The 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.
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
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.
“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.
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.
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 firstname.lastname@example.org.
‘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.)
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.
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.
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.
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.
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.
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.