Virginia Senate Candidates Face Tough Issues Beyond Medicare, While Key California House Races Are Shaped By It

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteyPolitico (Video): Baldwin Raises $4.6M In Third Quarter, Attacks Thompson For HHS Role Wisconsin Senate candidate Tammy Baldwin took in just under $4.6 million for her campaign during the third quarter of 2012, a campaign source tells POLITICO… Baldwin’s Republican opponent, former Wisconsin Gov. Tommy Thompson, hasn’t yet released his most recent fundraising information, though his campaign told the Milwaukee Journal Sentinel that he has raised between $2 million and $3 million since the primary. Balwin is putting some of her cash toward attacking the Republican on the airwaves for his role in the Bush-era Medicare Part D law. In an ad set for release today, Baldwin says that as secretary of health and human services, Thompson “cut a sweetheart deal with drug companies while working for George Bush, making it illegal for Medicare to negotiate lower prices. Then Tommy made millions at a DC lobbying firm working for drug companies.” That’s of a piece with the messaging Democrats have used to tear down Thompson since he entered the general election as a perceived front-runner over the summer (Burns, 10/15).
Source: kaiserhealthnews.org

Video: Vice President Joe Biden on Medicare – Blacksburg, VA

Virginians Can’t Wait

Earlier that day, state Sen. Emmett Hanger had told the Senate Finance Committee, “I believe this is the most important decision on our table in this session.” Jill Hanken, health law attorney for the VPLC, quoted Hanger’s words at the press conference. She also reported that Dr. Bill Hazel, Virginia’s Secretary of Health and Human Resources, reminded the senators, “Any delay puts us further behind and will lead to further delays.”
Source: vplc.org

Allison family blog: West Virginia Medicare

These two parts of Virginia had the west virginia medicare and to rent a vacation cabin rental companies will allow you to leave, and plan your vacation planning, to research the west virginia medicare and surrounding environment so that you must first file an application with the Social Security Administration, by either filling out an application with the west virginia medicare in mind that you must always find ways to rebuild credit. On the other parts have humid continental climate. It has humid subtropical climate while the west virginia medicare and financial standing will be paying a sub-prime rate that is compatible to fit a laptop is nice. It is my understanding that practically every direction.
Source: blogspot.com

HCAN Partners: Tax Corporations, Protect Medicare, Medicaid, ACA

Citizen Action of Illinois held a press conference outside the office of Rep. Rodney Davis (R-13) in Champaign, Illinois to highlight the negative impact of budget cuts and joined the Chicago Federation of Labor at a gathering in Chicago to push back against cuts to Medicare, Medicaid, the Affordable Care Act, and Social Security. Leaders were joined by U.S. Reps. Jan Schakowsky (D-9) and Bill Foster (D-11).
Source: healthcareforamericanow.org

Bipartisan Bill Would Repeal Medicare Hospital Payment Loophole

Sens. Claire McCaskill (D-Mo.) and Tom Coburn, MD (R-Okla.), have introduced a bill that would sunset Section 3141 of the Patient Protection and Affordable Care Act — a controversial provision that sets the Medicare hospital wage index floor for the entire country. Under Section 3141, the Medicare hospital wage index is adjusted so that a state’s urban hospitals must be reimbursed for wages paid to physicians and staff at least as much as rural hospitals. These reimbursements for hospital wages also come from a national pool of money, meaning that if one state receives higher Medicare wages, it will come at the expense of another state. In January, 20 state hospital associations — Alabama, Arkansas, Delaware, Georgia, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Carolina, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Virginia, West Virginia and Wisconsin — as well as the National Rural Health Association wrote a letter (pdf) to the White House arguing this provision is decimating their Medicare reimbursements.   A Boston Globe report found that Massachusetts had received an estimated $367 million in additional Medicare funding due to Section 3141 because the state’s only rural hospital — Nantucket (Mass.) Cottage Hospital, based in an affluent area with a high cost of living — set an inordinately high floor for wage reimbursements. In total, nine states received higher Medicare wages under the provision, while the remaining 41 lost Medicare funds. Sens. McCaskill and Coburn called the provision “unfair” and said it only benefited hospitals in some states to the disadvantage of many others.
Source: beckershospitalreview.com

Rankin: Hospitals support expansion of the Medicaid program

Affordable Care Act anthrax CDC Culpeper Regional Hospital Dana Tate Dantra Healthcare Dr. Abdul Durrani Dr. Andrew Reese Dr. Jody Crane emergency planning First National Brokerage Corporation Fredericksburg Fredericksburg Regional Chamber of Commerce Greenfield Senior Living H1N1 HCA health care Health Department HealthSouth Rehabilitation Hospital Julie Sutherland Kaiser Permanente Lindsey Waters Mary Washington Healthcare Mary Washington Hospital Medicaid Medicare MicAnd Assisted Living Mid-Rivers Cancer Center NextCare Urgent Care patient satisfaction Pratt Medical Center Rappahannock Area Health District Reese Medical Associates Robins & Morton Sandra Lamb Senior Care Geriatric Medical Center Snowden at Fredericksburg Spotsylvania Spotsylvania County Spotsylvania Regional Medical Center Stafford County Stafford Hospital VCU Massey Cancer Center Virginia Board of Medicine Virginia Department of Social Services
Source: fredericksburg.com

Virginia Cash Advance Loans: Fast Approve Negligence Law Suits

If Edna files a lawsuit against the supermarket for negligence and private injury and recovers ,000, Medicare will seek repayment of the monies paid on her behalf behalf for injuries related on the fall. Under Federal law, Medicare doesn’t ought to provide Edna notice which they intend on seeking repayment. See 42 CFR §411.26. But simply how much will Medicare seek in repayment? Sadly, we simply cannot answer that question for Edna or her family. Each lien is determined on a case by case basis… but by law, Medicare should reduce their demand, taking into consideration there were costs with filing a lawsuit or seeking money (including attorneys’ fees, expert’s fees, etc.). But what if your ambulance bill was 0; Emergency Room 00; Surgery 00; Four day hospital Stay 00; and twenty days in the Nursing Home getting rehab, 00. Medicare may have paid a minimum of ,400.00 for Edna’s care, and effectively can take nearly every penny of her ,000 settlement after attorneys’ fees and costs…so we warn clients, right away – THERE IS A POTENTIAL LIEN ON YOUR RECOVERY… AND WE WON’T KNOW HOW LARGE OF A LIEN UNTIL THE END. Not only is scary for many clients, it’ll get enough of an deterrent the household will decide to never file suit.
Source: blogspot.com

Survey: Medicare Beneficiaries Oppose Mandatory Mail Drug Plans

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 Care[…] Hoey continued “denying seniors, many of whom are on complex medication regimens, the right to obtain medication from the pharmacy of their choice and from a pharmacist they trust deprives them of vital face-to-face consultation with one of their healthcare providers. Local pharmacists help to reduce medication waste that may be associated with mail order, auto-ship programs. They also provide services unique to the community such as offering same day home delivery or fulfilling patient-specific requests.  These services not only benefit the patient, they benefit the healthcare system by reducing the number of preventable, bad outcomes that often lead to costly hospitalizations or emergency room visits that drive up healthcare costs.”Source: thepharmacyblog.com […]
Source: thepharmacyblog.com

Video: Medicare Part D and Prescription Drugs

Viewpoints: Sen. Hatch’s Prescription For Safeguarding Entitlements; Medicare Crackdown On CVS Drug Program; JFK’s Mental Health Vision Failing

Boston Globe: Hospital Fees Shouldn’t Apply For Treatments In Doctors’ Offices When health care providers send out confounding medical bills thick with mysterious fees, it’s stressful to patients, and it illustrates a troubling lack of transparency within the health care system. Consider the case of local patient Robert Reed, who had three pre-cancerous spots treated with liquid nitrogen at a suburban dermatologist’s office last year — and was billed not just for the doctor’s visit, but for $1,525 in operating room and hospital charges. Reed’s case, profiled in a recent Globe article, isn’t unusual. Amid widespread confusion about who’s paying whom and for what, it’s easy for costs to keep on going up. That’s why it’s important for medical bills to reflect the true price of the procedure — and avoid any add-ons that seem designed simply to take advantage of arcane insurance rules (2/5).
Source: kaiserhealthnews.org

Turning 65: Finding a Prescription Drug Plan

This is the fourth in a series of posts that examine the process of signing up for Medicare, navigating its rules, choosing supplemental coverage and planning for health care in a program with a very uncertain future.’  Here are the first, second’ and third’ posts in this series. If I were to choose a Medigap policy to supplement my basic Medicare coverage, I would still have to buy a separate plan for prescription drugs, since Medigap sellers can’t include drug benefits in those policies.’  In its effort to expand the market for private insurers, Congress wanted to keep the drug benefit separate.’  That way more sellers could offer more products.’  And offer more products they do’so many of them that it’s nearly impossible to weigh all the variables and pick the right one, given that your prescription needs can change during the year.’  In January, you might take only one medication or perhaps none.’  In December, you might need several for a newly discovered disease. ‘ So right off the bat, it’s impossible to assess your risks and needs.’ ‘  Still, I gave it a shot by using the shopping tools Medicare provides.’ ‘  The first thing was to figure out the retail cost of the drugs I currently take.’  I have always had super drug coverage, so it was shocking to learn that my drugs would cost $3,131 if I had to pay out of pocket.’  From interviewing seniors over the years, I know they can be paying four or five times that amount to cover multiple or even more costly medications.’  ‘ Armed with that information, I began the selection process by looking at Medicare’s handbook Medicare & You for initial guidance, noting that there were 33 stand-alone drug plans I could choose from in New York City. How to pick one, though?’  I called 1-800-Medicare and got nowhere.’  It took four minutes to make an electronic operator ‘understand’ what my Medicare number was.’  Once we got through that, the digits aligned, and I was informed that I had not chosen a drug benefit and needed to enroll in one or face a penalty.’  I knew that; I just wanted someone to answer three questions.’  Finally, the electronic voice said I could say ‘agent,’ and someone would help me.’  I did and was told I had to wait ten minutes.’  I hung up and called the Medicare Rights Center in New York City, a non-profit organization that’s supposed to help seniors through this selection morass. I once served on the board of directors for this Center and thought I knew how it worked. But the help I got was disappointing.’ ‘  How do I make a choice, I asked.’  Any senior might ask the same question.’  The counselor asked if I had access to the Internet and directed me to go to Medicare.gov and enter the requested information.’  ‘They will give you a few options,’ he said.’  But how do I choose among those options, I wanted to know.’  ‘Make sure the plan covers your most important drugs and of course, the cost of the plan’the monthly premium’may be a factor,’ he advised.’  Duh! I thought.’  I pressed: Was there anything else that I should consider?’  Yes, he said, don’t enroll in a plan on the Internet.’  It’s best to call Medicare directly.’  Sometimes it doesn’t go through (presumably the application), and you think you’re enrolled but you’re not.’  It’s best to speak to a live person at Medicare.’ After all the trouble I had reaching a live person, that advice hardly seems realistic. Having struck out with the help lines, I examined the handbook once again trying to find a suitable choice among the 30-some offerings displayed.’  The first thing I noticed was a string of stars after each plan’a satisfaction rating determined by Medicare.’  But what did satisfaction mean?’  Did people complain if they had to pay too much out of pocket?’  Did the pharmacy give them a hard time because of restrictions placed by the insurer?’  Did they have to wait more than an hour to fill a prescription?’  The broad term ‘member satisfaction’ was too vague for perfect decision-making so I asked the counselor at the Medicare Rights Center what it was.’  He told me he didn’t know and had to ask a colleague.’  Finally, he said the stars are ratings by Medicare as far as complaints or grievances, or from beneficiary surveys.’  “The more stars, the better the plan.”  I got that. Most of the plans rated two or three stars; a few got only one’not a great endorsement of quality even if I wasn’t quite sure what it was.’  So I looked at the two-star, four-star and five-star plans. Two of the five-star plans had deductibles of $310. ‘ One had a deductible of $100, but a higher premium’a common trade-off in this business.’  They all had coinsurance of 25 percent of the drug bill, but what did it apply to?’ ‘  The four-star plans had lower deductibles.’  One from First United American had a $110 deductible for some drugs and a premium of $49.80.’  The handbook said to call the plan.’  Just what I wanted, another phone call!’  The UnitedHealthcare/AARP four-star plan had a slightly cheaper monthly premium, $38.60, and no deductible applied to any drugs.’  One would require me to pay 33 percent of a drug bill; the other 30 percent.’  Again it wasn’t clear what that meant.’ ‘  The Medicare handbook didn’t say, but a sales brochure from UnitedHealthcare did.’  It would apply to ‘specialty tier’ drugs’unique and very expensive medications.’ ‘  I don’t take any of those.’  Seniors pay one way or another through a combination of higher or lower premiums, deductibles, copays and coinsurance.’  So the UnitedHealthcare/AARP plans looked like winners.’  The fact that they had no deductible also made them appealing. My shopping experience would not be complete unless I consulted Medicare.gov and went through the four steps of selecting a drug plan.’  At first, the process seemed pretty straightforward.’  I entered some basic information like the kind of Medicare I had, listed my three medications and selected the neighborhood pharmacy I use.’  Someone who takes lots of drugs could find it frustrating to gather all the prescriptions and enter the dosage and quantities before the website times out.’  I had to try a couple of times to get it right.’  Then came the comparison step, a frustrating and practically useless exercise.’  The website said I had 30 plans to choose from, but it seemed like they weren’t the same as the ones in the handbook.’  The website listed a Medco plan with four and a half stars.’ ‘  The handbook showed only three stars for Medco plans.’  I was growing suspicious of the website information. The ‘compare plans’ section provided a lot of data’monthly premiums, deductibles, copayments, estimated health and drug costs, and the estimated annual retail cost of my drugs.’  I presumed they were using retail prices that the pharmacy I listed was charging.’  But the numbers did not match those that the pharmacy gave me for the drugs.’  The pharmacy said that my drugs would cost $3,131, but Medicare.gov gave me totals in the $1,200 to $1,400 range for some of the options.’  I did discover a note that said costs may be different depending on the amount of the Part B premium and any Part D penalties.’  Maybe that was the difference.’ ‘  At this point, I lost patience, especially since trying to print lots of pages and comparing zillions of numbers was really hard. In the end, I didn’t trust the website information, and if I were to choose a stand-alone plan, I would probably pick one of the AARP offerings.’  The three-star plan was more comprehensive than the one with four stars, and knowing that I don’t like risk, I would probably choose it.’  The sales brochure was clear and told me what I needed to know. The next task for me to cover Medicare’s gaps was to examine Medicare Advantage plans, which would put my coverage totally in the hands of private insurers, not the government.’ ‘ ‘  More on Medicare Advantage in an upcoming post. Tags for this article: Medicare   Inside Healthcare   Prescription Drugs   Trudy Lieberman   Pay for your Health Care   Aging Well  
Source: cfah.org

State announces changes to prescription drug plans for retirees, pensioners

Some individuals qualify for extra help to pay for prescription drug premiums and costs. Those who want to see if they qualify can call Medicare at 1-800-MEDICARE (1-800-633-4227) any time (TTY users should call 1-877-486-2048); the Social Security Office at 1-800-772-1213 between 7 a.m.-7 p.m., Monday through Friday (TTY users should call 1-800-325-0778); or the state Medicaid office.
Source: udel.edu

Researcher: Older Medicare drug plans cost more

Medicare Part D program rules prohibit insurers from offering introductory discounts to gain market share, but Ericson says an insurer still has an incentive to find ways to use a subtle “invest then harvest” marketing strategy: setting initial rates low to attract first-time enrollees, then raising prices substantially once the insurer has a base of enrollees who are “stuck in place.”
Source: lifehealthpro.com

Report: Most top Medicare drug plans hiking premiums

President Barack Obama’s health care law does not appear to be the cause of the increases. The law actually is improving the prescription benefit by gradually closing a coverage gap called the “doughnut hole,” which catches people with high drug costs. Instead, the price hikes appear to be driven by market dynamics, and some insurers are introducing new low-premium options to gain a competitive advantage on plans that are raising their prices.
Source: sltrib.com

Medicare open enrollment: How can I find a better plan?

What about doctor availability? On the Medicare site you can directly compare up to three plans, and when I selected your current plan and these other two plans, I saw that your current plan says it has 1001-1500 “physicians and providers,” compared to 4001-5000 for the other two plans. For each plan you can click on “View provider and physician network website,” which takes you away from Medicare.gov and onto the plan’s own website, where you can search its provider directory to judge for yourself whether it has enough doctors to meet your needs.
Source: consumerreports.org

Last Chance to Disenroll from Your Medicare Private Health Plan

Beneficiaries who disenroll from their private plan may need to join a stand-alone Medicare prescription drug plan in order to maintain drug coverage. Medicare Rights advises beneficiaries who are choosing a plan to consider not only premium and copayment costs, but also whether the drugs they take are on the plan’s formulary (list of covered drugs) and whether they can use the pharmacies they prefer. Beneficiaries should also check to see whether the plan places any restrictions on the drugs they take. Restrictions can take the form of quantity limits, prior authorization and step therapy. To learn more about choosing a Medicare prescription drug plan that best meets your needs, visit Medicare Interactive.
Source: utahboomersmagazine.com

CBO Updates Spending Projections for ACA, Medicare, Medicaid

Posted by:  :  Category: Medicare

Budget vs Budget by boris.rasinAccording to CBO, the new estimate is the result of the American Tax Payer Relief Act, which maintained lower tax rates for U.S. residents with annual incomes below $450,000. The lower rates “reduce the relative attractiveness of employment-based insurance for low-income workers and for their employers.” In essence, offering health coverage as a tax-free form of compensation is less appealing when marginal tax rates are lower and a publicly subsidized option is available. CBO estimated that employers will pay $13 billion more in fines for non-compliance with the ACA’s employer mandate. 
Source: californiahealthline.org

Video: Medicare vs Medicaid

Tavenner Nominated Again To Lead Medicare

Kaiser Health News: Grassley Calls For Senate Consideration Of Tavenner’s Nomination President Barack Obama Thursday once again nominated Marilyn Tavenner to head the Centers for Medicare & Medicaid Services, and a key GOP senator said the chamber should consider the nomination. “The Senate should give Ms. Tavenner every opportunity to show she is a worthy choice to lead the agency responsible for Medicare, Medicaid, the Children’s Health Insurance Program, and a lot of the implementation of the Obama health care law,” said Sen. Charles Grassley, R-Iowa., who is a member of the Finance Committee and its former chairman and ranking member. Grassley said he hoped the panel would give Tavenner’s nomination “due consideration through regular order” (Carey, 2/8).
Source: kaiserhealthnews.org

Obama to set elders against the poor by going after Medicare not Medicaid

A blog (from “web blog”) is a discussion or informational site consisting of discrete entries (“posts”) typically displayed newest first. All Corrente posts are front-paged; there is no up-rate or down-rate process. Corrente posts are almost entirely community moderated. We encourage a clash of ideas, and do not encourage a clash of persons.
Source: correntewire.com

Gene Sperling: Medicaid Is Safe, Medicare Is Not

The one upside to the Supreme Court making the Medicaid expansion in the Affordable Care Act optional is that it has stopped the Obama administration from trying to cut it. Senior economic adviser Gene Sperling confirmed that the administration sees taking Medicaid completely of the table as necessary to make Obamacare function; but since President Obama is still obsessed with deficit reduction, he will instead focusing on cutting Medicare. The Hill:
Source: firedoglake.com

HCAN Partners: Tax Corporations, Protect Medicare, Medicaid, ACA

Citizen Action of Illinois held a press conference outside the office of Rep. Rodney Davis (R-13) in Champaign, Illinois to highlight the negative impact of budget cuts and joined the Chicago Federation of Labor at a gathering in Chicago to push back against cuts to Medicare, Medicaid, the Affordable Care Act, and Social Security. Leaders were joined by U.S. Reps. Jan Schakowsky (D-9) and Bill Foster (D-11).
Source: healthcareforamericanow.org

President Obama Mentions Medicare and Medicaid in his Second Inaugural Speech

In a speech with a strong focus on unity among Americans and with a heavy emphasis on social progress, President Barack Obama briefly mentioned healthcare in his second inaugural address on Jan. 21 outside the U.S. Capitol in Washington, D.C., as he addressed a crowd estimated at approximately 600,000 people on the side of the Capitol and spreading across the National Mall, as well as millions on live television. “We must make the hard choices to reduce the cost of healthcare and the size of our deficit,” the President said. “But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future. For we remember the lessons of our past, when twilight years were spent in poverty, and parents of a child with a disability had nowhere to turn.” Instead, the President said a moment later, “The commitments we make to each other—through Medicare and Medicaid and Social Security—these things do not sap our initiative; they strengthen us. They do not make us a nation of takers; they free us to take the risks that make this country great.”   The new Congress goes back into session on Jan. 22, with Medicare spending in contention in a series of upcoming legislative showdowns, including discussions over whether and when to raise the federal debt ceiling; whether and how to fund the federal budget for another year, or possibly allow the federal government to temporarily shut down; and how to handle still-unresolved issues around the budget sequestration that was temporarily delayed by the Jan. 1 vote to avert the so-called “fiscal cliff.” All three of those issues will have to be resolved within the next few months, and the exact disposition of each of the three issues remains uncertain.
Source: healthcare-informatics.com

Daily Kos: Poll finds majority support for exchanges, Medicaid, Medicare

Consider if one or more of these tags fits your diary: Civil Rights, community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don’t fit in any of these tags. Don’t worry if yours doesn’t.
Source: dailykos.com

Upcoming event: Medicare 101

Posted by:  :  Category: Medicare

Barack Obama on Social Security (photo by Transplanted Mountaineer (Flickr) by Been Buddy LongwayOn Monday, February 11, the Alliance for Health Reform and The Henry J. Kaiser Family Foundation are co-sponsoring a briefing on the hill called Medicare 101: What You Need to Know. It will be helpful to congressional staff members and others new to the issue, but it will also be a useful review for anyone dealing with Medicare issues, particularly as pressure intensifies to slow the growth of program spending.
Source: disruptivewomen.net

Video: 2007 Health Net Cup

American Counseling Association Weblog

Work Conditions: *The work conditions and physical demands listed below are representative of those that must be met by an associate to successfully perform the essential functions of this job. Associates are expected to follow the proper work safety practices and procedures for their personal safety and to prevent possible injuries. * Computer usage may be required up to 50 percent of the time, including heavy typing, keyboarding, data entry, repetitive motion, and/or eye strain. * May be exposed to confidential information and expected to maintain confidentiality at all times; must adhere to HIPAA rules and regulations. * May be required to work outside of normally scheduled hours as mandated by the client, project and/or workload (e.g. evenings, weekends, and/or holidays). * Phone usage may be required up to 15 percent of the time; headsets may be required. * May be required to maintain established work pace, meet deadlines; may have last minute urgent requests. * May be required to travel 25 percent of the time. * May be required to lift, carry and/or move equipment/supplies weighing up to 50 pounds. * May operate personal computers, printers, facsimile, telephones, copy machines and other commonly used office accessories/equipment. * Frequent interruptions/distractions; environment may be loud. * Physical activity may include: twisting, reaching, kneeling, bending, stooping, squatting, crawling, grasping, grabbing, pushing, pulling, repetitive motion, climbing, etc. * Significant reading required via internet and/or bound regulatory volumes. * Work may be sedentary, desk bound or seated up to 8 hours per day. * May be required to walk or stand up to 4 hour per day; walking and/or transporting supplies and equipment between buildings/parking lots and structures may be required
Source: counseling.org

Decrease Increasing Medicare Costs with Healthnet Medicare Arizona

Healthnet medicare arizona also helps you cover your medications. The more medication that you are on, the more money you will need to pay for these medications. The cost of medications keeps increasing, and since you need them, each month you will have a fixed cost for your medications. The only way to change a fixed cost is to change find a new provider for the medications or by enrolling into a new health plan that will help you reduce your monthly payments. By enrolling in healthnet medicare Arizona, you can save money on these medications and thus increase your discretionary income for each month. For example, if you make $3,000 a month and $400 of it goes to medications, then you enroll in healthnet medicare arizona, and your medication cost is decreased to $20 a month, you would increase your monthly discretionary income by $380. So, that is $380 that you can use on anything else you want instead of the medications that you need to live a healthy life.
Source: millionboatfloat.org

Dems Face Internal Divide On Medicare, Safety Net Questions

National Journal: Bold Medicare Reform May Require Going Beyond The CBO Score Liberal Democrats would rather not see any cuts to entitlement programs — period. Instead, they argue, the U.S. government needs to put policies in place that will bring down the costs of health care overall. Make care cheaper to administer, the argument goes, and Medicare and Medicaid won’t cost the federal government so much. It’s a beguiling idea with one big flaw: The Congressional Budget Office isn’t always able to put a dollar figure on how much money Democrats’ ideas would save. As Washington negotiators work toward a debt-reduction deal, Democrats want reducing the cost of care to be part of the conversation. But budget negotiators want to be able to talk in dollars. CBO’s scoring rules “much too much embed the status quo. They require levels of certainty about the costs and benefits that defy many forms of innovation,” said Donald Berwick, a Center for American Progress senior fellow and former administrator of the Centers for Medicare and Medicaid Services (Quinton, 11/20).
Source: kaiserhealthnews.org

Marin•Sonoma IPA inks Medicare contract with Health Net for Sonoma County Seniors

Great. Seniors get their coverage so that they don’t have to experience the inconvenience of leaving town. (Even though their property taxes are exempt from the huge costs to keep "their" local hospital in business.) The non-insured also get to keep their "free" local care; paid for by the rest of us. The only ones to be forced to leave town for their health care are working families, who must use Kaiser or other out-of-town options because the local out-of-pocket costs are too high. So those that are paying for this huge privilege of localized medical care in this town are the least likely to be able to use it. Something stinks about this picture.
Source: patch.com

Medicare imposes marketing and enrollment suspensions on HealthNet, Arcadian and Universal American (Today’s Options).

Arcadian had their webinar today as well. On the call the moderator did not and would not discuss the other companies. It was very refreshing for me to see that respect for the competitors. One of the things we did discuss was the sanctions, while marketing practices were a component, a large part of the sanctions revolved around Rx administration. The Rx vendor is not specifically mentioned nor will I name them. I am however disappointed that no specific action is to be taken when this vendor is responsible for issues with ALL the companies receiving sanctions. All of the companies/MAPD Plans are working hard with the CMS to correct the issues and will be back to marketing in 4 to 6 months. My feelings go out to all of the beneficiaries that will miss out on these plans. In some markets, the sanctioned plans are the most intelligent option.
Source: wordpress.com

Health Department Holds Tibetan Medicare System Review Meeting

The Tibetan Medicare System (TMS) experience sharing meeting started on 21s January at Micro Insurance Academy (MIA) conference hall with a welcome speech by the chairman of MIA, Prof. David Dror and a keynote address by Health Kalon Dr. Tsering Wangchuk. It was later followed by presentations by various health executive officers from numerous Tibetan settlements.
Source: tibet.net

Coburn, McCaskill Introduce Bill to End Medicare Payment Gimmick in Health Reform Law

(WASHINGTON, D.C.) – Today, U.S. Sens. Tom Coburn, M.D. (R-OK) and Claire McCaskill (D-MO) introduced a bill, S.183, that would sunset Section 3141 of the Patient Protection and Affordable Care Act (PPACA).  The provision adjusted the calculation of a hospital wage index used to make payments under the Medicare program. Unfortunately, the provision has the net effect of reducing Medicare reimbursements for hospitals in every state except for Massachusetts.  Sens. Coburn and McCaskill’s bill would eliminate this gimmick by sunsetting the provision, ending the favoring of hospitals in one state at the expense of all the other states’ hospitals.
Source: harrahfirst.com

Anthem Blue Cross Medicare Supplement Plan F

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSAlso California offers another special enrollment period that is guaranteed issue called the “California Birthday Rule”. The California Birthday rule is great for seniors who already have a Supplement Plan because it allows them to switch to a like or lesser plan guaranteed issue every year on the day of their birth and thirty days after.
Source: healthbrokerdave.com

Video: Medicare Supplement Insurance Plans – Where Do I Start?

Medicare and Medicare Supplemental Insurance

Medicare supplemental insurance is the easiest way to bridge the coverage gaps in traditional Medicare coverage.  The Medicare supplement plans will cover varying numbers and combinations of the nine gaps.  The most popular and expensive of the plans is plan F because it covers the all of the gaps, while plan A tends to be the least expensive because it only covers the minimum of four gaps.  Each plan has its merits but knowing which one to get can only be based off of your individual needs and budget. You can get a free quote of medicare supplement rates here.
Source: tablib.org

Cancel Medicare Advantage

Because of their flexibility, the ability to move states and the fact that the insurance company cannot change the plan are just a few of the reasons we prefer Medicare Supplement Insurance Plans to MAPD. If you would like to hear more about the reasons a Medicare Supplement can be a better fit for your insurance, please fill out the short form at the top of the page and one of our experts will get you a new medicare supplement quote and help explain how you can save the most off your medicare cost.
Source: medicarecost.net

What benefits are offered by Oregon Medicare supplement plan?

State and federal regulatory our body is responsible for managing Medicare supplement plans in Oregon. Same benefits are offered to the beneficiaries whatever the insurer. The only difference in the policies will be in the cost, kind of plan chosen from the insurers and administration who manages the program. You can contact and buy insurance plan through the health insurer that offer best benefits you can also simply shop around to find the best suitable Medicare supplement Oregon. One of the better and most suitable insurance plans is SELECT policy. This can be Oregon Medicare supplement plan in which beneficiaries can be found a complete network of hospitals, doctors and medical medical care services.
Source: wordpress.com

Medicare Supplemental Insurance Plans D, F, and G

In addition to what Plan A covers, Medicare Part D provides coverage for coinsurance for skilled nursing facility, Medicare Part A deductible and foreign travel emergency coverage. Over and above Plan A coverage, Medicare Part G provides coverage of skilled nursing facility, Medicare Part A deductible, foreign travel emergency coverage, and Medicare Part B excess cost coverage.
Source: medicaremedics.com

Comparing Medicare Supplemental Insurance Benefits

These plans, called “Medigap” plans, each have different medical care coverage. Variable benefits of coverage to be considered are: • Coinsurance plus coverage that last 365 days after medicare benefits end (Medicare Part A) • Coinsurance/Copayment for medicare part B. • Pints of blood (transfusions, first three pints) • Hospice care copayments or coinsurance • Coinsurance for Skilled Nursing Facilities • Part A medicare deductible • Part B medicare deductible • Part B excess charges • Emergencies during foreign travel • Preventative care coinsurance, per Medicare Part B If any of these are important for you to have covered, comparing medicare supplemental plans that include benefits is the only way to ensure they are included.
Source: seniorcorps.org

What Is A Medicare Supplement

There are ten different Medicare supplement plans.  Each one is given a different letter.  The letters skip a few here and there because plans that were once available have been retired and the labeled the new plans with the next letter in the alphabet so as not to create confusion for people who were grandfathered in on the old plans.  The plans themselves cover a varying number of combinations of the nine different coverage gaps that were left by the coverage you get with Medicare Part A and Medicare part B.  The Gaps include: the deductible, coinsurance, first three pints of blood and hospice care from Medicare Part A, The deductible and coinsurance for Medicare Part B, skilled nursing facility care, and expenses for foreign travel emergencies. Which plan you select dictates how many or what combination of these coverage gaps are covered.  Plan A covers only four of the gaps while Plan F covers all nine.
Source: seanbrock.com

Medicare Supplement Plans ARE created equal Medicare Supplement Insurance

The price, or commissions a company wishes to embed within the price, is the only difference between a Plan F from Company A or Plan F from Company B. The benefits are all the same. Today, all companies utilize electronic claims payment. They absolutely MUST pay the bill on Medicare-approved claims. While it is important to shop with “A” rated carriers for strength, it is equally important that seniors not fall in love with a brand name with Medicare Supplement insurance. Why? Because a policy with one company does not pay any more benefits than the policy with the lesser known company brand. They all function exactly the same.
Source: lifelonginsurance.com

Health Products for Members: Health Insurance, Dental Insurance, Fitness

AARP Health is a collection of health related products, services and insurance programs made available by AARP. Neither AARP nor its affiliate is the insurer. AARP contracts with insurers to make coverage available to AARP members.
Source: aarp.org

What Is Medicare Gap Insurance?

Posted by:  :  Category: Medicare

SCOTUS Obamacare Decision Makes Individual Mandate A Fact & Universal Healthcare Coverage A Fiction by watchingfrogsboilA lot of senior citizens do not realize that not all states carry Medicare gap insurance. You can consult an expert on the subject to know if you are eligible for such insurance, and if the state you are in is also carrying such insurance. Different states have different laws when it comes to Medicare supplemental insurance, an example is that some states allow you to apply for gap insurance on a limited window, and if you have already a Medicare part B. Again, it is best to consult with a professional to avoid confusion and headaches, and also speed up the whole process.
Source: seniorcorps.org

Video: Medigap Insurance Supplement in Missouri by 1-800-MEDIGAP®

Spend A Tension Free Retirement Life

The retirement life of any person is supposed to be great pleasure and relaxing; most people spend the most relaxed time of their life after this age. But, with age comes several problems; the most noticed of which are the physical ailments and other diseases. Old aged people are extremely vulnerable to all these and they get affected very quickly. At that age most people do not have any source of income; they spend the money which they have saved when they used to work. So, when a person needs medical treatment several financial problems occur. The life time savings of a person almost vanishes because of the huge medical treatment bills. In order to help the helpless elder citizens from such problems, govt. of several countries has introduced the medicare health insurance plans. The medicare health insurance plans cover a large part of the medical treatment bills and the govt. pays the money required for a persons treatment. However, since the medicare health insurance plans do not cover the entire medical bill, most people have to face serious financial problems. Having ready cash all the time is pretty difficult for any common person. So, when the medicare plan fails to cover the entire medical bill, the remaining amount has to be paid by the person.
Source: gastosocial.org

Policy Store Top 5 Medicare Supplemental Insurance Picks!

3.) Supplementtomedicare.com– A website designed to fulfill your every Medicaresupplemental insurance needs! Supplement to Medicare is certain that they are able to support you in finding the best Medicare Supplemental insurance policy for you. Not to mention, they are there for you 7 days a week. Should you have a question or concern, you have the option of calling an agent to help you. Supplementtomedicare.com is a website who is proud to be there for their customers.
Source: globenewswire.com

Reform Spurs New Vision, Dental and Gap Insurance Products from QualChoice

Under the Affordable Care Act, also known as Obamacare, health insurance companies must spend at least 85 percent of the premium they collect on health care for customers in large group policies and 80 percent on small group and individual policies. (A small group policy is up to 100 employees.) If the health insurance company spends less on health care costs under those plans, the difference could be refunded to policyholders.
Source: arkansasbusiness.com

2013 Medicare Advantage Plan Enrollment

While the political pundits argue that privatized Medicare insurance doesn’t work, the numbers tell a different story.  With ObamaCare focused on Medicare quality over quantity metrics to drive down insurance and healthcare provider costs, the gap between Original Medicare costs and Advantage Plan costs is narrowing.  The gap will close further in 2014. That’s when Medicare Advantage insurance carriers are required to spend no less than 85 percent of their insurance premium revenue on direct healthcare benefits.
Source: medicarewire.com

Texas Medicare Gap Insurance Quote

Contrary to what many people believe, Medicare does not cover all medical needs 100%. There are often times gaps which require an individual to purchase supplemental insurance. Medicare will cover most hospital bills from participating providers up to around 80%. The other 20% becomes the responsibility of the individual. A person interested in coverage for dental, hearing and vision will also find that Medicare does not provide the necessary coverage. Routine checkups and many prescription medications are also not covered. Long-term care is also not included in Medicare coverage. Because of the massive amount of things not covered by Medicare, getting a Texas Medicare gap insurance quote is the first step to comprehensive health insurance.
Source: medicareinsurancetexas.com

Matt Miller suggests Gov Jindal propose my book

ACA Affordable Care Act Amendment One Balancing the budget is a progressive priority budget deficit cadillac tax cbo Charles Blahous CLASS Act college tuition cost effectiveness debt ceiling debt limit deficit dual eligibles end of life fiscal commission health care costs health reform hospice Hospice/Palliative Care individual mandate IPAB Long Term Care Long Term Care Insurance Medicaid Medicare Medicare Advantage National Flood Insurance Program Negotiated Rulemaking NHS On The Record Patients’ Choice Act Paul Ryan premium support rationing RWJF smoking smoking cessation social cost of smoking Social Security Social Security Disability Insurance Super Committee tax reform The cost of smoking
Source: wordpress.com

Asterisk Predictive Dialer

Posted by:  :  Category: Medicare

There can be varied Texas Medicare Supplements and it really is can also straightforward method to select 1. The very first step would be to pick up a plan according to the individual’s requirements. Once the coverage is decided, then the premiums and compensated which has a large amount of advantages. The key advantage in the http://www.texasmedigapinsurance.com/texas-medicare-supplement is the fact that the consumer can bear treatment from any on the physicians who take medicare. Men and women can also get in touch with the officials totally free if in situation you can find any obligations. There are actually loads of factors which should be viewed as prior to selecting a program from Texas Medicare Supplements. As these ideas are effortless, very easy and simple to get, people today really should seek out the amount which is past the original capital. Generally, each of the firms can deliver premiums at a very low fee for the consumers along with the premiums may very well boost as they grow old. As the rates may well vary from corporation to corporation, people today can choose the business offering reduce high quality prices. This may perhaps be valuable for consumers these who usually do not come across the best plan inside the right organization, because the similar plan may be available in a distinctive price at a several organization. One can find also lots of agents helping persons for availing the Texas Medicare Supplements. The very best technique to avail the dietary supplements is together with the assist of those brokers, because they may well have make contact with with unique companies and could aid many people in getting the proper health supplement plan. You can find generally two components on the Medicare. One will be the element A plus the other is Portion B. Component A strategy offers medicare supplements for inpatients and hospital treatment. Component B offers the medicare supplemental for out sufferers. Hence the Texas Medicare Supplements are benefitiary for every one of the people since it could cut down the top healthcare costs.
Source: multiply.com

Video: Texas Medicare Supplements 2010: How to Choose a Plan.wmv

The Details of Texas Medicare Supplement

Texas Medicare Supplement plans are also referred to as Medigap plans. These plans are all labeled a letter, A through N, for easy identification. You should not however that some letters, such as E, are no longer open to people looking to enroll. Each letter corresponds with a different level of coverage. Some letters provide higher coverage while other levels provide lower coverage. Different insurance companies will offer Texas Medicare Supplement plans, however each lettered plan will be exactly the same in terms of coverage. This is because the government keeps a close eye on these plans and requires that each letter be the same, though prices may vary from provider to provider.
Source: posterous.com

Apply For Medicare Supplement Plans In Texas At The Lowest Rates

Just decision Texas MediGap Advisors at 1.866.894.3258 (512.341.3222) to induce the answers you would like and notice the simplest Medicare Supplement plans. MediGap Advisors will assist you type through the ten Medicare Supplement set ups currently obtainable by comparison your scenario and desires to the advantages of every plan. They’ll take a glance at your biggest health care expenses and show you the simplest Medicare Supplement plans to safeguard you from charges that Medicare doesn’t cowl.
Source: wordpress.com

Cigna Announces New Medicare Supplement Product

Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including American Retirement Life Insurance Company. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits and other related products including group life, accident and disability insurance. Cigna maintains sales capabilities in 30 countries and jurisdictions, and has approximately 71 million customer relationships throughout the world. To learn more about Cigna
Source: dlvr.it

Medicare Supplement Insurance Texas Agencies Offer Is Helpful To Certain Clients

The federal government allows private agencies to sell supplemental policies to customers. These policies help individuals to pay for the things that their original insurance does not cover. Companies that sell such policies must comply with very strict federal and state laws and regulations. They are standardized according to guidelines created by the United States government and all such policies must provide the same coverage, regardless of the agency from which the coverage is obtained. However, each agency is allowed to charge different rates for the coverage.
Source: myglobalseattle.org

Supplemental Security Income Disability Payments

Posted by:  :  Category: Medicare

The definition of disability for adults who apply for SSI is the same as for Social Security disability. Our article “What Is Disability According to Social Security Disability Law?” explains the definition. The requirements for a disabled child under age eighteen are somewhat different. Social Security will determine a child is disabled if he or she “has a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than twelve months.”
Source: disabilityadvisor.com

Video: Continued Medicare Eligibility and Work Incentives

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

ITEM Coalition Issues Survey RE Medicare Beneficiaries and Access to Assistive Technology Devices; Please Complete.

ITEM is currently surveying people with disabilities and chronic conditions to find out if they are experiencing problems accessing the devices needed to function independently.  ITEM is interested in medical device and assistive technology users that live in areas where Medicare has implemented a selective provider contracting program known as the DME Competitive Bidding Program.
Source: drnpa.org

Difference between Medicare and Medicaid

Eligibility for Medicaid:  May differ by state.  People with disabilities are eligible in every state.  Too much space would be needed here to get into all of the details of eligibility so I reccommend you use the Medicaid eligibility tool.  Here is the link:  http://finder.healthcare.gov/
Source: medicarehealthplans.com

Illinois Medicare Eligibility Requirements

Medicare benefits were originally designed to help United States citizens receive the health care they needed as they aged. In most cases, as long as you’re 65 or older and paid the appropriate taxes for at least ten years, then you’re eligible to receive Medicare benefits. Basically, if you or your spouse is entitled to receive Social Security or Railroad Retirement Board benefits or you’ve worked for federal, state or local government with Medicare covered employment, then you’re eligible for Medicare. If you are not 65, but have been receiving Social Security disability for at least 24 months or you have End-Stage Renal disease, you’re also qualified.
Source: ssiinsure.com

New Mexico Medicare Eligibility Requirements

Most New Mexico residents 65 or older are eligible to receive Medicare health benefits and are generally automatically enrolled.  If you are entitled to receive Social Security benefits because of age or you are disabled and have been receiving benefits for 24 months or longer, you are eligible to receive Medicare even if you are younger than 65. Part A benefits are free for most people, while Part B costs monthly. For those who are not qualified to receive Medicare, it can be purchase during the appropriate time period.
Source: newmexicomedicarehealth.com

Hinkle, Fingles & Prior, Attorneys at Law

For more information, contact us now. You may also use our contact form to schedule a free workshop at your school or organization. Comments and suggestions for future articles are welcome. The articles provided on the Hinkle, Fingles & Prior website are for your information and may be reprinted in publications, however copyrights cited for each apply. Each reprint must include the author’s name and contact information for Hinkle, Fingles & Prior, Attorneys at Law as follows: Hinkle, Fingles, & Prior, P.C., Attorneys at Law is a multi-state law practice with offices in Lawrenceville, Cherry Hill, Florham Park, and Paramus, New Jersey, and Plymouth Meeting and Bala Cynwyd, Pennsylvania. The firm’s partners and associates lecture and write frequently on topics of elder law, estate planning, special needs trusts, guardianship, special education, health care insurance & Medicaid, and accessing adult services, and are available to speak to groups in New Jersey and Pennsylvania at no charge. For more information, visit http://www.hinkle1.com/ or call (609) 896-4200, or (215) 860-2100.
Source: hinkle1.com

Another Reason We Need Medicare for All

This builds upon previous research that shows the Great Recession has seriously impacted older Americans’ ability to retire. An estimated 62 percent of working Americans now report they’re planning to put off their retirement — up from 42 percent in 2010 — largely due to job losses and financial insecurity. These issues go hand-in-hand particularly because, as health care costs continue to rise, Americans are increasingly worried about being able to afford their insurance coverage…
Source: politicsplus.org

Welfare State Explosion: Food Stamps Skyrocket, Disability Hits All

Under the president’s FY2013 budget proposal, means-tested spending would increase an additional 30% over the next four years. Such welfare spending refers to programs that provide low-income assistance in the form of direct or indirect financial support—such as food stamps, subsidized housing, child care, disability, etc.— which the recipient does not pay into (unlike Medicare or Social Security).
Source: ijreview.com

Office of Statewide Benefits provides information on Medicare Parts A, B enrollment

Failure to enroll and maintain enrollment in Medicare Parts A and B upon eligibility may result in the subscriber being held financially responsible for the cost of all claims incurred, including prescription costs. Retirees and spouses enrolled in Medicare Parts A and B must provide a copy of their Medicare Identification Card to be enrolled in the state of Delaware Special Medicfill plan.
Source: udel.edu

Medicare for All Rallies in Sacramento & Los Angeles to Celebrate Lobby Day, Feb. 11

Posted by:  :  Category: Medicare

Eliminate medicare advantage - Health care reform rally at San Francisco City Hall by Steve Rhodes■ San Francisco: San Francisco Main Library, Larkin and Fulton at 9 am. Reserve a seat through Don Bechler at Single Payer Now, 415-810-5826. ■ Richmond: Target, 42nd and MacDonald Avenue at 9:45 am. Reserve a seat through Cara at 510-663-4086. ■ Berkeley: Ashby Bart at 9:15 am. This bus will pick up in Richmond after the Berkeley stop. Reserve a seat through Cara at 510-663-4086. ■ San Jose: South Bay Labor Council, 2102 Almaden Road at 9:00 am. Reserve a seat through Greg Miller – (408) 254-3311. ■ Grass Valley: KMart, 111 W. McKnight Way at 9:30 am. Reserve a seat through Mindy’s email. ■ Roseville: UDW office, 800 Sunrise Avenue Suite C at 10:15 am. Reserve a seat through Diana at 916-435-9760. ■ Fresno: Mervyn’s Parking Lot, Ashlan and Shields at 7:30 am. Reserve a seat through Judy Hess – 559-907-0279. ■ Modesto: Old Krispy Kreme, Briggsmoore at Highway 99 at 9:15 am. Reserve a seat through Carol Bailey at 209-951-0499. ■ Stockton: Clarion Hotel, Highway 99 at Waterloo at 10 am. Reserve a seat through Carol Bailey at 209-951-0499.
Source: californiaonecare.org

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

Medicaid News: Minn. Effort To Expand Program Praised

California Healthline: Access Denied? Implications Of Medi-Cal Pay Cut In 2014, about 1.5 million adults in California are expected to gain access to Medi-Cal under the Affordable Care Act. However, insurance coverage could be all they get, as some observers say there might not be enough doctors willing to treat them. The fiscal year 2013-2014 budget proposal that Gov. Jerry Brown (D) released this month could be read as contradictory. On one hand, he makes it clear that California will pursue a full expansion of Medi-Cal, offering coverage to individuals with incomes up to 138 percent of the federal poverty level. At the same time, however, the governor’s budget plan also counts on $488.4 million in savings from a 10 percent cut to Medi-Cal reimbursements. Medi-Cal is California’s Medicaid program. State officials maintain that the provider pay cut should not hurt access to care during the expansion, but others fear the reduction could be implemented at the worst possible time (Wayt, 1/30).
Source: kaiserhealthnews.org

California: Brown OKs Medicaid expansion, fears costs

Dooley said she is concerned that the federal government has not finalized rules for reimbursing states to determine who is a newly eligible Medi-Cal recipient. It’s not clear what medical benefits will be required under the expansion. And even though Medicaid was exempted from across-the-board cuts that threatened to push the nation over the “fiscal cliff,” Dooley said it is possible Medicaid spending could be reduced in the next round of deficit talks.
Source: lifehealthpro.com

Prime hospital chain acknowledges it faces two federal investigations

In November, California regulators fined Prime $95,000 for violating state confidentiality laws in the case. Disclosing a patient’s medical records without consent also violates federal law. The chain denies wrongdoing and is confident it will win on appeal, wrote Glassman, Prime’s lawyer. He also contended that the SEIU had urged the patient to complain about her diagnosis.
Source: californiawatch.org

California WCMSA: Separate Settlements for Each Claim

In some cases in which there are two admitted specific injuries and a cumulative trauma claim, it is not unusual for counsel to enter into three compromise and release settlements, each for $24,999.99, rather than a joint compromise and release for $75,000.00 as an attempt to avoid having to include a WCMSA. It remains to be seen whether CMS would challenge this tactic, but such piecemeal settlements are technically consistent with the California Court of Appeal decision in Benson.
Source: lexisnexis.com

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

California leading the experiment of shifting Medicaid patients to managed care

That’s when she sits in her living room in this struggling Los Angeles suburb and sorts through the latest round of letters from her health plan, each rejecting her appeal to stay with her trusted oncologist at City of Hope, a local cancer center. For as long as she can remember, Saavedra, 53, a former cafeteria worker who suffers from bone marrow cancer, has been insured through Medicaid, the joint federal-state program for low-income people. For most of that time, she could go to any doctor willing to take her, but last year, the state revamped the program and assigned her to a managed care plan with a restricted network of doctors. Her oncologist is not on its roster.
Source: medcitynews.com

Volunteer Medicare Counselor: HICAP Services of Northern California Opportunity

Assist Senior Citizens in your community by helping them to navigate the Medicare maze. Become a Registered Volunteer HICAP Counselor and join a group of energetic, well-trained, computer-literate retirees who counsel individuals, on a one-to-one basis, about Medicare. HICAP provides extensive training & mentorship. Our next training session begins in February, 2013. Opportunities in these counties: Nevada, Yuba/Sutter, San Joaquin, Yolo, Sacramento, El Dorado, Placer.
Source: volunteermatch.org

California insurance firm over billed Medicare $424 million

Accident Arnold Schwarzenegger Arrest Arroyo Grande Atascadero Avila Beach California Cal Poly Campaign 2012 Court Crime Environment Estate Financial Inc. Event Photos Fire Grover Beach Guns Jerry Brown Kelly Gearhart Labor Unions Lawsuit Medical Marijuana Morro Bay Music New Job Nipomo Oceano Opinion Paso Robles Paso Robles Police PG&E Pismo Beach Politics Public Education Public Health Sad Sam Blakeslee San Luis Obispo San Luis Obispo County San Luis Obispo County Sheriff San Luis Obispo County Supervisors San Luis Obispo Police Taxes Water Wine
Source: calcoastnews.com

How Obamacare Will Affect Medicare Recipients in 2013

If your primary-care doctor or other primary-care practitioner determines you’re misusing alcohol, you can get up to four face-to-face counseling sessions per year (if you’re competent and alert during counseling). A qualified primary-care doctor or other primary-care practitioner must provide the counseling in a primary-care setting such as a doctor’s office.
Source: patch.com

Blog: 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: patch.com

Prime hospital chain acknowledges it faces 2 federal probes

As California Watch has reported, Prime hospitals have billed Medicare for treating extremely high rates of some difficult medical conditions, including septicemia, or blood poisoning, and kwashiorkor, a form of malnutrition seen among children in African famines. The billings have made Prime eligible for millions of dollars in Medicare bonus payments, according to federal records.
Source: ocregister.com

California Medicare Supplement: Benefits Explained

Instead of offering you help from the State, the California based Medicare Savings Program is a lovely initiative where you can save a lot of money, make sure you use them when you need it, and let your earnings accrue under Government supervision. This way, if you meet with untimely accidents or are diagnosed with huge illnesses, you have substantial savings to bail you out of trouble. If you fall short, the State can pitch in with a few thousands of dollars for help.
Source: wordpress.com

CMS Issues FY 2011 Medicare RAC Report to Congress

This week, CMS issued its annual Medicare Recovery Auditor report (pdf) to Congress, confirming that recovery audit contractors collected $797.4 million in overpayments from hospitals and other providers and repaid $141.9 million in underpayments in fiscal year 2011. The report was the second official Medicare RAC report. CMS concluded that after accounting for RAC contingency fees, appeals and other RAC-related costs, the RAC program saved Medicare more than $488 million in 2011. The FY 2011 collections figures pale in comparison to the RAC program’s projected FY 2012 results. In December, CMS said RACs recouped $2.29 billion in overpayments from providers and returned $109.4 million in underpayments in 2012. Here are some other major takeaways from CMS’ RAC report to Congress. Note: All figures are based on FY 2011. •    CMS spent $129.4 million to operate the RAC program. Of that total, roughly $82 million were paid to the private, for-profit RACs as contingency fees. (RAC contingency fees ranged from 9 to 12.5 percent for all claims except durable medical equipment.) •    Medicare hospitals and other providers appeal almost 61,000 RAC claims, which represent 6.7 percent of all overpayment claims. Of those claims, more than 26,000 claims — or 43.6 percent — were overturned in favor of the provider. •    HealthDataInsights, which is the HHS Region D RAC, collected the most in overpayments in 2011 — $318 million. •    RAC corrections were highest in California, New York, Illinois and Florida. •    The top overpayment denial reasons were medical necessity reviews for renal and urinary tract disorders and medical necessity reviews for acute inpatient admissions for neurological disorders. •    The top underpayment issues were providers using the incorrect MS-DRGs for severe sepsis and lysis of adhesions.
Source: beckershospitalreview.com

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

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: kp.org/newscenter.
Source: patch.com

This Valentine’s Day give your heart some love

Posted by:  :  Category: Medicare

Sign: Hands Off Social Security Medicare Medicaid www.saynocuts.org by Fifth World ArtYou might not be able to avoid Cupid’s arrow, but you can take steps to lower your risks and prevent heart disease.  Start by scheduling an appointment with your doctor to discuss whether you’re at risk for heart disease. 
Source: medicare.gov

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

Tavenner Nominated Again To Lead Medicare

Kaiser Health News: Grassley Calls For Senate Consideration Of Tavenner’s Nomination President Barack Obama Thursday once again nominated Marilyn Tavenner to head the Centers for Medicare & Medicaid Services, and a key GOP senator said the chamber should consider the nomination. “The Senate should give Ms. Tavenner every opportunity to show she is a worthy choice to lead the agency responsible for Medicare, Medicaid, the Children’s Health Insurance Program, and a lot of the implementation of the Obama health care law,” said Sen. Charles Grassley, R-Iowa., who is a member of the Finance Committee and its former chairman and ranking member. Grassley said he hoped the panel would give Tavenner’s nomination “due consideration through regular order” (Carey, 2/8).
Source: kaiserhealthnews.org

Tell the Centers for Medicare & Medicaid Services to Provide Language Access

The federally facilitated exchange (FFE) must comply with both Title VI of the Civil Rights Act and Section 1557 of the ACA. To prevent discrimination against LEP individuals, the FFE must ensure access and understanding for LEP consumers. In addition to the legal requirements, federal translation of the application would benefit all entities engaged in enrollment, outreach and education. Translated applications will assist in ensuring effective communication by creating a baseline for standardizing ACA-related enrollment terminology and creating translation “glossaries” that can be used by other entities for outreach, education and training, saving costs of re-translating the same terms. Translated applications can also help train bilingual staff and interpreters who will assist LEP individuals to ensure consistency and accuracy, thus aiding effective enrollment and information dissemination.
Source: asiaohio.org

CBO Updates Spending Projections for ACA, Medicare, Medicaid

According to CBO, the new estimate is the result of the American Tax Payer Relief Act, which maintained lower tax rates for U.S. residents with annual incomes below $450,000. The lower rates “reduce the relative attractiveness of employment-based insurance for low-income workers and for their employers.” In essence, offering health coverage as a tax-free form of compensation is less appealing when marginal tax rates are lower and a publicly subsidized option is available. CBO estimated that employers will pay $13 billion more in fines for non-compliance with the ACA’s employer mandate. 
Source: californiahealthline.org

President Obama Mentions Medicare and Medicaid in his Second Inaugural Speech

In a speech with a strong focus on unity among Americans and with a heavy emphasis on social progress, President Barack Obama briefly mentioned healthcare in his second inaugural address on Jan. 21 outside the U.S. Capitol in Washington, D.C., as he addressed a crowd estimated at approximately 600,000 people on the side of the Capitol and spreading across the National Mall, as well as millions on live television. “We must make the hard choices to reduce the cost of healthcare and the size of our deficit,” the President said. “But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future. For we remember the lessons of our past, when twilight years were spent in poverty, and parents of a child with a disability had nowhere to turn.” Instead, the President said a moment later, “The commitments we make to each other—through Medicare and Medicaid and Social Security—these things do not sap our initiative; they strengthen us. They do not make us a nation of takers; they free us to take the risks that make this country great.”   The new Congress goes back into session on Jan. 22, with Medicare spending in contention in a series of upcoming legislative showdowns, including discussions over whether and when to raise the federal debt ceiling; whether and how to fund the federal budget for another year, or possibly allow the federal government to temporarily shut down; and how to handle still-unresolved issues around the budget sequestration that was temporarily delayed by the Jan. 1 vote to avert the so-called “fiscal cliff.” All three of those issues will have to be resolved within the next few months, and the exact disposition of each of the three issues remains uncertain.
Source: healthcare-informatics.com

Daily Kos: Why Medicare and Medicaid cuts need to be off the table completely in fiscal talks

but health care costs are more tightly controlled.  Our medical care costs are driven sky high by people that have little or no health care until they reach Medicare age and then their lifetime of bad health becomes incredibly expensive.  We also have a medical system that is rewarded for finding and curing disease, so they find and cure non-existent cancers….wella….early detection and cures for microscopic cells that may or may not turn into cancer.  They scare people to death, poison them and call it a miracle and charge hundreds of thousands of dollars. ….it is a hell of a bad system.   We also fail to coordinate care which means, your specialist gives you a medication and then you never see them again, your primary fails to monitor and you end up being made incredibly ill by the side effects of the medication.   I have recently seen two cases of this and it is expensive and very damaging.  You have seniors taking 10 medications, what they hell would you need 10 medications for.  They just keep piling them on instead of addressing the problem.  Yes, there are people with special conditions that need all the meds but the “average” old person has a counter full of crap, all expensive and paid for by Medicare.  
Source: dailykos.com

Runaway Medicare and Medicaid Spending

Therefore, it is widely recognized that solving the Medicare/Medicaid crisis will to some extent involve changing the medical incentives of doctors and patients in order to lower healthcare costs overall, rather than solely targeting Medicare/Medicaid. This can be done in a number of ways. For example, making information on the comparative effectiveness of different treatments more accessible may prevent physicians from utilizing costly services when clinical benefits have not been fully demonstrated. As Professor Anirban Basu at University of Washington tells ARUSA, “I think it is most important that we support research on which drugs help which people so that we can target drugs effectively and get more bang for our buck. In most cases, the value of this research is quite high and the cost of research is quite low.” Professor Ruggie suggests that pharmaceutical advertising should be more tightly regulated in order to stop perpetuating the notion that “new” is inherently “better.”
Source: harvardpolitics.com

President Obama Commits To Medicare and Medicaid In His Inaugural Address

The overarching theme of President Obama’s speech was that the government has to change to meet the changing needs of the people. “But we have always understood that when times change, so must we; that fidelity to our founding principles requires new responses to new challenges,” the president said. He provided an example of how American soldiers could not have met and defeated the forces of fascism or communism with muskets and militias. The president said, “We understand that outworn programs are inadequate to the needs of our time.” He continued by saying, “So we must harness new ideas and technology to remake our government, revamp our tax code, reform our schools and empower citizens with the skills they need to work harder, learn more, reach higher.”
Source: wolterskluwerlb.com

Medicare and Medicaid waste equals the ‘cost’ of keeping Bush tax cuts

In 2011, Medicare and Medicaid made a combined $51 billion in improper payments, according to a new report from the Government Accountability Office. To put it another way, 6% of total spending in the two programs is wasted because of a) fraud and b) bureaucrats and contractors doing some of the same work.
Source: aei-ideas.org