Medicare Takes Center Stage In Close Pennsylvania Races

Posted by:  :  Category: Medicare

Mitt Mobile in the Final Stretch by DonkeyHoteyThe campaign jockeying over Medicare comes at a time when the program represents a huge fiscal challenge to both parties. With almost 50 million beneficiaries — and growing at the rate of 10,000 baby boomers every day — the entitlement program is one of the fastest-growing portions of the federal budget. Both parties acknowledge the need to curb its growth; both have also used the issue for political gain, casting themselves as the program’s protectors against what they portray as rivals’ threats.
Source: kaiserhealthnews.org

Video: State Takeover of Harrisburg, Medicare/Medicaid Funding [Pennsylvania Newsmakers]

Pennsylvania Federal Judge: HHS Must Turn Over Medicare Rulemaking Record

PHILADELPHIA – A federal judge in Pennsylvania on Oct. 16 ordered the U.S. Department of Health and Human Services to produce the complete administrative record, as well as the rulemaking record, regarding Medicare’s Disproportionate Share Hospital (DSH) regulations. Two Pennsylvania hospitals are challenging whether inpatient hospital services provided under the state’s general medical assistance program are to be counted in Medicare’s DSH calculation (Nazareth Hospital, et al. v. Kathleen Sebelius, Secretary of Health and Human Services, No. 10-3513, E.D. Pa.; 2012 U.S. Dist. LEXIS 148745).Full story on lexis.com
Source: lexisnexis.com

Ryan Takes to Pennsylvania to Push Medicare Message

Mr. Ryan was extrapolating from a 2010 report from Medicare’s Office of the Actuary. It analyzed the potential impact of lower premium supports paid to private companies that issue Medicare Advantage plans, popular alternatives to traditional Medicare with extra benefits such as gym memberships. To slow the growth of Medicare spending, the Affordable Care Act reduces support for the private plans, which Democrats consider inefficient. Beneficiaries would still be covered under traditional Medicare.
Source: nytimes.com

“99% VOTERS” CONFRONT A SURPRISED REP. FITZPATRICK: Call for Jobs, Not Cuts

Upon seeing Rep. Fitzpatrick in the hallway, the group gave their congratulations and asked him to explain his stance on Medicare and Social Security by holding public town hall meetings. Rep. Fitzpatrick denied that he had avoided town hall meetings this year, a stance disputed by the Courier Times.
Source: paworkingfamilies.org

Pennsylvania providers already feeling Medicare cuts, worrying about more to come

Among several examples: Hospitals now may lose Medicare money if too many patients are readmitted within 30 days of discharge — for any reason. The Centers for Medicare and Medicaid Services cut home health payment rates by 3.79 percent in 2011 and 2012, and will cut home health by another 1.32 percent in 2013, said Jennifer E. Battista, communications director of the Pennsylvania Homecare Association. Another Medicare program for rural hospitals that serve a high number of seniors also was left unfunded. At Wayne Memorial Hospital in Honesdale, Wayne County, that will cost $1.7 million.
Source: medcitynews.com

More Time to Enroll in Medicare If You Live in Storm Areas

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

‘Mediscare’ and the Pennsylvania Senate Race

What I find irritating is that for all the standard platitudes from Republicans about getting federal spending under control, they’re simultaneously attacking Democrats for allegedly wanting to cut the budget’s big-ticket items like Medicare and military spending. Democrats might deserve it for decades of trying to scare the pants off of seniors, but the GOP’s adoption of their tactics is evidence in support of the view that the parties merely represent two sides of the same coin. (Don’t forget the last big expansion of entitlements came from the Republican-engineered addition of a prescription drug benefit to Medicare in 2004.)
Source: cato-at-liberty.org

Proclaiming Liberty in Central Pennsylvania

I came to know Dr. John (he has a PhD  in economics) through his radio show. John had me on the show several times to preach the Gospel according to Cato. The show always began with his boisterous call to “Proclaim liberty throughout all the land!” John developed a reputation for getting under the skin of elected officials, and no politician was spared his wrath – particularly Republicans. So I was surprised when I found out that he had decided to quit his show and challenge the district’s long-standing representative in Harrisburg – the epitome of a career politician – in the GOP primaries.
Source: townhall.com

Pennsylvania Medicaid earning its stripes

Also, the provider must either be in the process of adopting, implementing, upgrading to or meaningfully using a federally-certified EHR system. If all qualifications are met, the providers have a standard incentive amount that is available to them each year they participate and the incentive amount for the hospitals is based on factors including their discharges and bed days. Medicaid provides up to $63,750 over six years (started in 2011). The payments are evenly distributed ($8,500 per year) after the first-year payment of $21,250.
Source: ehrintelligence.com

Medicare Key Issue in Close Pennsylvania Races

In the week since Romney’s announcement, Medicare has been catapulted from an issue that political strategists said could make a difference in close races to a central component of congressional campaigns nationwide — especially in states like Pennsylvania, Florida, Minnesota and Ohio with large numbers of older voters.
Source: aarp.org

What is a Medicare Advantage Plan? : Pennsylvania Law Monitor

A Medicare Advantage Plan is a type of Medicare health plan offered by a private health insurance company that contracts with Medicare to provide Medicare eligible individuals with Medicare Part A (hospital) and Part B (doctor/out-patient) benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Medicare. Most Medicare Advantage Plans offer prescription drug coverage as well.  Medicare Advantage Plans are often referred to as “Part C” Medicare plans.  
Source: stark-stark.com

PENNSYLVANIA TRIAL COURTS CONSISTENTLY HOLD THAT LIABILITY SETTLEMENTS MAY NOT BE DELAYED BY A DEFENDANTS REQUEST FOR INFORMATION REGARDING A PLAINTIFFS MEDICARE LIENS

Before resolving liability cases or drafting a settlement agreement, defense counsel and insurers will often request that the plaintiff produce a conditional payment letter or final demand letter from Medicare to show the reimbursement amount owed to Medicare for medical treatment related to the accident.  An ongoing dispute exists with respect to whether letters from Medicare are required before a settlement can be completed, which has resulted in a number of Pennsylvania decisions on the issue. The most heavily cited opinion in this area is Zaleppa v. Seiwell, 9 A.3d 632 (Pa. Super. Ct. 2010), a decision by the Pennsylvania Superior Court, which held that federal law does not permit defendants to assert Medicare’s right to reimbursement as a preemptive means of guarding against their own risk of liability. Click here for a discussion of the Zaleppa decision. Since the issuance of the Zaleppa decision, a series of Pennsylvania trial court opinions have reinforced the proposition that a defendant’s potential liability for a plaintiff’s Medicare lien does not provide authority for a defendant (a private entity) to assert Medicare’s right to reimbursement.
Source: themedicarespa.com

2013 Medicare Part D Zero

Specifically, Medicare has approved 38 Prescription Drug Plans for 2013, 14 of which are zero-premium for dual eligibles and other individuals receiving the full low-income subsidy. Select here for a complete listing of the 2013 Medicare Part D Standard Zero-Premium Prescription Drug Plans.
Source: phlp.org

COURT AFFIRMS NEED FOR MEDICARE SET ASIDE IN LIABILITY SETTLEMENT

Posted by:  :  Category: Medicare

Running Amok Again by elycefeliz., No. 4:09-CV-141, 2012 U.S. Dist. LEXIS 134900 (E.D.N.C. Sept. 5, 2012), the plaintiff, a Medicare recipient, received a settlement in a personal injury lawsuit. Plaintiff filed an unopposed motion for court approval of the settlement and a determination of the need for and amount of an MSA. The court examined documents submitted by the plaintiff’s physician, who estimated future medical costs of $4,500.00. The court approved an MSA in that amount to be paid from plaintiff’s settlement proceeds. The court also held that, to the extent the plaintiff received confirmation from Medicare of any previous conditional payments, he was required to promptly reimburse Medicare from his settlement funds.
Source: themedicarespa.com

Video: Medicaid Set Aside

Changes Coming for Medicare Set

Currently, parties in workers’ compensation cases may utilize a Medicare review process to determine how much money must be put into a MSA for future medical expenses.  But no such option exists for liability settlements because MSAs in liability settlements are much more complicated.  Settlements in liability cases usually resolve all claims in the case, which could include property damages, past and future medical expenses, pain and suffering, etc.  Consequently, it is often impossible to determine how much of a settlement the parties intended to compensate for future medical expenses.  Obviously, most plaintiffs who are covered by Medicare prefer to have as little of the settlement funds allocated to future expenses as possible.  But defense lawyers and their clients have to protect themselves against any future claims from Medicare if plaintiffs misappropriate settlement funds that they should have used for future medical expenses.  
Source: dbllaw.com

NJ Court: Federal Law Does NOT Mandate Medicare Set

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

Medicare Set Asides Not Required in Personal Injury Cases, Holds NJ Court

The court noted that Medicare set-aside agreements were not mandated by federal law in personal injury settlements. Such agreements are common in workers’ compensation settlements; however, the court observed the circumstances of a personal injury settlement are distinguishable. Payments in workers’ compensation cases are frequently capped by a statutory maximum, whereas personal injury cases can include noneconomic damages and “are not determined by an established formula.”
Source: sjclaw.com

Workers’ Comp Structured Settlements Beneficial in Medicare Set Asides

“We’ve done a decent amount of them over the years. I’m relatively new to Chartis, but from my prior background in the industry, being in the industry for a number of years, structures have always been utilized in workers’ compensation as a tool to help resolve the claim. Over the years, it has definitely become the preferred method of resolution on a workers’ compensation claim right now. Especially, again, because the majority of a settlement, there’s the indemnity dollars but the majority of a lifetime claim, especially on a workers’ compensation claim, given the long tails of exposures, are the medical aspects,” Kuss said.
Source: rickrussoinsurance.com

Obamacare ‘Surprise’ Threatens Access to Medicare Advantage Coverage, AMAC Charges

Posted by:  :  Category: Medicare

Senate Dems Protest Medicare Cuts by Talk Radio News ServiceThe Association of Mature American Citizens [http://www.amac.us] is a vibrant, vital and conservative alternative to those traditional organizations, such as AARP, that dominate the choices for mature Americans who want a say in the future of the nation.  Where those other organizations may boast of their power to set the agendas for their memberships, AMAC takes its marching orders from its members.  We act and speak on their behalf, protecting their interests, and offering a conservative insight on how to best solve the problems they face today.
Source: amac.us

Video: Compare Medicare Supplement Plans | Supplemental Medicare Insurance

Chart: Medicare Costs for Seniors Increase Under Obama’s Plan

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Source: heritage.org

Daily Kos: Insurers hoping for billions in Medicare profits back Paul Ryan budget supporters

Health insurers love the idea of the Romney/Ryan plan to turn Medicare into a voucher system. They love it so much that they are rewarding all of the Republicans who voted for it, according to new analysis by Public Campaign Action Fund (PCAF) and Health Care for America Now (HCAN). A Romney-Ryan victory coupled with a Republican takeover of the Senate would boost health insurance company stock prices by 10 to 20 percent, according to Citigroup analyst Carl McDonald. Based on share prices on Aug. 18, the day McDonald published his report, a GOP sweep in Washington would quickly jack up the total market value of the 10 largest health insurers by $12 billion to $25 billion. […]
Source: dailykos.com

Medicare Battle Heats Up California House Race

Bera was a newcomer to politics in 2010 when he ran a surprisingly strong campaign against Lungren, losing by 7 percentage points in a year in which Republicans made record gains in the House. But in this year’s rematch, Bera is placing greater emphasis on his medical background: he served as chief medical officer for a large California hospital chain and later in the Sacramento County public health department, tasked with providing medical care for some 225,000 uninsured people.
Source: kaiserhealthnews.org

Ins & Outs of Medicare

Our presenter, David Smith, served for 20 years as the attorney of the New York State Department of Health, was the CFO of a New York acute-care hospital, and currently sits on the Board of Directors for the Southern Maine Agency on Aging.
Source: oceanviewrc.com

The Ins and Outs of Medicare

Next is the step involving supplemental plans.  In order to purchase a Medigap policy you must be enrolled in Medicare coverage.  Enrolling in Medigap begins on the first day of the first full month that you are sixty five or have enrolled in Part B Medicare and ends after six months.  This is the period in which an insurance company must waive all exclusions such as pre-existing conditions and accept all participants.  The must also allow your coverage to begin immediately.  After the six months insurers have the right to deny selling you a particular Medigap Supplemental Plan.
Source: livingstonreporting.com

Do I Need To Supplement My Medicare Ins?

Insurance companies that offer Medicare Supplement Insurance will need to provide Plan A. Insurance companies will also need to offer Plan C and Plan F. You have the option to choose from plans ranging from A through N. However, plans E, H, I, and J are no longer available. Insurance companies in your state may not offer all Medigap plans for purchase. They also cannot deny you a policy for any type of pre-existing health issue.
Source: seniorcorps.org

Medicare Voucher Plan Remains Unpopular

Six-in-ten (60%) Republicans call Ryan an excellent or good choice, 20% say he is an only fair or poor choice and 20% do not offer an evaluation. Nearly seven-in-ten (68%) conservative Republicans say Ryan is an excellent or good choice, just 16% give the selection an only fair or poor rating. Independents view the Ryan selection somewhat more negatively than positively – 30% call him an excellent or good choice, compared with 42% who say he is only a fair or poor choice; 27% of independents offer no rating. Democrats view the Ryan choice overwhelmingly negatively – 70% say he is an only fair or poor selection; just 8% say excellent or good.
Source: people-press.org

Medicare Supplemental Ins 101

Medicare Portion A- This is the portion of Medicare that you immediately receive from doing work 10 many years or far more at a task in the United States. Medicare Element A covers the hospital portion of any medically required circumstance. Medicare Element A has some big gaps in it nevertheless, as of 2011 there is a $ 1132 deductible related with Medicare Element A, this deductible is a per benefit period deductible meaning that it wants to be paid for every separate accident or sickness that may happen. If you have an accident or illness that you are going back into the hospital for inside 60 day of the initial occurrence of the accident or illness you will not have to pay the deductible twice, only if you are going outdoors of that 60 day window. I know that this may sound confusing but think of it like this the wonderful majority of the time that you go into the hospital you will be accountable for a $ 1132 (2011) deductible. You will also be responsible for co-insurance coverage or co-pays to the hospital that Medicare does not cover. This is one of the primary causes why we see so several folks that are starting Medicare choose to have a Medicare Supplemental Ins strategy. There is also yet another large gap in Medicare, this is Medicare Part B.
Source: freelongtermcareinsurance.com

More Time to Enroll in Medicare If You Live in Storm Areas

Posted by:  :  Category: Medicare

New Online Rx System Makes UM Student 'Top Entrepreneur' Finalist by University of Maryland Press ReleasesThanks 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

Video: Medicare physical therapy patient testimonial bowie maryland.avi

Maryland Seeks A New Balance In Its Unique Hospital Payment System

The debate is part of a larger discussion about saving Maryland’s oft-praised price-setting regime while maintaining the state’s leadership in developing an insurance exchange and other components of the health act. One idea is to have HHS judge Maryland according to the total cost of care for Medicare and not just inpatient cases, according to a presentation given by a top HHS official to the hospital association earlier this summer, according to people who were there. That raises the possibility of cost controls (although not necessarily rate setting) on physicians. “Obviously, it’s something we’re watching closely,” said Gene Ransom, chief executive of MedChi, Maryland’s state medical society.
Source: kaiserhealthnews.org

Ethics Opinions Underscore Problems That Medicare Liens Create when Negotiating Settlements

In the absence of an agreement to indemnify from the plaintiff’s attorney, another alternative would be that the defendant/insurer would distribute the money to the plaintiff’s attorney, and the plaintiff’s attorney would agree to maintain an amount equal to or greater than the full amount of the lien until the final lien amount is negotiated.  In this scenario, the attorney is not taking on the client’s obligations, but rather is being held to his word that the lien will be protected, assuming the plaintiff consents to the withholding of some funds.  The plaintiff can receive some of the settlement funds immediately, but the defendant/insurer is assured that a sufficient amount will be held back to guarantee that the asserted lien is protected.  It is seemingly a better solution to the problem.  However, as may be evident, similar ethical concerns are raised by this scenario as well, and the MD Committee on Ethics has also had occasion to address it.  According to the Committee, it is questionable whether the plaintiff’s attorney can ethically agree to such an arrangement.  The Committee, in reviewing this practice, has expressed concerns that the plaintiff’s attorney would be violating the aforementioned ethical rules regarding the safekeeping of property of the client and/or a third party.  Under these ethical rules, the settlement funds belonging to a party may be placed in an interest bearing account, where the interest must be provided to the party.  However, the funds belonging to one person may not be placed in an interest bearing account where the interest will be credited to someone else.  The question, then, as the Committee sees it, is who do the funds belong to at the time they are given to the plaintiff’s attorney: the plaintiff, the third-party, or both?  Keeping in mind that the assertion of a lien is not the same thing as a ruling that the lien is valid, the Committee has decided that the plaintiff’s attorney must consider the legal question of when a lien holder has “ownership” of the funds.  Given the Committee’s Opinion on this matter, plaintiff’s attorneys are left to analyze when and whether the lien holder becomes the owner of the funds.  If it is the owner of the funds, then the attorney cannot ethically hold it.  Given this dilemma, and absent a controlling opinion from Maryland appellate courts, one would think that most plaintiff’s attorneys will be cautious and decline to agree to maintain the funds for “safe keeping” in order to avoid the risk of committing an ethical violation.
Source: mdliability.com

Accountable Care Organizations: Can They Work for Your Practice?

Craig Behm, executive director of MedChi Network Services, explains, “We own the legal entity designated as each ACO and intend to work with the participating practices to enter into a management agreement to provide care coordination and other services. Services must be tailored to each ACO due to community differences; in Garrett County, most practices are close to the hospital, whereas in Easton, they are more spread out. On the IT side, we’re currently demoing a number of systems that can provide both the care management system and the interface engine to gather and analyze data. Very few systems are good at both.
Source: mdphysicianmag.com

Maryland Has a Four Part Medicaid Program

Medicaid can cover people who fit into the following groups: low income families, children, pregnant women, and aged, blind, or disabled adults. The specific benefits that are offered, and the details about the eligibility requirements, are standard across the state of Maryland. A person can be covered by another form of health insurance and still be eligible for coverage through Medicaid.
Source: families.com

Blue State Politics: Referendum Wins in Maryland Make National Headlines

The election results are really sad. That the redistricting referendum failed and the dream act were passed are two really bad things for Maryland. It is a shame how the Democratic party rules. I’m sick of it. I’m worse off now than I was four years ago and with this recent election, I don’t think things are going to get better. Don’t people realize that the democrats redistricted in order to get a Republican out-of-office? The new redistricting is so ridick, not just the congressional, but also my local councilmember. Not that my previous councilmember did anything for me, but at least he was in the area. Now my new CM really could care less about those in my area. And the Dream Act–how can that not raise taxes and expenses for legal citizens? It’s just a shame hot the county, state, country has gone to pot. I’m not retiring for probably 20 years so I’m here until then, but I will not be living my retirement years in this state. Not that they care, I’m sure.
Source: patch.com

Greenbelt Explorations Unlimited Explores Medicare Supplements

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

Kaiser ranks in top 15 commercial and Medicare plans

Kaiser has two more new multi-specialty facilities slotted to open next year in the Mid-Atlantic region, and plans to open a new multi-specialty medical center in Baltimore County, Md. Also next year, Kaiser plans to expand and renovate its Largo Medical Center in Prince George’s County, Md. This year, Kaiser opened new centers in Northwest D.C., Tysons Corner and Gaithersburg, Md.
Source: ifawebnews.com

Nursing Home Could Lose Medicare and Medicaid Funding Due to Multiple Alleged Deficiencies :: Maryland Nursing Home Lawyer Blog

CMS reported that it had conducted three surveys of the facility in response to complaints in the past fifteen months. It compared the total number of deficiencies in the facility, twenty-four, to the national average of 7.5. The average number of deficiencies for facilities in Mississippi is six. The most recent survey of the nursing home, conducted on February 10, 2012, identified deficiencies in eight broad categories based on the regulatory requirements for participation in the Medicare and Medicaid programs: 1. Privacy and confidentiality of residents’ personal and medical information and records; 2. Provision of care that maintains “dignity and respect of individuality”; 3. Adequate housekeeping and maintenance; 4. Safety and cleanliness in food handling; 5. Labeling of drugs and maintenance of drug records in accordance with professional standards; 6. Effective planning to control the spread of infections; 7. Monitoring of nurse aides to ensure they can provide for resident needs; and 8. Recordkeeping on individual residents that meets accepted professional standards.
Source: marylandnursinghomelawyerblog.com

A Blog by Maryland Optometric Association President John L Burns O.D.: Meaningful Use.. Glasses after Cataracts with Medicare

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: blogspot.com

Maryland Blue Cross CEO: Hospitals Are "Biggest Driver" of State’s Cost Pressures

As Maryland hospitals and payors try to hammer a deal to control the state’s rising Medicare expenditures, the CEO of the state’s largest health insurer scolded hospitals on a recent proposal, according to a Kaiser Health News report. Maryland’s Health Services Cost Review Commission has dictated the Medicare rates for hospitals, as well as the overall hospital prices for payors, under a special exemption waiver from CMS. In order to receive the waiver, the state must show the federal government its Medicare costs grow more slowly than the rest of the country. The Maryland Hospital Association recently pitched an idea that would shave Medicare and Medicaid rates, but hospital rates for commercial payors would increase 7 percent over the next three years, according to the report.
Source: beckershospitalreview.com

GAO: Additional Imaging Self

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSAdditional imaging service referrals by providers who self-referred cost Medicare approximately $109 million, according to a U.S. Government Accountability Office report. The report, “Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions,” examined the rate of imaging referrals among providers who self-referred and those who did not, and the accompanying costs. Results showed that from 2004 through 2010, the number of self-referred MRI services increased by more than 80 percent, while the number of non-self-referred MRI services increased by only 12 percent. Overall, self-referring providers referred roughly twice as many imaging services in 2010 as providers who did not self-refer, according to the report. GAO estimates self-referring providers likely made 400,000 more referrals for advanced imaging services in 2010 than they would have if they were not self-referring, resulting in an approximate cost of $109 million to Medicare. Moreover, these additional referrals pose a risk to patient safety due to increased radiation exposure, according to the GAO report. The differences in referral rates between self-referring and non-self-referring providers remained after accounting for practice size, specialty, geography and patient characteristics, according to the report. To address the high rate of imaging service referrals among self-referring physicians, GAO made three recommendations to the administrator of CMS: 1. Insert a self-referral flag on its Medicare Part B claims form and require providers to indicate whether the advanced imaging services for which a provider bills Medicare are self-referred or not. 2. Determine and implement a payment reduction for self-referred advanced imaging services to recognize efficiencies when the same provider refers and performs a service. 3. Determine and implement an approach to ensure the appropriateness of advanced imaging services referred by self-referring providers. While HHS said it would consider the third recommendation, it did not concur with the first two. For the first recommendation, HHS said CMS believes a new checkbox on the claim form would be complex to administer and may not characterize referrals accurately. For the second recommendation, CMS commented that an additional payment reduction may cause providers to refer more services in an effort to maintain their income, according to the report.
Source: beckershospitalreview.com

Video: What Does Medicare Cost?

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

GAO Report: Medicare Rx Drug Costs Did Not Increase After Discounts

The cost of prescription drugs did not increase for Medicare beneficiaries after a provision in the Affordable Care Act that requires drugmakers to grant discounts to beneficiaries who reach the so-called “doughnut hole” in Part D coverage took effect, according to a Government Accountability Office report, Modern Healthcare reports (Zigmond, Modern Healthcare, 10/28).
Source: californiahealthline.org

Renate Pore: Health Reform Helps Thousands of West Virginia Seniors

In 2003, Congress and the Bush administration passed Medicare Part D, adding prescription drugs as a benefit. Adding prescription drug coverage to Medicare was the right thing to do. From the very first, however, the law was flawed. Fearing run-away drug costs, the law created a gap in benefits. Before the 2010 health reform law, Medicare paid for prescription drugs up to approximately $2,900. Thereafter the benefit ceased until the senior spent a total of $4,700 in out-of-pocket costs, at which point the benefit kicked in again. The law did not permit Medicare to negotiate with the pharmaceutical industry over prescription drug costs nor did the law include a mechanism to pay for the new benefit. Consequently Medicare Part D added billions to the deficit.
Source: wvpolicy.org

Medicare and ACA Facts and Updates; Jimmo Update 

The Center for Medicare Advocacy continues to work to effectuate terms of the settlement in Jimmo v. Sebelius (No. 11-cv-17 (D.Vt.), filed January 18, 2011).  The media have quickly picked up the story after Robert Pear ran an exclusive article in The New York Times last week, and beneficiaries, advocates, and other organizations with an interest in the clarification of coverage under the settlement have been contacting the Center daily, as well as reaching out to media themselves.  For example, the National Parkinson Foundation sent a letter praising the decision to The New York Times, citing a study they co-authored which supports that improved access to skilled maintenance care will result in preventing or shortening hospital stays, thus saving the Medicare program money on more intensive, expensive care.
Source: medicareadvocacy.org

10 health care reforms on track for 2013 after Obama election win

US President Barack Obama arriveS on stage after winning the 2012 US presidential election November 7, 2012 in Chicago, Illinois. Obama swept to re-election, forging history again by defying the dragging economic recovery and high unemployment which haunted his first term to beat Republican Mitt Romney. AFP PHOTO / Saul LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
Source: twincities.com

Common Sense Family Doctor: Lockboxes, Medicare reform, and the myth of “free stuff”

Recently, I had an interesting conversation with my dad about the current policy debates involving the Medicare program. Since he, along with my mother, is one of the two most important Medicare beneficiaries in my life, hearing his perspective was immensely valuable. Essentially, my dad said that what really upsets him when politicians describe Medicare is the use of the term “entitlement,” which implies that people like my parents who paid Medicare taxes for several decades doesn’t deserve to reap the full benefits of that investment. I pointed out that the reason Medicare is running out of money is that the dollar value of health benefits that seniors use today far exceeds the amount they paid in to the system thirty, twenty, or even ten years ago, since Medicare only began to pay for prescription drugs in 2006 and annual increases in the cost of health care have exceeded inflation since, well, forever. He countered that it was totally appropriate for retirees to get back more than they put in, since all good investors expect their money to grow over time. He’s right. The problem with this argument isn’t his fault: the federal government doesn’t put revenue from Medicare payroll taxes into the stock market, a savings account, or even the “lockbox” that Al Gore made famous during the 2000 presidential campaign. It spends those dollars, immediately, often on programs that have nothing to do with health care for seniors. As a nation, we can and should debate the best ways to keep Medicare solvent for my generation and my children’s generation. The President and Congress could, for example, turn the program into one with fixed costs but not necessarily fixed benefits. They could agree to large increases in the payroll tax that funds the program, rather than continuing the temporary payroll tax holiday put in to place to cushion families from the worst of the recession. They could cut Medicare payments to doctors by 30 percent, cross their fingers, and hope that at least a few of us would continue to see Medicare patients anyway. They could do some or all of these things at the same time. What we as citizens cannot do is allow them to continue to point fingers at each other and, for purely political  reasons, avoid the question of what to do. Which brings me to one of my pet peeves about health reform in general, and the Affordable Care Act in particular: the selling of reforms as good because they provide people who already have health insurance with more “free stuff.” Thanks to the ACA / Congressional Democrats / President Obama, a typical political ad will say, women can now get free mammograms, Pap smears, cholesterol tests, and birth control pills! Isn’t that great? This kind of ad is misleading because none of the preventive health services defined by the bill have suddenly become free. In fact, some cost hundreds or even thousands of dollars. Instead, the costs of these (often but not always worthwhile) services have just been shifted – into higher insurance premiums, on to an employer, or to the federal government (and therefore the individual taxpayer or an international investor that holds some portion of the U.S.’s $16 trillion national debt). The above discussion notwithstanding, my fellow blogger Josh Freeman recently made the very good point that health should generally not be considered a commodity, but a social good. I supported most provisions of the Affordable Care Act because its implementation will eventually allow millions more Americans to more reliably access health care, especially primary care, when they need it. As a family physician, I do not believe that any group of people “deserves” health care any more than others. My dad and mom deserve their health care. But so do I, so do my wife and kids, and so do you and your loved ones. And our country will never have an honest debate about health reform as a social good and a shared sacrifice if we let politicians of both parties, only concerned about the next election, portray it as a false choice between rationing and free stuff.
Source: blogspot.com

GAO Highlights Increasing Medicare Ambulance Provider Costs : Health Industry Washington Watch

The GAO has released a report examining Medicare payments and provider costs for ground ambulance services, along with beneficiary utilization of ambulance services. The GAO found that in 2010, costs per transport varied widely among ambulance providers in the GAO’s sample, ranging from $224 to $2,204 per transport, with a median cost of $429.  The report discusses the factors impacting these costs, including volume of transports, the proportion of transports that were nonemergency, and the extent to which providers received government subsidies. The median Medicare margin for 2010, including add-on payments, was about 2% for the providers in GAO’s sample, but it varied from about -2% to +9%, (without add-on payments, the margin ranged from about -8% to +5%). Medicare utilization levels also have been on the increase, with ground ambulance transports for all Medicare fee-for-service beneficiaries increasing 33% from 2004 to 2010, with the highest growth in super-rural areas. According to the GAO, ambulance provider organization representatives suggested the increase in transports may stem from increased billing by local governments, since some local governments that used to provide Medicare transports free of charge may now be billing Medicare because of budgetary pressures. On the other hand, the GAO notes that the OIG has cited improper payments as a potential cause for increases in Medicare ambulance utilization.
Source: healthindustrywashingtonwatch.com

Is it time for another lawsuit? Advocating to change the Medicare Hospice Benefit eligibility requirements

I have decided that there is compelling evidence that the Medicare Hospice eligibility requirements are outdated and need to be re-written.  These policies are not driven by patient need and the evidence is mounting that limiting access to hospice and palliative services actually increases the cost of health care at the end of life.  Those with concerns about the rise in the cost of the Medicare Hospice Benefit appear to put undue focus on the increasing length of stay of a number of hospice patients without considering that hospice and palliative care can be more cost effective than usual care.  This cost reduction does not come from “irrationally rationing” health care but by facilitating conversations that allow patients and families to understand prognosis and verbalize preferences and goals about end-of-life care.  These conversations enable health care providers to guide patients away from costly treatments and interventions that do not facilitate attainment of patients’ goals or add to the quality or length of their lives. If you agree that it is time for a change to the eligibility requirements, what can we do as hospice and palliative medicine providers to advocate for our patients to receive high-quality palliative and end-of-life care in a manner that makes sense? Do we wait until the results of the concurrent care demonstration project are in? Do we ask AAHPM, NHPCO, and HPNA’s Public Policy and Advocacy Committees to weigh in on the matter?  Or do we wait until the lawyers file another class-action lawsuit against Medicare? by: Shaida Talebreza Brandon (all opinions expressed are my own)
Source: geripal.org

Buy Zoloft Without Prescription

Posted by:  :  Category: Medicare

Sign at Occupy St Pete: "Hands Off Social Security, Medicaid Medicare"  "www.SayNoCuts.org" by Fifth World ArtBuy zoloft without prescription, The Democratic Party and Republican Party hold two different views on how to reform Medicaid, the state-federal program for the poor, women, children and disabled. Buy zoloft online australia, Under the Affordable Care Act, President Obama made it mandatory for every state to expand Medicaid eligibility to 138% of the federal poverty level (FPL) otherwise they would lose some of their federal funding, zoloft no rx required. Zoloft in malaysia, This would have given access to about 17 million new enrolles, but the Supreme Court decision in June made it optional for states to expand their Medicaid programs, approved zoloft pharmacy. Zoloft online review, Republican Presidential Candidate Mitt Romney and Republican Vice Presidential candidate Paul Ryan wish to repeal the health care law and make drastic federal cuts to Medicaid should they take office. They also would give states more control over the program by giving them block grants to decide eligibility and benefits, buy cheap zoloft online. These grants would increase at the rate of inflation, but opponents say annual increases would not be able to compete with the growing amount of health care costs, buy zoloft without prescription. Zoloft approved, Both parties also have different views when it comes to reform of Medicare, the federal health insurance program for senior citizens 65 and older, free zoloft. Purchase zoloft overnight delivery, Under the Affordable Care Act, President Obama will keep Medicare the way it is today overall, generic zoloft, Buying generic zoloft, while reducing costs. The Republican party’s views on Medicare is to transform it to a voucher system where seniors will be given a certain amount of money and will have the responsibility of taking care of expenses over the cost of their premiums.  Also the Medicare eligibility age would be raised from 65 to 67 by 2034, no prescription zoloft. Low cost zoloft, While the overall goal of the Romney-Ryan transformation plans for Medicaid and Medicare is to “reduce costs,” there seems to be little regard for access to healthcare for  the country’s most vulnerable citizens, zoloft online without prescription. Zoloft without a prescription, Since states would have more control over the Medicaid program, under their Medicaid plan, order zoloft no prescription required, Buy zoloft internet, they would most likely cut eligibility for some people and prevent some from enrolling in the program. Those that had been previously covered would no longer have coverage and would be left in the dark while those who would have been enrolled would not have had a chance to be covered by Medicaid, zoloft online sales. Buy zoloft in us, Secondly, if the eligibility age was raised from 65-67, discount zoloft without prescription, those 65 year olds that are poor would have to wait two more years, then they traditionally would have, before they would have coverage under Medicare.
Source: clinicians.org

Video: Medicare and Medicaid: What’s it all mean?

Medicare and Medicaid Reforms Coming in a Second Obama Administration

By comparison, the Patient Protection and Affordable Care Act was projected to cut $575 billion from Medicare over 10 years, but the President and lawmakers persuaded stakeholders to accept these cuts on the promise that 34 million uninsured Americans would gain health insurance (Memorandum of Richard Foster, Chief Actuary, Centers for Medicare & Medicaid Services, “Estimated Financial Effects of the ‘Patient Protection and Affordable Care Act,’ as Amended,” April 22, 2010).  Despite all the hand-wringing, the sequestration mandated by the Budget Control Act of 2011 would cut only $120 billion from Medicare over a 10-year period, and cut nothing from Medicaid (C. Stephan Redhead, Congressional Research Service, Budget Control Act: Potential Impact of Sequestration on Health Reform Spending, at 10–11, October 2012).
Source: jdsupra.com

13 Recent Medicare, Medicaid Issues

1. Hospital outpatient departments will receive Medicare payment rate increases of 1.8 percent, while ambulatory surgery center Medicare rates will increase by 0.6 percent, according to CMS’ final rule on outpatient policy and payments. 2. CMS issued its final rule on the Medicare physician fee schedule for 2013, saying Medicare reimbursement rates for physicians will be slashed by 26.5 percent on Jan. 1, 2013, unless Congress bypasses the sustainable growth rate. 3. Starting Jan. 1, 2013, through the end of 2014, certain primary care physicians will see their Medicaid payments increase to Medicare rates. 4. The American Hospital Association and four hospitals sued HHS over denied Medicare payments resulting from RAC audits. 5. The American Hospital Association and the Association of American Medical Colleges commissioned Dobson DaVanzo & Associates to look at bundled payments and provide analysis on different episode-based payment bundles that providers could expect. The study looked at 16 MS-DRG families that represent a significant portion of Medicare’s fee-for-service payments. 6. Additional imaging service referrals by providers who self-referred cost Medicare approximately $109 million from 2004 through 2010, according to a U.S. Government Accountability Office report. 7. A new study in the Archives of Internal Medicine revealed that per capita Medicare spending is growing three times faster for seniors in the United States compared with seniors in Canada. 8. CMS approved Washington’s HealthPathWashington initiative — a project that aims to improve the care of state residents enrolled in both Medicare and Medicaid. 9. Here is a list of total Medicare beneficiaries by state in 2012. 10. As federal and state agencies attempt to reduce the growth of spending for people eligible for both Medicare and Medicaid, new research showed it may be hard to find large savings in new demonstration programs. 11. The Medicaid expansion provision of the Patient Protection and Affordable Care Act will start in 2014, adding millions of people to Medicaid rolls, but hospitals and other providers may not understand how to best tailor their medical and business practices to take advantage of the provision. 12. Here is a table of Medicaid cost-containment actions 50 states and Washington, D.C., have taken in 2012. 13. In a recent webinar, Ken Perez, senior vice president of marketing and director of healthcare policy for MedeAnalytics, broke down the current state of Medicare, discussing everything from the politicization of Medicare to detailed breakdowns of presidential Medicare plans.
Source: beckershospitalreview.com

CMS Issues Final Rules on Medicaid, Medicare Provider Payment Rates

The payment increase applies to physicians practicing in family medicine, general internal medicine, pediatric medicine and related subspecialties, such as board certified pediatric cardiologists. The rule clarifies that primary care services delivered by medical professionals working under the personal supervision of a qualifying physician, such as nurse practitioners, also are eligible for the higher payment rate (Reichard,
Source: californiahealthline.org

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

Illumina Takeover Chatter, Medicare & Medicaid Insurers Jump: Healthcare Business Update

Some companies won last night when the Electoral College was decided, some didn’t. Winners include the Medicare and Medicaid insurers as the President’s re-election keeps the Affordable Care Act on the books and ensures that dollars will continue flowing to their firms. Shares of Centene Corporation (NYSE:CNC), Molina Healthcare (NYSE:MOH), and WellCare Health Plans (NYSE:WCG) all moved up on the news.
Source: wallstcheatsheet.com

Obamacare, Medicare, Medicaid and Medical Marijuana on 2012 Ballots

Obamacare, Medicaid and the Federal Medicaid Program Reelecting Obama and Biden will mean implementation of the Patient Protection and Affordable Care Act will continue on schedule.

Find Out What Medicare Covers, on Medicare.gov | HelpingYouCare®

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 marsmet526Medicare health plans provide Part A and Part B benefits to people with Medicare who enroll in these plans, which include Medicare Advantage Plans, Medicare Cost Plans, Demonstration/Pilot Programs, and Programs of All-inclusive Care for the Elderly (PACE).
Source: helpingyoucare.com

Video: #30.4 Supplemental Insurance Covers What Medicare Doesn’t – How to Handle the Medicare Maze (4 of 5)

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

8 Mistakes to Avoid During Medicare’s 2013 Annual Enrollment Period

5) Ignoring long-term care needs: According to an Opinion Research survey sponsored by PlanPrescriber.com, paying for long-term care is a top concern for baby boomers. Original Medicare will only pay for care in a skilled nursing facility for up to 100 days, and beneficiaries typically have to pay for a portion of those costs out of pocket. And, in most cases, Medigap plans will only cover out-of-pocket costs for services that are also covered by Medicare. So, once Medicare stops paying, your Medigap plan will stop filling in the gaps. But, long-term care insurance is available to help fill in the gaps.
Source: seniorlivingcare.com

Medicare Home Health: What Is Medicare Supplemental Insurance?

Medicare is an entitlement program created by the federal government as its principal health care plan for seniors. To qualify for Medicare all you need to do is reach the age of 65, become permanently disabled or have end stage renal disease. Medicare was originally created to help our elderly with the burden of paying for health care. Medicare is not free however; recipients pay a monthly premium as well as portion of the cost of services they receive as a co-payment or deductible amount.
Source: blogspot.com

Medicaid in Rhode Island is Different

In 2009 and 2010, Rhode Island received an additional $320 million from a federal stimulus package that would be used on Medicaid. This probably helped the experiment. It seems to me that the big difference between Medicaid in other states, and Medicaid in Rhode Island, is that the state found a way to have a bit more flexibility in how it spends money earmarked for Medicaid.
Source: families.com

Medicare Covers Alcohol Misuse Screening and Counseling Under Affordable Care Act

Medicare recipients can receive free alcohol misuse screening and counseling, as well as certain programs to help people quit smoking, under the Affordable Care Act (ACA). These are some of the ways in which the new healthcare law affects people with substance use disorders who are covered by public insurance programs, according to The Health Foundation of Greater Cincinnati.
Source: drugfree.org

Medicare confusing, but don’t put off enrolling

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Source: fredericksburg.com

KS: Rising obesity weighs on public health

Posted by:  :  Category: Medicare

Bush Crimes: IMPEACH BUSH before Bush pardons himself: 73 Days left. by eyewashdesign: A. GoldenThe recent obesity study released by the Robert Wood Johnson Foundation, “F as in Fat,” ranked Kansas 13th overall with an obesity rate of 29.6 percent, tied with Ohio, and just behind Missouri. The ranking is three slots higher than last year when Kansas came in at 16th, with a 29 percent obesity rate. Kansas was only 18th for obesity in 2009.
Source: watchdog.org

Video: Kansas Medicare Supplements

State Roundup: Ga. Considers Medicaid Managed Care ‘Light’ Touch

Modern Healthcare: AMA Joins Friend-Of-The-Court Brief In Fla. ‘Docs And Glocks’ Case The American Medical Association and nine other medical specialty societies have filed a friend-of-the-court brief opposing a Florida statute that prohibits physicians from asking patients and families about guns in their home and from noting a patient’s gun ownership in his or her medical record. “Not only do physicians lose the right to express themselves freely, but their patients are deprived of the full range of medical care and professionalism that they could expect from their physicians,” the brief stated. In July, a U.S. District judge in Miami blocked enforcement of the law. The state of Florida appealed this decision. The brief filed by the medical societies is in opposition to Florida’s appeal (Robeznieks, 11/5).
Source: kaiserhealthnews.org

Kansas EHR incentives quickly reach $25 million

The state’s Medicaid program in the Centers for Medicare & Medicaid Services (CMS) Electronic Health Record (EHR) Incentive Programs has paid out $25,190,638 to nearly 500 eligible professionals (EPs) and eligible hospitals (EHs) between March and September. In a press release issued yesterday, the Kansas Department of Health and Environment (KHDE), which oversees the program, announced that it had disbursed the first and last sets of payments on March 22 and Sept. 27, respectively.
Source: ehrintelligence.com

Kansas Chamber PAC mailer may have missed the mark

Obamacare, known by some as the Affordable Care Act, will reduce estimated Medicare spending by $700 billion over ten years, or roughly $70 billion annually. Usually, Republicans accuse Democrats of the $700 billion (or $716 billion) number.
Source: midwestdemocracy.com

Medicare Coverage Standard May Be Eased In Wichita Kansas

The Medicare board has had a longstanding practice to require a likelihood of medical or functional improvement before a beneficiary could receive coverage for skilled nursing or therapy services, whether institutional or home-based. That left many care recipients in a lurch. If this settlement goes through and becomes practice, then the requirement is no longer “improvement” but “maintenance.” Accordingly, Medicare will provide services if they are needed to “maintain the patient’s current condition or prevent or slow further deterioration.”
Source: mccaffertylaw.com

Strengthening CMS Demos for Persons Dually Eligible for Medicare and Medicaid

Posted by:  :  Category: Medicare

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Source: aahd.us

Video: EHR: Medicare, Medicaid EHR Incentive Program Webinar for Eligible Professionals

Face the Facts: Dual eligible

Though dual eligibility people cost Medicare and Medicaid more, the number of those beneficiaries varies greatly by state. At the high end of the scale, for example, is Maine where 36 percent of Medicare beneficiaries are also eligible for Medicaid. On the opposite end of the picture are states such as Colorado, Montana, Utah and Nevada where 12 percent of Medicare beneficiaries also qualify for Medicaid.
Source: voxxi.com

Daily Kos: Dear Mr. President, Social Security and Medicare are Not Grand Bargaining Chips

THE PRESIDENT: Look, here’s my expectation — and I’ll take John Boehner at his word — that nobody, Democrat or Republican, is willing to see the full faith and credit of the United States government collapse, that that would not be a good thing to happen. And so I think that there will be significant discussions about the debt limit vote. That’s something that nobody ever likes to vote on. But once John Boehner is sworn in as Speaker, then he’s going to have responsibilities to govern. You can’t just stand on the sidelines and be a bomb thrower. That political malfeasance and naivete on display is why we are still dealing with the fallout of this easily predictable and entirely avoidable debt ceiling debacle that this so called fiscal cliff spawned from. The only thing that seems destined to fall off the cliff is any intelligence whatsoever about fiscal issues and our monetary system. It would have been nice had more people not had deluded themselves into thinking the President had some brilliant plan, because after all, if he did, we wouldn’t be dealing with any of this by the end of this year in the first place.
Source: dailykos.com

Large Savings May Be Hard to Find in Dual Eligible Reform Programs

As federal and state agencies attempt to reduce the growth of spending for people eligible for both Medicare and Medicaid, new research shows that it may be hard to find large savings in new demonstration programs, according to a report from the Kaiser Family Foundation (pdf). People who are eligible for both Medicare and Medicaid are commonly referred to as dual eligible beneficiaries, and they are one of the poorest, sickest and costliest groups of patients for hospitals and other providers. Dual eligibles constitute 21 percent of Medicare beneficiaries but 31 percent of Medicare costs, and they represent 15 percent of Medicaid beneficiaries but 39 percent of Medicaid costs. The KFF study looked at evidence regarding the various programs and demonstrations that aim to reduce the costs of treating these patients, and a review of nine reports and studies, in particular, showed that massive savings may not be feasible.
Source: beckershospitalreview.com

Health & Medicine Policy Research Group

On Wednesday, October 17th, Kristen Pavle, Associate Director of the Center for Long-Term Care Reform at HMPRG, and Gayle Shier, Program Coordinator at Health & Aging at Rush University Medical Center gave a riveting presentation to The Chicago Bridge, an emerging aging professionals  group.  The presentation topic was on Medicare and Medicaid dually eligible beneficiaries and current policy changes in Illinois for this population.
Source: hmprg.org

Reducing Costs for Dual Eligible Medicaid and Medicare Beneficiaries is Tricky

It is impossible to write about elder care in America, without consistently revisiting the subject of caring for dual-eligible beneficiaries. Older adults (those +65 years of age) account for 61 percent of this population of 7 million who are eligible for full benefits under the Medicaid and the Medicare program. The remaining dual-eligible beneficiaries are  younger Americans with physical disabilities who qualify for SSI benefits. Dual-eligibles tend to be low-income individuals with few financial assets and unfortunately also tend to have significantly higher rates of serious health conditions, ADL limitations and cognitive impairments. As the chart (below) illustrates, they represent a disproportionate portion of total expenses for both the Medicare and Medicaid programs. It is not surprising that reducing spending (while improving care delivery) for this population is the holy grail of policymakers in Washington and every state capital in the nation.
Source: chicagonow.com

The Opinion Blog: Face the Facts

FACT: 9 million Americans are on Medicare and Medicaid simultaneously and consume a disproportionate share of program resources. Being a so-called “dual-eligible” is legal; dual-eligibles tend to be both low-income and elderly. In 2008, the most recent data year available, they comprised 20 percent of Medicare clients but accounted for 31 percent of Medicare spending ($132 billion). They represented only 15 percent of Medicaid clients but took up 39 percent of Medicaid funds ($129 billion). The population of dual-eligibles varies widely by state. Maine is the high end, where 36 percent of Medicare recipients are dual-eligible. The low end is in Colorado, Montana, Nevada and Utah, where it’s 12 percent.
Source: typepad.com

Can I Be Eligible for Medicare or Medicaid Benefits?

One of the most popular requirements to receive Medicare benefits is that you have to be at least 65 years of age since this Social Security program solely caters to senior citizens. Additionally, an applicant must have worked for at least 10 years while paying taxes into Medicare, and they must also be a citizen of the United States of America. In rare cases, Medicare coverage is awarded to patients who are suffering from end stage Renal disease.
Source: seniorcorps.org

Information About Medicaid in Connecticut

Medicaid is a public, or government run form of health insurance. It is designed to provide health insurance coverage for individuals and families who are low income and who cannot afford to buy a health plan from a private insurance company. Medicaid is funded, in part, by the federal government. It is also funded by the government of an individual state.
Source: families.com

Get Your Medicare Supplement Quote Now

Posted by:  :  Category: Medicare

Medical Drugs for Pharmacy Health Shop of Medicine by epSos.deMedicare supplements do not have to be confusing. Years ago, Medicare supplements were very confusing. However, the federal government passed the standardization act in 1992. The new law said that all Medicare supplement companies must offer the same basic plans.
Source: gkpeventsonthefuture.org

Video: Medicare Supplements – How to Select the Best Medicare Health Insurance

The Many Benefits of Owning a New York Medicare Supplement Insurance Plan

Due to the potential difference in premiums, residents of New York who possess Medicare Parts A and B and who are interested in applying for Medicare Supplement insurance should compare plans from several different insurers prior to deciding upon which coverage option they will choose. This can help to ensure that they are purchasing the benefits that they need for the best possible premium amount.
Source: edublogs.org

Understanding Your Options: What is Best for You? Medicare Advantage Plan or Medicare Supplement and Part D Drug Plan?

If you have a Medigap policy and join a Medicare Advantage Plan (like an HMO or PPO), you may want to drop your Medigap policy. Your Medigap policy can’t be used to pay your Medicare Advantage Plan copayments, deductibles, and premiums. If you want to cancel your Medigap policy, contact your insurance company. In most cases, if you drop your Medigap policy to join a Medicare Advantage Plan, you won’t be able to get it back. If you have a Medicare Advantage Plan, it’s illegal for anyone to sell you a Medigap policy unless you’re switching back to Original Medicare. Contact your State Insurance Department if this happens to you. If you want to switch to Original Medicare and buy a Medigap policy, contact your Medicare Advantage Plan to disenroll.
Source: indoamerican-news.com

chamarasilva: Medicare Supplement Insurance Coverage

For what ever purpose, your tooth, eyes, and ears are not viewed as components of the physique that are coated where well being insurance is worried.? As a result, since they are excluded from almost all overall health insurance strategies, the only way to get coverage for these important places of remedy is with individual dental insurance policy, eyesight insurance, and listening to insurance coverage ideas.While hearing insurance policies programs are rare, MWG Insurance policy Mall can help you discover a dental plan and/or a vision plan within your funds.The individual ideas support to go over yearly consultation costs as properly many treatments and/or methods.Even though person insurance policies plans are normally a lot more costly than family members or group ideas, by employing some of the greatest firms in the industry, MWG Insurance coverage Mall gives each specific dental and person eyesight ideas for you and your family at the most competitive rates readily available.
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

Has Your Medicare Supplement Gone UP in Price?

During this time of year we can help you make sure you have the best price and coverage for your doctor and hospital care.  Many people think all they need is a Part D comparison, but why pay more for your Medicare Supplement than you have to?  Medicare only pays 80% of your doctor and hospital costs.  If you are turning 65 and in your open enrollment, you cannot get turned down for coverage during those months no matter what kind of health issues you may be experiencing.  That is why it is so important NOT to get a Medicare Advantage Plan!!!  Start off with the BEST coverage available!!
Source: mypartdusa.com

Getting The Most Out Of Medicare Supplemental Insurance Coverage

Seniors turning sixty five are faced with a myriad of decisions to make in regards to their future.  Health care, social security, retirement packages and the list could continue on.  The fact is that truing sixty five is a year full of changes for most seniors.  It is the year you go from being middle aged and classified as a senior citizen.  It is the year the Medicare takes effect for many qualified individuals. Medicare brings on a completely different set of decisions.
Source: seniorhealthdirect.com

Medicare Supplement or Medicare Advantage? Which is Best?

As you’ve probably realized from reading that last bullet point, Medicare Advantage plans are usually less expensive than Supplement plans. So, if you’re willing to deal with the restricted network (i.e., you don’t plan on being a perpetual globetrotter) and your funds are limited, the Medicare Advantage plan may be the best choice for you. But, of course, there are other very important factors beyond monthly cost that you should be aware of.
Source: elevateseniorlife.com

United American Medicare Supplement Insurance Quotes

Fortunately, United American is one of those companies.  At present, they offer some of the lowest priced High Deductible F Plans across the state.  That is great for seniors who want a low priced Medicare insurance plan with a reasonable deductible.  (As of 2012, the HD Plan F deductible is $2,070 yearly.)
Source: ohioinsureplan.com