Medicare & Retirement Sales Director (Pennsylvania) Job for Insurance Sales Web.com at UnitedHealth Group

Posted by:  :  Category: Medicare

Mitt Mobile in the Final Stretch by DonkeyHoteyView All Insurance Sales and Marketing Jobs Jobs by Type Account Representatives / Executives / Managers Brokers Directors / Executives District / Regional Managers Field Sales Associates / Representatives Insurance Agent Jobs Insurance Agent Jobs Property / Casualty Agency Insurance Agent Jobs Life / Annuities Agency Insurance Marketing Insurance Producer Insurance Sales Assistants Marketing Managers
Source: insurancesalesweb.com

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

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

Medicare Takes Center Stage In Close Pennsylvania Races

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.
Source: kaiserhealthnews.org

Broad And Pennsylvania: No Debt Deal Should Raise Medicare Eligibility

The correct move would be to move the eligibility age down. Sure, in the first couple years of raising eligibility, the government does save some temporary dollars by covering less people, but that goes up, and the costs get entirely dumped onto consumers then. Lowering the eligibility age to 55 years old, optionally, would bring millions more onto Medicare, improving purchasing power. This would lower reimbursement rates even more, or lower the cost of health care in laymen’s terms. This would allow most early retirees to get affordable insurance too. Even more important possibly, it would take the 55-65 consumers, the most expensive people on the private market, out of the private market, leaving them with insurance pools that are younger and healthier. This means the insurer assumes less risk, and does not have to charge higher premiums. Finally, I just take issue with this whole Greece analogy. I love Greece, it’s history and culture, and am saddened by what’s happened there. It could happen anywhere. There’s no sign it’s happening here. We hear all this doomsday talk, and about the only similarity in the two situations is that there is a deficit in both nations. The bond market continues to buy American Treasury bonds at near zero rates. We quite literally, based on the market’s decisions and behavior, do not have a debt issue in the United States, today. I’m not saying I’m against all entitlement reforms. I could probably swallow mean’s testing on Medicare.   I’m not crazy about it, but the program does cost more and more annually, and this could help. This is different though than harmful ideas, like raising the Medicare eligibility age, or turning Medicaid into a “block-grant” program. These ideas have no real point other than to kill the programs. The problem right now is that Democrats can’t even negotiate tough, but fair changes to entitlements with the GOP, because the GOP’s goal isn’t debt reduction, it’s the end of government. There’s no common ground.
Source: blogspot.com

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

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

Pa. Home Health Care Providers Worried About Medicare Cuts

AAHomecare AARP AARP Public Policy Institute Alliance for Home Health Quality and Innovation Almost Family Amedisys Amedisys Inc. American Association for Homecare American Association for Long Term Care Insurance Apria Healthcare Group Avalere Health Brookdale Senior Living Care.com Center for Medicare Advocacy Centers for Medicar & Medicaid Services CMS Employee Benefit Research Institute Ensign Group featured First Care Home Health Care Gentiva Gentiva Health Services Gentiva Health Services Inc. HHS Home Health Depot Home Health International Houston Compassionate Care Humana IntegraCare Intel-GE Care Innovations Jordan Health Services Kindred Healthcare MDLIVE MedPAC Microsoft NAHC National Association for Home Care & Hospice Nationwide New York Times Northwestern Medicine Paraprofessional Healthcare Institute Partnership for Quality Home Healthcare PHI Sentara Healthcare VA
Source: homehealthcarenews.com

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

HHS Should Help Curb Medicare Identity Theft, Lawmakers Say

Posted by:  :  Category: Medicare

The Social Security number is THE driver behind identity fraud and one of the central reasons why Medicare loses billions of dollars each year to fraud. Politicians constantly talk about how Medicare is going bankrupt to bad policy or bad budgeting but no one ever talks about how to stop the billions lost because of identity fraud. Prevention is needed, and getting rid of the SSN is a good start. To replace the SSN, Health ICONN from TASCET is the answer. With Health ICONN, identity fraud simply cannot occur. Identities remain protected and billions will be saved. This is the direction healthcare is going.
Source: ihealthbeat.org

Video: You Can Help Fight Medicare Fraud

Why Medicare Cards Still Show Social Security Numbers

In a report issued in 2006, C.M.S. said it would cost $300 million to remove SSNs from Medicare cards. Then, in an updated report last November, it said it would cost at least $803 million, and possibly as much as $845 million, depending on the option chosen. Much of the cost, the agency said, was for upgrading computer systems not only at the federal level, but also at the state level, for coordination with Medicaid systems.
Source: nytimes.com

Medicare cards should not expose Social Security numbers

“Making the necessary changes will require significant monetary investments, multiple systems and operational changes, not just for CMS and its contractors, but also for (the Social Security Administration), state Medicaid programs, private health plans and providers that CMS interacts with regarding beneficiary information for enrollment and claims payment,” Tavenner said.
Source: triblive.com

OIG: Medicare exposed to financial losses from ID theft

The report “CMS Response to Breaches and Medical Identity Theft,” issued by the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) on October 10, investigated CMS’ response to 14 security breaches occurring between September 23, 2009 and December 31, 2011. The medical identities of nearly 14,000 Medicare beneficiaries were stolen during this two-year period— significant when considering CMS’ responsibility to maintain the protected health information of millions of Medicare beneficiaries and their role in developing breach prevention regulations.
Source: ahima.org

Report: Medicare ID Theft a Burden on Providers, Beneficiaries

OIG Recommendation: Develop a Method for Ensuring That Beneficiaries Who Are Victims of Medical Identity Theft Retain Access to Needed Services CMS should mitigate the damage of medical identity theft by ensuring that beneficiaries retain their access to services if their Medicare numbers have been misused by others. Misuse of a beneficiary’s number could delay or prevent that beneficiary from receiving needed services, particularly when the services are subject to a cap. CMS could insert an indicator in the beneficiary claim record that would exclude certain claims from frequency and utilization edits, allowing for payment of legitimate claims for victims of medical identity theft. CMS could also develop other methods for providing assurances and documentation to these beneficiaries that their access to services will not be restricted as a consequence of the theft.
Source: insidepatientfinance.com

Recent OIG report reignites call for CMS to drop SSNs from Medicare IDs

Edward Marx is senior vice president and CIO for Texas Health Resources, a 24-hospital system based in Dallas-Fort Worth. He earned his B.S. in psychology and an M.S. in consumer sciences (business) from Colorado State University. He also served 15 years in the Army Reserve, first as a Combat Medic, then as a Combat Engineer Officer. Marx is a member of CHIME and the Society of Information Management (SIM), and is a HIMSS fellow. He also has served as the president of the Ohio and Tennessee chapters of HIMSS and chair of the membership services committee.
Source: fiercehealthit.com

Medicare ID Card Protection Overdue, Medicare Fraud

The Defense Department launched a strategy to remove Social Security numbers from identification cards issued to service members, their families and retirees in April 2011. Veterans Affairs has also stopped issuing ID cards and health authorization cards that show the veteran’s Social Security number. When asked by Johnson why the Medicare agency "can’t follow in the footsteps of DOD and VA," Trenkle said the organizations are set up differently and conduct different operations.
Source: aarp.org

Medicare Billing Housekeeping during the Holidays

The holiday season is coming with food, fun and family time ahead. However, billing must continue and claims must be sent as part of supporting the overall health of home health organizations.  The general decrease in workload due to lighter patient loads and absences from the office provides a little extra time to catch up on “housekeeping.”  Now is a good time to review old claims that have not been sent and adjustments that have not been completed or any other claim problems that have not been resolved. Clearing these problems up as well as continuing with current billing are enough to keep one busy, and keep everything current. Keep in mind to review claims for timely filing deadlines and get those claims completed and sent. The timely filing deadline for all claims is one year from the end of episode date for each claim.
Source: axxessweb.com

Silver Cross Physicians Join New Blue Medicare Advantage (HMO) Plan

Posted by:  :  Category: Medicare

Learn how to protect yourself from some of the expenses Medicare doesn’t cover. Attend a free Our All-in-One Package: Medicare Advantage Prescription Drug (MAPD) program in the Silver Cross Hospital Conference Center, Pavilion A, 1890 Silver Cross Blvd., New Lenox.  One-hour sessions will be held on Oct. 26 and Nov. 1, 16 and 28 at 10 a.m. and 1 p.m.  Each seminar features an informative presentation followed by a question and answer session with a BCBSIL Product Specialist.  A sales person will present information and applications. Free valet parking and shuttle service will be available.  Refreshments will be served.  Register to attend by calling BCBSIL at 1-877-632-5920, TTY/TDD 711, 8 a.m. – 8 p.m., local time, 7 days a week.  For accommodation of persons with special needs at a sales meeting, call 1-877-632-5920, TTY/TDD 711. Friends and family members welcome.
Source: patch.com

Video: Blue Medicare Options Illinois or Medicare Options Illinois

Are you ready for 2013? 4 questions to ask yourself

Don’t forget, if you have Medicare Part B and are in Original Medicare, you’ll have to meet your deductible before your Medicare coverage pays for services and supplies. Next year, the Medicare Part B deductible will be $147. Make sure to plan your health care budget to account for the increased cost of doctor visits for the time that it will take to cover your deductible.
Source: medicare.gov

Blue Cross & Blue Shield of NC Shows High Blue Medicare Ratings

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Source: richdayhealthplans.com

Blue Care Network expands Medicare Advantage service area, Blue Cross and Blue Care Network add plan options

In addition, BCN Advantage members will now be able to “buy up” to more comprehensive dental and vision benefits for a modest additional premium. Members will receive partial coverage on restorative services such as fillings, root canals, crowns and crown repairs. They’ll also get an allowance for frames and lenses to improve their vision health.
Source: hcwreview.com

Florida Blue Partners with Healthways to Offer SilverSneakers® Fitness Program Through 2015

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

Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline, CPT Code Billing: review of blue cross Medicare HMO details.

Blue Cross insurance (Medicare HMO) The Blue Cross is a consumer health advocate with the public interest as its driving force. Their plans have been providing families with the highest quality of health insurance services for 70 years. The Blue Cross Blue Shield Association only offers its members the highest quality, most innovative & customer focused, health insurance plans available. As we step further into the 21st century, medical breakthroughs are going to require changes in policies and coverage, and Blue Cross Blue Shield will be there for its customers, every step of the way. Blue Cross offers a single Medicare + Choice HMO plan, the Blue Cross Senior Secure plan. The benefits of this plan include low or no, monthly premiums, low copayments for doctor office visits, and coverage for vision, dental and routine podiatry care. This plan, however, is only available in select geographic locals.
Source: medicarepaymentandreimbursement.com

sweetbear: Medicare HMO Coverage

Advantage plans with prescription drug coverage and our supplemental medicare plan our healthplus medicareplus advantage hmo and ppo plans and our supplemental to medicare plan. Medicare, medicaid, insurance, hmo problems: hmo coverage, life in san antonio, tx news – view daily local business news, resources & more in san antonio, texas. Healthplus of michigan – medicare you dropped your supplemental medicare coverage policy to join a medicare hmo, and the three isques apply to you: 1 this is the first time you have ever been in a. Blue cross to drop medicare hmo coverage in northeast ohio with peoples health group medicare (hmo-pos), you’re able to get more coverage than with medicare alone peoples health group medicare (hmo-pos) is an employer group waiver plan. How does hmo work with medicare ehow.com blue cross to drop medicare hmo coverage in northeast ohio find knight ridder/tribune business news articles div id “be-doc-text”knight ridder/tribune business news akron.Health alliance medical plans – medicare hmo 20 july 20, 2000 2000-r-0724 prescription drug coverage available to someone who loses medicare hmo coverage by: robin cohen, principal analyst. What are your rights when your medicare hmo pulls out life in limbo, spine clinic, healthnet insurance: i would definatly fight it if you can get a referral to him for an exam, then you can get a referral for surgery he will need. Peoples health group medicare (hmo-pos) an hmo, or health maintenance organization is a managed care plan some medicare hmo’s do offer additional benefits outside of traditional medicare coverage, like prescription. Humana expands medicare hmo coverage to more south texas counties if you’re on medicare, health alliance medicare hmo 20 (hmo) our medicare-approved hmo can enhance and simplify your health care coverage health alliance medicare hmo 20.
Source: blogspot.com

Cigna Medicare plans and Blue Cross Medicare plans An Overview

HMO (Health Maintenance Organization) plans are the least expensive option. The effect of lower cost is reflected as restricted access to health care. Plans have a set monthly fee, covering doctors within the plan. If you visit a doctor outside of the plan, you are then responsible for the bill. Within a given plan, you have given the right to choose a Primary Care Physician (PCP) who will look after your care. The HMO CIGNA medicare plans cover regular and preventive care costs, referrals to a network specialist or facility when necessary, treatment for injuries and illness. There is no need of paying any additional fees in HMO plans as it has no fees for doctor visits. The CIGNA Part D plan is called CIGNA Medicare Rx offers coverage for 94% of available drugs, access to over 58,000 network pharmacies, no deductibles for select plans, no copayments for common drugs and diseases like diabetes and drug pressure. The CIGNA plan D in turn offers three types of plans namely, Plan 1, Plan 2 and Plan 3.
Source: smarticledirectory.com

Florida Blue Is New Name for BCBS of Florida

They are also trying to decrease or hold steady their Medicare supplement rates while competitor AARP is increasing their supplement rates by 5%.  This new approach is a welcome change from the old BCBS of Florida who seemed to rely on their name recognition and less on robust benefits or a value based approach.  In less than a week the new benefit information for 2013 will be released.  Starting on October 15th you will be able to enroll into one of the Florida Blue plans if you want.  I will have updated information on this site so check back regularly.  If you have not already, sign up for my free mini-course in the upper right hand corner!
Source: medicare-plans.net

O.C. HMO patients stuck in contract dispute

Blue Shield’s Davila said that, even after the termination takes effect, many patients will be able to keep their doctors because the doctors already belong to other medical networks contracted with Blue Shield or will join them. He said Blue Shield’s contract with Monarch applies to 16,800 customers in the commercial HMO market and 2,400 in Medicare.
Source: ocregister.com

How to fix Medicare in 100 words

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSIf we expect to bend the Medicare cost curve, we must change the financial incentives that promote the use of services. The federal subsidy cannot grow without limit, and Medicare’s payment arrangements must make that clear to both consumers and providers. Giving beneficiaries a choice of competing health plans, providing a defined contribution subsidy, and maintaining an appropriate oversight role for the government will promote more vigorous efforts by the health sector to contain costs without sacrificing access to care. The goal should be to get the incentives right to promote system improvement rather than a good budget score created by politically unsustainable spending limits.
Source: aei-ideas.org

Video: Medicaid and Medicare: Too much income to qualify?

Prepare for new Medicare taxes in 2013

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Source: keyrealty.us

Death By 1000 Medicaid Cuts

ARIZONA: Last October, as she ignored 26 other possible funding solutions, Gov. Jan Brewer (R) implemented painful cuts to the state’s Medicaid program, which resulted in 2 deaths and left 98 Arizonians waiting for transplant funding. After months of protests, Brewer finally agreed to set aside $151 million in an “uncompensated-care pool to pay health-care providers for ‘life-saving’ procedures, including transplants.” However, House Republicans refused to restore funding for organ transplants because, as House Appropriations Committee chair Jon Kavanagh (R) said, “not enough lives would be saved to warrant restoring millions in budget cuts.” Then, while peoples’ lives were in danger, Brewer eagerly signed tax cuts for businesses that will cost the state $538 million.
Source: ourfuture.org

Medicare Silver Bullets: What’s The Best Way To Control Costs?

If I could make only one change, it would be a massive reform of Medicare’s payment policies. Right now, Medicare payment policies drive overuse, waste, inappropriate and sometimes harmful use of services. There should be a number of changes, such as paying in ways that encourage the use of team-based care, telephone, group and e-visits, more flexibility to allow nurses and other health professionals to operate at “the top of their licenses” with physician oversight and in the most quality and cost-effective ways. The more we can bundle payments to reward improved health (not just health care), and allow providers to self-organize to deliver the greatest benefits for patients and value or payers, the better off we will all be. The most successful providers tend to be integrated delivery systems. Although we will never have enough such systems around the whole country, we can develop and support as many of these as possible and also have payment models that foster virtual integrated delivery systems and reward the best performers, that is, the ones that provide the safest care in the most efficient manner.
Source: kaiserhealthnews.org

Impact of Federal Affordable Care Act on Hawaii’s Medicaid Buy

2012 Legislative Session Act 48 Act 130 appointed Board of Education Art at the Capitol Ask Your Senator Board of Education Department of Land and Natural Resources Education Week Governor Neil Abercrombie Hawaii State Budget Hawaii State Capitol Hawaii State Senate House Bill 2012 Senate Bill 1174 Senate Bill 2012 Senate Committee on Education Senate Committee on Ways and Means Senate President Shan Tsutsui Senate Special Committee on Accountability Senator Brian Taniguchi Senator Brickwood Galuteria Senator Carol Fukunaga Senator Clarence Nishihara Senator Clayton Hee Senator Colleen Hanabusa Senator David Ige Senator David Y. Ige Senator Donna Mercado Kim Senator Donovan Dela Cruz Senator Dwight Takamine Senator Gilbert Kahele Senator Jill Tokuda Senator J Kalani English Senator Maile Shimabukuro Senator Malama Solomon Senator Michelle Kidani Senator Mike Gabbard Senator Pohai Ryan Senator Ronald D. Kouchi Senator Roz Baker Senator Shan Tsutsui Senator Suzanne Chun Oakland Senator Will Espero University of Hawaii
Source: hawaiisenatemajority.com

What You Need To Know About the Medicare Surtax

What planning can you do to increase your economic returns on investments?  As part of rebalancing your portfolio and depending on your investment strategy and at what level you are paying the surtax, municipal bonds may become much more attractive as this interest is not subject to the surtax.  Converting traditional IRAs to Roth IRAs may still be beneficial even if you are closer to retirement due to the fact that Roth IRA distributions when taken out do not increase your MAGI.  This could potentially keep you under the surtax income limits.  Installment sales could spread out gains recognized over a period of years.  This can only be used for certain types of asset sales.  Maximizing your contributions to your qualified retirement plans will maximize your MAGI and the earnings are tax deferred as well.  Distributions from qualified plans would increase and be included in your MAGI if you are close to retirement and will be drawing those funds down.
Source: verospartners.com

Mathematica Policy Research

Disability  Early Childhood  Education   Family Support     Health      International      Labor         Nutrition   
Source: mathematica-mpr.com

Medicare allies take their message to Parliament Hill

Posted by:  :  Category: Medicare

San Diego, CA by Oggie DogThe delegates were briefed by communication experts and the Canadian Health Coalition on our asks for the 2014 Health Accord: home and community care, pharmacare, and the enforcement of the Canada Health Act to protect universal health care from those looking to make a profit off sick Canadians. They also took a message to the Hill to stop the $36-billion cuts that the federal government will be taking from the Canadian Health Transfers, and the need to take pharmaceutical patent extensions out of CETA. Public health care needs federal leadership to ensure everyone has access to the full spectrum of care from cradle to grave.
Source: rabble.ca

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

Saving Medicare Through Premium Support

Comments are subject to approval and moderation. We remind everyone that The Heritage Foundation promotes a civil society where ideas and debate flourish. Please be respectful of each other and the subjects of any criticism. While we may not always agree on policy, we should all agree that being appropriately informed is everyone’s intention visiting this site. Profanity, lewdness, personal attacks, and other forms of incivility will not be tolerated. Please keep your thoughts brief and avoid ALL CAPS. While we respect your first amendment rights, we are obligated to our readers to maintain these standards. Thanks for joining the conversation.
Source: heritage.org

A Need for Free Market Competition in Medicare

While limited government advocates would be expected to cheer this change, it would in fact have far greater negative impacts on the size of government.  Medicare’s prescription drug benefit (“Part D”) is notable in that it has come in over 40 percent under budget.  By making drug companies compete for seniors, market forces have delivered a far more efficient prescription drug benefit compared to Medicare’s hospital insurance and doctor visit components.
Source: capoliticalreview.com

SinglePayerCentral: From SPnow

Some might be surprised that the for-profit healthcare system Dr. Coates criticizes so sharply is mostly paid for with our tax dollars. Through tax subsidies for private health insurance and for public employee health benefits, through direct government Medicare and Medicaid subsidies and through numerous other ways, our taxes pay around 60 percent of our current health spending, or as PNHP leaders Drs. Steffie Woolhandler and David U. Himmelstein say, we are “paying for national health insurance and not getting it.”
Source: blogspot.com

Obama Skeptical Of Raising Medicare Eligibility Age

“When you look at the evidence it’s not clear that it actually saves a lot of money,” he said in an interview with ABC News’ Barbara Walters aired Tuesday night. “But what I’ve said is let’s look at every avenue, because what is true is we need to strengthen Social Security, we need to strengthen Medicare for future generations, the current path is not sustainable because we’ve got an aging population and health care costs are shooting up so quickly.”
Source: talkingpointsmemo.com

California Labor Federation : Report: Lame Duck Congressional Deal to Cut Social Security Could Harm Millions of Californians

Oakland, California – According to a new report released by the AFL-CIO, nearly 5 million Californians could be negatively impacted if Congress attempts cuts to Social Security, including 662,232 people with disabilities and 364,365 children. Of the 11 million Californians who get their health care coverage from Medicaid, 4.4 million children and nearly a million seniors could be affected if the lame duck Congress makes cuts to Medicaid benefits.  Social Security, Medicare and Medicaid combined deliver $156.7 billion per year into California’s economy. As the so-called “fiscal cliff” approaches, members of Congress have suggested cutting these vital programs, even while calling for extending the tax cuts for the richest 2%. If those tax cuts are renewed, the richest 2% in California would receive an average tax break of $30,820, while the rest of Californians would receive an average of $1,440. The 2012 House Republican budget plan would cut federal support to California’s Medicaid program by at least $85 billion (22%) over 10 years.  “We can’t afford to let lame duck legislators in Washington play politics with our social safety net,” said California Labor Federation Executive Secretary-Treasurer Art Pulaski. “We need to protect Medicare, Medicaid and Social Security benefits for those among us who need it the most. Retirees, people with disabilities and children shouldn’t have to suffer because some in Congress want to give more tax breaks to the richest 2%.  It’s time for the rich to pay their fair share, and it’s time for our elected officials to strengthen these and other vital programs that create jobs and support the middle class.”  California’s working families have been mobilizing around the lame duck session and will continue calling on Congress to end tax cuts for the richest 2% and to say no to cuts to Medicare, Medicaid and Social Security. For more information and highlights from the report, visit http://bit.ly/1119SsR. 
Source: calaborfed.org

How to Prepare for Medicare Decisions

Consider cost and coverage.  Some Medicare Advantage Plans (Medicare Part D) cover much of your overall health care costs and some even have exceptional medication programs to suit your needs.  If you are happy with your current Medicare coverage, make sure that the benefits for 2013 are what you need and can afford.  Ask your doctor what health plans they like and how satisfied are their enrollees.
Source: patch.com

Learn About Medicare Changes November 14

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Source: patch.com

Senior Care in Redondo Beach, CA: Open Enrollment for Medicare –Now through Dec 7, 2012

Would a small increase in premiums result in a large reduction in health care costs you pay? Check, for example, what coverage is available for prescription drugs you take? Medicare representatives can create a report containing the costs and benefits of various insurance products if you supply them with a list of your drug prescriptions. Ask questions about participating doctors and clinics. Some Medicare Advantage plans limit which physicians a patient can visit.
Source: lasouthbayhomecare.com

Medicare Targets Health Plans With Low Ratings

Medicare officials are encouraging 525,000 beneficiaries to switch out of these 26 Medicare Advantage and drug plans that have received low ratings for three consecutive years and enroll in better plans for next year. The poor performing plans will have this warning symbol next to their names on Medicare’s plan finder website to steer shoppers to other plans.
Source: kaiserhealthnews.org

Kaiser Permanente’s Medicare Plans In California Get Top Ratings In The Nation For The Second Straight Year

Kaiser Permanente has announced that its Medicare plans in California again have received an overall rating of 5 stars for parts C and D, the highest rating possible from the Centers for Medicare & Medicaid Services (CMS).Through the Medicare Star Quality Rating System, CMS assigns scores of 1 to 5 stars to Medicare plans based on 50 quality and service measures.This is the second year that CMS has awarded such ratings to Medicare plans around the country, and the second year that Kaiser Permanente has the only 5-star rating in California. The new 2013 ratings for the state encompass Kaiser Permanente’s Northern California and Southern California regions.“Kaiser Permanente is a model for health care in this country and this Medicare 5-Star rating confirms the value we provide to patients,” said Robert Pearl, MD, executive director and CEO of The Permanente Medical Group. “The combination of superb physicians and the most advanced information technology systems leads to excellence in quality and service. By providing coordinated medical care and greater ease of access, we are able to achieve outstanding outcomes both in prevention of disease and management of the most complex medical conditions. I applaud the U.S. Centers for Medicare and Medicaid Services for helping shift the focus of our country from rewarding volume to recognizing superior outcomes. If the whole nation could match this 5-star performance, thousands of lives could be saved each year.”The 2013 star ratings for Medicare health plans are available on the Medicare “Plan Finder” on the www.medicare.gov website. Plans that earn 5 stars are designated with a special “High Performing” icon for easy identification.“Kaiser Permanente is a member-focused organization, and our staff and physicians in California – working together and enabled by our electronic medical record and integrated delivery system – make it their mission to provide high-quality care and service to all of our members, including our Medicare members,” said Kaiser Permanente Northern California Regional President Gregory Adams. “We are proud and gratified to receive the CMS’s top possible rating for the second straight year, and we are working hard to continually improve and better serve our membership.”   Star ratings provide Medicare beneficiaries with information to help them assess health plan quality of care and service delivery to make an informed choice when selecting a Medicare plan. Plan performance summary star ratings are assessed each year and may change from one year to the next. In addition to receiving high quality service and satisfaction, 5-star excellence means that Medicare beneficiaries may enroll in a 5-star plan from December 8, 2012 to November 30, 2013 without having to wait until the next annual enrollment period.The 2013 Star ratings are consistent with the recently released National Committee for Quality Assurance assessment of the nation’s health plans, in which Kaiser Permanente’s Medicare plans in Southern California and Northern California ranked No. 1 and 3 in the U.S., respectively.Medicare beneficiaries can learn more about the Medicare Star Quality Ratings and Kaiser Permanente’s Medicare plans by visiting kp.org/medicarestars, medicare.gov, or by calling 1-800-MEDICARE (1-800-633-4227) 24 hours a day, seven days a week. 
Source: patch.com

Romney draws on 2010 playbook in Medicare offensive

Posted by:  :  Category: Medicare

Dr. Raj for Premier by dave.cournoyerWe have the segment of society that cannot afford private insurance (either by earning too little or by having too many other obligations) but also earn too much to qualify for government sponsored care through Medicaid. These people fall into two groups–group one goes to the doctor and pays for the services they receive, while group two goes to the doctor and does not pay for the services they receive. This second group of this segment of population has been claimed by many to be the reason why an enforcement of insurance use by all is necessary, as the doctors and hospitals claim to have raised prices to the insured to cover the cost of “deadbeats”. There are two problems with this idea: 1. Doctors and Hospitals admit to be steeling funding from guaranteed payers in order to cover the cost of the deadbeats, and 2. A vast majority of these deadbeats simply cannot afford to pay for the care because the costs are entirely too high–it is not that they choose to be sick and to cheat the system by walking away from their bills–and the costs are too high because the hospitals and doctors continue raising prices on the payers in order to cover those who can’t pay. We have to ask the question, will guaranteeing more payers (there will still be those who cannot be guaranteed) cause the costs to go down? It is doubtful, as the wages earned by those in the healthcare industry are some of the only wages that have outpaced ordinary inflation, so they are used to a certain lifestyle. Further we should ask the question, will guaranteeing more payers to a group that has proven itself to misuse their trusted position by dubiously increasing costs on people who could pay to offset losses and make extraordinary profits that allowed them such greater wage benefits as the vast majority of the rest of society, make that group somehow more trustworthy–ie will prices then stabilize, defying supply and demand (as supply of everything medical will decrease while demand will increase, which usually results in increased prices)? Furthermore we must recognize that the people who go bankrupt because of the cost of health care are the truly ill of this group and the group of employer-insured people above (not the privately insured as they obviously earn a good deal of money in order to afford private insurance). These people earn too much to qualify for medicaid. We can raise the medicaid floor, however the medicaid floor must remain at pace with wages. OR We can determine a way to bring cost of care back in line with overall costs and wages, so that care and insurance both become more affordable to everyone. This would probably mean the FTC or some entity like that coming down hard on doctors and hospitals for arbitrarily increasing cost of care to people not receiving the care, which sounds a lot like theft.
Source: nbcnews.com

Video: clinical chart documentation review crosswalking CMS Medicare 2010 regulations.mov

Raised Medicare Eligibility Age, and Other Links

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Source: ncpa.org

Remember Your 2010 Conversion to a ROTH IRA?? That Conversion May Hurt For 2013 Medicare B

It may have made good sense to Convert your TIRA to a ROTH IRA in 2010, you could spread the income tax bite over 2 years, 2011 and 2012. So you made your first income tax payment earlier this year when you filed your2011 tax return, and now you are preparing to pay the last half of that tax bill when you file your 1040 for 2012. But you have already received a big surprise, your Medicare B premium for 2013 DOUBLED from what the premium was in recent years. Since 2004, Medicare Premiums have been partly determined based on income. Those in the higher income brackets get to pay more for their Medicare B premiums. The modified adjusted gross income (magi) from your tax return will impact your Medicare B premium 2 years later. So from your 2011 tax return your modified adjusted gross income may impact your Medicare B premium starting in January 2013. The good news is that this increase cost for Medicare B is on a year by year basis. When the taxpayer’s modified adjusted gross income exceeds $170,000 (married filing jointly) the Medicare B premium will be increased. There is a graduated scale that will increase their Medicare B costs. Let’s suppose this married couple typically has an AGI of $70,000. Their Medicare premium has been less than $100 per month for each of member of the couple. In 2010 they converted TIRA funds to a ROTH IRA in the amount of $400,000. Half of this income was reported on their 2011 tax return increasing their AGI to $280,000. This increase would set their Medicare premium for 2013 at $209.80 for each of them. When they file their 2012 tax return reporting the second half of the 2010 ROTH Conversion, and have a similar AGI their 2014 Medicare B premium will be increased due to the taxpayer’s AGI. The Medicare B premium will be set in late 2013. The good news is if their 2013 is back below the threshold, the Medicare B premium will return to the amount payable by most Medicare beneficiaries. Here is the 2013 Medicare B premium table for MFJ tax payers with higher AGI: Modified AGI is: More than: But not over:………………………2013 Part B Premium $170,000…….. $214,000………………………….. $146.90 $214,000…….. $320,000………………………….. $209.80 $320,000…….. $428,000………………………….. $272.70 $428,000…….. No Limit……………………………. $335.70 You can learn more about Medicare B premiums and deductibles here: http://www.medicare.gov/your-medicar…at-glance.html
Source: christianpf.com

Providers Filed 85% of Medicare Appeals in 2010

A study from the HHS Office of Inspector General (pdf) found that hospitals and other Medicare providers filed 85 percent of payment appeals at the administrative law judge level, 56 percent of which went in favor of providers, and the OIG concluded that serious improvements are needed to clarify Medicare policies. Medicare providers and beneficiaries may appeal certain decisions regarding claims for healthcare services. For example, hospitals may appeal payment recoupments from Recovery Auditors, or RACs, if they believe their actions were consistent with Medicare law and standards. There are four general levels of appeal: Level One goes to CMS Medicare Administrative Contractors, Level Two goes to CMS Qualified Independent Contractors, Level Three goes to ALJs and Level Four goes to the Medicare Appeals Council. The ALJ level is the most common platform of the four. The OIG looked at the 40,682 Medicare appeals filed to ALJs in fiscal year 2010. It found that hospitals, physicians and other providers filed 34,542 of those appeals, or roughly 85 percent. In addition, a small number of providers accounted for nearly one-third of all appeals. The OIG tagged 96 providers as “frequent filers,” meaning they filed at least 50 appeals each. One provider filed 1,046 appeals alone. For 56 percent of appeals that made it to level three, ALJs also reversed 56 percent in favor of appellants, indicating a “number of inconsistencies and inefficiencies in the Medicare appeals process,” according to the OIG’s report. The OIG had 10 recommendations for CMS and the Office of Medicare Hearings and Appeals, including more coordinated training on Medicare policies to ALJs and QICs, better identification and clarification of Medicare policies that are unclear, and digitization of appeal case files. CMS and OMHA concurred fully or in part with all of the OIG’s recommendations.
Source: beckershospitalreview.com

Viewpoints: Politicians Flirting With Danger On Medicare Eligibility Age; Maybe Doctors Should Be Paid Less

The Medicare NewsGroup: Progressives Launch Medicare Defense Campaigns It remains to be seen whether the White House will go beyond the above-stated “savings” and venture into the realm of even-more radical reform at this point in the fiscal-cliff battle. The next tier of savings may involve chipping away at the Medicare’s expensive, but-popular, “fee for service” model, which many progressives have suggested needs to be reexamined and possibly abandoned over time. Despite the pitched battle that has created this political equivalent of a World War I-style stalemate, radical reform—if it comes at all—will most likely be delayed … It’s far too complicated and politically toxic to undertake now as Congress faces a year-end deadline with no compromise in sight  (John F. Wasik, 12/12).
Source: kaiserhealthnews.org

Providers Filed 85 Percent of Medicare Law Judge Appeals in 2010

Fewer than 100 providers—including hospitals, physicians, medical equipment suppliers and others—were  responsible for one-third of the 40,682 appeals submitted to the judges, the study found .The report noted that some providers routinely appeal every denial “because the cost is nominal and a favorable decision is likely.”
Source: dmagazine.com

Medicare Open Enrollment: last chance to review and compare plans

With the holiday season upon us, it’s easy to get busy this time of year. Some pretty important tasks can get left to the last minute. One of those important tasks is ensuring you are in the right health insurance plan in Medicare.  Selecting the right plan is a personal choice, and a lot of thoughtful consideration goes into finding the right match.  But just like the holidays, those key dates come whether or not you are ready.
Source: medicare.gov

GAO Report Looks at Medicare Spending on Part B Drugs

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

Do I Need A Medicare Supplemental Insurance Policy?

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSThe cost of each plan will be based on the age, gender, overall health, and location of the individual to be insured. Anyone just turning 65 or going on Medicare Part B for the first time can enter into a plan during the Open Enrollment. Open enrollment means that for 6 months, individuals have the opportunity to enroll in a Medicare supplemental insurance plan without having to go through a health examination. Anyone with a serious health condition or lifestyle that normally would result in an increased premium for their health insurance, for example smokers, can enroll during this period and pay the exact same rates that any other insured individual would pay.
Source: skepticwiki.org

Video: Learn About Medigap Plans

Looking Into Different Aspects Of Medicare Supplemental Insurance

One issue that is near and dear to our hearts when considering health insurance is prescription drug coverage.  It is notable to understand that any Medicare Supplemental Policy you currently purchase will not come with prescription drug coverage.  This is something that needs to be purchased through separately and is referred to as Medicare Part D prescription drug coverage.
Source: seniorhealthdirect.com

Medicare Supplemental Insurance Website Server Starts Data Center Fire, Authorities Say

A blaze which started at a Denver data center on Wednesday night has been contained with no one hurt, authorities say. The fire was reportedly started by an overheated server utilized by local Medicare Supplemental Insurance comparison website: http://medicaresupplementalinsurancecomparison.net. The fire started roughly two hours after the website’s initial launch. As the server heated up from the initial rush of traffic the CPU cooling system malfunctioned causing a chain reaction that led to the fire starting. The fire rapidly consumed a corner of the first floor in the data center. “This isn’t the first time a website’s launch has caused a server to overheat,” says Marcus Stevenson, director of operations at FSPServerDirect. “Overheating servers are common with websites that underestimate the demand they’ll receive at any given time. Though a fire would not have started if the system had not malfunctioned in the way that it did.” The fire reportedly caused significant damage to the host building but none of the neighboring structures were affected. Experts say the most expensive loss will likely come from the damaged server racks- Each one costing up to $10,000. The Medicare website owners would not comment, but according to a company spokesman the website is back up and running and was only down for 3 hours. “Admittedly we underestimated the sheer demand for this type of website,” says a company spokesperson. “We received 18 thousand visits in our first 2 hours online, most of which came from people searching for Medicare supplemental insurance through Google. As we entered our second hour after launch our site was suddenly kicked offline. Only the next morning were we told that our website might have caused the fire, but since hosting is an outside service we were not held accountable. The data center admitted to us that their own negligence was a major contributor to the fire. Needless to say we have upgraded to a brand new server and had it checked over thoroughly. We will now be able to handle as much traffic as we can get.” Experts say the demand for the site was so high because it’s one of the first websites of its kind to provide side by side comparisons of Medicare supplemental insurance companies by only entering a zip code. “This is rare for these types of sites,” says a company spokesman. “Most sites like this require personal info before they provide quotes, and the non-invasiveness of our site has definitely contributed to its popularity.” To learn more about the fire, or to get free side by side comparisons of the most reputable Medicare supplemental insurance providers in an area, please visit: http://medicaresupplementalinsurancecomparison.net/ About medicaresupplementalinsurancecomparison.net Medicaresupplementalinsurancecomparison.net was created in December of 2012 to help shoppers get the best rates for Medicare supplemental insurance. The website utilizes the absolute latest in price quote technology, and has already received rave reviews from the industry.
Source: sbwire.com

Medicare Supplement Plan F

At first glance this doesn’t make any sense at all since I just told you that it was more expensive on a monthly basis, but when you break down what it covers and the risk involved the Medicare supplement plan f will save you money in the long run.  With the coverage gaps left by Medicare Part A and Part B you can choose any of the ten Medicare supplement plans.  The problem is that each plan covers a different amount or combination of those coverage gaps.  So if you choose plan A you are still open to extra costs from a need for skilled nursing care, the Medicare part A deductible of $1,156, the Medicare part B deductible of $140 annually, any foreign travel expenses, and an charges that fall under Medicare Part B that are above the Medicare approved amount.  In this example if you went into your doctor’s office he would charge you $140 before any of your coverage comes into play.  If that same doctor decided you need to be admitted to the hospital you would then owe the $1,156 for being admitted.  After that you would be subject to additional charges if they moved you to a skilled nursing facility.  Just one quick incident can add up fast and instead of worrying about all this you can moderate your life by just getting a Medicare supplement plan F.
Source: dzida.org

Exclusive Medicare Supplement Leads

Speaking of Medicare supplement leads, let’s just take a moment to mention exclusive Medicare supplement leads. Maybe you have already heard about exclusive Medicare supplement leads, and not in a good way. Perhaps a colleague told you about the time they got ripped off by some company that said their leads were exclusive, but really sold them to at least seven other agents. Those are NOT exclusive Medicare supplement leads. But YES, there IS such a thing as exclusive leads. You just have to know where to find them. Shop around for a company that knows what it is doing, check out their programs, and ask lots of questions, after all, it’s your money. If you don’t get something they are telling you, then keep asking even more questions, until you understand how their lead system works and what the differences are between regular leads and the exclusive ones. In other words, you want to buy your leads from a company that when it says “exclusive” leads, they MEAN exclusive to ONLY you.
Source: benepath.net

Medicare Supplement Plans

Medicare coverage has become restricted. Those who are just beginning, or have already reached their Golden years, are more susceptible illness.  To benefit from sickness benefits with ample coverage, a Medicare Supplement is a must. To find the right Medicare Supplement plan for you, medicarequotefinder.com is the way to go.  Search for the Medicare supplement that will complement your already existing Medicare coverage. Sometimes Medicare Supplements can be difficult to understand.  There are many different plans with many different types of coverage, and occasionally you get lost when all you want is to find the Medicare Supplement that you know will work best for you. Medicarequotefinder.com doesn’t want you to feel lost in the maze of Supplement plans. They make it easy to maneuver through their site to find what you need.
Source: medicarequotefinderblog.com

Medigap: Sacramento, Placer Medicare Supplement Rates

Independent agent for health and life insurance in northern California. CA LIC. 0H12644. Focusing on families, individuals, self employed and small business. Representing several insurance carriers including Medicare Advantage and Part D Plans. Life insurance, final expence and funeral trusts. My pledge to my clients: 1. I respect your time and decisions. 2. I will not try to sell you something you do not want or need. 3. I will not call you after 5pm unless you ask me to.
Source: insuremekevin.com

Florida Medicare Part D Plans

Anyone who require for this medical facility can opt for this service in any case if he or she is with limited source of income. Those who do not earn much have facility of getting extra help for various services that included in medication part D plan. $4,000 is almost amount that you will get as an extra help from these medication plan. Monthly premium and it can also be your prescription payment for which you will get all help. This can act as big saving for those who do not earn much. So make sure that are you clearing criteria of getting that much help.
Source: medicare-supplement-advisor.org

Anthem Blue Cross Blue Shield Medicare Supplement Plans Are Affordable…

Based in beautiful Jackson Hole, Wyoming, we currently market health insurance in 18 different states from our website IndividualHealth.com. I have worked in the domestic and international markets for most of my adult life. Recently we launched a newly revamped website www.tetonmarketing.com which has a primary focus on music and Native American Flutes and hand crafted items made in Wyoming. Check it out! I want the Insurance Simplified Blog to be a place you can visit from time to time and read about real world issues that individuals and families face daily. Our parent website IndividualHealth.com we like to think of as a virtual brochure. But with the blog I want to talk about the topics behind the brochure. Also check out our blog www.JacksonHoleTim.com which is “All Things Wyoming, Everything Jackson Hole” . If you love the Yellowstone basin this is blog for you! Then when you are ready check out our new Social Network site Jacksonholetim.ning.com – this is a place you can connect with other who visit and live in Wyoming. And finally we have just launched another new blog. Jackson Hole Tim (www.jacksonholetim.com) is a new place to visit that talks about “All things Wyoming, Everything Jackson Hole”. I hope you find these blog helpful.
Source: wordpress.com

Compare Quotes on Medicare Supplement Insurance

Every single program, Prograde supplements A by way of L, has a various set of rewards. Every insurance coverage company decides for itself which of the A by means of L policies it desires to sell. An insurance coverage company must, nonetheless, sell plan A if it sells any other Medicare supplement insurance plan. The rewards in plans A by way of L differ, but they are the same for any insurance coverage business. That is, plan A has a distinct set of advantages from strategy B, but strategy A has the very same benefits no matter who sells it. However, diverse insurance companies can charge various premiums. So, although strategy A has the exact same positive aspects no matter who sells it, distinct insurance businesses can charge different premiums for a plan A policy.
Source: trevorchan.org

'Old' Myself, and None Too Pleased

Posted by:  :  Category: Medicare

What's In My Bag... by Amy DiannaWhen my friends and I go out now, we talk about cataracts, basal cell carcinoma, joint replacements, lumpectomies, the difference between forgetting your keys and forgetting what keys are for. It’s an “organ recital,” as my mother used to say. I work for myself, but some days my job is to go to the doctor, despite a blessedly short list of maladies. I’ve forgotten how people with 9-to-5 jobs do what’s expected of them, keep all their body parts in working order and also go to the dry-cleaner or out to see a movie.
Source: nytimes.com

Video: The Medicare Common Access Card Explained

Are you ready for 2013? 4 questions to ask yourself

Don’t forget, if you have Medicare Part B and are in Original Medicare, you’ll have to meet your deductible before your Medicare coverage pays for services and supplies. Next year, the Medicare Part B deductible will be $147. Make sure to plan your health care budget to account for the increased cost of doctor visits for the time that it will take to cover your deductible.
Source: medicare.gov

New Medicare Scam Targets Seniors

The Better Business Bureau has a few tips incase scammers come after you.  First, do not give out personal information to anyone, ever.  Second, Medicare does not make phone calls regarding new cards, nor will they ask for sensitive financial information.  Lastly, if you suspect anything suspicious, just hang-up.
Source: klkntv.com

In Your Corner: Medicare card scam

AARP, Elderly, in your corner, kfor, medicare card scam, medicare number, medicare open enrollment, oklahoma insurance department, oklahoma state attorney general, scam artists, Seniors, social security card
Source: kfor.com

Medicare card scam scaring information from recipients

Tips from a study at USC (http://n.pr/UKyFOT). • Compare reviews not only within a site, but across different websites. • Reviews by people who are verified by the site are more trustworthy than reviews by anonymous reviewers — especially when it comes to negative reviews. • Read reviews less for whether they give a hotel or a restaurant one star or five stars, but more for the specific information they give about the experience. • Reviews are very useful for information that experts or merchants might not think to provide — how late a swimming pool stays open could be useful if you are traveling with a family. • Focus on aggregates, not outliers. You can’t trust a handful of bad reviews or glowing reviews, but trends are much harder to fake.
Source: wordpress.com

How to Prevent Medicare Card Identity Theft

Note: You’ll notice that your Medicare ID has one or two additional letters or numbers following the digits of the SSN. These identify what kind of beneficiary you are, according to the Social Security Administration. For example, the letter T mainly indicates that you are entitled to Medicare, but are not yet filed for Social Security retirement benefits; whereas W1 indicates that you are a widower who is eligible for Medicare through disability. For the purposes of your photocopy, it doesn’t matter whether you delete these final letters (or letter-number combinations) or leave them in. Also of interest: You can help fight health care fraud. 
Source: aarp.org

Phone Scams Target Senior Citizens

During the first incident, on Dec. 7, someone called an elderly woman and claimed to be her grandson. He said that he was arrested in a South American country and needed money to post bail. She also spoke with another man who claimed to be a U.S. Embassy official. The victim wired a large amount of money to another person in the country and told them her social security number. 
Source: patch.com

Medicare card ID protections overdue

The Defense Department launched a strategy to remove Social Security numbers from identification cards issued to service members, their families and retirees in April 2011. Veterans Affairs has also stopped issuing ID cards and health authorization cards that show the veteran’s Social Security number. When asked by Johnson why the Medicare agency “can’t follow in the footsteps of DOD and VA,” Trenkle said the organizations are set up differently and conduct different operations.
Source: seattletimes.com

Medicare Seeks More Time To Estimate Cost Of Fixing Card Security Issues

CQ HealthBeat: Cost Estimates For Removing Numbers From Medicare Cards Expected In 6 Months A Medicare official agreed to give Congress new cost estimates in six months for a proposal to remove Social Security numbers from beneficiaries’ Medicare cards. Lawmakers of both parties at a House Ways and Means joint subcommittee hearing Wednesday agreed that displaying the full number on Medicare cards puts seniors at risk for identity theft. Beneficiaries are instructed to always have their cards on them, but that makes the sensitive number easy for someone else to obtain. Despite congressional pressure, lawmakers said, the Centers for Medicare & Medicaid Services has not come up with a plan for removing the Social Security numbers (Ethridge, 8/1).
Source: kaiserhealthnews.org

Phone scam targets Medicare users

Consumers have reported a cold caller tells them to expect a new Medicare card in January. But before getting the new card, you have to verify your social security number or supply a bank account number.
Source: wmbfnews.com

Durbin: White House Won't Increase Medicare Age

Posted by:  :  Category: Medicare

WASHINGTON (AP) — One of President Barack Obama’s top Senate allies says he’s been assured by the White House that the president won’t yield to GOP demands to increase the eligibility age for Medicare.
Source: realclearpolitics.com

Video: Inova LifeChoice Portable Oxygen Concentrator Featured on Good Morning Texas

Daily Kos: Open thread for night owls: Raising Medicare eligibility age would hurt minorities most

un-Constitutional, since illness and injury are not age-dependent. Separating populations by age and income is little more than a sop to segregationist sentiments — sentiments which, in turn, merely satisfy an ideological commitment to hierarchy as a fundamental principle of society. Ranking humans in order to give some more or less authority over others is not natural. If humans are equal, admittedly an ideological commitment, but one that is enshrined in our organizing document, then hierarchy is in basic conflict. Insisting on it merely serves to undermine our democracy. Of course, we have a long history of not living up to our aspirations. But, that’s what moving forward is about. If we are going to make progress, then irrelevant distinctions have to be removed. Medicare should be an option for all, especially now that all income earners are paying into it. Money, btw, is a social utility. People who use it incur some obligations for our communal certification that their IOUs are good. If some people get along with handshakes, more power to them. We won’t expect them to pay in.
Source: dailykos.com

Raised Medicare Eligibility Age, and Other Links

American Medical Association cancer CBO consumer driven health care diabetes doctors drugs electronic medical records email emergency room EMR ER exercise FDA genetics Health Care Access Health Care Costs health care quality health insurance health IT health policy Health Reform Health Savings Accounts heart disease hospital HSA insurance life expectancy Massachusetts Medicaid Medicare medicare advantage NHS ObamaCare obesity pay for performance public option SCHIP seniors socialized health care Social Security stimulus tax unemployment Uninsured
Source: ncpa.org

Daily Kos: Are Democrats abandoning raising the Medicare eligibility age?

Meteor Blades, skybluewater, SME in Seattle, bink, Renee, Angie in WA State, cslewis, Sylv, chuck utzman, Irfo, hester, slinkerwink, Gooserock, PeterHug, Andrew C White, eeff, willyr, TX Unmuzzled, Duncan Idaho, jancw, expatjourno, eyeswideopen, bronte17, cyberKosFan, Einsteinia, susakinovember, whenwego, pedrito, Nate Roberts, Eddie C, revsue, psnyder, figbash, 2laneIA, defluxion10, RebeccaG, grrr, lcrp, inclusiveheart, ybruti, lonespark, Wife of Bath, Sybil Liberty, Skennet Boch, drofx, radarlady, 3goldens, ichibon, irate, sc kitty, Alice Venturi, wallys son, Flint, dewtx, Dobber, Laurence Lewis, ratzo, bleeding blue, Sun Tzu, skyounkin, markdd, Ozzie, spunhard, xaxnar, Jim R, splashoil, Jim P, begone, Born in NOLA, velaski, Patriot Daily News Clearinghouse, vigilant meerkat, Kimball Cross, rl en france, martyc35, kestrel9000, DarkestHour, triv33, twigg, real world chick, el cid, sceptical observer, Timothy J, Clive all hat no horse Rodeo, bstotts, ms badger, sea note, BentLiberal, ammasdarling, Tamar, One Pissed Off Liberal, phonegery, fabucat, Habitat Vic, tgypsy, puakev, beth meacham, dclawyer06, deepeco, jedennis, leonard145b, madgranny, trueblueliberal, JDWolverton, MKinTN, CroneWit, mconvente, TruthFreedomKindness, also mom of 5, HappyinNM, wayoutinthestix, zerone, prettyobvious, Involuntary Exile, elwior, treesrock, KJG52, jamess, Therapy, Lujane, tofumagoo, petulans, venger, Tonga 23, JamieG from Md, Nica24, Mike Taylor, maggiejean, prettygirlxoxoxo, Rhysling, cybrestrike, J M F, Throw The Bums Out, Scott Wooledge, Alex Budarin, maryabein, Zotz, mkor7, papahaha, kevinpdx, sfarkash, Lacy LaPlante, emptythreatsfarm, FogCityJohn, flitedocnm, Crabby Abbey, Progressive Pen, Polly Syllabic, sunny skies, ATFILLINOIS, melpomene1, gulfgal98, Lady Libertine, ItsSimpleSimon, Puddytat, Egalitare, sharonsz, addisnana, Betty Pinson, ericlewis0, cocinero, Oh Mary Oh, fiercefilms, stevenaxelrod, Onomastic, mama jo, Liberal Capitalist, Mr MadAsHell, BlueJessamine, OhioNatureMom, smiley7, marleycat, thomask, Wolf10, whaddaya, ratcityreprobate, stlsophos, Willa Rogers, Mentatmark, SouthernLiberalinMD, allergywoman, SycamoreRich, wolf advocate, Cordyc, anodnhajo, SparkyGump, cwsmoke, pistolSO, Siri, Citizenpower, IndieGuy, rustypatina, S F Hippie, effervescent, Trotskyrepublican, JGibson, congenitalefty, Mr Robert, BobSoperJr, geojumper, radical simplicity, MartyM, pittie70, Vote4Obamain2012, avsp, marty marty, dotdash2u, George3, wasatch, Marjmar, fauve, Sue B, simple serf, Illinois IRV, jbob, Linda1961, Panama Pete, goodpractice, The Hamlet, alice kleeman, Jollie Ollie Orange, marcr22, chicklet, pragmaticidealist, MBishop1, Catkin, Chas 981
Source: dailykos.com

Raising Medicare age would hurt seniors and the economy

The much-touted Republican plan to raise the eligibility age of Medicare would raise health care costs for seniors, hurt the overall economy, and put increasing pressure on older Americans, a study by the Kaiser Family Foundation found. “This is a policy change that seems straightforward, but has surprising ripple effects,” Tricia Neuman, Medicare specialist with Kaiser, said. “It’s a simple thing to describe … but I don’t think people have thought through the indirect effects.” The idea of raising Medicare’s eligibility age became a national demand of Republicans after House Budget Chair and vice-presidential candidate Paul Ryan put forward his budget, which called for massive cuts to Medicare, Social Security, Medicaid and other federal programs that help poor and working Americans, while pushing continued huge tax cuts for the wealthy. Among the indirect cost shifts the Kaiser study identified are the following; * Higher Medicare premiums for those on Medicare because younger (and healthier) 65- and 66-year-olds would be kept out of the program, raising Medicare’s insurance costs.  Kaiser said the cost increases for seniors could top three percent due to this change. * An increase in costs for companies providing health care to their workers due to older workers staying on company health care plans instead of going onto Medicare at that age. * Higher premiums for those on private insurance programs across the board as older, and less healthy, workers are forced to stay with private insurance rather than moving onto Medicare, as they now do. * Much higher out-of-pocket expenses for more than two-thirds of older adults, as they are forced to wait two years longer to be Medicare-eligible. * Kaiser and the nonpartisan Congressional Budget Office (CBO) projected a huge increase in uninsured Americans if Medicare eligibility is raised by two years. Texas and other states where Republican administrations have said they will refuse the federal increase in Medicaid under the Affordable Care Act are expected to be particularly hard hit. Republicans, led by House Speaker John Boehner of Ohio, continue, even after suffering a historic defeat in the recent elections, to make the change in Medicare eligibility a centerpiece in their campaign to slash federal spending for poor and working Americans while keeping major tax cuts for the wealthy. While President Obama is taking a tougher post-election position in budget talks, some Democrats appear ready to accept raising the Medicare eligibility age. Steny Hoyer, leading Democrat from Maryland, said last week that the Medicare eligibility shift is “clearly on the table.” The AFL-CIO, AARP, Alliance for Retired Americans and other organizations representing working and retired Americans are working hard at mobilizing their grassroots base, demanding “No cuts to Medicare, Medicaid, and Social Security – have the wealthy pay their fair share.” “These vital programs have not caused the deficit,” ARA President Barbara Easterling said in a recent public letter. “Instead, reckless tax cuts and loopholes for the wealthy and greedy Wall Street behavior have. Make those who caused the deficit pay for it.” Tim Burga, president of the Ohio AFL-CIO, in a radio interview last week, compared the so-called “fiscal cliff” to the Mayan Cclendar, which some alarmists have stated sets this year as the “end of the world.”   “I think we’ll be here the day after both of these phony, made up, so-called ‘crises’,” he said. ” The point is that we can’t let self-promoting corporate snake oil salesmen stampede us off of a real cliff, destroying real programs that really help real people and our real economy.”
Source: peoplesworld.org

AARP: Don’t raise the eligibility age for Medicare

AARP is a nonprofit, nonpartisan organization, with a membership of more than 37 million, that helps people 50+ have independence, choice and control in ways that are beneficial to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, the definitive voice for Americans 50+ and the world’s largest-circulation magazine; AARP Bulletin, the go-to news source for the 50+ audience; AARP VIVA, a bilingual lifestyle multimedia platform addressing the interests and needs of Hispanic Americans; and national television and radio programming including My Generation and Inside E Street. The AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. AARP has staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Learn more at www.aarp.org.
Source: aarp.org

Owner of Louisiana Health Care Company Convicted in Texas Medicare Fraud

Msiakii used Joy Supply’s Medicare provider number to submit claims to Medicare for DME, including orthotic devices, that was medically unnecessary and, in some cases, never provided. Many of the orthotic devices were components of “arthritis kits” and purported to be for the treatment of arthritis-related conditions; however, the devices were neither medically necessary nor appropriate for such conditions. The arthritis kit generally contained a number of orthotic devices including braces for both sides of the body and related accessories such as heat pads.
Source: batonrougetoday.com

Texas Medicare Advantage Disenrollment : Learn Your Options

If saving money is a goal, you may want to consider a Medicare Supplement Plan. In Texas, there are several different plans to choose from, all with different combinations of benefits and coverage options.  High deductible plan F may be a good solution for reducing out-of-pocket expenses and the monthly cost may be significantly lower than you might expect. With great benefits, no network restrictions and lower costs, a Medicare Supplement plan may be a good alternative to your Texas Medicare Advantage plan.  Remember, if you choose to disenroll in your Medicare Advantage plan, you will still need to qualify for a Medicare supplement plan and you will be enrolled in Original Medicare.
Source: texasmedicarehealth.com

Grand Prairie Reporter: Texas General Hospital Receives Medicare Certification

Cherie Newman also reported, “This would not have been possible without the passion of Dr. Hashmi, Suleman Hashmi, management team and its employees.” She stated, “It was a daily challenge, with being told what we were doing could not be done, but Grand Prairie now has not only has the highest quality, most luxurious hospital in the metroplex, but where you will receive the most passionate patient care in the metroplex.”
Source: grandprairiereporter.com

Medicare Silver Bullets: What’s The Best Way To Control Costs?

Posted by:  :  Category: Medicare

Medicare for All by juhansoninIf I could make only one change, it would be a massive reform of Medicare’s payment policies. Right now, Medicare payment policies drive overuse, waste, inappropriate and sometimes harmful use of services. There should be a number of changes, such as paying in ways that encourage the use of team-based care, telephone, group and e-visits, more flexibility to allow nurses and other health professionals to operate at “the top of their licenses” with physician oversight and in the most quality and cost-effective ways. The more we can bundle payments to reward improved health (not just health care), and allow providers to self-organize to deliver the greatest benefits for patients and value or payers, the better off we will all be. The most successful providers tend to be integrated delivery systems. Although we will never have enough such systems around the whole country, we can develop and support as many of these as possible and also have payment models that foster virtual integrated delivery systems and reward the best performers, that is, the ones that provide the safest care in the most efficient manner.
Source: kaiserhealthnews.org

Video: Centers for Medicare & Medicaid Services’ (CMS) Hospital Acquired Conditions

Preventive & screening services

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Source: medicare.gov

ICYMI: Health Affairs Article: Medicare Advantage Provides Higher

A recent article in the latest edition of Health Affairs provides further evidence that Medicare Advantage plans are delivering higher-quality care to seniors and people with disabilities than the fee-for-service (FFS) part of Medicare.  Data from the article show that Medicare Advantage beneficiaries utilize some health care services, such as the emergency department and ambulatory surgery or procedures, at a rate 20-30 percent lower than those in FFS Medicare.  This data suggests that Medicare Advantage enrollees “might use fewer services and be experiencing more appropriate use of services than enrollees in traditional Medicare.”
Source: ahipcoverage.com

Chronic Conditions No Longer Barrier to Medicare Services

In fairness to Medicare providers, I suspect that many denials of coverage were an over zealous response to the Federal governments continued efforts to combat Medicare fraud and abuse. Training guidelines for nursing home administrators and physical therapists are replete with warnings about providing unneccessary services (i.e. Medicare abuse). Also, although the Medicare manual provisions did not include an “improvement standard” they were sufficiently vague regarding services for those with chronic conditions that not only providers, but also administrative law judges found the subject confusing. Additionally, Medicare providers often assumed (falsely) that if they erred, the patient would appeal the denial of coverage. In practice, the mechanics of appealing the denial of coverage often seemed daunting for many older adults who perceived the effort to be an exercise in futility.
Source: chicagonow.com

Many Practices Would Cut Medicare Services Without ‘Doc Fix’

Another practice shift I see many specialists and generalists engaging in (as a cash only pracatice) is dermatology based therapies, i.e. laser therapy, Levulox therapy etc. It appears to be working as even a locBoard Certified pediatrician specializing in pediatric anesthesia and infectious diseases has terminated those practices in favor of the cash pay dermatology patient. The same with a Board Certified Internist/Medicare based hospital intensivist. Laser manufacaturers strike all sorts of deals to lure these frustrated and highly needed docs into the cash and carry “zap your wrinkles” business. With a long term equipment lease and minimally educated technicians, the business model provides a low practice cost, no insurance/government billing, no A/R or bad debt, no more “less than cost” negotiated managed care rates and no long hours and on-call. While tragic in nature and contrary to those with an initial desire to help mankind, the current state of affairs now gives us this.
Source: californiahealthline.org

Medicare Advantage Outperforms Medicare

We found that utilization rates in some major categories, including emergency departments and ambulatory surgery or procedures, generally were 20-30 percent lower in Medicare Advantage HMOs in all years. Medicare Advantage HMO enrollees initially had lower rates of ambulatory visits and hospitalizations, although these rates converged by 2008; they also received about 10 percent fewer hip or knee replacements. In contrast, HMO enrollees underwent more coronary bypass surgery than patients in traditional Medicare. These findings suggest that overall, Medicare Advantage HMO enrollees might use fewer services and be experiencing more appropriate use of services than enrollees in traditional Medicare.
Source: ncpa.org

Saving Medicare Through Premium Support

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Source: heritage.org