Can I get dental coverage from a Medigap policy?

Posted by:  :  Category: Medicare

Martin Place 1 by Greens MPsMedigap does not pay for everything. It is meant to supplement Medicare, not replace it. Medicare pays the defined portion, and then your Medigap policy kicks in to pay for costs it covers. Unlike Medicare Advantage, Medigap is not part of your Medicare coverage, but is instead a supplemental policy which makes your existing Medicare coverage more useful and less expensive. Medigap has separate premiums that must be paid in addition to the premiums for your Medicare Part A and Part B insurance.
Source: usinsurancenet.com

Video: Medicare dental coverage Dallas

Medicare Eligibility and Senior Health Care

Medicare Advantage popularly known as MA refers to a health insurance program which offers an eligible individual with the US Medicare benefits. MA differs from the previous Medicare model that offered a standard plan offered directly by the United States. In contrast, MA is program that is normally provided by private providers.
Source: eazyretirement.com

Medicare Open Enrollment: More is better

For those choosing Original Medicare, the benefit package continues to grow stronger and provide greater value. For example, EVERYONE with Medicare has access to a variety of preventive services and screenings, most at no cost to them when furnished by qualified and participating health care professionals. This includes things like diabetes and cancer screenings, and a yearly “wellness” visit. During the first 9 months of this year, over 20 million people with Original Medicare received at least one preventive service at no cost.
Source: medicare.gov

Health Law Offers Dental Coverage Guarantee For Some Children

Specific coverage requirements will be determined by each state within guidelines set by the federal Department of Health and Human Services. HHS guidance to date suggests that medically necessary orthodontia — to correct a problem with chewing, for example — may be required in addition to preventive and restorative care. Dental coverage may be embedded in a medical plan that’s sold on the exchanges or offered on a stand-alone basis.
Source: kaiserhealthnews.org

ZPIC Audits of Specialty Dental Practices are Here! Is Your Dental Practice Ready?

Assuming that each of the previous elements have been correctly addressed and met, has your staff correctly billed for the dental services rendered to the patient, private payor or public payor responsible for payment? r Billing Practices – Were the services rendered correctly billed to Medicare?  None of are perfect.  Mistakes occur.  Your biller may accidentally double-bill a payor for a service.  Alternatively, your biller may accidentally bill for the wrong code. When faced with an overpayment remember:  If it doesn’t belong to you, give it back.”  Virtually NO overpayments belong to a dentist or a dental practice.  Any unclaimed overpayments which are either refused by a private payor (sounds odd but it occurs), or cannot be returned for other reasons (perhaps the patient to whom the refund was owed has died), is likely required to be turned over to your state’s “escheat” fund.  Failure to turn over unclaimed monies in a prompt fashion can subject a dental practice to fines.  In some states, it can even result in criminal action.
Source: theprecise1.net

Pros and Cons of Offering Dental Insurance to Employees

4.  Funding of the Benefit   If you decide to pay for your employees’ dental insurance, consider how you will finance the cost. Should you purchase a fully insured product or fund the dental plan yourself? For larger employers, self-insurance may make sense, because dental costs are fairly predictable, and most plans have annual caps of $2,000 or less, which lowers the overall financial exposure. Additionally, self insurance allows employers to avoid state premium tax and has the potential of avoiding other healthcare reform-related taxes and administrative issues. Weighing the benefits and drawbacks of group dental insurance can be tricky, based both on the considerations previously listed and a company’s present circumstances. If you need additional assistance on this matter, please feel free to contact Hill, Chesson & Woody with any questions you may have.
Source: hcwbenefits.com

New Benefits, Taxes Under The Affordable Care Act

Expanded Medicaid Coverage: Connecticut was the first state to receive federal approval to expand Medicaid enrollment even before the Affordable Care Act takes effect. States must decide whether to expand Medicaid by 2014, with the federal government paying 90 to 100 percent of the costs. The number of low-income adults receiving Medicaid has grown from an estimated 47,000 to about 86,800 from July 2010 to December 2012, reports the state Department of Social Services. Some lawmakers question whether the increase stems from a bad economy or if people are deliberately moving to Connecticut to receive benefits. For now, the Centers for Medicare & Medicaid Services is reviewing a request by Connecticut to institute a $10,000 asset test and parental income reporting for applicants.
Source: ctwatchdog.com

Eight mistakes to avoid during Medicare enrollment

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

Top Medicare Part D Plan Costs Spike in 2013

Posted by:  :  Category: Medicare

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Source: webmd.com

Video: Medicare Part D Prescription Drug Plan Basics

False Claims Act Reaches Medicare Part D Preferred Benefit Managers; Case Against Caremark to Proceed

Among the important issues decided by the judge are that: (1) Prescription Drug Event records (PDEs) by Part D PBMs are “claims” under the FCA; (2) the relator/plaintiff properly pled falsity based on a PBM’s false certification of the accuracy, truth, and completeness of its Part D PDEs as well as under a worthless services theory (failure to provide Part D services, including DUR, subjects providers, including PBMs, to FCA liability); and (3) the reverse false claims section of the FCA applies because false Part D claims impact the Part D reconciliation process. Other points of note include an excellent discussion by DOJ in its SOI of why its declination decisions should not be interpreted as a decision on the merits of the case; and the court’s rejection of Caremark’s public disclosure argument, finding that neither the exchange of information covered by a confidentiality agreement in discovery during civil litigation, nor the submission of Part D PDE to CMS is a public disclosure that could jurisdictionally bar relator’s suit.
Source: bostonwhistleblowerlawyerblog.com

Most Medicare Part D beneficiaries not in low

An analysis of more than 100,000 user sessions on PlanPrescriber.com found only 5 percent of customers were in the Medicare prescription drug plan (PDP) with the lowest total out-of-pocket costs available to them. Only 24 percent of customers were in the Medicare Advantage prescription drug (MAPD) plan with the lowest total out-of pocket costs.
Source: lifehealthpro.com

Need Advice on Issue with Humana PDP

For seniors themselves, the proposed change of enrollment age would have affected some people very little, and some very greatly. People already approaching their 65th birthday would have been exempt from the age change, along with those soon to approach the Medicare cut-off date. For those seniors not exempt and looking for coverage after the age of 65, options would have included Medicaid for low income earners, and exchanges wherein insurance could have been privately purchased while waiting to join Medicare. For minorities, however, the stakes could have been much higher. Studies at the time showed that the proposal to raise the Medicare enrollment age would have affected minority Americans disproportionately. Due to income levels and a statistical tendency to be in poorer health at earlier ages, minorities especially would be losing out on an important service from the government. Some researchers noted that raising the Medicare age based on an assumption of higher life expectancy could even be seen as discriminatory considering that high life expectancy trends apply primarily to the most white and the most wealthy Americans. Source: globalsurance.com
Source: medicarehelpco.com

Need Advice on Issue with Humana PDP

Board, I am at my wits end with Medicare and Humana (PDP). I have a client who I helped enroll into a Humana PDP on 12/29/12 (enrolled and received confirmation from Medicare.gov). They had an SEP (losing group coverage) and were initially enrolled with Humana. Humana then disenrolled them the same day saying they did not qualify. Both the client and I have called Medicare and they say it’s Humana’s problem. Humana says that the client did everything right, but since Humana received the application from Medicare on 1/2/13 they could not enroll them and the earliest effective date is 2/1/13 now. Medicare says Humana can backdate the PDP for 1/1/13 and Humana says it can be done, but no one at Humana seems to have the authority to backdate the coverage. Client spent 2 hours on the phone with the billing and enrollment department and had no luck. I am not licensed with Humana, so I cannot make much headway with them. Do anyone here know of someone at Humana that could make this happen? R
Source: insurance-forums.net

eHealth Study: 95 Percent of Medicare Part D Beneficiaries Not in Lowest

User Session Data: Those Who Hit The Donut Hole with Existing PDP and MAPD Plans —————————————————————————- *Numbers may not total 100% % of All Users Reaching % Among Sessions that due to Month Donut Hole* Reach Donut Hole* rounding —————————————————————————- Never 66.62% NA 52%: Between January and August —————————————————————- January 0.02% 0.07% —————————————————————- February 0.08% 0.25% —————————————————————- March 0.11% 0.34% —————————————————————- April 0.68% 2.03% —————————————————————- May 2.97% 8.88% —————————————————————- June 4.05% 12.12% —————————————————————- July 4.72% 14.13% —————————————————————- August 5.08% 15.22% —————————————————————————- September 4.42% 13.26% 48%: From September to December —————————————————————- October 4.02% 12.03% —————————————————————- November 3.54% 10.62% —————————————————————- December 3.69% 11.05% —————————————————————————-
Source: ulitzer.com

Medicare Part D Prescription Drug Plan Availability in 2012

This fact sheet contains 2013 state-specific summary data about available Medicare drug benefit options, including premium ranges and the number of plans available at no cost to qualifying beneficiaries.
Source: kff.org

AMCP Submit comments on proposed rule Medicare Part D

Protected categories of interest under Part D: CMS proposes new definitions for determining when a class or a class of drugs meets both requirements of the law of protected categories of concern under the Part D protected classes require that all or substantially all the class of drugs available to beneficiaries. The two requirements to meet this threshold today are: limited access to drugs in the category or class would have important consequences for life threatening or clinic for people who have a disease or disorder treated with drugs in that category or class, and There is a strong need for them to have access to multiple drugs within a category or class due to unique chemical actions and pharmacological effects of drugs within a category or class. These provisions came as a result of improved Medicare for patients and providers Act of 2008 .
Source: landrumlawkc.com

Mo. To Change Medicare 'Spend Down' Rules

Posted by:  :  Category: Medicare

"Never spend your money before you have it." ~ Thomas Jefferson. by eyewashdesign: A. GoldenAlyson Campbell, the director of the Department of Social Services’ Family Services Division, told lawmakers that, in some cases, department staff had been incorrectly giving credit for the full amount of a person’s medical bill – even if parts of it were paid for by Medicare or private insurance or were written off altogether by the person’s medical provider. That means some people in the program might have received Medicaid coverage for which they were not truly eligible.
Source: kmbc.com

Video: Medicaid spend down

Daily Kos: Republican U.S. senator: Cut Medicare … or we’ll shut down the government

Republicans approve of the American farmer, but they are willing to help him go broke. They stand four-square for the American home–but not for housing. They are strong for labor–but they are stronger for restricting labor’s rights. They favor minimum wage–the smaller the minimum wage the better. They endorse educational opportunity for all–but they won’t spend money for teachers or for schools. They think modern medical care and hospitals are fine–for people who can afford them. They consider electrical power a great blessing–but only when the private power companies get their rake-off. They think American standard of living is a fine thing–so long as it doesn’t spread to all the people. And they admire of Government of the United States so much that they would like to buy it. 65 years later and nothing changed. They just got worse.
Source: dailykos.com

The Upside Down Constitution: Part II (The Spending Power)

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Source: libertylawsite.org

Medicaid and the Myth of GOP Cost Cuts

Children: Currently, state Medicaid programs must provide children with health care services and treatments they need for their healthy development through the Early Periodic Screening, Diagnostic and Treatment (EPSDT) aspect of Medicaid, which provides regular preventive care for children and all follow-up diagnostic and treatment services that children are found to need. A block grant would likely permit states to drop EPSDT coverage, meaning that children, particularly those with special health care needs, would not be able to access some care that medical professionals find they need (because Medicaid would no longer cover certain health services and treatments for children, and their parents wouldnt be able to afford to pay for that care on their own).
Source: ourfuture.org

A Different Proposal On Medicare

Posted by:  :  Category: Medicare

Racism by elycefelizThe knee jerk reaction of those on the right (with supposed centrists all too eager to follow along) is to raise the Medicare eligibility age. But, for the fair minded, it’s not that simple, because life expectancies have not increased uniformly for all income brackets. Those at the top truly are living much longer. Those closer to the bottom? Not so much. Indeed, recent data suggests that life expectancies may be declining for those near the bottom of the income scale. It’s not hard to figure out that raising the Medicare eligibility age is unfair because of differing life expectancies. I’ve written about this in a previous post regarding social security, but the same principles apply. Obviously, if one income group has a 15-year life expectancy at age 65 and another income group has a 20-year life expectancy at age 65, the first income group loses a larger portion of its benefits if the eligibility age arbitrarily is increased from age 65 to age 67.
Source: blogforarizona.com

Video: Dave Hamilton Medicare Advantage Open Enrollment” Retirement Planner Jeff Vogan Mesa Tucson Arizona

10 Recent Medicare, Medicaid Issues

Here are 10 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent. 1. The average per capita costs of hospital services covered by Medicare and commercial insurance increased 3.57 percent in the 12-month period ended November 2012 — a historic low since the S&P Healthcare Economic Indices started tracking the data. 2. A bill that would extend a 1.45 percent fee on Georgia’s hospitals to help fund a deficit in the Medicaid program passed the state’s Senate and is expected to go before the state House Jan. 28. 3. South Carolina Gov. Nikki Haley (R) announced during her State of the State address that 19 Medicaid-designated rural hospitals in the state will receive 100 percent funding for any uncompensated care, starting this October. 4. Several groups, not just those in healthcare, lost something financially in the fiscal cliff deal, but do hospitals have a legitimate gripe? Was this year’s Medicare SGR patch an illusory solution? 5. Legislation to reauthorize the Children’s Hospitals Graduate Medical Education program was reintroduced in the House Energy and Commerce Committee’s Health Subcommittee. 6. The Business Roundtable, a group of CEOs representing the largest U.S. companies, recommended the retirement age at which beneficiaries become eligible for Medicare and Social Security should be raised from 65 to 70. 7. Maine Gov. Paul LePage (R) announced the state will repay roughly $186 million in Medicaid payments owed to 39 hospitals through a revenue bond and the state reclaiming control over liquor sales. 8. Seniors tended to choose Medicare Advantage plans with higher quality ratings on CMS’ five-star scale, according to a study published in the Journal of the American Medical Association. 9. Arizona Gov. Jan Brewer recommended state lawmakers expand the Medicaid program in her state of the state address Monday, becoming only the third Republican governor to do so. 10. Twenty-one states demanded the government change a rural hospital Medicare loophole embedded with the Patient Protection and Affordable Care Act that has given Massachusetts hundreds of millions of dollars in extra Medicare funding at the expense of other states.
Source: beckershospitalreview.com

Lawmakers must accept Medicaid expansion

Even conservative state senators and representatives, who may harbor some ideological objection to Obamacare, should see the immense value in accepting Medicaid expansion. For support, they need look no further than the conservative state of Idaho, where a statewide commission unanimously recommended expanding the program.
Source: theolympian.com

Implications of the New Medicare AFO Reimbursement Policy and Suggestions How to Appropriately Bill Prefabricated and Custom Fabricated Devices

Thanks for commenting. Arizona AFO and every other prefabricated and custom AFO manufacturer are adjusting to the recent Medicare AFO height requirement. Arizona AFO has always had some devices including the Extended model that extend to behind the calf and so qualify. Medicare reimbursable versions of the Standard, the Articulated, the Split Upright Thermoplastic Articulated and the Moore Balance Brace are in the works. Samples will be shown at the SAM conference this weekend and at the NY Clinical Conference next week. The new designs will all feature ease of adjustability for patient comfort while offering the increased stability afforded by the additional height. Increased height does necessitate that patients be casted using the STS Bermuda sock that comes up over the calf. Expect to see pictures of new models and revised order forms next week. Josh
Source: safestepblog.net

David Sayen: How Medicare works with other insurance

Medicaid and TRICARE (the healthcare program for U.S. armed service members, retirees, and their families) never pay first for services that are covered by Medicare. They only pay after Medicare, employer plans, and/or Medicare Supplement Insurance (Medigap) have paid.
Source: santacruzsentinel.com

How a GOP Governor Walked Arizona into Obamacare’s Medicaid Expansion Trap

One of the most transformative aspects of Obamacare is that it conscripts state governments for the purpose of providing subsidized health insurance to their residents. Most red states have done their best to refuse, by declining to expand their Medicaid programs, and by passing up the opportunity to set up state-based insurance exchanges, through which Obamacare’s subsidies would flow. But a handful of Republican governors are doing their part to implement Obamacare. Arizona’s Jan Brewer, in particular, is proposing to do so in a way that sheds a lot of light onto the trap that Obamacare has set for state governments.
Source: wordpress.com

Options for Medicare Beneficiaries discussed by an Arizona Broker

PRLog (Press Release) – Dec. 12, 2012 – Options available to Medicare Beneficiaries besides Original Medicare Medicare Part A which covers inpatient treatment for Medicare Beneficiaries and Medicare Part B which provides for outpatient services are both available to seniors and some people on disability under age 65 and is referred to as original Medicare.  However, original Medicare by itself can leave the senior with significant out of pocket expense. “As an Independent Insurance Broker in Arizona” states Ralph Bredahl with Arizona Medicare Advisors, “I find a lot of confusion among seniors on what is available to them to help with medical costs. I trust this list will help to answer some of the questions that I hear”   http://www.ArizonaMedicareAdvisors.com Medicare Supplement also called a Medigap plan; a supplement pays for many of the costs that are not covered by Medicare.  It is a separate plan and the company providing the coverage may ask health questions. There are certain times and situations where a beneficiary is guaranteed issue.  Also, there are several Medicare supplement plans available. Plan A, B, C, F, G, K, L, M and N.  Not all companies carry all plans. I won’t go into the differences here but it is important to point out that all plan types are the same with every company. In other words Plan F with company A will be the same basic coverage as Plan F with company B.  Arizona Medicare Advisors can answer your questions on plans in Arizona but consult a broker licensed in your state for particulars. http://ArizonaMedicareAdvisors.com Part D Prescription Drug Plan provides coverage for prescription drugs and has copays for various tiers of drugs. In addition, it has a premium that is paid by the beneficiary. Low income seniors can apply for assistance with the premiums and copays through social security. There is an open enrollment and special enrollment periods. If a senior declines to enroll when eligible they will have a penalty if enrolled later. As with Medigap Arizona Medicare Advisors can answer your questions on plans in Arizona but consult a broker licensed in your state for particulars Medicare Advantage is also known as part C. These plans are available in Arizona and in many other areas as well. Once again, check with your local broker. With a Medicare Advantage plan the beneficiaries opts to receive their medical coverage from a private company. The company must provide coverage as good as or better than original Medicare. The plans provide coverage for Part A and for Part B and often incorporate Part D into the plan. Like the Part D plans, Medicare Advantage plans are guaranteed issue and have open enrollment. There is also a disenrollment period if the senior wants to return to original Medicare. http://ArizonaMedicareAdvisors.com Ralph Bredahl Arizona Medicare Advisors.com 602-390-8573
Source: prlog.org

Medicare Select* Contracting Hospital Listing

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CareMortgage Payment Calculator Barack Obama Biography Microsoft Project Tutorial Sony PDA Audi Q7 Disadvantage of VoIP Pro Engineer Free Tutorials Debt Consolidation Non Profit Free VoIP Facts about Barack Obama Audi R8 Wallpaper Cheap Web Hosting Mortgage Calculator PDA Comparison Chart Chase Credit Card XML Tutorial Toys R Us Free Cell Phone Number Search Have Phone Number Need Name Affordable Health Insurance Free Web Hosting Oracle Forms Free Tutorial Refinance Mobile Home Loan on Rented Lot Explain Refinancing a Mortgage Audi R8 Beginner LINUX Tutorial Benefits of VoIP LINUX Tutorial Definition of VoIP Domain Name Search
Source: projectedu.com

Video: Jazzy Select Elite Power Chair, Medicare Approved

Who Can Issue Medicare Select Coverage?

Medicare Select is a managed health care system. If you have purchased a Medicare Select supplemental insurance policy, you have to use a hospital that is approved and on their list of approved health car providers. You can still use your own doctor but you have to use a hospital that is an approved provider of the Medicare Select program. The approved hospitals are local hospitals who have agreed to charge a designated sum as approved by the private insurance companies that underwrite private supplemental insurance to bridge the gap between Medicare and meeting qualifying deductibles, which means how much you have to pay before Medicare covers your health care.
Source: seniorcorps.org

Medicare to Cover Paradigm Spine Coflex Technology in Select States

Paradigm received a favorable Medicare determination by Cahaba Government Benefit Administrators, a contractor with the Centers for Medicare and Medicaid Services, for the post-decompression and motion preserving interlaminar stabilization device. The Coflex received FDA PMA approval at the end of 2012, and reached a favorable Medicare determination for use as a non-fusion alternative for symptomatic spinal stenosis. More Articles on Devices: Drug-Device Combination Market to Reach $30.5B by 2017 InspireMD Names Alan Milinazzo President, CEO Soft Tissue Regeneration Receives Market Approval for Rotator Cuff Repair Device
Source: beckersspine.com

What is Medicare SELECT and How Does it Work?

This kind of insurance has to give the same benefits as a regular Medigap policy but usually comes in at a lower cost based on its additional conditions. If you are prepared to be restricted to the plan’s network, then this could give you cheaper premium costs. You can, of course, choose to use a hospital/doctor outside of the network but, although Medicare will cover its costs as usual, you would then have to pay for any gaps otherwise covered in-network by a SELECT policy.
Source: suite101.com

Medicare Part C, Medicare Advantage Plans, What Does It Cover, Who Is Eligible

Before you enroll in a Medicare Part C plan you will have to enroll in Medicare Parts A and B. Generally, individuals are automatically enrolled in both if they are already receiving Social Security. Otherwise you will need to contact your local Social Security office to enroll. Once you are enrolled in Parts A and B you can select a Medicare Advantage Plan. For most people, this can all be done at the same time, when they turn 65 years of age. There is a seven month window to enroll which starts three months before your birthday month and ends three months after.
Source: bradeninsurance.com

Medicare payment boost in Massachusetts prompts angry letter to Obama

Brian 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

Medicare For Those With Disabilities

• If you have End-Stage Renal Disease you are not automatically enrolled in Medicare, but you can apply if you have worked the required amount of time according to Social Security or the Railroad Retirement Board, or if you are the spouse or dependent child of someone who has. Contact Social Security for details. You would need both Medicare A and B to cover certain dialysis and kidney transplant services. The coverage usually starts the fourth month of dialysis treatments.
Source: medicareecompare.com

Guaranteed Issue Medicare Periods

Since MA plans may not reduce their benefits or increase premiums or cost-sharing during the plan year, you will only be notified of any reduction in benefits or increase in premiums or cost-sharing for the new plan year during the Annual Election Period (AEP) which allows you to disenroll from your Medicare Advantage plan. The AEP is October 15 – December 7 each year. If you disenroll during this period, the effective date of your disenrollment will be January 1 of the following year. A MA plan may, however, discontinue its contract with a provider anytime
Source: floridahealthinsurancebroker.com

Medicare Select Supplement Insurance Plans

Much like Medicare Advantage plans, the primary disadvantage is simply the constraints of the network. It is important to be certain of any network limitations by first checking with the insurance company and/or the agent before purchasing a policy. And consumers must be aware that certain doctor groups and facilities may be in the approved network one year and out the next.
Source: ohioinsureplan.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98Between January 1–February 14, if you’re in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare. If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.
Source: medicare.gov

Video: Medicare Supplemental Insurance Comparison

Despite Potential Benefits, Medicare Slow to Utilize Telehealth

Health, Person Location, Person Career, Quotation, Telehealth, Health informatics, Medicare, EHealth, American Telemedicine Association, Medicine, Technology, Medical informatics, Videotelephony, telemedicine, Presidency of Lyndon B. Johnson, telehealth services, USD, Jonathan Linkous, Chicago, Institute of Medicine, Mike Thompson, California, stroke, stroke care, bipartisan Fostering Independence Through Technology, Richard Brennan Jr., telehealth technologies, dozen services, certain telehealth services, chief executive officer, John Thune, practicing neurologist, Lee H. Schwamm, American Heart Association, Harvard Medical School, acute stroke, bypass, video conferencing, National Association for Home Care & Hospice, chronic care management, Medicare Payment Advisory Commission, cessation services, reimbursable telehealth services
Source: reportingonhealth.org

Medicare vs Medicare Advantage

For Part A and Part B of Medicare, members must pay 20% of costs out-of-pocket. For inpatient hospital visits, members must pay a $1,184 deductible for the first 60 days, and then $296 coinsurance per day until day 90. After day 90, members can have another 60 days at $578 per day in their lifetimes, after which they must pay all costs. The Part B deductible is $140 per year. Those who have Part D (prescription coverage) must also pay an average deductable of $325. After the deductible has been paid, members may either have a co-pay program, where they pay a flat fee for each drug, or co-insurance program, where they pay a percentage of the cost. However, members may face the “doughnut hole”: after the total cost of drugs exceeds $2,970, members must pay 47.5% of the cost of brand-name drugs and 79% of the cost of generic drugs. Once the cost of drugs has exceeded $4750, Medicare kicks in again, with 95% of drug costs covered.
Source: diffen.com

A (Very Brief) Comparison of Romney and Obama on Medicare

So which do you like better? A plan that reduces reimbursement levels and relies on top-down control/encouragement to produce more cost-effective medical care? Or a plan that relies on competitive bidding to keep costs under control? The choice, for both liberals and conservatives, is not as simple as you might think. Conservatives need to acknowledge that, like it or not, cost controls have a proven track record and that Obamacare’s top-down programs really might help improve the efficiency of healthcare delivery. Liberals need to acknowledge that those top-down controls aren’t a sure thing and that competitive bidding might make a real difference.
Source: motherjones.com

Comparison of Medicare Premium Support Proposals

This brief provides a side-by-side comparison of recent proposals to transform Medicare into a premium support program and slow the future growth in Medicare spending. These proposals each would convert Medicare from a defined benefit program, in which beneficiaries are guaranteed coverage for a fixed set of benefits, to a defined contribution or “premium support” program, in which beneficiaries are provided a fixed federal payment to help cover their health care expenses.   The brief compares the premium support provisions of these proposals, including how the level of premium support for beneficiaries would be determined; whether traditional Medicare would remain an option; what protections would be provided for low-income beneficiaries; and whether and how the proposals would cap federal spending on Medicare.  These differences have important implications for Medicare beneficiaries, the federal budget, health care providers and private health plans.
Source: kff.org

Comparing Medicare prescription drug plans

Also, be aware that if you’re a low-income beneficiary and your annual income is under $16,755 or $22,695 for married couples living together, and your assets are below $13,070 or $26,120 for married couples, you may be eligible for the federal Low Income Subsidy known as “Extra Help” that pays Part D premiums, deductibles and copayments. For more information or to apply, call Social Security at 800-772-1213 or visit socialsecurity.gov/prescriptionhelp.
Source: pomeradonews.com

Medicare Supplemental Insurance Comparison Website Created by Senior Citizen Announces 25,000th Customer Helped

Medicare Supplemental Insurance Comparison (MSIC) announced today that they have successfully assisted their 25,000th customer. For anyone who has searched for Medicare supplemental insurance they know it can be a challenging process. The advent of the internet has certainly made the process easier, but only until recently clients still had to part with sensitive information such as their name, age and home address. Medicare Supplemental Insurance Comparison was created with the researcher’s privacy in mind, and is one of the first comparison websites of its kind to give insurance quotes while only requiring a zip code. “This is what allowed us to take our website to the next level,” said Steven Pewter, creator of the MSIC. “I’m a senior citizen myself and I wanted to create something that anyone could be comfortable using. The majority of our clients just aren’t OK with giving personal information up front. Our goal was to allow people to search for supplemental insurance anonymously, and I think our success with that has made us so popular.” “Hitting the 25,000th visitor helped is indeed a fine achievement,” said David Bartholomew, director of marketing. “We’ve found that as soon as anything ‘personal’ is requested people immediately click away. They just don’t want that, it feels completely invasive. With our site people can search all the most reputable Medicare supplemental insurance providers in their area and do so 100% anonymously. They can contact the companies on their own terms, and the fact that they get competing price quotes puts them in the place of power during negotiations.” MSIC also recently announced that they have added 250,000 companies to their database, all of them vetted according to reputation and years in business. To learn more, or to get a fast comparison of all the highest rated insurance companies in a specific area, please visit: http://medicaresupplementalinsurancecomparison.net/ About MSIC Medicaresupplementalinsurancecomparison.net (MSIC) was created in September 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: A comparison – Stand Up For America

The orthodox conditions of apostasy are that the person in question (a) has understood and professed the shahada, (b) has acquired knowledge of those rulings of the shariah necessarily known by all Muslims, (c) is of sound mind at the time, (d) has reached or surpassed puberty, and (e) has consciously and deliberately rejected or consciously and deliberately intends to reject as untrue either the shahada (and what it is commonly known to entail) or those rulings of the shariah necessarily known by all Muslims.[40][41] Maliki scholars additionally require that the person in question (f) have publicly engaged in the obligatory practices of the religion.[42] For example: if a sane adult Muslim, knowing and professing that God exists and is one, were to then declare that God does not exist, then this would constitute apostasy. Another example: if a sane adult Muslim, knowing that salat (prayer) is fard al-ayn (personally obligatory), were to then declare that it was not personally obligatory, then this would constitute apostasy. By contrast, for example: if a sane adult Muslim, knowing that consumption of alcohol is haram (forbidden), were to consume alcohol knowing and professing that it was forbidden, then this would merely constitute disobedience and not apostasy. Another example, if a sane adult Muslim carelessly and thoughtlessly makes a statement of unbelief, then this would not constitute apostasy.[43] In traditional Islam, there is a distinction between private and public apostasy. Private apostasy is the satisfaction of the above conditions, but without any public declaration. For example, if a sane adult Muslim performed daily prayers, professed them to be obligatory, but personally believed them to not be obligatory, then this would constitute private apostasy. Or for example, if a person professed the shahada with knowledge of its meaning, but in their home secretly worshiped idols, then this would constitute private apostasy. Public apostasy is the satisfaction of the above conditions by means of public declaration.
Source: wordpress.com

2013 Medicare Annual Enrollment Period: eHealth Provides Tips for Comparing Coverage Side

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

What Is The Best Method For Making A Medicare Supplement Plans Comparison?

A list of physicians and healthcare professionals, by geographical location, can be found on the official Medicare website: https://questions.medicare.gov/find-a-doctor . This is an easy and convenient method to find participants in local areas. Every year there is an open season when individuals have the opportunity to make a Medicare supplement plans comparison to ensure both providers and services will continue. As with the original Medicare Parts A and B, the monthly fees for Medicare supplement plans are reviewed and adjusted on an annual basis. The Medicare monthly costs for Parts A, B, and D can be found at www.medicare.gov/costs/ . Supplemental insurance carriers will notify participants of any changes in annual fees or altered services during the November to December timeframe. Anyone who wants to change or drop a current insurance carrier can do so during the annual open season, January through March. Comparing costs today will lower individual expenses tomorrow.
Source: seniorcorps.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

CMS Names 106 New Medicare ACOs

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteyCMS has named 106 new accountable care organizations that will participate in the Medicare Shared Savings Program, effective Jan. 1. With the addition of the 106 new organizations, as many as 4 million Medicare beneficiaries will be covered by a CMS ACO. According to CMS, the savings achieved by its ACOs could be up to $940 million in four years. The new group of ACOs includes 15 Advance Payment Model ACOs, which are physician-based or rural organizations that will benefit from greater access to capital. The application period for organizations wanting to participate in the MSSP in 2014 will begin this summer. The 106 new ACOs named to the MSSP are listed here, with their service areas: 1.    A.M. Beajow, MD Internal Medicine Associates ACO, P.C. (Nevada) 2.    AAMC Collaborative Care Network (Maryland) 3.    Accountable Care Clinical Services, PC (California, Connecticut, Iowa, Massachusetts, Pennsylvania) 4.    Accountable Care Coalition of Central Georgia (Georgia) 5.    Accountable Care Coalition of DeKalb (Georgia) 6.    Accountable Care Coalition of Georgia (Georgia) 7.    Accountable Care Coalition of Greater Athens Georgia II (Georgia) 8.    Accountable Care Coalition of Greater Augusta & Statesboro (Georgia, South Carolina) 9.    Accountable Care Coalition of New Mexico (New Mexico) 10.    Accountable Care Coalition of North Central Florida (Florida) 11.    Accountable Care Coalition of North Texas (Texas) 12.    Accountable Care Coalition of Southern Georgia (Georgia) 13.    Accountable Care Coalition of Western Georgia (Alabama, Georgia) 14.    Accountable Care Organization of New England (Connecticut, Massachusetts) 15.    ACO of Puerto Rico (Puerto Rico) 16.    Advocare Walgreens Well Network (New Jersey) 17.    Affiliated Physicians IPA (California) 18.    Akira Health (California) 19.    Alegent Health Partners (Nebraska) 20.    Alexian Brothers Accountable Care Organization (Illinois) 21.    Amarillo Legacy Medical ACO (Texas) 22.    American Health Alliance (Florida) 23.    American Health Network of Ohio (Ohio) 24.    APCN-ACO (California) 25.    Arizona Care Network (Arizona) 26.    Atlanticare Health Solutions (New Jersey) 27.    AVETA Accountable Care (Puerto Rico) 28.    BAROMA Health Partners (Florida) 29.    Billings Clinic (Montana, Wyoming) 30.    Bon Secours Good Helpcare (Kentucky, New York, Ohio, South Carolina, Virginia) 31.    Cambridge Health Alliance (Massachusetts) 32.    Cape Cod Health Network ACO (Massachusetts) 33.    Cedars-Sinai Accountable Care (California) 34.    Central Florida Physicians Trust (Florida) 35.    Central Jersey ACO (New Jersey) 36.    Christie Clinic Physician Services (Illinois) 37.    Collaborative Care of Florida (Florida) 38.    Collaborative Health ACO (Massachusetts) 39.    Colorado Accountable Care (Colorado) 40.    Community Health Network (Minnesota) 41.    Diagnostic Clinic Walgreens Well Network (Florida) 42.    Doctors Connected (Virginia) 43.    Essential Care Partners II (Texas) 44.    Fort Smith Physicians Alliance ACO (Arkansas, Oklahoma) 45.    Franciscan Northwest Physicians Health Network (Washington) 46.    Franciscan Union ACO (Illinois, Indiana) 47.    GPIPA ACO (Arizona, New Mexico) 48.    Hartford HealthCare Affordable Care Organization (Connecticut) 49.    HHC ACO (New York) 50.    HNMC Hospital/Physician ACO (New Jersey) 51.    Independent Physicians’ ACO of Chicago (Illinois) 52.    Indiana Care Organization (Indiana) 53.    Indiana Lakes ACO (Indiana) 54.    Integral Healthcare (Florida) 55.    Integrated ACO (Texas) 56.    KCMPA (Kansas, Missouri) 57.    KentuckyOne Health Partners (Indiana, Kentucky) 58.    Keystone Accountable Care Organization (New York, Pennsylvania) 59.    Lahey Clinical Performance Accountable Care Organization (Massachusetts, New Hampshire) 60.    Lower Shore ACO (Delaware, Maryland, Virginia) 61.    Marshfield Clinic (Wisconsin) 62.    Maryland Collaborative Care (Maryland, Washington, D.C.) 63.    MCM Accountable Care Organization (Florida) 64.    Medicare Value Partners (Illinois) 65.    Mercy ACO (Arkansas, Missouri) 66.    Meridian Accountable Care Organization (New Jersey) 67.    Meritage ACO (California) 68.    Morehouse Choice ACO-ES (Georgia) 69.    National ACO (California) 70.    Nature Coast ACO (Florida) 71.    NOMS ACO (Ohio) 72.    Northeast Florida Accountable Care (Florida) 73.    Northern Maryland Collaborative Care (Maryland) 74.    Northwest Ohio ACO (Michigan, Ohio) 75.    Ochsner Accountable Care Network (Louisiana, Mississippi) 76.    OneCare Vermont Accountable Care Organization (New Hampshire, Vermont) 77.    Owensboro ACO (Indiana, Kentucky) 78.    Paradigm ACO (Florida) 79.    Partners in Care (Michigan) 80.    Physician Organization of Michigan ACO (Michigan) 81.    Physicians Collaborative Trust ACO (Florida) 82.    Physicians HealthCare Collaborative (North Carolina) 83.    Pioneer Valley Accountable Care (Connecticut, Massachusetts) 84.    Primary Care Alliance (Florida) 85.    Primary Partners ACIP (Florida) 86.    ProCare Med (Florida) 87.    ProHealth Physicians ACO (Connecticut) 88.    Qualable Medical Professional (Tennessee, Virginia) 89.    Rio Grande Valley Health Alliance (Texas) 90.    Saint Francis HealthCare Partners ACO (Connecticut) 91.    San Diego Independent ACO (California) 92.    Scott & White Healthcare Walgreens Well Network (Texas) 93.    SERPA-ACO (Nebraska) 94.    South Florida ACO (Florida) 95.    Southcoast Accountable Care Organization (Massachusetts, Rhode Island) 96.    Southern Maryland Collaborative Care (Maryland, Washington, D.C.) 97.    St. Luke’s Clinic Coordinated Care (Idaho, Oregon) 98.    Summit Health-Virtua (New Jersey) 99.    The Premier Health Care Network (Georgia, New Hampshire) 100.    UCLA Faculty Practice Group 101.    UW Health ACO (Wisconsin) 102.    Virginia Collaborative Care (Virginia) 103.    Wellmont Integrated Network (Tennessee, Virginia) 104.    Winchester Community ACO (Massachusetts, New Hampshire) 105.    Yavapai Accountable Care (Arizona) 106.    Yuma Accountable Care Organization (Arizona)
Source: beckershospitalreview.com

Video: Supplemental Insurance for Medicare in Georgia by 1-800-MEDIGAP®

‘Accountable care’ takes big leap in state

Two previously announced Georgia ACOs are also overseen by the Universal American subsidiary. The Universal American organizations will cover several areas of the state, including metro Atlanta, Athens, Augusta, Statesboro, Albany, Warner Robins, Columbus and Savannah, said Chuck Trinchitella of Collaborative Health Systems, the subsidiary.
Source: georgiahealthnews.com

The Official Medicare Set Aside Blog And Information Resource: The MSP, the Supremacy Clause, and Georgia WC Reform Capping Medical Benefits

” (emphasis added). Wonder in what tone you have to make that statement so that it does not sound like an intentional attempt to shift the burden of treating workers’ compensation injuries to Medicare? I am all for limiting the federal government’s reach when it determines how much is necessary to protect Medicare’s fictitious and theoretical interests; however, unilaterally cutting medical benefits to the detriment of those that may actually have lifetime medical needs short of being labeled “catastrophic” hardly seems like the appropriate response to dealing with MSAs. Yes, MSAs are a pain to deal with, but this director’s perceptions are incorrect. His perceived problems lie in the voluntary WCMSA review program, not with the MSP exemption itself. And, at the end of the day, a state cannot pass legislation for the sole purpose of circumventing federal requirements. It would be interesting to see if instituting a benefit cap would even accomplished the intended goal. Do they really think CMS will go away that easily???
Source: medicaresetasideblog.com

Medicare Secondary Payer Bill Summary

CMS is required to maintain a secure web portal with access to claims and reimbursement information. The web portal must meet the following requirements: • Payments for care made by CMS must be loaded into the portal within 15 days of the payment being made. • The portal must provide supplier or provider names, diagnosis codes, dates of service and conditional payment amounts. • The portal must accurately identify that a claim or payment is related to a potential settlement, judgment or award. • The portal must provide a method for receipt of secure electronic communications from the beneficiary, counsel, or the applicable plan. • Information transmitted from the portal must include an official time and date of transmission. • The portal must allow parties to download a statement of reimbursement amounts. The Reimbursement Process The SMART Act requires parties to notify CMS of when they reasonably anticipate settling a claim (any time beginning 120 days before the settlement date). CMS then has 65 days to ensure the portal is up to date with all of the appropriate claims data. CMS can have an additional 30 days on top of the 65 days to update the portal if necessary. At the expiration of the 65 and potentially the 30 day periods, the parties may download a final conditional payment amount from the website. The final conditional payment amount is reliable as long as the claim settles within 3 days of the download.
Source: wordpress.com

Georgia: Medicare In Georgia

Free industrial zone has its positive sides. There are many different ways to purchase Georgia foreclosure listings give intelligent home buyers should start looking at Georgia foreclosure listings, depending on who currently holds the medicare in georgia to the medicare in georgia without knowing the medicare in georgia or the Blue Ridge Georgia vacation rentals put you right in the medicare in georgia of the medicare in georgia in Georgia job search. To simplify your search and avoid missing possible job opportunities, make sure that you have to file this form before, during, or after your deployment at your disposal. Luckily, you do have these tools to give you not only an immediate quote, but competitors rates as well.
Source: blogspot.com

Medicare agrees to pick up the tab for obesity counseling — Health — Bangor Daily News — BDN Maine

Unfortunately, those best prepared to provide obesity counseling will not be able to bill directly to do so. CMS has limited who is able to bill for those services to primary care physicians and practitioners, including nurse practitioners, clinical nurse specialists and physician assistants. Those with expertise in the field, such as registered dietitians, are not eligible to bill directly. Medicare will cover services from “auxiliary” providers only if the service is provided in a physician’s office suite and the physician is immediately available to provide assistance and direction.
Source: bangordailynews.com

Georgia Medicare retirees celebrate anniversary of Social Security

2012 about Aquarium Atlanta Attorney Attractions auto Beautiful best business cities College Colleges Cool county find Football from Georgia good Health images insurance Jobs lawyer License Loans Military Nice North photos pics pictures road Rome School schools small some State States’ Tech Technical Universities University
Source: wordwd.com

Expand Medicaid to Reduce Uninsured in Georgia

AARP Georgia’s top legislative priority this year is getting many of those people — and hundreds of thousands of others in the same boat — covered under Medicaid, the federal-state health insurance program for the poor.
Source: aarp.org

Transforming Healthcare One Medicare Patient at a Time

So are ACOs going to single handedly solve Medicare’s budgetary woes. Probably not, but they offer the hope of creating a patient centered system that can help patients better navigate a complex system of healthcare providers and professional healthcare services. It is this promise of better coordinated care with an emphasis on prevention, wellness, and patient safety that can help in the transformation of the US health delivery system … one Medicare patient at a time.
Source: ajc.com

Devil is in the details of a new Medicare plan to buy medical supplies

Cramton, together with economist Brett Katzman and mathematician Sean F. Ellermeyer of Kennesaw State University in Georgia, analyzed Medicare’s system to see whether it would set the same price as other systems. They computed what’s called the “Bayesian Nash equilibrium,” which is a bidding strategy for all participants in which no one could earn more money by changing their own bid, assuming that everyone else’s bids stay the same. Over time, bidders would be expected to converge toward the Bayesian Nash equilibrium strategy.
Source: sciencenews.org

A Different View about Obama’s Medicare “Actual Facts”

The Affordable Care Act assumes deep reductions in payments to doctors, hospitals, nursing homes, and Medicare Advantage program, totaling $716 billion over ten years. By paying providers less, the trust fund may last a bit longer, but it means seniors will have a harder and harder time finding a doctor to see them as they drop out of the program or stop taking new Medicare patients. The law may not explicitly cut benefits, but it certainly will impact access to care. What good is a Medicare card if you can’t find a doctor? That is precisely the problem that patients on Medicaid — the program for lower-income Americans — face today, forcing them to go to hospital emergency rooms for even routine care. Do seniors want that?
Source: georgiapolicy.org

Medicare Spends About As Much Screening For Breast Cancer As Treating It

Posted by:  :  Category: Medicare

The Medicare NewsGroup: Medicare Sees 2011 Spending Spike While Overall Health Spending Hold Steady Medicare spending rose an estimated 6.2 percent during 2011, driven by a big jump in payments to skilled nursing facilities, more spending at doctors’ offices and bigger outlays for Medicare Advantage plans, the Center for Medicare and Medicaid Services (CMS) reported Monday in its annual survey of projected health spending. The report has projected figures for 2012 forward, and estimated figures for 2011 spending. Medicare’s total outlays reached $554 billion in 2011, an increase of $32 billion from the previous year. The 6.2 percent growth in spending accelerated from an expansion of 4.2 percent in 2010 (Rosenblatt, 1/8).
Source: kaiserhealthnews.org

Video: Improving Medicare in 2011

Ellison rips cuts to Medicare in proposed 2012 budget

GOP ‘path to prosperity’ would end Medicare April 6, 2011 Pawlenty, other 2012 hopefuls tread carefully on Ryan budget April 6, 2011 GOP Budget point man unveils major budget cuts April 5, 2011 GOP 2012 budget to make $4 trillion-plus in cuts April 3, 2011
Source: publicradio.org

Medicare growth attributed to change in skilled nursing facility pay rates

Medicaid spending slowed significantly in 2011 on a year-over-year basis. The program grew 2.5% in 2011, a significant drop from 5.9% growth in 2010. The CMS report said budgetary pressure on states caused by the weak economy and the June 2011 expiration of federal aid to the states contributed to the slower growth.
Source: mcknights.com

Obama Puts Social Security and Medicare Cuts on the Table

The debt-ceiling debate adds more than a little urgency to the negotiations. The debt ceiling expires on August 2, and as Felix Salmon writes, “No responsible legislator would risk letting it pass. Beyond that date is uncharted territory: Here Be Dragons stuff.” The Treasury Department is trying to figure out how they might slay some of those dragons (and, by the way, prevent “financial meltdown”) if the deadline arrives without a deal. They’ve looked into whether the government could delay or prioritize payments, and, intriguingly, whether the New York Fed could broker a deal on the Treasury’s behalf to raise its borrowing cap in global markets.
Source: nymag.com

UCLA Health System Selected as a Medicare Shared Savings Program Accountable Care Organization

The UCLA Health System, which comprises the UCLA Hospital System and the UCLA Medical Group and its affiliates, has provided a high quality of health care and the most advanced treatment options to the people of Los Angeles and the world for more than half a century. Ronald Reagan UCLA Medical Center, the Resnick Neuropsychiatric Hospital at UCLA, Mattel Children’s Hospital UCLA, and UCLA Medical Center, Santa Monica (which includes the Los Angeles Orthopaedic Hospital) deliver hospital care that is unparalleled in California. Ronald Reagan UCLA Medical Center is consistently ranked one of the top five hospitals in the nation and the best in the western United States by U.S. News & World Report. UCLA physicians and hospitals continue to be world leaders in the full range of care, from maintaining the health of families to the diagnosis and treatment of complex illnesses.
Source: newswise.com

Medicare issuing 2011 PQRS, eRx bonuses with “L” on RAs

For that reason, carrier accounting systems may place a negative sign before the dollar amount of a levy on a remittance notice. However, “in the case of PQRS and eRx incentive payments, the LE indicator represents an incentive payment and although the negative sign may appear on the remittance advice, the amount indicated does not represent a withhold or overpayment amount,” the Palmetto website continued. Both Medicare electronic and paper remittance advice provide additional coding to help practitioners identify PQRS and eRX incentive payments, the carrier noted.
Source: newsfromaoa.org

Medicare Changes for 2011

New Requirement for Face-to-Face Encounter as Part of Process for Certifying Beneficiary Home Health Care The Affordable Care Act (ACA) mandates that a physician conduct a face-to-face encounter to certify a beneficiary need for home health care services. The CMS rules to implement this provision require that the face-to-face encounter must occur within the 90 days prior to the start of home health care, or within the 30 days after the start of care. Review the details of this new requirement, which has significant impact on internists.
Source: acponline.org

 Health Care Insights

Posted by:  :  Category: Medicare

AARP * Aetna Inc * Alabama Insurance Department * American Specialty Health * Amerigroup Corporation * Ameri-Plus Select Services * Arcadian Health Plan & Management Services * Arnold & Porter * Balboa Nephrology Medical Group * Barclays Capital * BCBS of Minnesota * Blue Cross Blue Shield of Tennessee * Boehringer Ingelheim * California Association of Physicians Group * Capital District Physicians Health Plan * Care 1st Health Plan * Care N Care Health Plan * Caremore * Clarian Health Plans * DCA Solutions * DCIPA * Deft Research * Dendreon Corporation * Dial America * DMW Direct * Dynamic Healthcare Systems * Endo Pharmaceuticals * Essence Health Care * Essex Woodland * Express Scripts Inc * Family Health Plans * Firstsource * Forest Laboratories Inc * Fresenius Medical Care * Geisinger Health Systems * GemCare Health Plan * Gorman Health Group * Group Health Cooperative * Health Alliance Medical Plans * Health Data Essentials * Healthcare Partners * HealthMetrix Research Inc * HealthNet Government Programs * HealthPlan CRM * HealthSpring * Healthways Inc * Henry Ford Health System * HMS Permedion * Humana * Independence Blue Cross * Inspiris * Inter Valley Health Plan * Kaiser Foundation Health Plan of Colorado * Kaiser Permanente * Leprechaun * Marketing Direct Inc * Matrix Medical Network * Medagate Corporation * MedAssurant * MVP Health Care * North Texas Specialty Physicians * Old Surety Life Insurance Company * Oliver Wyman Actuarial Consulting * Peak Health Solutions * PopHealthMan * Preferred Care Partners * Quest Diagnostics * SCAN Health Plan Arizona * Sharp Health Plan * Silverlink Communications * South Shore * Sterling Life Insurance Company * Texas HealthSpring * The Bright Sight Group * The Harry Walker Agency * The Kaiser Family Foundation * The National Advisory Board on Improving Health Care Services for Seniors and People with Sisabilities* The Permanente Federation * Thoroughbred Research Group * TMG Health * TriZetto Group * Tucson Medical Centre * UMWA Health & Retirement Funds * United American * United Community Health Plans * United Health Care * Univita Health * UPMC Health Plan Inc * Varis * Visiting Nurse Service of New York * VNS Choice Medicare * Wilen Direct
Source: blogspot.com

Video: VNSExtras.flv

Clinical Evaluation Manager

We deliver professional and paraprofessional services throughout all five boroughs of New York City and Nassau and Westchester counties.The VNS CHOICE Medicare program provides full coverage to individuals with Medicare and Medicaid for hospital stays, physicians, ancillary services and care coordination – enabling access to high-quality, cost-effective medical care for New York City’s residents.
Source: findmeajobx.com

Medicare Open Enrollment: last chance to review and compare plans

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSWith 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

Video: Medicare and You – Resources for Open Enrollment

Cravaack, Nolan battle over Medicare

Referring to Medicare’s low administrative costs relative to what private insurers spend on overhead, Nolan said, "It costs roughly 3 or 4 percent to administer Medicare. Private insurance on average runs somewhere between 27 and 30 percent administrative costs. So once you turn Medicare back over to the insurance industry, you know, right out of the chute you are dramatically increasing the administrative costs."
Source: publicradio.org

Medicare Beneficiary Options

Seniors approaching Medicare eligibility are often confronted with choices and timelines that may be confusing.  If you are six months away from celebrating your 65th birthday and would like to discuss your Medicare options (i.e. Original Medicare, Medicare Advantage Part C, Medicare Part D and Supplements), call me.
Source: patch.com

Things to Think about when You Compare Medicare Drug Coverage

Monthly Premium Most drug plans charge a monthly fee that varies by plan. You pay this fee in addition to the Medicare Part B (Medical Insurance) premium. If you’re in a Medicare Advantage Plan or a Medicare Cost Plan that includes Medicare prescription drug coverage, the monthly premium you pay to your plan may include an amount for prescription drug coverage. Note: What you pay for Medicare prescription drug coverage could be higher based on your income. This includes coverage you get from a Medicare Prescription Drug Plan, a Medicare Advantage Plan, a Medicare Cost Plan, or an employer group Medicare Advantage Plan that includes Medicare prescription drug coverage. If the modified adjusted gross income that you reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain limit, you will pay an extra amount in addition to your plan premium. Usually, the extra amount will be deducted from your Social Security check. If you have to pay an extra amount and you disagree (for example, you have a life event that lowers your income), call Social Security at1-800-772-1213. TTY users should call 1-800-325-0778. For more information, visitwww.socialsecurity.gov.
Source: growingolder.org

Senior Medigap and Medicare Advantage Options

Many different insurance companies offer medigap supplemental plans ranging from very basic supplemental coverage in conjunction with Part A and Part B traditional medicare to comprehensive protection that eliminates many copays and deductibles. From Plan A to Plan F plans you can shop different plans and different carriers such as Anthem, Aetna, Blue Shield, United Healthcare (AARP) and others. Most of these carriers and plans are virtually identical and monthly premiums are within a certain range so its basically a matter of choosing a carrier that contracts with your physician and a plan that you can afford and suits your coverage needs.
Source: wordpress.com

Caregiving & Medicare Open Enrollment: It’s Time, But Not For Long!

Will Medicare pay for a home-health care worker if I am unable to continue caring for my loved one? Some home health care services are paid for by Medicare. However, if the only care your loved one needs falls under basic home help or “homemaker services” like bathing, dressing, using the bathroom, shopping, cleaning, and laundry, Medicare will not pay for these services. If a doctor certifies that your loved one is homebound, Medicare will cover the expenses of a home health aid. If your loved one is eligible for this type of care and you are considering using a home health service in 2013, be sure your loved one is enrolled in a plan that will cover these expenses. Click here for more information.
Source: nhcoa.org