiles of influential Washingtonians. In 2006, she received a fellowship at the Ohio State University through the Kiplinger Public Affairs in Journalism program, where she worked on a project that looked at rebuilding affordable housing in Mississippi after Hurricane Katrina. She has appeared on C-SPAN’s Washington Journal, NPR and Feature Story News, where she participated in a weekly radio roundtable on the 2008 presidential campaign. In the late 1990s, she worked at the Housing and Urban Development Department as a career employee. She is a graduate of Colgate University.
Source: govexec.com

Some schools, authorities may quit state health plan

What prompted the quest for a new insurance provider is a decision by the state that’s boosting the employer’s share of monthly premiums by $150 this year and by the same amount in each of the next two years, Jones reported. If a school district or authority opts out of SHBP, their current retirees would stay in the plan. Newly hired workers, though, would not have that coverage.
Source: georgiahealthnews.com

Trinity Health plans merger with Pennsylvania health system

“To serve people best in today’s health care environment, health systems must have ready access to resources and ideas across the broad spectrum of care, and this consolidation would help us achieve that goal with an exceptional national network,” Trinity Health President and CEO Joseph Swedish said. “We are excited about the benefits our combined organizations will bring to people and communities nationwide.”
Source: mibiz.com

Priority Health wins Michigan benchmark health plan competition for model plan on state insurance exchange

If you enjoy the content on the Crain’s Detroit Business Web site and want to see more, try 8 issues of our print edition risk-free. If you wish to continue, you will receive 44 more issues (for a total of 52 in all), including the annual Book of Lists for just $59. That’s over 55% off the cover price. If you decide Crain’s is not for you, just write “Cancel” on the invoice, return it and owe nothing. The 8 issues are yours to keep with no further obligation to us. Sign up below.
Source: crainsdetroit.com

2013 Medicare Changes: Some Plans Covering More Mental

For example, plans now may choose to cover benzodiazepines, a class of drugs that includes Valium and is used to treat anxiety and insomnia, and certain barbiturates such as those used to treat chronic mental disorders. Those drugs in the past were excluded from Part D and were typically covered out of pocket.
Source: ourparents.com

AMA report acknowledges Harkin Law repeal effort stalled by AOA

“Optometry rallied as never before to become a force in the battle over national health care reform and the AOA-backed patient access provisions included in the new law clearly show it,” said Ron Hopping, O.D., M.P.H. “The simple fact is that whether anti-optometry groups like it or not, millions more Americans will gain access to their local optometrist because the new federal law we fought for will target the discriminatory practices of health plans.”
Source: newsfromaoa.org

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

Posted by:  :  Category: Medicare

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

Video: Learn About Medigap Plans

Does Medigap Rate Change when Subscriber Moves?

Are you an Insurance Agent Forum member yet? To sign up for your FREE INSTANT account, fill out the form below! Username:     Password:   Confirm Password:     E-Mail:   Confirm E-Mail:     Question of the day:   Which holiday is on Dec.25-th ? Agree to forum rules 
Source: insurance-forums.net

Many Years Young: What’s the best Medigap policy?

Sadly, what you won’t see are prices. For that, you’ll need to contact the companies one by one. Or you can work with a trusted independent health insurance broker who can get that information for you. Be aware that in states without extra consumer protections there are only specific times when you’re entitled to buy a Medigap policy with no questions asked about your health history. At other times, you can be turned down or charged more for a pre-existing condition.
Source: manyyearsyoung.com

AARP’s $2.8 Billion Medigap Windfall from ObamaCare Hurts Seniors

In light of yesterday’s column, Alabama Gov. Robert Bentley helpfully weighs in on the RESTORE Act, here: “The Alabama Gulf Coast experienced significant environmental and economic harm from the BP oil spill. BP and the other responsible parties must be held accountable for those damages. The Restore Act gives state and local officials the power and the responsibility to use BP money to most effectively restore both the environmental and economic strength of our region. Governor Bentley supports and appreciates Congress’s desire to see these decisions made at the state and local level. While both NRDA and the Clean Water Act are critical tools for recovery from the BP oil spill, the Governor will oppose any effort by the federal government or by BP to undermine the principle of local control…[more]
Source: cfif.org

Understand How Doctors Work With California Medigap Coverage

We’re blessed in California with not only extensive shoreline and a beautiful State but with an extensive and sophisticated health care infrastructure. Some of the premium hospitals and physicians in the U.S. call California home. Just think of UCLA, UCSF, Stanford, and Cedar Sinai to name a few of the prestigious medical facilities available. This does not even scratch the surface of the broad level of physician expertise that also resides in California. How does all of this work with Medicare and a California Medicare supplement insurance plan. Fortunately, we can report back that it works very well although the future does provide some challenges which we’ll discuss. Let’s take a look at doctors and hospitals available with California Medicare supplement plans. Let’s start with the basics. First, does California Medicare have a “network” of allowed providers be it hospital or physician? The quick answer is yes but it’s less of a concern than you would think (for now). A California medical provider does need to participate with Medicare. The vast majority of hospitals participate in the California Medicare network. In fact, we have never seen an issue with a facility lacking participation although it’s always good to check first with a desired facility for non-emergency care. As for California physicians, you’re more likely to find a doctor not in the California Medicare network than with a facility but it’s still very unlikely. A physician does need to “opt in” and participate with Medicare which among other requirements, dictates an allowed amount that the provider can charge for a given procedure. This is the main means of Medicare to control health care costs as the typical re-imbursement has been estimated to be 60% of what a provider would charge otherwise. There is a wrinkle however with this designated California Medicare negotiated rate and that has an important impact on which California Medigap plan to choose. California health care providers can choose to charge “excess” or up to 15% higher than what Medicare allows for California providers. If the allowable amount is $1000 for a given procedure, the provider that is charging full excess would charge $1150 or an additional $150. That’s manageable but what if you have a series of expenses that run $10K? Now we’re looking at an additional $1500 out of pocket. So how important is this with California Medicare providers? It’s still relatively manageable since most providers will accept Medicare’s negotiated rate. Unfortunately, this is changing with time as Medicare continues to struggle with finances pointing in the wrong direction. More and more California Medicare providers will likely start to charge the excess to compensate for reduced re-imbursements from the program. Every year, Congress has voted to put off sizeable reductions in California Medicare provider reimbursements but eventually, Congress will be forced to squeeze more out of that side in spite of the political jeopardy this creates. When that happens, more California Medicare doctors will be forced to charge excess. The F plan is California Medicare supplement insurance plan that covers this excess charge and for that reason, it stands above the beyond the other Medigap plans. The actual California Medigap carriers themselves look to Medicare to establish benefit and provider eligiblity so they will act accordingly in dealing with California health care providers. Occasionally, we have seen California Medigap carriers have slightly different benefits for their own PPO network (such as a small office copay for a limited number of visits) but the trend is towards a uniform network of providers that follow California Medicare’s dictate. Dennis Jarvis is a licensed insurance agent concentrating on California Medicare supplement insurance.

vsp eye insurance: Home News Water Air Soil Showroom CSR and Social Innovation

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Home News Water Air Soil Showroom CSR and Social Innovation & Clean Tech environmentalist Fri Crunch About Mission Who We Are Organization Advertiser Magazine Archive Contact medicare canada Environment and Climate Change medicare canada Jobs Newsletter Signup Contest With environmentalists newsletter gives you all the important medicare canada news direct to your inbox. This publication brings together the main themes and stories published monthly. You can always unsubscribe through the unsubscribe link at the bottom of the newsletter. policy change and the environment, medicare canada water / on September 19, 2012 12:56 / In recent years, Denmark has undergone several major drinking water contaminants, excellus bcbs including Tune and Køge, where users were sick or had to boil water for months . So are all Danish plumbing system routines. The aim is to avoid contamination of drinking water, according to a press release from the Ministry excellus bcbs of Environment and Water. Now water can have fixed combinations of what you do to maintain a high quality of drinking water. The requirement for the introduction of management systems of all public water supplies, which supplies water to more than 10 families agreed by all parliamentary parties except the Liberal Alliance. – Clean water is a good thing, because we all tend to lose a shorter or longer. Now do whatever excellus bcbs we can to avoid the biggest polluters of drinking water, we have seen the way in Copenhagen, Køge and melody. Both small and large water must meet the new requirements to reduce the risk of drinking water contaminants and provide clean water to all citizens, says Environment Minister medicare canada Ida Auken in the press release. Report prepared by the Ministry of Environment in 2009, believes that the introduction of management systems can halve the number of water pollutants. medicare canada Individual supply medicare canada a plan for how often and how much drinking water system must be checked for defects. For example, excellus bcbs they should be aware of how often the tank should be examined for holes? What cleaning products can be water? What water should excellus bcbs be in control excellus bcbs when digging medicare canada in the ground to repair water pipes? According to the press release. Most say the biggest Denmark has about. 2,500 public water supply. About 90 of them serving more than 4,400 families and 160 works supplying water to about. excellus bcbs 1200-4400 families. The remaining 2,250 small water provides water for between 10 and 1200 families. Social Democrat environment Torben Hansen, spokesman has already raised the issue with the previous government. He was pleased excellus bcbs that we were able to agree on demands medicare canada for water: – The requirement for anyone who comes Danes drinking water. But the biggest requirements for those who provide the procedures are more complex hydraulic structures, we deliver excellus bcbs 100,000 families than providing water to 10 families. But basically this is that everyone must know their system medicare canada very well and establish procedures to ensure that the plumbing is in good condition, he said in a press release. A study by Nature Agency and the Agency for Protection of Health medicare canada excellus bcbs in 2011 showed excellus medicare canada bcbs that approximately three percent of the water delivered each year Where too many harmful bacteria in the water. This is partly medicare canada related to the maintenance and running in rainwater that problems arise.
Source: blogspot.com

Video: Excellus BCBS Medicare plan travels with you

Excellus BlueCross BlueShield Emphasizes Fitness For Seniors

Any American who is 65 years old or older has access to Medicare, but only covers a limited amount of health care costs. That’s why many seniors purchase Medicare Supplement plans from private insurance companies to fill in the coverage gaps.
Source: gohealthinsurance.com

Irreconcilable Differences: The Problem of Health Care

We may be ahead of the curve here in Rochester. The Rochester Medical Home Initiative, a trial approach to primary care administered by Excellus and MVP, proved that vigilant primary care can reduce overall system cost. Participating doctors reduced unnecessary hospital admissions, cut re-admissions and reduced use of hospital emergency departments. This trial that will be dramatically expanded under the $26.5 million awarded to the Finger Lakes Health Systems Agency by the Federal Center for Medicare & Medicaid Innovation grant program. The grant provides the more comprehensive primary-care model to patients at high risk for hospitalizations and emergency-room visits. And in the works is the Finger Lakes Regional Clinical Quality Improvement Initiative, a consortium of all of Rochester’s major health care players, intended to identify what works, what doesn’t, and to disseminate this information to physicians throughout the region.
Source: policy-wonk.org

2013 Medicare Changes: Some Plans Covering More Mental

Posted by:  :  Category: Medicare

Bubbles? Take something like 'Not I! ...item 1.. Wakulla Republicans Protest Against Taxes in the County (September 06, 2011) ... by marsmet552For example, plans now may choose to cover benzodiazepines, a class of drugs that includes Valium and is used to treat anxiety and insomnia, and certain barbiturates such as those used to treat chronic mental disorders. Those drugs in the past were excluded from Part D and were typically covered out of pocket.
Source: ourparents.com

Video: Medicare Supplement Plans – Changes for 2010

Here’s what role healthcare reform, Medicare is having in the Wisconsin Senate campaign

Ryan, 42, has described himself and the often confrontational Walker, 44, as “protégés of the Tommy Thompson farm team,” but the 70-year-old Thompson has sought to distance himself from their policy embrace on broad social issues. Although he has called for overturning the health law and has endorsed the concept promoted by Ryan to give seniors premium supports to buy health coverage in order to keep the system from running out of money, Thompson also has said he would want significant revisions in that plan, such as increased federal payments and an expanded pool for high-risk patients.
Source: medcitynews.com

Settlement Proposed for Medicare Coverage of Home Health Care

The changes would apply to the traditional Medicare program and private Medicare Advantage plans. More than 10,000 beneficiaries whose claims were denied before Jan. 18, 2011 — when the lawsuit was filed — are expected to benefit as their claims would be re-examined under the new standards, the Times reports.
Source: californiahealthline.org

Questions Linger About Implementing Doctors’ Medicaid Pay Raise

–It’s not completely clear which doctors can get the higher pay. Traditional primary care doctors, such as family physicians, internists and pediatricians, are assumed to be covered. But some specialists, such as pediatric cardiologists, also could be eligible if they provide a certain amount of primary care, according to a preliminary regulation released by the Department of Health and Human Services in May. There is also come confusion about what services are covered under the pay raise. The regulation said the raise will apply to “evaluation and management” of patients, not procedures or performing diagnostic tests.
Source: kaiserhealthnews.org

Medicare cost control in action

Modern Principles of Economics Launching The Innovation Renaissance The Great Stagnation: How America Ate All the Low-Hanging Fruit of Modern History, Got Sick, and Will(Eventually) Feel Better Create Your Own Economy: The Path to Prosperity in a Disordered World Discover Your Inner Economist Good and Plenty: The Creative Successes of American Arts Funding Judge and Jury: American Tort Law on Trial Markets and Cultural Voices: Liberty vs. Power in the Lives of Mexican Amate Painters (Economics, Cognition, and Society) The Voluntary City: Choice, Community, and Civil Society (Economics, Cognition, and Society) Creative Destruction: How Globalization Is Changing the World’s Cultures Changing the Guard: Private Prisons and the Control of Crime What Price Fame? In Praise of Commercial Culture Entrepreneurial Economics: Bright Ideas from the Dismal Science
Source: marginalrevolution.com

Social Security & Medicare Changes for 2013

The Social Security Administration (SSA) announced on Tuesday, October 16, 2012 that the 2013 social security wage base will be $113,700, an increase of $3,600 from the 2012 wage base of $110,100.  As in prior years, there is no limit to the wages subject to the Medicare tax; therefore all covered wages are still subject to the 1.45% tax.  Wages paid in excess of $200,000 in 2013 will be subject to an extra 0.9% Medicare tax that will only be withheld from the employees’ wages.  Employers will not pay the extra tax.
Source: oasisky.com

Medicare Loosens the Purse Strings

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

New Round Of Medicare Help Sessions Announced

Medicare recipients in Potter County have the chance to get personalized help from trained local counselors during an enrollment programs being held at several locations. Another series of appointments is being scheduled for Nov. 5 through Dec. 4 at six sites across the county. Potter County Human Services reports that there are a number of changes to Medicare this year, and beneficiaries are encouraged to take advantage of these opportunities to learn more. Appointments are required and can be made by calling 1-800-800-2560. Free assistance is available as follows:
Source: coudynews.com

McMahon ad promotes Medicare inaccuracy

The Kaiser Family Foundation found that while Medicare Advantage was offered by President George W. Bush as a way to save money over the fee-for-service traditional Medicare, the plans actually cost some 14 percent more for each patient. The subsidies will be reduced over time starting this year to 2 percent, but quality plans will be rewarded with bonuses and by 2014, all of them will be required to spend at least 85 percent on direct care and not overhead.
Source: nhregister.com

Insurance Department: Medicare Enrollment Going on Now

Posted by:  :  Category: Medicare

Also significant this year is that a number of Medicare Health Plans, also known as Medicare Advantage Plans, have chosen not to renew their Medicare contracts. If you received a non-renewal notice this year, the notice should also have included information about the options available in your area. Help enrolling or changing prescription drug plans, in your local area, can be found by contacting the Wyoming State Health Insurance Information Program (WSHIIP) in Casper at 1-877-634-1006, in Cheyenne, at 1-877-634-1005, or statewide, in Riverton, by calling 1-800-856-4398. You can also call 1-800-MEDICARE (1-800-633-4227) for assistance, or by using Medicare’s Prescription Drug Plan Finder at www.medicare.gov.
Source: kgab.com

Video: A GRACIOUS GIFT

Dental Insurance for Medicare

Some dental insurance for Medicare is extensive and covers everything while other plans are very limited. Out-of-pocket costs associated with routine and non-routine dental care can be financially devastating so adding dental coverage will help with that. Original Medicare may cover a medical emergency involving your teeth but routine services such as cleanings or filings may not be covered. Make sure to read the fine print on each plan so you know how much you will need to pay for routine visits and how much you will be required to pay out of pocket for an emergency. To learn more about the dental services that Medicare does cover is to go to Medicare’s website: www.medicare.com.
Source: seniorcorps.org

Medicare will prod users to switch from low

The announcement comes on the eve of Medicare open enrollment, which runs from Monday through Dec. 7. During that eight-week period, people can enroll in different Medicare Advantage and prescription-drug plans.When people turn 65 years old, they can sign up for traditional Medicare coverage or opt for those additional coverage plans that might better suit their health-care needs.
Source: telcoretirees.org

Who Qualifies for Medicare?

Certain disabled persons are eligible before they turn sixty-five. In order to qualify as disabled, you must go through a strict process of proof. In most cases, there is a requirement that you qualify for social security disability insurance in order to also receive Medicare as a disabled person. If you are applying for disability Medicare, there are several things you should know. For instance, there is a twenty-four month waiting period after qualification before Medicare benefits accrue.
Source: totalmedicare.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 confusing, but don’t put off enrolling

Posted by:  :  Category: Medicare

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Source: fredericksburg.com

Video: Improving Medicare in 2011: Fighting Medicare Fraud

Settlement Proposed for Medicare Coverage of Home Health Care

The changes would apply to the traditional Medicare program and private Medicare Advantage plans. More than 10,000 beneficiaries whose claims were denied before Jan. 18, 2011 — when the lawsuit was filed — are expected to benefit as their claims would be re-examined under the new standards, the Times reports.
Source: californiahealthline.org

“Consumer Reports” Walks Through Choosing a New Medicare Plan

Leigh Ann Otte is a freelance writer who specializes in health and aging issues. She covers finding and paying for senior care for OurParents. If you have any questions about this post or need help finding senior-care options for a loved one, call 1-866-483-4896 to speak with a care advisor in your area.
Source: ourparents.com

Is Medicare.gov the Best Option

I much prefer using the med.gov over the carriers because for one it has a spell checker and predictive spelling and suggest the generic alternative on the same page so you can get the clients drugs input correctly the first time. UHC ‘s agent and I believe also the consumers website formulary finder doesn’t have a spell checker and blocks my spell checker from working.Its so frustrating because many times the seniors cant even say or remember the name of the drug much less spell them and they will tell you the brand name because that’s what they took for so long when they had good drug coverage from their employer i.e many times they will tell you Flomax when they are actually taken the generic tamsulosin but to them its still Flomax..Med.gov will let you figure it out as you go along.Why in the heck would a giant PDP carrier like UHC not have a spell checker in there formulary search? Must be a liability issue I guess. And oh yeah i was reading the compliance information for UHC and it says that we must tell prospects they MIGHT go in donut hole if its a possibility but we can face disciplinary action up to termination if we tell a consumer with certainty they WILL go in the gap. Of course we are not allowed to ask them if they take drugs in the first place because that is considered underwriting or cherry picking and CMS has a special place for agents and companies that violate that rule.
Source: insurance-forums.net

The Impact of the Medicare Sequester

Physicians have become accustomed to uncertain Medicare rates, Dr. Lazarus states. Yearly scheduled cuts under the sustainable growth rate formula have threatened to lower payments for Medicare services for the past decade. On Jan. 1, 2013, the SGR will lower rates by an estimated 27% unless Congress overrides the reduction with a temporary payment freeze or slight increase. Sequestration would implement reductions separate from that process. “This 2% possible cut adds another level of uncertainty,” Dr. Lazarus said. “We hear from physicians all around the country about their concerns about this. They are trying to make decisions about whether they can continue to treat Medicare patients. It’s a concern of ours, particularly in terms of access to care for Medicare patients.”
Source: physicianlicensing.com

Medicare Doc Pay Anxiety Chills Physicians’ Interest In Demo Programs

The Medicare NewsGroup: Driving Off The Fiscal Cliff: Will Providers Be There After The Crash? A planned 2 percent cut in Medicare spending, scheduled to take effect in January 2013 unless Congress intervenes, would limit patients’ access to essential health care, say industry leaders and policy analysts. Provider organizations, beneficiary advocates and others, however, are voicing strong words of caution that the cuts to Medicare represent a real danger to patient care. The medical lobby says Medicare patients will be the ultimate victims because of reduced access to care at hospitals and at doctors’ offices. … The sequestration cuts are dictated by the Budget Control Act of 2011 and were designed to be a painful stick to prod the Congressional supercommittee to adopt deficit reduction measures by November 2011 (Bates, 10/23).
Source: kaiserhealthnews.org

Medicare will prod users to switch from low

The announcement comes on the eve of Medicare open enrollment, which runs from Monday through Dec. 7. During that eight-week period, people can enroll in different Medicare Advantage and prescription-drug plans.When people turn 65 years old, they can sign up for traditional Medicare coverage or opt for those additional coverage plans that might better suit their health-care needs.
Source: telcoretirees.org

How Much Does Medicare Advantage Cost?

eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, the nation’s leading online source of health insurance for individuals, families and small businesses. Through the company’s website, www.eHealthInsurance.com, consumers can get quotes from leading health insurance carriers, compare plans side by side, and apply for and purchase health insurance. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 180 of the nation’s leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia, making it the ideal model of a successful, high-functioning health insurance exchange. Through the company’s eHealthTechnology solution (www.eHealthTechnology.com), eHealth is also a leading provider of health insurance exchange technology. eHealthTechnology’s exchange platform provides a suite of hosted e-commerce solutions that enable health plan providers, resellers and government entities to market and distribute products online. eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options, choose the right plan and enroll in select plans online through its wholly-owned subsidiary, PlanPrescriber.com (www.planprescriber.com) and through its Medicare website www.eHealthMedicare.com.   
Source: ehealthinsurance.com

IWS Documented News DAILY POSTINGS: [IWS] EBRI: SAVINGS NEEDED FOR HEALTH EXPENSES FOR PEOPLE ELIGIBLE FOR MEDICARE: SOME RARE GOOD NEWS {24 October 2012]

This information is provided to subscribers, friends, faculty, students and alumni of the School of Industrial & Labor Relations (ILR). It is a service of the Institute for Workplace Studies (IWS) in New York City. Stuart Basefsky is responsible for the selection of the contents which is intended to keep researchers, companies, workers, and governments aware of the latest information related to ILR disciplines as it becomes available for the purposes of research, understanding and debate. The content does not reflect the opinions or positions of Cornell University, the School of Industrial & Labor Relations, or that of Mr. Basefsky and should not be construed as such. The service is unique in that it provides the original source documentation, via links, behind the news and research of the day. Use of the information provided is unrestricted. However, it is requested that users acknowledge that the information was found via the IWS Documented News Service.
Source: blogspot.com

Important Information Regarding Medicare Claims and Payments for Part A Indiana and Michigan ProvidersHall Render

Posted by:  :  Category: Medicare

National Government Services, Inc. (NGS) recently announced important information regarding Medicare claims and payments for Part A Indiana and Michigan providers.  With the impending transition of these providers to Wisconsin Physician Services (WPS), NGS posted the following transition timeline:
Source: hallrender.com

Video: Audit Alert: Codes for Evaluation & Management Services Performed at Nursing Facilities

NGS Financial/Account Ops Specialist

WellPoint is the nation’s leading health benefits company serving the needs of approximately 28 million medical members nationwide. An independent subsidiary of WellPoint, Inc, National Government Services (NGS) is one of the largest Medicare contractors in the country, serving nearly 200,000 providers and suppliers and over 20 million customers with Medicare in 20 states and five U.S. territories.   Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.   The Financial/Accounts Ops Specialist will be responsible for performing diverse operational financial and policy activities of a non-routine nature. Interprets and communicates departmental and organizational policies and procedures.   Primary duties may include, but are not limited to:
Source: careers.org

Check And Update Practitioner Specialty Code To Stay Clear of Claim Rejections

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Source: inhealthcare.com

NGS to Administer Medicare Claims Payment in New York (S U P R A S P I N A T U S)

NGS will serve as the first point of contact for the processing and payment of Medicare fee-for-service claims from hospitals, skilled nursing facilities, physicians and other health care practitioners in the two states. The new Part A/Part B Medicare Administrative Contractor (A/B MAC) was selected using competitive procedures in accordance with federal procurement rules.
Source: nysbar.com

CMS Allows Medicare Providers to Submit Documents Electronically to CMS Contractors

If providers do want to participate in the esMD program, they must first find out if their review contractor accepst esMD transactions. Additionally, providers will have to obtain access to an esMD gateway. To obtain access to a gateway, providers can either build their own or hire a Health Information Handler (HIH) to construct the gateway system. To find out which HIHs offer esMD gateway services to providers, click here. To learn more about requirements for participating in the esMD program, click here.
Source: thehealthlawfirm.com

Preventive & screening services

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

Medicare Audits on Prosthetic devices

So the second question is: why aren’t doctors following Medicare guidelines when prescribing prosthetic devices?  For discussion purposes let’s assume all physicians are aware of this requirement; which 99.9% are unaware.  Over the past 20 years the US healthcare system has slowly moved away from a general practice platform to a system where physicians specialize in one subset of healthcare.  When a physician specializes he/she generally relies on other physicians to treat conditions outside of their specialty.  So when a patient needs a prosthetic device the physician will rely on a prosthetist to take care of the patient knowing he/she is the specialist in prosthetics. Now lets compound the problem with the fact that physicians are being paid less by all insurers (including Medicare), forcing them to see more patients per hour while spending less time with each patient.  From what I have seen and been told, most physicians today spend less than 10 minutes with each patient.  Medicare’s policy in prescribing prosthetic devices requires the physician to conduct a thorough evaluation that takes at least 20 minutes to conduct, if he/she knows what they are doing.  It is just not reasonable to expect that physicians, under increased pressure in today’s healthcare environment, are going to take more time to conduct a thorough evaluation to prescribe a device he/she knows nothing about.  By today’s standards, physicians want to do what comes natural, refer the patient to the prosthetic specialist.  I have even had a few physicians tell me that they don’t get paid enough to do this thorough evaluation and the documentation required by Medicare when prescribing a prosthesis.  Clarifying “it’s not my job, it’s yours.”
Source: advancedprostheticscenter.com

Medicare Doc Pay Anxiety Chills Physicians’ Interest In Demo Programs

Posted by:  :  Category: Medicare

Cynthia Markus, Ingrid McDonald, and Diana Birkett discuss Medicare at the KUOW Studios by kuow949The Medicare NewsGroup: Driving Off The Fiscal Cliff: Will Providers Be There After The Crash? A planned 2 percent cut in Medicare spending, scheduled to take effect in January 2013 unless Congress intervenes, would limit patients’ access to essential health care, say industry leaders and policy analysts. Provider organizations, beneficiary advocates and others, however, are voicing strong words of caution that the cuts to Medicare represent a real danger to patient care. The medical lobby says Medicare patients will be the ultimate victims because of reduced access to care at hospitals and at doctors’ offices. … The sequestration cuts are dictated by the Budget Control Act of 2011 and were designed to be a painful stick to prod the Congressional supercommittee to adopt deficit reduction measures by November 2011 (Bates, 10/23).
Source: kaiserhealthnews.org

Video: Romney’s Medicare Program = Disaster

The Impact of the Medicare Sequester

Physicians have become accustomed to uncertain Medicare rates, Dr. Lazarus states. Yearly scheduled cuts under the sustainable growth rate formula have threatened to lower payments for Medicare services for the past decade. On Jan. 1, 2013, the SGR will lower rates by an estimated 27% unless Congress overrides the reduction with a temporary payment freeze or slight increase. Sequestration would implement reductions separate from that process. “This 2% possible cut adds another level of uncertainty,” Dr. Lazarus said. “We hear from physicians all around the country about their concerns about this. They are trying to make decisions about whether they can continue to treat Medicare patients. It’s a concern of ours, particularly in terms of access to care for Medicare patients.”
Source: physicianlicensing.com

CMS using McKesson CDS criteria for Medicare programs

The Centers for Medicare & Medicaid Services (CMS) will be using McKessons InterQual Criteria, an evidence-based clinical decision support (CDS) criteria, for its Medicare inpatient services auditing programs. The agreement is being administered by Buccaneer Computer Systems & Services, on behalf of CMS. Through the agreement, quality improvement organizations, Medicare fiscal intermediaries, and Medicare administrative contractors can access InterQual Criteria, as well as historical criteria to support their utilization review and quality oversight functions. The criteria also will be used by departments within CMS and administrative law judges to assist with appeals. CMS entities will be using a 2011 InerQual release, which builds on acute care content by adding new condition-specific criteria subsets for the review process and patient-specific care decisions.  
Source: healthimaging.com

Rep. Issa Issues Subpoena for HHS Documents

By letter dated July 11, 2012, GAO’s General Counsel advised HHS Secretary Kathleen Sebelius that the Centers for Medicare & Medicaid Services (CMS) has not established that the agency’s Medicare Advantage (MA) Quality Bonus Payment Demonstration is within its legal authority under section 402 of the Social Security Amendments of 1967 as amended. In March 2012, GAO issued a report recommending that CMS terminate the $8 billion demonstration because of the demonstration’s high cost and significant design shortcomings. CMS is implementing the demonstration in lieu of the MA quality bonus payment program established under the Patient Protection and Affordable Care Act. GAO’s General Counsel concluded, based on the March report findings and correspondence with CMS, that the agency has not established that the demonstration complies with section 402, which provides the agency authority to initiate Medicare payment changes to determine whether, and if so, which, changes in methods of Medicare payment or reimbursement have the effect of increasing the efficiency and economy of Medicare services through the provision of additional incentives.
Source: thenewamerican.com

Fact Check on Medicare Advantage

  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

WellPoint Program for Medicare Advantage Members Earns URAC Gold Award in Consumer Empowerment and Protection

At WellPoint, we believe there is an important connection between our members’ health and well-being—and the value we bring our customers and shareholders. So each day we work to improve the health of our members and their communities. And, we can make a real difference since we have approximately 34 million people in our branded health plans, and approximately 65 million people served through our subsidiaries. As an independent licensee of the Blue Cross and Blue Shield Association, WellPoint serves members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. In a majority of these service areas, WellPoint’s plans do business as Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Georgia and Empire Blue Cross Blue Shield, or Empire Blue Cross (in the New York service areas). WellPoint also serves customers across the country through our UniCare subsidiary and in certain California, Arizona and Nevada markets through our CareMore subsidiary. Our 1-800 CONTACTS, Inc. subsidiary offers customers online sales of contact lenses, eyeglasses and other ocular products. Additional information about WellPoint is available at www.wellpoint.com.
Source: scrubsandsuits.com

New Round Of Medicare Help Sessions Announced

Medicare recipients in Potter County have the chance to get personalized help from trained local counselors during an enrollment programs being held at several locations. Another series of appointments is being scheduled for Nov. 5 through Dec. 4 at six sites across the county. Potter County Human Services reports that there are a number of changes to Medicare this year, and beneficiaries are encouraged to take advantage of these opportunities to learn more. Appointments are required and can be made by calling 1-800-800-2560. Free assistance is available as follows:
Source: coudynews.com

Will the Obamacare provision that pays primary docs more money really be enacted?

–It’s not completely clear which doctors can get the higher pay. Traditional primary care doctors, such as family physicians, internists and pediatricians, are assumed to be covered. But some specialists, such as pediatric cardiologists, also could be eligible if they provide a certain amount of primary care, according to a preliminary regulation released by the Department of Health and Human Services in May. There is also come confusion about what services are covered under the pay raise. The regulation said the raise will apply to “evaluation and management” of patients, not procedures or performing diagnostic tests.
Source: medcitynews.com

What Can You Do If Your Medicare Supplement Gets Too Expensive?

Posted by:  :  Category: Medicare

Medicare B has no cap on the co-insurance amount.  If your medical bills for the year are $100,000 you have to pay $20,000.  Medicare supplement insurance will pay that for you.  If you cancel your Medicare supplement insurance, you will have to use your retirement savings, Social Security or pension income to pay your medical bills.
Source: wordpress.com

Video: Medicare Advantage vs. Medicare Supplement Insurance

Plan Your Finance Insurance Loan

One thing you should know that no active participation of government will be here. It is wholly administrated by private body. Several private companies are in this insurance business. Though this same policy can be marketed by different companies, but there are some strict rules which ought to be maintained by the all private companies. These rules include the same amount of premiums should be drawn from the policy holder. All the plans should be same with same benefits. According to the law the private insurance companies can offer only twelve standard Medicare Supplement Insurance Plans, named A through L. each of these plans have their own set of benefits, different from the others. However, almost all of the twelve Medigap policies provide the basic benefits of Medicare part A and B. Therefore it is always recommended to study all the Medigap plans before deciding to choose the one that would fit the best for you. Besides that the fact that should be kept in mind is that, no matter from whatever insurance company you may purchase a particular plan, all of the plans with the same letter cover must provide the same benefits. As for example if you purchase a Medigap plan C policy, it should cover the same benefits without depending on the company that is selling the plan. However, the premium rates may vary for different companies. Therefore you are free to purchase any Medigap policy from the company you like and be sure to get the same benefits provided by the other companies.
Source: plantmd.org

Medicare Home Health: Medicare Supplement Insurance

For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium. The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month. For additional details, see our FAQ titled: “2011 Part B Premium Amounts for Persons with Higher Income Levels”.
Source: blogspot.com

Find Medicare Supplemental Insurance in Your Area With the Senior Advisor Group

The Senior Advisor Group is an independent insurance advisory group specializing in Medicare insurance and other insurance options for those on Medicare. Their role is to assists seniors in finding with the best Medicare Supplemental Insurance, including advice on Supplemental Plans, Advantage Plans, Medicare Part D insurance and other related supplemental insurance. By partnering with over 40 different insurance companies, the Senior Advisor Group works on the side of the client’s with no obligation to any one insurance company. For the individual client they will search from all of the top insurers to find the best products at the best price – as well as provide ongoing professional, personalized service to each Medicare beneficiary year after year. The Senior Advisors also provides clients on Medicare with dental, hearing, and vision coverage, as well as Rx discount cards at no cost to customers. As a national advisory group, Senior Advisor Group represents all of the top rated and the largest Medicare supplemental insurance providers available. Their objective is to provide unbiased advice on Medicare Supplemental Insurance from highly trained, Medicare insurance specialists. Each specialist is trained on the various Medicare Insurance options, and will assist each individual with a plan selection, and provide continual advice year after year on Medicare supplement plans and Medicare Part D coverage. As Medicare insurance specialist, Medicare Insurance is not just a part of their business it is their business. The Senior Advisor Group was established to deliver what insurance companies can’t – unbiased and objective advice. They will assist and complete enrollment in the best available plan for the client, not the best available plan for the provider. For those new to Medicare or just looking to compare coverage options simply submit a request and one of their specialist will call within 24 hours.
Source: sbwire.com

Medicare Supplement Plan, Medigap Plans, Mymedicare, Supplemental Medicare.

Find right coverage Medigap Plans and Medicare Supplement Plan for insure your supplemental medicare after retirement. Mymedicare advisor helps you make a decision about how to choose a Medigap Plans, Medicare Supplement Plan, and Supplemental Medicare plan. MyMedicareAdvisor 2300 Computer Ave. Ste. H-40 Willow Grove, PA 19090 email: mymedadvisor@gmail.com 215 658 1776 http://www.mymedicareadvisor.com Medicare Supplement Plan, Medigap Plans, Mymedicare, Supplemental Medicare http://www.mymedicareadvisor.com/north-carolina-medicare/
Source: anunico.us

fri9nds: On Line Medicare Supplement Insurance Rates

The program Y can pay your Medicare Part B deductible and your Medicare Part A deductible. In other words, Medicare will pay 80% of your charges and your complement will get the rest of the 20%. You need to rarely have any medical bills out of your wallet.
Source: fri9nds.com

Medicare Supplement Insurance

In 2004, Jess and Sandra heard about some exciting options for Medicare. Jess and Sandra started to learn more about the different Medicare Advantage, Medicare Supplement, and Part D prescription plans. As Sandra puts it, “They dove into the senior market heavily; it just exploded.” Jess and Sandra have become experts in the Medicare marketplace. The demand was great back then and continues to be to this day. Sandra said, “We are certified with every company that does business here in Indiana. 80% of what we do is Medicare focused.” The annual election period is October 15 to December 7 for Medicare. “Every participant can change their current plan with Easy Street,” said Jess. Jess and Sandra look at many options to find the right plan to match each client’s needs.
Source: atcentergrove.com

Medicare Supplement Basics

Medicare Supplement Insurance, sometimes called Medigap plans, are insurance policies made available by private insurance companies that do what their names imply; they supplement or fill the gaps in Original Medicare coverage. To properly understand Medicare Supplements it is important to first have a basic understanding of what they supplement – Medicare.
Source: reed-insurance.net

‘Obamacare’ is not where credit is due

The Affordable Care Act (Obamacare) has so far had little to no effect on Medicare and, if it does get fully implemented, which it most likely will be if President Obama is reelected, it will negatively affect benefits for many Medicare beneficiaries as well as many other Americans. It has already caused rates for individual and family coverage to increase because of mandates implemented thus far.
Source: hometownargus.com

The California Medicare Supplement Plan Landscape

Maybe you’re tired of the A, B, C soup that seems to be swirling around you when you glance at the newly received California Medicare supplement plan offerings and with good reason. There are so many A’s, B’s, and F’s, that you would think you’ve come full circle back to kindergarten. We hope to shed some light on the subject of California Medigap plans to make clear how the various plans differ and reduce the chance of brochure induced headache, a very serious condition NOT covered by Medicare. So let’s dive into the California Medigap plans with a quick scan of what Traditional Medicare does, and more importantly, does not cover. California Medicare is best thought of as an 80/20 plan with deductibles, two of them to be exact. It generally breaks down the core benefit (which account for the majority of your health care cost outside of medication which we’ll save for another article on California Part D) into hospital (Part A) and physician (Part B) costs. That’s the first two letters you’ll see before even looking at California Medicare supplement plans. Remember the “Part” part of the name since that tells you we’re talking about traditional Medicare and not a California Medigap plan. Part. Part. Part. Medicare section. Part A is generally facility based (hospital, surgi-center, etc) while Part B is generally physician based. Now that we understand the bulk of what makes up your health care costs, let’s look at the California Medicare supplement plans. The California medicare plans are A, B, C, D, F, F high deductible, G, K, L, M, and N. In general, they increase in benefits (and cost) from A through F. The remaining generally add in cost sharing to the Medicare supplement subscriber but offer lower prices. For all the California Medigap plans, the main categories of traditional Medicare that they fill the gaps in are the following: Part A deductible, Part A co-insurance, Part B deductible, Part B co-insurance, Part B excess, Hospice Care, Skilled Nursing Facility, Foreign Emergency Travel, 1st 3 pints of blood, and Preventative co-insurance. The lettered California Medicare plans differ in these categories listed above. The F plan covers all these categories and remains the most popular California Medigap plan on the market. All the plans cover the Part A co-insurance completely. A through F cover the Part B co-insurance while G through N have varying degrees of coverage. It’s probably best to look at a California Medicare supplement plan comparison chart to make it clear but we’ll discuss the primary issues to concentrate on when deciding on your Medigap plan. We want to focus on the costs that can either be very large or uncapped. This would be the Part B Excess charge (doctors can charge up to 15% higher than standard Medicare rate), Skilled Nursing Facility, and Part A deductible. The other expenses are probably less exorbitant but still important. The key is this – we’re not talking 100’s of dollars of difference in monthly premium between each California medicare plan so why take on the risk when it’s probably $10-20 difference per month between given plans. That’s why the F plan is so popular. It covers all the main gaps in California Medicare at a relatively low price. Also keep in mind that you’re entering a period of time when medical care (very expensive medical care) becomes more common and frequent regardless of your health at the time of enrolling. It’s a bad bet to buy a less rich California Medigap plan and save a few bucks only to pay much more later on. Take a look at the comparison chart at californiamedigap.com to get a better understanding and we’re happy to walk through your plan options as licensed California Medicare agents but all roads lead to the F plan. We’re happy to be your road map. Dennis Jarvis is a licensed insurance agent concentrating on California Medicare supplement insurance.

An explanation of Medicare

Posted by:  :  Category: Medicare

Part D is coverage for prescription drugs, and like Part C, the program is administered by private insurance companies. Part D plans have their own list of covered medicines, with a tiered pricing system. This means that some drugs, such as generics, may be in the lowest tier and have the lowest copayment. Drugs in the highest tiers would have the highest copayment. If you sign up for a Part D plan when you are first eligible you avoid paying a penalty. A penalty would be assessed if you don’t join when you were first eligible and you don’t have other drug coverage or don’t receive “Extra Help”. Beneficiaries with limited income and assets may qualify for “Extra Help” to help pay for prescription drugs. This program is administered through the Social Security program and Medicare. For more information, please visit www.SSA.gov/prescriptionhelp/.
Source: utu.org

Video: Humana Made Medicare Easy

Palmetto GBA Medicare Advisory Training Set for Feb. 14th

Palmetto GBA will host its J11 HHH Medicare Advisory Training Session on Monday, February 14, 2011, from 2 p.m. to 3 p.m. ET. The purpose of this session is to discuss articles and information published in the February 2011 Medicare Advisory.
Source: hcafnews.com

Palmetto GBA: Submitting a Psychiatric Approval Request for Visits by an RN

Palmetto GBA released the article below that lists the qualifications that would meet the requirements necessary to provide psychiatric evaluation and therapy to Medicare home health patients. Home health agencies should submit the resume of any registered nurse that will be providing psychiatric services under the home health Medicare benefit. The address is provided in this article.
Source: hcafnews.com

Aerial yoga a hit at Palmetto Art Center

For more information about aerial yoga classes at the Palmetto Art Center, 907 Fifth St. W., Palmetto, and a schedule of upcoming workshops, visit Brownewell’s website at www.yogagirlie.com. Cost of the 75-minute workshops is $20. You can register and reserve a spot on the website or call Brownewell at 941-527-9847.
Source: bradenton.com

Is reimbursement for interpretation of prostate biopsies about to be slashed?

When this January 2012 NCCI update appeared, there was no contemporaneous publication by CMS or any of the Medicare contractors confirming its general adoption by the Medicare program. Moreover, there has been confusion as to whether NCCI intended the G codes to be utilized only where the biopsies were collected from a saturation biopsy technique, or regardless of the collection methodology. NCCI’s medical director has informed some private sources that the G codes should be used any time there are five or more prostate biopsy specimens, regardless of collection methodology. The August 7, 2012 Palmetto GBA policy adopts the NCCI update, explaining that the number of prostate biopsy specimens (regardless of collection technique) that can be reported with CPT Code 88305 is limited to four units per case, and the evaluation of five or more prostate biopsies must be reported using the G codes.
Source: pathologyblawg.com

Palmetto, Medicare’s Biggest Carrier, Proposes to End Code Stacking for Molecular Clinical Laboratory Tests

Palmetto GBA is a Medicare Authorized Contractor (MAC) that serves Jurisdiction 1 (J1) and Jurisdiction 11 (J11). Two draft proposed local coverage determinations (one on molecular diagnostic tests (MDTs) and one on lab-developed tests (LDTs), and a molecular diagnostics pPalmetto GBA is a Medicare Authorized Contractor (MAC) that serves Jurisdiction 1 (J1) and Jurisdiction 11 (J11). Two draft proposed local coverage determinations (one on molecular diagnostic tests (MDTs) and one on lab-developed tests (LDTs), and a molecular diagnostics program (MolDx) have been proposed only for J1. If implemented, they would affect labs serving Medicare patients in California, Nevada, and Hawaii.
Source: darkdaily.com

How Affordable Care Act Data Validation Stifles Drug Manufacturers

Experts Affordable Care Act (1) Anti-Corruption (3) Business (2) Centers of Excellence (1) Clinical Trails (1) Clinical Trials (3) Communication (1) Consultants (1) Criminal Liability (2) Ethics (6) Faud (2) FDA (9) Fraud (1) Hazardous Waste Management (1) Healthcare (1) Human Resources (2) iGATE Patni (2) IT Compliance (2) Joint Ventures (1) Legal (3) Managing Risks (1) Medical Governance (1) Mergers & Acquisitions (3) Newswire (63) Observational Research (1) Outsourcing (1) Partnering (1) Pharmaceutical Advertising (2) Pharmaceutical Compliance (49) Pharmaceutical Counterfeiting (5) Pharmaceutical Marketing (2) Pharmaceutical Risk Assessment (17) Pharmaceutical Techology (6) Prescription Drug User Fees Act (1) R&D (4) Recent Articles (31) Regulatory Enforcement (11) Reputation (1) Social Media (1) Sunshine Act (3) Top Stories (10)
Source: pharmacompliancemonitor.com

Car Trouble Can Be Inpredictable

If your vehicle breaks down, pull off the road as far as possible on the right shoulder (or in the center median, if getting to the shoulder is impossible). Activate your hazard lights and place flares or reflective triangles far enough behind your vehicle to warn oncoming traffic of your presence. Many authorities advise against you attempting to change your tires or jump your battery while traffic is present. Open your hood, then stay in your vehicle and wait for help.
Source: imms.com

CardioDx Gets Medicare Coverage for Coronary Artery Disease Test

A research team from New Zealand, South Africa, and the US has sequenced the mitochondrial genomes of four Polynesian individuals believed to be among the first people to settle in New Zealand an estimated 750 years ago. As they report in PNAS, the researchers used DNA from ancient remains found at a site called Wairau Bar on the northeastern coast of New Zealand’s south island. The four mitochondrial genomes contained two of the three variants previously linked to Maori populations, the researchers report. But they also found diversity within the mtDNA, which fell into three different haplotypes. “These data represent complete mitochondrial genome sequences from ancient Polynesian voyagers,” University of Otago researcher Elizabeth Matisoo-Smith, the study’s senior author, and her colleagues write, “and provide insights into the genetic diversity of human populations in the Pacific at the time of the settlement of East Polynesia.”
Source: genomeweb.com

North Carolina Medical Society

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