Access to dental care declining in Colorado

Posted by:  :  Category: Medicare

In both rural and urban areas, the Colorado Health Access Survey found that insufficient numbers of dental providers participate in the Medicaid program, so despite an increase in the number of children who had dental insurance, fewer actually visited dental providers. An additional 66,300 children had dental insurance in 2011 compared to 2009.
Source: healthpolicysolutions.org

Video: Boston: Medicare Fraud Summit Providers Panel

Cuts to California Medicaid could hurt reform, providers say

Chris Perrone, a deputy director at the California HealthCare Foundation, a not-for-profit health policy group, said California already has very low payment rates compared to other states, and some findings suggest that access is already poor. One study found that California reimburses primary care physicians an average of 53% of Medicare, the federal healthcare program for seniors, he said. According to the state Department of Health Care Services, Medi-Cal pays $24 for a 15-minute visit to the doctor’s office. By comparison, Medicare would pay roughly $70. Some Democratic lawmakers want the state to rescind the cuts approved last year. At the time it was passed, AB 97 was projected to save $660 million, with half the savings going to the state’s general fund. “We’re now in a much different environment than we were when we first made those cuts, so given the opportunity, I would like to see those restored,” said Sen. Ed Hernandez, a Democrat from Baldwin Park and chair of the Senate Health Committee. The federal healthcare law seeks to increase health coverage by 2014 by creating new online insurance markets for individuals and small businesses to shop for subsidized private coverage, and by expanding Medicaid for low-income people. Medicaid is known as Medi-Cal in California and currently serves 7.7 million adults and children. Gov. Jerry Brown has not said whether California will commit to fully expanding its Medi-Cal program to take advantage of federal funding. Under an expansion, Medi-Cal would cover people up to 138 percent of the federal poverty line, or about $15,400 for an individual. It’s estimated such a move would add between 1 million and 1.4 million people to Medi-Cal. The state is also in the process of moving 900,000 kids from the children’s health insurance program known as Healthy Families to Medi-Cal. “The court decision does not change the state’s commitment to ensure access to healthcare for Medi-Cal members in a manner that fully complies with federal and state law,” said Norman Williams, a spokesman for the state Department of Health Care Services. More than 400 hospitals and about 130,000 doctors, pharmacists, dentists, and other health care providers participate in the Medi-Cal program. However, the state doesn’t track whether some of them have stopped accepting new Medi-Cal patients or limit the number of patients they take. “If you’re going to set payment standards for pharmacies and for the other providers which are below their cost, and they won’t provide services, then all those millions of people coming into Obamacare in California are going to get third-world medicine,” said Lynn S. Carman, an attorney for a group of pharmacies. Carman said his group intends to file an appeal next week seeking to be heard by the full court, not just the three-member panel in the 9th U.S. Circuit Court of Appeals that ruled Thursday. Molly Weedn, a spokeswoman for the California Medical Association, which represents 35,000 doctors, said it’s expected that the 10% cut won’t take effect while health providers pursue their legal challenge. But Brown’s finance officials have indicated the state expects to see additional savings by having the cut applied retroactively to June 2011. The doctors group warned that if the cut is upheld, many physicians will have little option but to stop taking qualified patients because the reimbursements do not meet the cost of overhead and supplies to treat them. Faced with multibillion budget deficits in recent years, the state Legislature already approved a series of Medi-Cal benefits cuts, some of which are still awaiting federal approval. For example, the state has cut dental care for adults and weeded out services such as podiatry, psychiatry and optometry. Health reform does bring a glimmer of hope to California’s low reimbursement rates. Primary care providers are expected to receive a temporary two-year payment boost under the federal health care law to match Medicare rates. But California will only get the boost if it maintains its current rates, said Anthony Wright, executive director of Health Access California, a group that lobbies for healthcare for the poor.
Source: modernhealthcare.com

OIG Report Poses Potential Problems For Medicare Providers

According to the report, providers (physicians, suppliers, hospitals, etc.) filed 85% of all Medicare appeals in 2010; beneficiaries accounted for 11%; and state Medicaid agencies accounted for the remaining 3%.  Furthermore, a small number of providers accounted for the majority of appeals.   For example, one provider appealed over 1,000 claims, whereas the average provider appealed 6 claims. Additionally, ALJs reversed 56% of all prior-level decisions at appeal, in favor of appellants.  Reversals were highest for Part A providers – 62% (hospital appeal reversals were 72%).  Reversals for Part B providers were 59%; DMEPOS suppliers were 53%; Part C providers were 18%; and Part D providers were 19%.
Source: dmagazine.com

State Roundup: Report Finds Racial Gap in Colo. Dental Coverage; Health Cuts Part Of Conn. Budget Plan

CT Mirror: Malloy Defends His Plan To Collect More Revenue From Businesses Gov. Dannel P. Malloy defended his plan Monday to seek an extra $22 million in revenue from businesses and power plants to help close the current budget deficit, arguing this doesn’t break his pledge not to raise taxes. … Though details were limited, the “road map” — as referred to by the administration — called for $220 million in spending cuts and $22.6 million in new revenue. … Malloy also acknowledged he could face a tough road with his fellow Democrats in the House and Senate majorities. The largest single-reduction proposed Friday involves $122 million aimed at the Department of Social Services, which administers a wide array of health care and other support services for the poor, aged and disabled, most of which are partially supported with federal aid. That proposed $122 million cut is expected to save the state just $63.5 million since the reduction would trigger a $58 million loss in federal assistance (Phaneuf, 12/10).
Source: kaiserhealthnews.org

First Choice News: 9 Health Care Providers Charged With Medicaid Fraud In NC

Raleigh, N.C. – Nine health care providers in five North Carolina counties were charged Tuesday in the state’s continuing crackdown on Medicaid fraud, authorities said. The suspects – a dentist, home health care workers, a mental health care provider and an HIV case manager – are accused in various schemes that netted about $200,000 in fraudulent payments, according to Attorney General Roy Cooper. State Bureau of Investigation agents made the arrests in Wake, Cumberland, Dare, Alleghany and Sampson counties, and authorities said more were expected in the coming weeks. A Medicaid fraud sweep last December resulted in 20 arrests. Seventeen of those suspects have been convicted, and two more are awaiting trial. “We’re continuing our crackdown to deter those who would commit health care fraud,” Cooper said. “Cheating Medicaid is illegal, and our investigators and attorneys are finding violators and making them pay.” The suspects arrested Tuesday include: Gloria Sawyer, HIV case manager, Wake County. Sawyer, owner of I Believe in Miracles, is accused of concealing her felony drug convictions when she applied to be a state Medicaid provider. Authorities said she received more than $100,000 for her services to Medicaid recipients. Sawyer is charged with three counts of obtaining property by false pretenses and two counts of obtaining property by false pretense. Kellie Hickman, home health care aide, Sampson County. Hickman is accused of submitting false timesheets for care she did not provide to two Medicaid recipients while she worked for United Home Care Inc. The state estimates the loss at $2,932.50, which United Home Care Inc. has already reimbursed. Hickman is charged with two counts of medical assistance provider fraud. Dr. Francis Bald, dentist, Dare County. Bald, who owns practices in Nags Head and Elizabeth City, is accused of billing Medicaid for extra dental procedures he didn’t perform or were unnecessary. The state estimates the loss at more than $3,180. Bald is charged with medical assistance provider fraud and obtaining property by false pretenses. James Tillman, mental health provider, Cumberland County. Tillman is accused of falsely representing his educational qualifications in order to provide mental health services. Authorities said he wrongly received more than $74,000 in Medicaid payments for his services. He is charged with three counts of medical assistance provider fraud, three counts of obtaining property by false pretenses and two counts of falsifying documents issued by a postsecondary education institution. Deborah Aroche, Tammy Atkins, Michelle Bottomly, Jessica Cook, Amy Lyall, home health care aides, Alleghany County. The women, who were employees of Families First Home Health Care, are accused of submitted false timesheets for personal care services they did not provided. The state estimates the loss at more than $21,000. They are each charged with medical assistance provider fraud. The Attorney General’s Medicaid Investigation Division nearly doubled in size last year to take on more cases. The team of attorneys, investigators, crime analysts and support staff investigate fraud and abuse of Medicaid benefits by patients, health care providers, pharmaceutical companies, ambulance services and others. Cooper said the division has recouped more than $500 million in the past decade and secured convictions for hundreds of suspects. http://wral.m0bl.net/w/news-top/story/80862565/
Source: blogspot.com

The business behind dental treatment for America’s poorest kids

Kool Smiles does far more crowns than average on children age 8 and under on Medicaid, according to an analysis of 2010 Medicaid data in two states done by CPI and FRONTLINE. In Texas, a child under the age of 9 at Kool Smiles has nearly a 50-50 chance of getting a crown as a restoration to treat problems like cavities, our analysis found. That compares to a one in three chance on average at other providers. And in Virginia, a child 8 or under on Medicaid going to Kool Smiles is twice as likely on average to get crowns than at other dental offices.
Source: publicintegrity.org

What Raising the Medicare Eligibility Age Means

Posted by:  :  Category: Medicare

Raising the eligibility age saves very little money, on the order of a few billion dollars a year. That’s because the 65 and 66-year-olds will have to get insurance somewhere, and many of them are going to get it with the help of the federal government, either through Medicaid or through the insurance exchanges, where they’ll be eligible for subsidies. However, since many Republican-run states are refusing to expand Medicaid in accordance with the Affordable Care Act, lots of seniors who live in those states will just end up uninsured, which will end up leading to plenty of financial misery and more than a few premature deaths. Put this all together, and the Center on Budget and Policy Priorities estimates that while the federal government would save $5.7 billion a year from raising the eligibility age, costs would increase by more than twice in other parts of the system—for the seniors themselves, employers, other enrollees in exchanges who would pay higher premiums, and state governments.
Source: prospect.org

Video: Debunking the “Raise the Medicare Eligibility Age” Argument

Raising Medicare’s Eligibility Age Is Tough Issue For Democrats

The Associated Press/Detroit News: Durbin: White House Won’t Yield On GOP Demands To Increase Medicare Eligibility Age But Illinois Democratic Sen. Dick Durbin said he didn’t get it directly from the president or the White House. However, he is regularly updated on the negotiations. … Durbin’s comments on the Medicare eligibility age were surprising, since top Senate Democrats like Majority Leader Harry Reid of Nevada, have been careful to not preclude the possibility of agreeing to such an increase — perhaps as a late-stage concession in a potential deal between Obama and Boehner (Taylor, 12/13).
Source: kaiserhealthnews.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

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

Listen Up, White House! Take Medicare Eligibility Age Off The Table NOW.

…with the electorate. Act 1. A disaster scenario (created by the WH & Congress) aptly named a ‘fiscal cliff’ MUST be solved by Dec. or we’ll all die. Both parties posture and pose and pretend to hold out for a deal their base supports. Act 2. Media run non-stop stories about the fiscal cliff ‘disaster’. Theme: If no compromise is reached before (artificial) deadline life will end for us all. Good cop, bad cop drama ensues. Act 3.The WH/Congress leak Pete Peterson’s plan to a couple of insiders to float. Outrage from both bases. Media frenzy. WH/Congress wait out the storm. Act 4. Float a slightly more palpable plan with “tweaks”. Media insiders in both parties give it a tepid thumbs up claiming it was the best they could do given the intransigence of the other party. Act 5. Tweaked entitlement “reform” bill gets bipartisan support. Act 6: The public finds out 9 mos later about the poison pills lobbyists for Pete Peterson wrote into the bill. Act 7. Medicare age raised to 67. SS cola ‘tweaked’. Taxes raised 2% on millionaires. Captial Gains tax untouched. Defense cuts- not so much.
Source: crooksandliars.com

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

Medicare Eligibility Age Increase Rejected By Obama Allies

DURBIN: I do believe there should be means testing. and those of us with higher income in retirement should pay more. That could be part of the solution. But when you talk about raising the eligibility age, there’s one key question. what happens to the early retiree? What about that gap in coverage between workplace and Medicare? How will they be covered? I listened to Republicans say we can’t wait to repeal Obamacare, and the insurance exchanges. Well, where does a person turn if they are 65 years of age and the medicare eligibility age is 67? They have two years there where they may not have the best of health. They need accessible, affordable medical insurance during that period.
Source: firedoglake.com

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

OPINION: don't raise the Medicare eligibility age

Proponents of this idea say its time has come because starting in 2014, insurers will no longer be able to deny coverage to anyone because of age or health status, thanks to the Affordable Care Act.  People who can’t get coverage through the workplace will by then be able to shop for it on the state exchanges. But insurers will still be able to charge older people three times as much as younger folks. That would pose afinancial hardship for many seniors. The Kaiser Family Foundation estimates that two-thirds of 65 and 66–year-olds would have to pay at least $2,200 a year more for coverage than they would if they were on Medicare.
Source: publicintegrity.org

The Medicare Eligibility Age: Impacts on Health Behavior and Outcomes

The impact of Medicare eligibility on health outcomes is harder to assess, both because of difficulties in measuring health, and because health is less likely to change discretely in response to insurance coverage. Perhaps surprisingly, we find a statistically significant impact of reaching age 65 on self-reported health, with the largest gains among the education and race groups that experience the largest increases in insurance coverage at age 65. On the other hand, we find no evidence of a discrete change in mortality rates at 65, nor do we see any shift in the rate of growth of mortality after 65. These findings have to interpreted cautiously since it is difficult to identify a plausible comparison group for post-65 mortality rates in the absence of Medicare. Taken as a whole, we believe our findings point to a significant but relatively modest impact of health insurance coverage on health. 
Source: wordpress.com

Avik Roy: Let’s Raise Medicare’s Eligibility Age

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

Medicare Experts Discuss Proposal to Raise Eligibility Age

Juliette Cubanski, associate director for the Program on Medicare Policy at the Kaiser Family Foundation; Gail Wilensky, senior fellow at Project HOPE, and a former Medicare and Medicaid administrator; David Certner, federal policy director at AARP, who previously served as chairman of the ERISA Advisory Council at the Department of Labor; and Paul Dennett, senior vice president for health reform at the American Benefits Council, which represents Fortune 500 companies, and a congressional staff veteran; discussed the costs and benefits of raising the eligibility age.
Source: c-span.org

United Healthcare Acknowledges Payment Shortcomings : AAFP Leader Voices

Posted by:  :  Category: Medicare

Honestly, Dr. Cain, does United think we’ll swallow this load of hooey? They ask us to believe that: “United’s leaders” had no idea that for over two decades they’ve been forcing take-it-or-leave-it sub-Medicare contracts on family physicians (“Gambling in Casablanca? I’m shocked”); that, with all the resources of the country’s largest insurer, they’ve been unable during the past 14 months to identify physicians with those contracts; that they’re “developing solutions” while doing absolutely nothing; and that, icing on the cake, they “recognize the value of primary care” but, in the linked article say they will pay “incentive payments and fees GROWING (my caps) to a range of $0.45 to $3.30 PMPM” for medical home services. Dr. Cain, these are not decent, honorable people. They are con men: their words are lies, and their actions show nothing but contempt for the AAFP and family physicians. Every year, we read of these meetings, and every year things get worse. This approach does not work. Let me repeat: this approach DOES NOT WORK. The AAFP must take a strong adversarial approach if it wants to adaquately represent its members. A couple of suggestions: a major publicity campaign aimed at patients and employers outlining the actions/inactions of United and other insurers; a hot-line so physicians with these contracts can identify themselves, with the AAFP forwarding this information to United (along with the suggestion that, since their “leaders” didn’t know about these contracts, they re-process all claims from the last 10 years!); a blog in which physicians can report their experiences in renegociating their contracts; and, most importantly, the AAFP must walk out of the PCPCC, with a simple, public statement that we can no longer work in any capacity with organizations that are so hostile to our members and so damaging to our speciality. No family physicians, no medical home: this would carry some weight! We must refuse to allow our good name and reputation to be used as cover by these groups. The AAFP HAS to draw a line beyond which they will no longer tolerate this abuse of their membership. Thank you.
Source: aafp.org

Video: Medicare Basic Overview by United Healthcare Medicare Solutions

Authorized to Offer AARP Medicare Solutions

Dear Friends: Our Agency is now Authorized to offer AARP Medicare Solutions through the United Health Care System. This can be a great way to go for some people. AARP also offers a Medigap Policy and the separate PDP Drug Plan. We are having Seminars on these products and others right here in our office at the end of January and beginning of February. People who are signing up for Medicare need good instructions on the whole process and we give great classes on the procedure wihtout pushing anyone to buy our product. Our goal remains to make sure that people are happy with their insurance choices! Please call me at 386-860-0001 X7 for more information. It is truly my pleasure to meet with you at my Seminar or in person. Thanks — and a very Happy New Year to all! Ron Silverman, Agent.
Source: silvermaninsurance.com

UHC ICA Bad Experience in Bay Area, CA

Hello, I wanted to share my experiences with the UHC ICA system. I have been an agent for 10 years, selling LTC & annuities. Maybe this will help other agents considering the same thing and maybe I can acquire more ideas on how to best make more money by adding senior health products. A Sales Manager at UHC under the ICA system advertises on Craig

Applicability of New Medicare Tax on Unearned Income to 404(k) Dividends

Posted by:  :  Category: Medicare

seen but not heard by eyewashdesign: A. GoldenIn recently issued proposed regulations on this new Medicare tax on unearned income, the IRS has provided some additional guidance on whether certain types of dividends are subject to the new tax. Although these regulations do not specifically discuss 404(k) dividends, they do clarify that “substitute dividends” paid in a securities lending transaction will be considered “net investment income” subject to the tax.  The IRS’s clarification on this point is potentially meaningful because 1) like 404(k) dividends, “substitute dividends” are another type of dividend that is not eligible for the lower capital gains tax rate for “qualified dividends,” and 2) “substitute dividends” are reported on a 1099-MISC, which shows that the IRS will consider certain dividends to be subject to the new tax even if they are not reported on a 1099-DIV.  These factors seem to suggest that 404(k) dividends would likewise be considered “net investment income” subject to the new tax, but IRS guidance directly addressing this subject would be welcome.
Source: beyondhealthcarereform.com

Video: AUFC TV ad: Paul Ryan voted to end Medicare, Give the Rich Another Tax Break

Proposed Regulations Issued on Additional Medicare Tax

Tagged as: *Tax Quips, best, Business/Finance, Department of the Treasury, fiscal follies, Free, Government, Healthcare reform in the United States, Income tax in the United States, Internal Revenue Service, IRS News, jokes, Labor, Medicare, Money Funnies, Pay-as-you-earn tax, Political economy, Presidency of Lyndon B. Johnson, Public economics, Social Issues, tax answers, tax blogger, tax humor, Tax Information, tax jokes, tax podcast, tax questions, tax tips, Tax withholding in the United States, tax writer, Taxation in the United States, TaxMama, terrific, top, USD, Withholding taxes
Source: taxmama.com

IRS Releases New Information About Medicare Tax Surcharges

The IRS released a lovely FAQ today about the 0.9% surcharge that applies wages, self-employment earnings and other compensation above $200,000 (single filers) / $250,000 (joint filers). When this surcharge applies to wages, employers are required to withhold it, but the withholding rules are a bit strange. Taxes won’t be withheld until you receive that first dollar in compensation in excess of $200,000; taxes might be withheld even if the surcharge won’t ultimately apply to you because your spouse is not employed; and taxes might not be withheld even if the surcharge will apply to you, because you and your spouse together earn more than the threshold. The FAQ explains these peculiar rules, both from the employee’s and the employer’s perspective.
Source: perkinsaccounting.com

IRS Provides Guidance for the 0.9% Additional Medicare Tax

If the employer over-withheld (see Example 1 above), the employee will be able to apply the excess HI tax as payment against federal income tax liability. If the employer under-withheld (see Example 2 above), the employee will pay the additional amount on their individual income tax return. Employees will not be able to request employers to specifically withhold the additional HI tax. However, the employee may request additional federal withholding by adjusting their Form W-4, Employee’s Withholding Allowance Certificate, or submit estimated tax payments. Self-employed individuals will need to pay the additional HI tax through estimated tax payments.
Source: bkd.com

HANYS Benefit Services: Questions and Answers on the Additional Medicare Tax

If a former employee receives group-term life insurance coverage in excess of $50,000 and the resulting income is in excess of $200,000, how does an employer report Additional Medicare Tax on this? The imputed cost of coverage in excess of $50,000 is subject to social security and Medicare taxes, and to the extent that in combination with other wages it exceeds $200,000, it is also subject to Additional Medicare Tax. When group-term life insurance over $50,000 is provided to an employee (including retirees) after his or her termination, the employee share of social security and Medicare taxes and Additional Medicare Tax on that period of coverage is paid by the former employee with his or her tax return, and is not collected by the employer. An employer should report this income as wages on Form 941, Employer’s Quarterly Federal Tax Return (or the employer’s applicable employment tax return), and make a current period adjustment to reflect any uncollected employee social security, Medicare, or Additional Medicare Tax on group-term life insurance. However, unlike the uncollected portion of the regular (1.45 percent) Medicare tax, an employer may not report the uncollected Additional Medicare Tax in box 12 of Form W-2 with code N.
Source: hanysbenefits.com

farmdocdaily: Farms and the New 2013 Medicare Tax Increases

The total amount of capital gain and depreciation recapture is $365,000 ($300,000 + $50,000 + $15,000). Samantha did not materially participate in the farming activity for 2013. She worked full-time as a stockbroker. In addition to paying capital gains tax on the $300,000 gain on the sale of the farmland, she will also pay the 3.8% Medicare tax on some or all of that capital gain and on the depreciation recapture amount on the assets sold. The total amount of Medicare tax she will pay on the transaction depends upon her income from other sources and how much income she has over the $200,000 threshold for a single filer that applies once her other income and the income from the farm sale are reported. If Samantha has $200,000 or more income from her stockbroker position, the 3.8% Medicare tax will apply to the entire capital gain and depreciation recapture amount. Her total amount of the new Medicare tax will be $13,870 (3.8% X $365,000). If she has under $200,000 of income from other sources, only part of the farm sale transaction (that amount in excess of $200,000 of income) will be subject to the new 3.8% Medicare tax.
Source: illinois.edu

IRS: Discussion of the Additional Medicare Tax

The following questions and answers provide employers and payroll service providers information that will help them as they prepare to implement Additional Medicare Tax which goes into effect in 2013. Additional Medicare Tax applies to individuals’ wages, other compensation, and self-employment income over certain thresholds; employers are responsible for withholding the tax on wages and other compensation in certain circumstances. The IRS has prepared these questions and answers to assist employers and payroll service providers in adapting systems and processes that may be impacted.
Source: investment-fiduciary.com

2013 new Additional Medicare Tax on employees! Are you ready?

If you pay wages in 2013 or later to employees who are subject to Medicare tax (regardless of whether you think you will ever pay any of them over $200,000), you must set up this new payroll tax item. This lets QuickBooks handle tracking, calculating, withholding, and reporting the Additional Medicare Tax appropriately and automatically so you don’t have to worry about if or when to apply it.
Source: advantedgeonline.com

Planning for the New 3.8% Medicare Tax on Unearned Income

Footnotes 1 Health Care and Education Reconciliation Act of 2010, P.L. 111-152. 2 Sec. 1411(d). Sec. 911(a)(1) refers to the exclusion from income of foreign- earned income for citizens or residents of the United States living abroad. Sec. 911(d)(6) refers to the disallowance of any deduction or exclusion from gross income to the extent that such deduction or exclusion is properly allocable to or chargeable against amounts excluded from gross income under Sec. 911(a). 3 Secs. 1411(a)(1)(A) and (B). 4 Secs. 1411(c)(1)(A) and (B). 5 Sec. 1411(c)(2). 6 Sec. 1411(c)(5). 7 Joint Committee on Taxation, Technical Explanation of the Revenue Provisions of the “Reconciliation Act of 2010,” as Amended, in Combination with the “Patient Protection and Affordable Care Act” (JCX-18-10), p. 135 (March 21, 2010). 8 Sec. 1411(c)(1)(iii). 9 Joint Committee on Taxation, Technical Explanation (JCX-18-10), at 135. 10 Secs. 1411(a)(2)(A) and (B). 11 Secs. 1411(e)(1) and (2). 12 Joint Committee on Taxation, Technical Explanation (JCX-18-10), at 135. 13 Id. 14 Id. 15 Jobs and Growth Tax Relief Reconciliation Act of 2003, P.L. 108-27. 16 Secs. 469(c)(7)(B)(i) and (ii). 17 Sec. 469(c)(7)(A) (flush language). 18 See, e.g., David E. Watson PC, 714 F. Supp. 2d 954 (S.D. Iowa 2010), in which the IRS successfully litigated unreasonably low compensation for the shareholder of an S corporation. 19 Sec. 1411(c)(6). 20 Sec. 1411(c)(3) and reference to Sec. 469(e)(1)(B). 21 Sec. 1411(c)(4)(A). 22 Id. 23 The example under Temp. Regs. Sec. 1.469-1T(e)(6)(iii) specifically states that interest, dividends, and capital gains derived from a partnership that is a trader of securities are not passive income. 24 Sec. 1411(c)(2)(B). 25 Sec. 469(c)(3)(A) and Temp. Regs. Sec. 1.469-1T(e)(4)(i).
Source: independencecfp.com

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

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

Anthem high Deductible F plan Connecticut

Posted by:  :  Category: Medicare

DAMN!! -- I THINK WE'RE F*%KED by SS&SSAARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 Anthem Anthem High F plan Anthem Medicare Anthem Medigap Anthem Supplement Coverage Gap Donut Hole Drug Help High Deductible F supplement LIS Connecticut Medicare Medicare Advantage Medicare Complete Medicare Complete connecticut Medicare Connecticut Medicare for Dummies Medicare Guide Medicare Introduction Medicare part B Medicare part D Medicare prescription drug plans Medicare Rx Medicare Saving program Medicare Supplement Medicare Supplement Connecticut Medigap Medigap rates 2013 Medigap rates NY 2013 MSP Connecticut Part D Part D Drug help Rx Help Rx help connecticut united healthcare United Healthcare AARP United Medicare complete 2013
Source: croweandassociates.com

Video: Medicare Supplement AARP Plan F Select is A Good Option

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

What is the Cadillac Medicare Advantage plan

A plan’s network of providers: People often think Medicare Advantage plans are only offered as part of healthcare management organizations (HMOs), but many are also preferred provider organizations (PPOs). With HMOs and PPOs, insurance companies typically have a list doctors, specialists and hospitals that are preferred so when you go to those providers, you presumably pay a lower price for care. Either that, or the insurer covers more of your out of pocket costs, or both. Your costs typically differ if you get “in network” care versus “out of network” care. You’re more likely to think of a plan that includes your doctors, specialists and hospitals at a lower price to be a Cadillac plan.
Source: ehealthinsurance.com

New Medicare Tax Goes Into Effect January 2013: Year

Deferred compensation is not generally subject to Medicare until it is vested and ascertainable. For defined benefit plans, this means that Medicare tax often is not paid until an employee terminates employment, when the total value of the plan benefit is ascertainable. For defined benefit deferred compensation plans that currently have vested and accrued benefits, the employee can electively pay FICA taxes presently for vested, accrued benefits on an estimated basis. If such early elections are made in 2012, the additional Medicare tax can be avoided for amounts accrued and vested this year. Early FICA inclusion will also exempt the future value of that amount from any additional FICA tax, including the additional .9 percent rate applicable to years after 2012.
Source: jdsupra.com

A Plan F is a Plan F, is a Plan F

   Rates can vary significantly.  In Virginia, as of this writing,( September 17, 2012) a Plan F rate for a 65 year old female can range from a low of $92.13 per month to over $300 per month.  (We are talking identical coverage!) These rates vary due to many factors such as the area in which you live.  For example, a person who lives in one zip code can pay $20/per month less than their neighbor who lives down the road but in a slightly different zip code.  A smoker may pay more with some companies.  Males may have a higher rate with some companies.  Some plans have rates which are guaranteed to increase every year as you get older.  Some plans level off their rates after age 75.  (Unfortunately, all of them can – and do- raise their rates on an across the board basis.)
Source: pqwic.com

High Deductible F Plan For Medicare Supplemental Coverage

The Medicare supplemental insurance market was a pretty staid affair for years (if not decades). You had a standard suite of plans to choose from which from from A to J and all was well with the world. Things have change quite a bit just in the last decade and will undoubtedly change more into the next decade for different reasons. One of the first changes that occured was the release of an F plan with a high deductible. Most Medicare supplement shoppers and agents for that matter were taken back since we were all so use to the relatively rich benefits of traditional medicare supplements that a high deductible F plan approached heresy. Why on Earth would any one want a high deductible on their Medicare supplement plan? That was back in the early days of rapid health care cost inflation which would quickly answer the previous question. The high deductible F Medicare supplement insurance plan would save you money. It’s now firmly established and somewhat popular. Let’s take a closer look at the high deductible F plan to see how it shakes out versus the other Medigap plans including the standard F plan. First, let’s define the deductible on the F plan. The deductible is an amount you will have to pay before getting help in most types of insurance and it holds true here but differs slightly. Usually, you have to pay the whole bill until the deductible is met with traditional health insurance but in the case of a high deductible F plan, Medicare is already paying part of the bill so really the deductible only applies to what Medicare isn’t picking up. What does this mean in practical terms? You will have to pay your Part A (hospital) and Part B (physician) deductibles in full and these amounts go towards the F plan high deductible. These amounts are scheduled to go up annually according to Medicare’s inflation index. You can find the detail at our Medicare current year deductible page. That feels like what we mean with a deductible but it differs quite a bit after that. After the Part A and Part B deductibles are met, you then start paying 20% of the remaining (allowable) charges. This still holds true with the high deductible F plan. Once the Part A and B deductibles are met, you will then pay 20% of the charges until you meet the rest of your F Plan Medicare supplement high deductible. This isn’t that bad. 20% coinsurance is great on the insurance market today. So how do we compare the standard F plan with its high deductible cousin? Simple. They’re exactly identical plans except for the high deductible component we described above. You then look at what the annual deductible amount is and compare it with the annual premium difference between the two plan. In most situations, the deductible will be greater than the premium savings, otherwise…why go with the standard F plan at all. They may however be pretty close. For example, if the deductible is $2000 annually and the premium savings is $1500, you could argue for the high deductible option if you’re in good health (less likely to hit the full deductible especially since the last part of it is at a 20% clip). Keep in mind though that we are making a decision for years if not decades and the probability is that our health care costs will increase as we get older. At some point, you may be hitting the deductible every year and then it swings out of your favor. It may be impossible to change plans at that point due to health. Look at those two numbers (deductible and premium savings) to decide what you feel most comfortable with…possible premium savings versus reduced health care costs risks. That’s how you analyze the F Medicare Supplement plan with high deductible. Dennis Jarvis is a licensed insurance agent concentrating on medicare supplement insurance.

Tufts Medicare Advantage?

Posted by:  :  Category: Medicare

For a company Ive never heard of they sure do have a lot of Med Advantages in your state. Tufts Medicare Preferred HMO Basic $16.00 Tufts Medicare Preferred HMO Basic $0 Tufts Medicare Preferred HMO Basic Rx $38.00 Tufts Medicare Preferred HMO Basic Rx $22.00 Tufts Medicare Preferred HMO Basic Rx Plus $48.00 Tufts Medicare Preferred HMO Basic Rx Plus $32.00 Tufts Medicare Preferred HMO Prime $96.00 Tufts Medicare Preferred HMO Prime $72.00 Tufts Medicare Preferred HMO Prime Rx $118.00 Tufts Medicare Preferred HMO Prime Rx $94.00 Tufts Medicare Preferred HMO Prime Rx Plus $128.00 Tufts Medicare Preferred HMO Prime Rx Plus $104.00 Tufts Medicare Preferred HMO Value $58.00 Tufts Medicare Preferred HMO Value $42.00 Tufts Medicare Preferred HMO Value Rx $80.00 Tufts Medicare Preferred HMO Value Rx $64.00 Tufts Medicare Preferred HMO Value Rx Plus $90.00 Tufts Medicare Preferred HMO Value Rx Plus $74.00 Tufts Medicare Preferred PFFS Basic $50.00 Tufts Medicare Preferred PFFS Basic $45.00 Tufts Medicare Preferred PFFS Basic Rx $72.00 Tufts Medicare Preferred PFFS Basic Rx $67.00 Tufts Medicare Preferred PFFS Basic RxPlus $82.00 Tufts Medicare Preferred PFFS Basic RxPlus $77.00 Tufts Medicare Preferred PFFS Prime $111.00 Tufts Medicare Preferred PFFS Prime $92.00 Tufts Medicare Preferred PFFS Prime Rx $133.00 Tufts Medicare Preferred PFFS Prime Rx $114.00 Tufts Medicare Preferred PFFS Prime RxPlus $143.00 Tufts Medicare Preferred PFFS Prime RxPlus $124.00 Tufts Medicare Preferred PPO $87.00 Tufts Medicare Preferred PPO $82.00 Tufts Medicare Preferred PPO Rx $109.00 Tufts Medicare Preferred PPO Rx $104.00
Source: insurance-forums.net

Video: How it Works – Tufts Medicare Preferred

Social Security and Medicare Forum at Tufts

Christie Hager, representing the HHS Secretary Kathryn Sebelius and by extension the Obama Administration, touted the achievements made by the Administration, saying there was, “Historic good news about Medicare,” adding, “These historic benefits include discounts in prescription drugs, in the donut hole,” and preventative services. “[By] keeping you well before you need more costly and more risky medical care.” Hager also stated that her agency along with the Department of Justice has, “Recovered over 10 billion dollars in four years in fraudulent claims.” This in the last four years.
Source: thesomervillenews.com

Pets Best Health Insurance health insurance companies australia

Business & Insurance. Plan is considered one of the best in the Boston area and offers multiple types of plans for individuals and families. Welcome to Catastrophic Insurance! Everyone knows how important it is to have health insurance, but what about coverage for events such as a bicycle or auto. Health Insurance Plans Accepted by Harvard Vanguard. Harvard Vanguard accepts most insurance plans and most indemnity and Medigap plans. (For Behavioral. Benefit Highlights Plans as of April 2012 (Scroll down for 2011 info) 15 Health Plan salary reports. A free inside look at Tufts Health Plan salaries posted anonymously by employees. Welcome to Tufts Plan Please complete all of the employee sections of the membership application in full. Failure to do so could delay enrollment. Welcome to the Registrars home page for the Public Health and Professional Degree Programs of Tufts University School of Medicine. This section was developed to be. Our mission is to set the standard for outstanding quality health care, service, and value. Our dedication to excellence makes us one of the leading plans in. Dear Human Resources Director: I am writing to express my interest in applying for the position of Research Assistant.
Source: individualmandatehealthcare.com

Executive Office of Elder Affairs

Between January 1 and February 14, you can leave your plan and switch to Original Medicare, but you cannot switch to another Medicare Advantage Plan. Your Original Medicare coverage will begin the first day of the following month. If you drop your Medicare Advantage plan during this period, you will be able to join a Medicare Prescription Drug Plan to add drug coverage. Your prescription drug coverage will begin the first day of the month after your enrollment. You may also add a supplement at this time.
Source: mass.gov

Selected Work : Allianz Life websites

I was initially contracted to redesign their public sites, but took on subsequent projects working in conjunction with the Allianz in-house team including Flash development for interstitial pieces and online video presentation, DVD interface design, and design of a comprehensive e-mail marketing system.
Source: jduerr.com

Nothing found for 2011 06 Why

The Roundtable Commons is a community of independent bloggers and writers. The comments and ideas expressed are solely those of the author, and not necessarily those of the moderators or the larger Commons community.
Source: trcommons.org

Unjustified Repeat Tests Common Among Medicare Patients

Medscape: Medicare Patients Often Receive Unjustified Repeat Tests In an accompanying commentary, Jerome P. Kassirer, MD, from Tufts University School of Medicine, Boston, Massachusetts, and Arnold Milstein, MD, MPH, from Stanford University School of Medicine, Palo Alto, California, write: “After decades of attention to unsustainable growth in health spending and its degradation of worker wages, employer economic vitality, state educational funding, and fiscal integrity, it is discouraging to contemplate the fresh evidence by Welch et al of our failure to curb waste of health care resources”  (Kelly, 11/19).
Source: kaiserhealthnews.org

One extreme to the other, ey? : Medicare.gov

Posted by:  :  Category: Medicare

I cannot imagine my father back in the day walking into the SS office in a walker with a breathing machine on and those people thinking he was faking?  OMG!!!  He was so broken then and the stupid meds he was on made a rash and his skin was peeling and his hair falling out and the pain was sooooooooooo obvious and on top of that, he was fighting for my mother as well.  On one of those days when they were at the SS office someone broke into their place and stole all their meds and there was a big ol bunch of meds.  My dad was so broken after that.  MY parents were so betrayed by everyone (the system) back then.    (We did have a pharmacist that helped us out when he could……  he was a good family friend that me, my brother and my uncle went camping with a couple times………  I must say that he was very helpful but he had to do things off the books to help at all.  If I remember correctly he got daddy’s meds replaced, the ones he desperately needed anyways and he helped get the meds for my mom as well……  she had phlebitis and the scars from the cancer treatments is what the doctors said were what finally killed her, it wasn’t a return of the cancer but the other stuff used to remove the cancer………  colbalt treatments.)  The treatments she got were experimental and done at Doctors Hospital in San Francisco….  I don’t think the cobalt were popular back then.  I don’t remember much so maybe i’ll do search on those treatments as I haven’t heard that term used much in a lot of years.  I was only 13 when that went on. 
Source: blogspot.com

Video: Two Useful (but frustrating) Websites: MyMedicare.gov and Missouri Case.net

15% Medicare Supplement Rate Increase is Outrageous!!! » Toni Says

Cindy, one Medicare rule that you should be aware of since you are not happy with your rate increase from your current Medicare Supplement company is…if you had a Medicare Supplement policy before you joined a Medicare Advantage Plan for the first time, and you aren’t happy with the Medicare Advantage Plan, you will have special rights to buy a Medicare Supplement policy if you return back to “Original Medicare” within 12 months of first joining a Medicare Advantage plan.  If you had a Medicare Supplement policy before you joined, you may be able to get the same plan back if the company still sells it.  If it isn’t available, you can buy another Medicare Supplement policy. (Please see page 66 of the
Source: tonisays.com

When Can I Get Out of My Medicare Advantage Plan?

First and foremost, you should apply for the supplement plan with either a February 1 or March 1 effective date. Approval on a Medigap policy can take 2-3 weeks to complete underwriting. So it is important to do this well in advance of when you want the plan to start. For example, if you want to make the changeover effective 2/1/13, apply early in January for the supplement (or even during the last couple weeks of December). Once your Medigap plan is approved, you can proceed with returning to Medicare with a Part D plan. The easiest way to do this is to call Medicare (1-800-MEDICARE) and select a Part D plan, while at the same time disenrolling from your Medicare Advantage plan. You cannot have both a Part D plan and a Medicare Advantage plan, so this changeover can be done within the same phone call. Make the changeover effective either 2/1/13 (if doing it in January) or 3/1/13 (if doing it between 2/1 and 2/14).
Source: medicare-supplement.us

Why Wait? Use MyMedicare.gov

Do you balance your checkbook and review the charges on your credit cards, looking for charges you didn’t make? Reviewing your Medicare claims is another way you can protect yourself from fraud. Use MyMedicare.gov to check your claims online – they’re usually available within a day of processing.
Source: medicare.gov

Watchdog Blog Blog Archive

I was impressed when I first enrolled in Medicare how genuinely interested the government official who handled the paperwork was in doing what was in my interests. I had no sense of an adversarial relationship or that the government had an agenda separate from mine. The feeling of confidence that Medicare was on my family’s side was buttressed during every step of my wife’s prolonged illness. Her eventual death was more bearable by the virtually hassle-free experience of dealing with Medicare during her illness.
Source: niemanwatchdog.org

Docudharma:: "Keep Your Hands Off My Medicare"

The popularity for Medicare, Medicaid and Social Security, the three programs that are the major components of the social safety, is overwhelming. According to an ABC News/ Washington Post Poll (pdf) 79% of Americans do not want Medicare cut at all. By a large majority (65%) they would prefer tax hikes on the wealthy than reduction of payments to hospitals and doctors. Meanwhile, the Republicans in the House and Senate, who still think they won in November, are demanding drastic cuts after they campaigned against those very cuts.
Source: docudharma.com

Optomotrist Busted for Medicaid Fraud 

badgercare plus Better Business Bureau charity scams credit card fraud credit card scams election fraud false claims act fraud fraud alert newsletter Frauds healthcare reform identity theft job scams medicaid fraud Medicare medicare fraud medicare overbilling medicare part D medicare reform medicare reimbursement mortgage fraud phishing scams podcasts prevent medicare fraud scams storm chasers storm scams telephone scams Training volunteer voter fraud wisconsin bbb wisconsin check fraud wisconsin child care fraud wisconsin election fraud wisconsin fraud wisconsin head start fraud wisconsin medicaid fraud wisconsin mortgage fraud wisconsin scam wisconsin scams wisconsin smp wisconsin smp training wisconsin unemployment benefits wisconsin unemployment fraud
Source: wisconsinsmp.org

Practical Paralegalism: Use MyMedicare.com to Get Lien Information Fast

Shortly thereafter, I was chirpily advised my place in the queue was 147. Then Medicare played muzak by some Yanni wannabe that sounded like a cat practicing yodeling, followed by creepy Twilight Zone music (the hairs on the back of my neck rose, and I almost bailed on the call at that point, which I think was Medicare’s intent). Occasionally a recorded voice message came on and made me jump in surprise. Midway through the call, I regretted the 36 oz big gulp sweat tea I had with lunch, but figured out it would be completely uncool to take the phone headset with me to the loo.
Source: practicalparalegalism.com

Tricare Help – Can wife, over 65 but ineligible for Medicare, be put on Tricare Prime?

What you need to do is contact your local Social Security Administration office and make them aware that your wife is not eligible for Medicare Part A under either her own work history or yours. As such, she should be eligible to receive a “Notice of Disapproved Claim” from the SSA. Once you have that in hand, take it to your nearest military installation ID Card/DEERS office. DEERS is the Defense Enrollment Eligibility Reporting System, the Defense Department’s eligibility portal for Tricare. The SSA’s “Notice of Disapproved Claim” should be sufficient to allow your wife to retain eligibility for Tricare Prime, Standard and Extra even though she is already past her 65th birthday, once you update your wife’s DEERs registration file and get a new ID card for her.
Source: militarytimes.com

Hartford Hospital gets $420K in Medicare overpayments; Healthcare organizations increase privacy, security budgets;

Posted by:  :  Category: Medicare

The PARTY Is OVER ...item 4.. Today, Mitt Romney Lost the Election (Sep 17, 2012 6:02 PM ET) ...item 5.. James Brown - Get On The Good Foot, Soul Power, Make It Funky Soul Train 1973 ... by marsmet471Brian Harte, M.D., is president of South Pointe Hospital, a 173-bed acute care, community teaching hospital in Warrensville Heights, Ohio, and part of the Cleveland Clinic Health System. He is also the medical director of the medical operations department of business intelligence and former chairman of the department of hospital medicine. He specializes in perioperative care and hospital-based medical illnesses. He is a senior fellow of hospital medicine with the Society of Hospital Medicine.
Source: fiercehealthcare.com

Video: DNC Chair Gets Blitzed By Wolf On False Medicare Attacks

Ohio Health Policy Review: Ohio Medicare

The federal Department of Health and Human Services announced last week that Ohio has been approved to undertake a pilot project to better coordinate care for 114,000 Ohioans who are eligible for both Medicare and Medicaid (Source: "State gets OK to alter Medicare, Medicaid," Columbus Dispatch, Dec. 13, 2012).
Source: healthpolicyreview.org

Tricare Help – If wife gets Medicare early due to disability, does she get TFL at the same time?

20/20/20 age appeal catastrophic cap child born out of wedlock claims continued care cost share death DEERS dental dependent disabled divorce doctor doctors FEHBP handbook health care reform hospital ID card marriage maternity care Medicare military treatment facilities other health insurance outside the U.S. parents Part A Part B pharmacy pre-existing condition pregnancy reserves secondary insurance social security spouse supplements surgery Tricare For Life Tricare Prime Tricare Standard Tricare Young Adult Program VA widow
Source: militarytimes.com

Raising the Medicare Age Is a Uniquely Terrible Idea

Medicare currently is significantly more cost effective than private insurance. Raising the Medicare retirement age would mean shifting many older people from a more cost effective government program to a less efficient private insurance system. This would not just force those near retirement to pay the full cost of their insurance, but since private insurance is a worse bargain these seniors would need to pay even more to get the same level of coverage Medicare would have provided.
Source: firedoglake.com

Oncologist Dr. Meera Sachdeva gets 20 years for Medicare fraud

Response to How is it guaranteed patients will receive appropriate chemo doses when they are on a trial? It is in the way any clinical trials are designed and conducted. There are well established standards, good clinical practices (GCP), quality asurance system, reporting of any devations,violations ,during the conduct of a clinical trial, then there is, monitoring, checks and double checks and reporting. Not only the oncology team supervises what happens to a patient on clinical trial but the study sponsors (Cooperative groups, Industry sponsors, Acedemic institutions, FDA) monitor everything done. So this would be impossible to happen if patient were on a clincal trial.
Source: pathologyblawg.com

Caldwell optometrist gets three years for Medicaid, Medicare fraud

Here’s a news item from the Associated Press:  BOISE, Idaho (AP) — An optometrist from southwest Idaho convicted for defrauding Medicaid and other health care programs has been sentenced to three years in prison. A federal judge on Tuesday also ordered 60-year-old Christopher Card of Caldwell to pay $1 million in restitution and another $100,000 in fines. Card pleaded guilty in a deal with federal prosecutors in August to defrauding health care programs. He is the former owner and care provider at Total Vision, P.A. The plea agreement says that between 1993 and Aug. 31, 2010, Card gave phony diagnoses of glaucoma, colorblindness or other eye diseases so he could bill and be reimbursed by Medicaid, Medicare and other insurance programs for expensive tests and treatments that he never administered. Federal officials say health care fraud nationally costs taxpayers $78 billion annually.
Source: spokesman.com

Medicare Offers More Time for Enrollment due to Hurricane

If you enroll in a new plan, coverage under this plan will begin the first day of the month after you enroll. For example, if you enroll on Jan. 10, your plan coverage will begin Feb. 1. You will be automatically re-enrolled in your current plan if you don’t enroll in a new one for 2013.
Source: allsup.com

Daily Kos: Raising Medicare Age Could Leave As Many As Half A Million Without Insurance

The proposal to raise the Medicare age has a moral dimension that must be exposed.  As many as 500,000 seniors will lose medical insurance if this happens.  Some argue it won’t be bad because Obamacare and Medicaid will pick up those poor seniors (but where are the savings then?).  This ignores that the Supreme Court in upholding Obamacare let the states reject the Medicaid expansions (by ruling unconsititutional the hammer forcing compliance, which was removing all Medicaid funds if the state refused).
Source: dailykos.com

CareFirst BCBS’s Medicare plan gets high ranking from CMS

The ranking is for Medi-CareFirst’s BlueRx standard and enhanced prescription drug plans (Part D), and is an improvement over last year’s 4-star ranking. The CMS Medicare program each year rates all health and prescription drug plans in four categories, with ratings of up to five stars.
Source: ifawebnews.com

Medicaid, Medicare, medical? So confused, help please

I asked my attorney about this and he said if I got ssdi I would be getting medicare but that there is a 2 year wait list which starts when you first apply so your wait time could be very short and he said I would get medical in the meantime. I will also be getting ssi if I win and if you have medical before you get medicare you are then medi-medi and won’t have to have an amount taken out of your social security like others do and that’s because if you get ssi then you are pretty much low income. This happened to my ex-fiance and I personally checked out the whole thing and met with a rep and we found an HMO for him and he doesn’t have anything taken out of his social security. It can be around a hundred dollars so this was good for him.
Source: mdjunction.com

Kaiser Permanente Leads the Nation with Six 5

Posted by:  :  Category: Medicare

About Kaiser Permanente Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.
Source: kp.org

Video: Jed Weissberg, MD, Talks About Medicare Advantage Health Plans and the Special Enrollment Period

Medicare Star Ratings: Consumers Ignore, Industry Debates

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Source: patientexperience.com

 Health Care Insights

This February at The Medicare Congress, we’ll host the first annual Stars Summit,which will bring professionals from around the industry together to help professionals in the field raise their star rating. For more information on the Summit and the rest of the agenda, download the brochure. If you’d like to join us, register and mention code XP1706BLOG and save 15% off the standard rate. Do you agree with the new Star Rating System? What is the one thing you think needs improvement?
Source: blogspot.com

Kaiser named top rated Medicare plan in Hawaii

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Source: hawaii247.com

Medicare Trying To Nudge Seniors Out Of Plans With Low Ratings

Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, an industry trade group, said the letter to beneficiaries is “premature” because the ratings system is flawed.  It is based on measures that do not sufficiently take into account, for example, plans serving a disproportionate number of beneficiaries with multiple chronic conditions or special needs, or who live in medically underserved areas.  “These are unique challenges to providing care to those populations,” he said.
Source: kaiserhealthnews.org

Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

To encourage Medicare Advantage plans to provide quality care, the 2010 health reform law authorized Medicare to pay plans bonuses beginning in 2012 if they receive four or five stars on the program’s five-star quality rating system, or are unrated.  Building on that provision, the Centers for Medicare and Medicaid Services subsequently launched a demonstration that allowed more plans to receive bonuses and increased the size of the bonuses to encourage plans to maintain or improve their rating.  
Source: kff.org

Why Medicare star ratings are important to you during Open Enrollment

More high-quality Medicare plan choices in 2013 According to Health and Human Services Secretary Kathleen Sebelius, more 4- and 5-star plans will be available in 2013 than ever before. In 2013: • People with Medicare will have access to 127 four- or five-star Medicare Advantage plans. In 2012, people with Medicare had access to only 106 four- or five-star plans, which served only 28 percent of enrollees. • People with Medicare will have access to 26 four- or five-star prescription drug plans, which currently serve 18 percent of enrollees. This is an improvement from 2012, in which only 13 plans with four or five stars serve just 9 percent of enrollees.
Source: themeddiva.com

2011 Medicare Advantage and Mediare Part D Star Ratings

The 5-star rating system is used by CMS to monitor plans to ensure that they meet Medicare’s quality standards.  The ratings provide Medicare beneficiaries with a tool to compare the quality of care and customer service that Medicare health and drug plans offer. In addition, a “low performer” icon is to be placed next to the names of plans that have received less than three stars for the past three years.  CMS’ star rating system considers 53 quality measures, such as success in providing preventive services, managing chronic illness, and keeping consumer complaints to a minimum. 
Source: wordpress.com

Registration for Medicare EHR Incentives To Open on Jan. 3

Posted by:  :  Category: Medicare

San Diego, CA by Oggie DogMany of the states that are ready to begin registration in the next few months plan to issue their first incentive payments by late January or early February 2011 (Modern Healthcare, 12/23). Other states might not launch their incentive programs until spring or summer of 2011 (Kraynak, HealthLeaders Media, 12/23).
Source: ihealthbeat.org

Video: EHR: Medicare and Medicaid Incentive Program Registration Webinar for Eligible Hospitals

CVS Caremark Corporation (CVS) To Help Pharmacy Patients Who Are Registering In Medicare Part D

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Source: stockmarketvideo.com

Getting Started in Medicare

 JABA’s health insurance counseling program, VICAP, has been hosting these workshops several times per year for quite a while now. This service is part of the statewide Virginia Insurance Counseling and Assistance Program (VICAP) administered by the Virginia Division for the Aging (VDA). All JABA VICAP specialists and volunteers receive regular training. They’re experts at helping people sort through confusing info, and, here’s the clincher, they are
Source: wordpress.com

Tips to Demystify Medicare Open Enrollment

Once you’ve found a plan that fits your budget and medication needs, don’t forget about convenience when filling your prescriptions. A pharmacy accepted as “preferred” by a Medicare Part D Plan is a network pharmacy that offers covered drugs to plan members at lower out-of-pocket costs than what the member would pay at a non-preferred network pharmacy. For example, Walmart is a preferred pharmacy on multiple plans including the Humana Walmart-Preferred Rx Plan. (Incidentally, people who have high blood pressure or who are concerned about heart health should also know that Humana and Walmart just announced that members of the Humana Walmart-Preferred Rx Plan will have access to 10 hypertension drugs for a penny each when filled at one of the 4,400 Walmart or Sam’s Club pharmacy locations).
Source: alexisabramson.com

Registering For Medicare Is Straightforward

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Source: outofcontrolteens.org

Registration Opens for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs

While the Medicare EHR Incentive Program is administered by CMS, the Medicaid EHR Incentive Program is voluntarily offered and administered by the states. California, Missouri, and North Dakota are expected to open registration for the Medicaid Incentive Program in February 2011, with other states likely to offer the program during the spring and summer of 2011. Registration marks a major step for providers in the process of obtaining incentive payments under the EHR Incentive Programs. Under these programs, Medicare and Medicaid incentive payments totaling as much as $27 billion from 2011 to 2021 will be available for payment to eligible professionals (EPs) and eligible hospitals for the “meaningful use of certified EHR technology.” Providers are encouraged by CMS to register and participate early to obtain the maximum incentive payments.
Source: lexisnexis.com

Registration for CMS EHR Incentive Programs

On your mark: Determining your eligibility Before you register, you need to determine if you are eligible. Eligibility differs for eligible hospitals and professionals — criteria that you should review as soon as possible. Those who’d prefer a more interactive experience can use CMS’s Eligibility Wizard to reveal what program(s) they qualify for. It’s crucial to know that EPs qualifying for both Medicare and Medicaid Incentive Programs have to choose one or the other prior to registration. (Hospitals can receive payments from both.) Moreover, EPs can only change programs once before 2015 after receiving their first incentive payment. The major difference between the programs is money, nearly $20,000 (Medicare’s 44,000 to Medicaid’s $63,750), but there are plenty more. Choose your own adventure.
Source: ehrintelligence.com

Life Care Centers of America denies massive Medicare fraud charges; judge criticizes feds in secret whistleblower case

Medicare reimbursed $4.2 billion to Life Care Centers between 2006 and 2011, the newspaper reported. While skilled nursing facilities averaged 35% of treatments for rehab patients at the ultra-high level nationwide in 2008, Life Care Centers had 68% of therapies at the ultra-high level, court records say. Rehab therapy claims have come under increased scrutiny in recent years, with other nursing home chains also have faced accusations of upcoding. 
Source: mcknights.com