Texas Teen Suing School District After She Was Punished for Not Reciting Mexican National Anthem in Class

Posted by:  :  Category: Medicare

This is a typical post by a lib. Not only do you obviously have no pride in country, but you are ignorant of the law. Again, not surprising. It is illegal to force students to say the Pledge of Alleigance, but not illegal to force them to recite foreign national anthems in the press for multiculturalism. The liberal embraces hypocrisy because it furthers their ends and when confronted with logic, patriotism or a combination of both, they resort to name calling and blind, blanket statements. How very Alinskian of you. You, VoiceofConfusion are the one who is ignorant, stupid, ugly and uninformed. I believe that covers most of the slams you threw against this young patriot for standing up for her 1st Amendment rights, refusing to bow to the progressives.
Source: theblaze.com

Video: Big Country

Making Texas Battleground State By 2016

And while Republicans like Mr. Norquist and Texas Gov. Rick Perry say that the Democrat’s goal is a pipe dream because of the Texas GOP’s differences from the national GOP, they would be well served by studying the case of former Massachusetts Sen. Scott Brown, who, despite a roundly liberal record on abortion and other social issues, was painted as part of a national, socially conservative machine by 2012 Democrats. Then-candidate Elizabeth Warren didn’t focus attacks on Mr. Brown for his quotes regarding abortion, for example — she instead ran ads attacking former Missouri Rep. Todd Akin’s quotes on abortion.
Source: businessinsider.com

A Holiday As Grand As It's Size

Most of you are familiar with the U.S. Declaration of Independence which sits over in the National Archives. But most of you would probably be surprised to know that Texas has its own Declaration of Independence. Drafted at the Convention of 1836 at Washington-on-the Brazos on March 1, it echoes the contentions of Thomas Jefferson and John Locke when discussing governmental philosophy including complaints against the governing nation (Mexico) and a call for independence. The declaration draft was submitted the next day to the delegation of approximately 54 men representing each Texas settlement. With little discussion or debate, the declaration officially seceding from Mexico, and launching the Republic of Texas, was adopted on March 2, 1836.
Source: clotureclub.com

Universal American Financial Corp. Insurance Company

The company is committed to collaborate with communities, such that in 2010, Universal American Financial launched its ”Collaborating for Good Health” Giving Back Program. Universal American Financial’s healthy collaboration exemplifies a dedication to work together for better health of its members. The company lives up to its promise by nurturing strong relationships with doctors, pharmacists, and other healthcare providers who take part in its joint model of care to maintain good health for its members. If members have closer relationships with their doctors and pharmacists, they can manage their chronic disease better, detect illness earlier and live more contented, more satisfying lives.
Source: usacoverage.com

How the Dems plan to make Texas a battleground state by 2016

On Tuesday morning, the Democrats launched an independent group called Battleground Texas, which is capable of making the Lone Star state a battleground by 2016 and a lean-Democrat state by 2024, effectively breaking the back of the national GOP and blocking a Republican path to the White House. Yes

CMS Releases Proposed 2014 Payment Plan for Medicare Part D, Advantage

Posted by:  :  Category: Medicare

3.27.06 Los Angeles Times 1 by Korean Resource Center 민족학교For the first time in Medicare Part D’s history, CMS would lower beneficiary’s deductibles and copays for covered prescription drugs as part of the agency’s proposed payment plan for 2014. Among other features of the proposed rule (pdf) are details regarding the health law’s 85 percent medical loss ratio requirement for Medicare Advantage and prescription drug plans. The proposed rule would also forbid plans from raising costs to members more than $30 per member per month, which is even more stringent than the previous cap of $36 per member per month. Another key element of the rule would be a new requirement on Part D pharmacies to require a beneficiary’s consent for each prescription drug delivery unless he or she personally requested the refill. That’s a move to help eliminate unwanted shipments to covered Medicare beneficiaries who could be billed for drug shipments they no longer required.
Source: beckershospitalreview.com

Video: 2012 Medicare Part D Annual Enrollment Period

Part D: Bending the Medicare Cost Curve

Part D’s 10-year projection has now been reduced by over $100 billion the past three years, and these projections are almost half of their initial estimated cost when the program was enacted seven years ago.  Through market-based competition, Part D is successfully able to offer a mix of plans to help seniors access medicines which, in turn, helps them adhere to doctors’ orders. This improved use of medicines helps lower other health costs, such as hospitalizations and expensive procedures.
Source: phrma.org

Part D Politics: Medicare Drug Rebates or Price Controls?

While health care was barely mentioned in the recent State of the Union address, President Obama generated some interest in his proposal to cut Medicare spending by reducing “taxpayer subsidies to prescription drug companies.” That’s code for requiring pharma marketers to pay rebates on medicines provided by Medicare Part D plans to low income “dual eligibles” who previously received prescription drugs through state Medicaid plans. Savings to Medicare are calculated at about $150 billion over ten years, and many Democrats and consumer advocates think it’s a great idea.  
Source: pharmexec.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Privately Run Medicare Plans are Really Expensive

Austin Frakt draws my attention today to a new article about the administrative costs of Medicare. Exciting stuff! Long story short, Kip Sullivan of the Minnesota chapter of Physicians for a National Health Program wants everyone to understand just what’s involved in figuring out the true administrative costs of Medicare. The cost of collecting payroll taxes is one frequently overlooked element, for example. More interestingly, though, there’s a large and growing gap between the overhead calculations of the Medicare Trustees and those of the National Health Expenditure Accounts. Why is that?
Source: motherjones.com

Top Medicare Part D Plan Costs Spike in 2013

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

Choice, Numeracy, and Physicians

In this study, we examined the effect of choice-set size and numeracy levels on a physicianin-training’s ability to choose appropriate Medicare drug plans. Design: Medical students and internal medicine residents (N  100) were randomly assigned to 1 of 3 surveys, differing only in the number of plans to be evaluated (3, 10, and 20). After reviewing information about stand-alone Medicare prescription drug plans, participants answered questions about what plan they would advise 2 hypothetical patients to choose on the basis of a brief summary of the relevant concerns of each patient. Participants also completed an 11-item numeracy scale. Main outcome measure: Ability to answer correctly questions about hypothetical Medicare Part D insurance plans and numeracy levels. Results: Consistent with our hypotheses, increases in choice sets correlated significantly with fewer correct answers, and higher numeracy levels were associated with more correct answers. Hence, our data further highlight the role of numeracy in financial- and health-related decision making, and also raise concerns about physicians’ ability to help patients choose the optimal Part D plan. Conclusion: Our data indicate that even physicians-in-training perform more poorly when choice size is larger, thus raising concerns about the capacity of physicians-in-training to successfully navigate Medicare Part D and help their patients pick the best drug plan. Our results also illustrate the importance of numeracy in evaluating insurance-related information and the need for enhancing numeracy skills among medical students and physicians.
Source: curemyway.com

CMS Issues MLR Rules For Medicare Plans

Medpage Today: CMS Issues Rules On Loss Ratios For Medicare Plans Rules that spell out what Medicare plans must spend on care rather than marketing and overhead will mirror those of commercial plans, the Obama administration said late Friday. Starting in 2014, Medicare Advantage plans and Part D prescription drug plans will have to spend 85 percent of revenue on clinical services, prescription drugs, quality improvements, and other direct patient benefits, the Centers for Medicare and Medicaid Services (CMS) said in a proposed rule that details medical loss ratio (MLR) requirements established by the Affordable Care Act (Pittman, 2/18).
Source: kaiserhealthnews.org

CMS Announces Medicare Advantage and Prescription Drug Program MLR Proposed Rule

Unlike the commercial MLR statutory requirement, the Medicare MLR statutory provision does not include language regarding expenditures on quality improvement activities. Nevertheless, the proposed rule provides that MAOs and Part D sponsors may include certain quality improvement expenses in the numerator of the MLR. Like the commercial MLR rules, the proposed rule would permit MAOs and Part D sponsors to count a non-claims expense as a quality improvement activity if it is designed to improve health outcomes, prevent readmissions to hospitals, improve patient safety, promote health and wellness, or enhance the use of health care information technology. In addition to fitting within one of those broad categories, the activity must be designed to meet all of the following criteria: (1) improve health quality; (2) increase likelihood of desired health outcomes in ways that are capable of objective measurement and producing verifiable results; (3) target individual enrollees or specified segments of enrollees or provide benefits beyond the population of enrollees without increasing costs to enrollees; and (4) be grounded in evidence-based medicine. Quality improvement activities may satisfy more than one category, but may not be double-counted. Moreover, any shared quality improvement expenses must be apportioned among entities and lines of business or products.
Source: crowell.com

OIG Report: Medicare Part B Overpaying for Infusion Medications

OIG recommended that CMS “seek legislative change” over reimbursement policies or include the devices used with such drugs in the next round of competitive bidding. According to “RegWatch,” CMS “partially” has agreed to ask Congress to change the rules and said it will go forward with the competitive bidding suggestion (Wilson, “RegWatch,”
Source: californiahealthline.org

CMS Releases Parts C and D proposals, Reduces Part D Deductible for 2014

The 2014 advance notice and call letter notes that some pharmacies do not always verify that a beneficiary still wants a drug before delivering each refill, and others automatically deliver new prescriptions that were phoned in or e-prescribed without confirming that the beneficiary wants the prescription filled and delivered. When the prescription has been delivered, pharmacies cannot return the medication to stock and generally do not reverse the claim if the patient does not want it. To abate this practice, CMS proposed the new requirement for 2014 that pharmacies obtain consent to deliver a prescription, either new or refill, before each delivery.
Source: wolterskluwerlb.com

Feds Say Nursing Homes Overbilled Medicare By $1.5 Billion

Posted by:  :  Category: Medicare

Christiana Care Kicks off Participation in Home Care Program by Christiana CareThe study released this week by the inspector general’s office of the Department of Health and Human Services concluded that nursing homes billed about a quarter of claims incorrectly in 2009 – the year it studied. Most of those claims were “upcoded,” which means Medicare was billed for services that were more extensive than what was provided or needed. Many of the claims were for intensive physical, speech or occupational therapy.
Source: kaiserhealthnews.org

Video: Medigap Supplements in Kentucky by Medicare Pathways

Presence Cor Mariae Center is Named Among America’s Best Nursing Homes

“We are proud that Presence Cor Mariae has achieved this distinction,” said Connie March, President and CEO of Presence Life Connections, which is part of Presence Health. “Our physicians, nurses, therapists, nurses aides and other staff dedicate themselves to providing the highest quality of care to all our residents. This achievement is due to their commitment and compassion.”
Source: wifr.com

Hawaii No. 1 for long term care facility quality

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Source: hawaii247.com

Forced to Choose: Nursing Home vs. Hospice

The study, using data from the National Health and Retirement Study from 1994 through 2007, looked at more than 5,000 people who initially lived in the community – that is, not in a facility. About 30 percent used the skilled-nursing facility benefit during the final six months of life; those people were likely to be over 85 and family members said, after their deaths, that they had expected them to die soon. (The benefit is commonly referred to as S.N.F., which people in the field pronounce as “sniff”).
Source: nytimes.com

RAC audits: Skilled nursing facilities accounted for miniscule portion of 2011 Medicare overpayments

Physician, Durable Medical Equipment and “other” claim types each accounted for between roughly $33 million and $35 million in overpayments. Outpatient claims represented more than $17 million. SNFs — the only other claim type specified by the report — therefore accounted for less than 0.3% of all collected overpayments. The RACs review did not identify any underpayments to skilled nursing facilities.
Source: mcknights.com

5th Circuit Affirms Finding Of Medicare Violations At Mississippi Nursing Home

NEW ORLEANS – A Fifth Circuit U.S. Court of Appeals panel on Feb. 7 in an unpublished opinion affirmed findings that a nursing home violated Medicare regulations after residents were found to be in immediate jeopardy (Mississippi Care Center of Greenville v. United States Department of Health and Human Service, No. 12-60420, 5th Cir.; 2013 U.S. App. LEXIS 2668).Full story on lexis.com
Source: lexisnexis.com

No ruckus about Medicare cuts in sequester

The cannibalism case against a police officer took another macabre turn on Thursday when an FBI agent testified that a New York Police Department supervisor was among the women the officer considered a potential target for a…
Source: kttc.com

Idaho Governor Will Oppose Medicaid Expansion

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteyAs you’ll hear in a moment, we have some pretty good ideas about that kind of managed care model. But there’s a lot more work to do, and we face no immediate federal deadline. We have time to do this right, and there is broad agreement that the existing Medicaid program is broken. So I’m seeking no expansion of those benefits.
Source: firedoglake.com

Video: Idaho Medicare

Idaho has advisers on hand as Medicare deadline approaches

The SHIBA program this year launched a mini call center and a marketing campaign. Supervisor Phyllis Barker said SHIBA’s volunteer advisers are getting about 700 calls per week just in the main office in Boise. That doesn’t include three other regional SHIBA offices. There are 150 trained volunteers working as SHIBA counselors around the state.
Source: idahostatesman.com

Idaho Has Several Parts to its Medicaid Plan Insurance Families.com

The Basic Benchmark plan gives you all that, plus coverage for dental, vision, basic mental health, therapies, prosthetics / orthotics, durable medical equipment and supplies, and school based services. The Enhanced Benchmark plan gives you all of that coverage, plus private duty nursing, ICF/ID, expanded mental health clinic, psychosocial rehabilitation, and more.
Source: families.com

DisAbility Rights Idaho Blog: Idaho Medicaid Managed Care Proposal

The PMPM method does not by itself provide incentives for effective DD supports services or treatment. The goal of these supports is to increase the capacity of the person for self determination, independence and community integration. The success of such services is not measured by their physical health status or need for more expensive medical treatment. Short of institutional placement, there is no consequence to the MCO for providing inadequate or ineffective services and supports. Placement in a state facility like SWITC would even be a net savings to the MCO and for certain individuals ICF/ID placement could be a savings over a robust and effective community supports plan. To be effective, there must be a strong incentive to provide effective developmental services and supports. This can only be accomplished with a robust and accurate quality assurance system and well designed incentives to meet the expectations of that system. We are not aware of any examples of such a system. Traditional health insurance plans do not have expertise or experience with these services.
Source: blogspot.com

Otter shows 'absence of leadership' on health exchange, says Tea Party Boise

Governor Otter announced Idaho will move forward with creating a state health exchange. This is disappointing. It will require an estimated $77 million to create the exchange and another $10 million per year to run it. This money will either be taken out of the pockets of your fellow Idahoans or will be denied to other government services. Either way, we will all be poorer, and for what? To put a “Made in Idaho” label on something that was designed by the federal government, conforms to new federal rules, and introduces new federal taxes does not appear to be an “Idaho solution.”
Source: idahostatesman.com

Physicians Fear Medicare Cuts Due to Fiscal Cliff

(WASHINGTON) — Medicare physicians are preparing for fee hikes for their patients if Congress is unable to resolve the fiscal cliff, according to a statement by the Centers of Medicare and Medicaid Services (CMS). According to the statement, “Medicare Physician Fee Schedule claims for services rendered on or before December 31, 2012, are unaffected by the 2013 payment cut and will be processed and paid under normal procedures and time frames,” but the CMS will notify Medicare physicians “on or before January 11, 2013” if fees will go up. The CMS says, “We continue to urge Congress to take action to ensure these cuts do not take effect.” Copyright 2012 ABC News Radio
Source: eastidahonews.com

Clayton Cramer’s Blog: Letter to Senators Risch & Crapo of Idaho

If you live in another state, you might want to adapt this material for use on your U.S. Senators. Dear Senator Crapo: Once again, Democrats are intent on gun control, because the alternative is to look at the root cause of these random acts of mass murder: the deinstitutionalization of the mentally ill, starting in the 1960s and 1970s. Senator Feinstein’s assault weapons and high capacity magazine ban is doomed to failure, for the same reason that the 1994 federal ban failed: the banned weapons are functionally equivalent to many protected weapons, and the size of the magazine doesn’t much matter when the killer is shooting at unarmed victims.  This bill is a waste of time. The national background check requirement is not as obviously wrong, but it still suffers from a fundamental set of problems.  One is that many states (including Idaho) are not turning over involuntary mental health commitment records to the national background check system.  We have read that 14 states have filed less than five such records in the entire twenty years that the national background check system has existed. Secondly, because many people with serious mental illness problems are never involuntarily committed, even if states were filing these records, the effect would be seriously compromised.  The core problem involves mentally ill people in need of treatment. Thirdly, during Senate Judiciary Committee hearings yesterday, both a police chief and U.S. Attorney arguing for the national background check requirement admitted that they put NO effort into prosecuting people who lie on gun purchase applications.  Why should we expect any more effort to be made on private party transfers done without a background check?  What’s the point of such a law? If necessary for political purposes, allow the current background check system to be available to private parties.  We suspect that the vast majority of law-abiding citizens would be happy to take advantage of it — and the ones who would not be willing to do so, are likely as not going to break the new law anyway — and they won’t be prosecuted. Remember what the Brady Law and the 1994 federal assault weapons ban did for the Democrats: it caused them to lose control of both houses of Congress.  Republicans who vote for these measures can expect to be retiring next year. Very Truly Yours, Clayton & Rhonda Cramer
Source: blogspot.com

How Is Idaho Medicaid Different Than Idaho Medicare?

The remaining 80-day component falls under a group of care named Idaho Medicare Part A. This is for skilled care. If at any time throughout the 80 day phase a patient fails to thrive or refuses to do the treatments, then that will trigger an incident where the patient will drop off of Medicare coverage and go to private pay. The medical condition is now known as a long term care condition.
Source: mtwestassetprotectionservices.com

Travel for Seniors: Idaho

This post is a guest post by John Walters who is a freelance writer who attended the 1973 Clarion West science fiction writing workshop and is a member of Science Fiction Writers of America.  He writes mainstream fiction, science fiction and fantasy, and memoirs of his wanderings around the world.  For many years he lived in Greece with his Greek wife and five sons and taught English as a second language to help pay the bills, but he has recently moved back to the United States and now lives in San Diego. 
Source: medicareecompare.com

Happy 46th Birthday for Medicare, Medicaid and Social Security

Medicare, Medicaid and Social Security are critical programs that help Ida-hoan’s get needed health care and keep countless seniors out of poverty. July 30, 2011 marks the 46th birthday of these programs. Normally we would celebrate with birthday cake and balloons but this year is different. This year, we needn’t be celebrating with elected officials. In Idaho for example, politicians cut $39 million from Medicaid in last year’s legislative session. Now Congress is flirting with the idea of cutting billions from Medicaid, Medicare, and Social Security.
Source: idahocan.org

CBIA Webinar on ConnectiCare’s Medicare Advantage Program for 2013

Posted by:  :  Category: Medicare

Ten Commandments – I am the LORD thy God. Thou shalt have no other gods No graven images or likenesses. Not take the LORD’s name in vain. Remember the sabbath day Honour thy father and thy mother. Thou shalt not kill. Thou shalt not commit adultery. Thou shalt not steal. Thou shalt not bear false witness. Thou shalt not covet.
Source: youradfree.com

Video: CBIA Webinar on ConnectiCare’s Medicare Advantage Program for 2013

ConnectiCare and Healthways Partner to Offer SilverSneakers® Fitness Program Through 2015

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

Aetna, ConnectiCare Push Collaborations With Health Providers In Private Medicare Plans

Treatment of some Medicare patients presents unique challenges, the insurers say. Patients who require more than basic care often have several doctors or other points of contact in the medical care system, which means coordinating treatments can be more difficult. For instance: ConnectiCare said a typical Medicare patient sees more than seven doctors in a year and uses nine different medications, so a key piece of its pilot program will be identifying high-risk patients and providing data to help coordinate their care.
Source: courant.com

Connecticut Nursing Jobs: Health Navigator (NR12

Further informations about this occupation opportunity kindly read the description below. Reports to: Supervisor, Medicare Case Mgmt UnitFLSA: ExemptManages: NonePurpose: Provides telephonic health navigation services to high-risk dual eligible members enrolled in ConnectiCare’s Medicare Advantage products. Navigator services include Care Transition Interventions, appointment scheduling, transportation coordination, telephonic outreach, dissemination of educational messages, and linkage to internal and external/community resources. Works directly with members, caregivers and other health care delivery system entities, and communicates with physicians and nursing staff to enhance the coordination of care for members.KEY ACCOUNTABILITIES:1. Independently completes designated call outreach to Medicare beneficiaries for the purpose of program introduction, health screening, psychosocial assessment, functional assessment, health coaching and/or triage.2. Expected to manage a flexible work schedule in order to meet the needs of beneficiary and to optimize reach rates.3. Utilizes good judgment and discretion in referring cases to a Nurse Case Manager, Social Work Case Manager and/or Pharmacist when appropriate.4. Enters and maintains critical data in ConnectiCare case management/ physician office electronic medical record systems meeting defined timeframes and performance standards.5. Provides Care Transition Interventions including discharge plan review, medication review, ensures post-discharge appointment with PCP or specialist, assists with scheduling needed tests, arranges for transportation identifies early warning signs for re-hospitalization and creates a plan of action with member, and links member to internal and external resources6. Identifies all HEDIS measures for which the member is eligible, determines if member is already compliant and if works with the member to achieve HEDIS compliance for all eligible measures7. Identifies chronic conditions that have not been diagnosed and documented in the calendar year and works with PCP to ensure member has a PCP visit and the conditions are appropriately captured. Actively collaborates with medical group physicians and nursing staff as well as other ConnectiCare case managers and navigators.8. Actively collaborates with medical group physicians and nursing staff as well as other ConnectiCare case managers and navigators.9. Performs other related projects and duties as assigned. 1. At least 3 – 5 years experience in a managed care setting with familiarity with care coordination is required. Experience in discharge planning, care transition interventions, HEDIS measures and HCC coding preferred is desirable.2. Excellent oral and written communication, organizational, and interpersonal skills required.3. Previous system user experience in a highly automated environment and strong personal computer literacy on Windows products required.4. Demonstrated ability to work independently and effectively offsite, and to prioritize multiple tasks required.5. Experience with coordination of internal and external/community resources preferred6. Bilingual in English/Spanish or English/Polish preferredCOMPETENCIES:1. Member and Customer Focus: Recognizes that members and customers (internal & external) are the driving force behind every business activity. Continuously makes an effort to exceed the expectations of members and customers.2. Quality Orientation: Assumes responsibility for providing the highest level of quality to members and customers.3. Innovation: The ability to see opportunities for change, to capitalize on them and implement them when appropriate for the benefit of ConnectiCare.4. Communication: The ability to communicate with clarity both orally and in writing.5. Teamwork: Demonstrates enthusiasm for the mission of ConnectiCare and inspires the same in others.6. Results Orientation: The ability to break a complex problem down into its component parts and arrive at the appropriate solution in a timely fashion.7. Change Mastery: Embraces change.8. Learning Orientation: Assumes responsibility for personal and professional development.ConnectiCare is an equal opportunity employer. M/F/D/V – . If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to ConnectiCare Inc..
Source: blogspot.com

ConnectiCare Enters Medicare Advantage Market

Consumers looking for a Medicare Advantage product will find many options to match their health insurance needs from ConnectiCare. Individuals, who enroll in our Medicare Advantage plans, will receive all the benefits of original Medicare plus benefits such as disease management programs, health and wellness support, limited dental benefits and more.
Source: wordpress.com

Connecticare Sets The Stage For Fun In 2010

PRLog (Press Release) – May 25, 2010 – Inspired by timeless adages such as “Laughter is the Best Medicine” and “An Active Mind is a Healthy Mind,” ConnectiCare has created the 2010 “Setting the Stage” program for its VIP Medicare members. The program will provide free admission to events such as trivia game shows, dance classes, museums, movies, comedy shows and more to give members incentive to stay active and healthy. “Our ‘Setting the Stage’ program will provide free admission to a number of fun events around the state for our VIP Medicare members. It’s a great way to help keep our members feeling vital, fit and always smiling,,” says Tony Tedeschi, Director of Medicare Program Management with ConnectiCare. “Additionally, we are hosting four trivia competitions at locations around the state to see who knows the most about the 1950s through the 1980s. The top three contestants will advance to a final challenge in September in Cromwell hosted by Scot Haney of WFSB TV 3 and Better Connecticut, where the top finisher will be crowned the ‘Know it by Heart’ trivia king or queen. It should be lots of fun and an event-filled summer for all of our members.” Details about all of the ConnectiCare VIP Member exclusive events can be found on ConnectiCare’
Source: prlog.org

ConnectiCare Makes Biggest Contribution to Date Raising $113,578 for the United Way

After all of the individual pledging and special events,  the donations were tabulated and the seventy-five percent participation goal was met and overall giving increased by 6%. ConnectiCare is in the running for United Way’s Best of Awards in the category of Best In Show, Medium Company. “ConnectiCare is known for its culture of caring, as evidenced by this outstanding effort.  United Way’s Best of Awards are an opportunity for us to recognize organizations throughout central and northeastern Connecticut and their campaign coordinators, volunteer committees and employees for outstanding participation in the annual United Way Community Campaign.  We are pleased to honor ConnectiCare and other companies for their commitment, enthusiasm and creativity,” says Ann Pean, Senior Manager, Donor Relations for United Way who has been working with ConnectiCare since 2001. Over the past several years, ConnectiCare has been recognized by the United Way for leadership and innovative approaches to fundraising – establishing themselves as one of the top annual contributors in the Medical Division. About ConnectiCare ConnectiCare is a health plan based in Farmington, Connecticut, and a subsidiary of EmblemHealth. ConnectiCare has a full offering of products for business, municipalities, individuals and those who are Medicare-eligible. A local company, ConnectiCare maintains all operations, and 500 employees in Farmington, CT. Visit our website: www.connecticare.com
Source: patch.com

CT Medicare Advantage, Medicare Supplement, Prescription Drug Plans

Our agency is expanding! Shortly we will be Medicare Advantage and Medicare Supplement brokers. (We will continue to help Connecticut residents buy medical insurance.) We will be offering Zero Premium Policies (that right, some of the policies require none of your money be sent to the insurance company!) as well as other policies with premiums and enhanced benefits.
Source: 1800insurancect.com

Insurer Teams With Medical Group To Improve Patient Care

The second part of the program involves end-of-life care, a term that invokes stigmas after debate about federal health care reform. In this instance, the term means that patients will meet with their doctors and health insurer to talk about treatment options before it’s a last-minute decision in an intensive-care unit, said Dr. Paul Bluestein, ConnectiCare’s chief medical officer.
Source: courant.com

Emdeon Current: New Payer Transactions

Claims Management Services, Payer ID: 39141 Clarian Health Plans Inc., Payer ID: 95444 Connecticare – Medicare, Payer ID: 78375 CoreSource Little Rock, Payer ID: 75136 DiaTri LLC, Payer ID: 36439 Employee Benefit Systems, Payer ID: 42149 Fallon Community Health Plan, Payer ID: 22254 GHI – Medicare Private Fee for Service, Payer ID: 22937 GHI – New York (Group Health Inc.), Payer ID: 13551 GHI HMO, Payer ID: 25531 Geisinger Health Plan, Payer ID: 75273 Group Health Cooperative of South Central Wisconsin, Payer ID: 39167 Group Health Inc., Payer ID: 22937 HIP – Health Insurance Plan of Greater New York, Payer ID: 55247 Harrington Health-Kansas (formerly known as Fiserv Health-Kansas), Payer ID: 62061 Harvard Pilgrim Health Care, Payer ID: 4271 ISLAND HOME INSURANCE COMPANY, Payer ID: IU Medical Group Primary Care, Payer ID: SX172 Integra Group, Payer ID: 31127 LIFE Pittsburgh, Payer ID: 25181 Landmark Healthcare Inc, Payer ID: LNDMK MED PAY, Payer ID: 88058 MEDICA HEALTH CARE PLAN INC., Payer ID: 78857 March Vision Care Inc., Payer ID: Call Meritain Health / Agency Services, Payer ID: 64158 Meritain Health/North American Administrators, Payer ID: 64157 Metropolitan Health Plan, Payer ID: 10850 Montefiore Contract Management Organization, Payer ID: 13174 Network Health, Payer ID: 4332 Network Health Insurance Corp-Medicare, Payer ID: 77076 North American Administrators Inc., Payer ID: 64157 North American Health Plan, Payer ID: 64157 North American Preferred, Payer ID: 64157 Northstar Advantage, Payer ID: 60058 ODS Health Plan, Payer ID: 13350 PacificSource Health Plans, Payer ID: 93029 Paragon Benefits Inc., Payer ID: 58174 Prism-First Health, Payer ID: 37303 Screen Actors Guild, Payer ID: 99289 Touchstone Health PSO, Payer ID: 23856 Trellis Health Partners, Payer ID: 36397 Vytra Healthcare, Payer ID: 22264 Weyco Inc., Payer ID: 38232 Wisconsin Department of Corrections, Payer ID: 74101 Anthem Blue Cross, Payer ID: 47198 Associated Benefits, Payer ID: 50266 Blue Cross Blue Shield of New Mexico, Payer ID: SB790 Blue Cross Blue Shield of Oklahoma, Payer ID: SB840 Illinois Medicaid, Payer ID: SKIL0 Nebraska Medicaid, Payer ID: SKNE0 New Hampshire Medicaid, Payer ID: SKNH0 Eligibility Inquiry and Response Ameritas Group, Payer ID: AMERITAS Ameritas Life Insurance Company, Payer ID: 425 CoreSource – FMH, Payer ID: CORSE00204 CoreSource – FMH, Payer ID: CRSKC CoreSource – Little Rock, Payer ID: CORSE00205 CoreSource Little Rock, Payer ID: CRSAR Coresource – FMH, Payer ID: 204 Coresource Little Rock, Payer ID: 205 First Ameritas of New York, Payer ID: 426 First Ameritas of New York, Payer ID: AMTAS00426 First Reliance Standard Life Ins Co., Payer ID: 428 First Reliance Standard Life Insurance Company, Payer ID: AMTAS428 MMSI, Payer ID: 85 MMSI, Payer ID: MMSI Medica, Payer ID: 404 Medica, Payer ID: MEDIC Medical Mutual of Ohio, Payer ID: 211 Medical Mutual of Ohio, Payer ID: MMO00211 Nippon Life Benefits, Payer ID: NIPON Peoples Health, Payer ID: PPLSH Reliance Standard Life Insurance Company, Payer ID: 427 Reliance Standard Life Insurance Company, Payer ID: AMTAS00427 SAMBA Health Benefit Plan, Payer ID: SAMBA Standard Insurance Company, Payer ID: 429 Standard Insurance Company, Payer ID: AMTAS00429 Standard Life Insurance Company of New York, Payer ID: 430 Standard Life Insurance Company of New York, Payer ID: AMTAS00430 ameritas, Payer ID: AMTAS00425 Blue Cross Blue Shield of Pennsylvania (Highmark), Payer ID: BCPAC Blue Cross Blue Shield of Pennsylvania – Highmark, Payer ID: 440 Mountain State, Payer ID: MTNST Affinity Health Plan, Payer ID: AFNTY New Jersey Medicaid, Payer ID: AID19 New Jersy Medicaid, Payer ID: NJ South Dakota Medicaid, Payer ID: AID28 South Dakota Medicaid, Payer ID: SD Claim Status And Response: Ameritas Group, Payer ID: AMERITAS Ameritas Life Insurance Company, Payer ID: 425 CoreSource – FMH, Payer ID: CORSE00204 CoreSource – FMH, Payer ID: CRSKC CoreSource – Little Rock, Payer ID: CORSE00205 CoreSource Little Rock, Payer ID: CRSAR Coresource – FMH, Payer ID: 204 Coresource Little Rock, Payer ID: 205 First Ameritas of New York, Payer ID: 426 First Ameritas of New York, Payer ID: AMTAS00426 First Reliance Standard Life Ins Co., Payer ID: 428 First Reliance Standard Life Insurance Company, Payer ID: AMTAS428 MMSI, Payer ID: 85 MMSI, Payer ID: MMSI Medica, Payer ID: 404 Medica, Payer ID: MEDIC Nippon Life Benefits, Payer ID: NIPON Peoples Health, Payer ID: PPLSH Reliance Standard Life Insurance Company, Payer ID: 427 Reliance Standard Life Insurance Company, Payer ID: AMTAS00427 SAMBA Health Benefit Plan, Payer ID: SAMBA Standard Insurance Company, Payer ID: 429 Standard Insurance Company, Payer ID: AMTAS00429 Standard Life Insurance Company of New York, Payer ID: 430 Standard Life Insurance Company of New York, Payer ID: AMTAS00430 For all payers, visit https://access.emdeon.com/PayerLists/
Source: blogspot.com

Bristol Doctor Wins ConnectiCare Honor

The award is part of ConnectiCare’s “Tell Us About Your Doctor” online survey for members, and goes to physicians who receive high marks and no complaints from patients. The survey assesses doctor-patient communication and doctor availability, and covers  how their office staffs make appointments and manage waiting time.
Source: courant.com

Connecticare Health Insurance Online Home Insurance

Sexual & reproductive health services in Bridgeport, CT. Planned Parenthood has been providing trusted health care for nearly 100 years. Learn about the insurance providers that offer plans in your state, whether you’re looking for individual, group or Medicare coverage. a abpa acec acs benefit services inc acs health net adventist risk management aetna aetna health choice aetna us care allied benefits system american. Find the right health insurance company for you, no matter where you live in the United States and what type of insurance you need. What We Do – Have you found it difficult to find a health insurance plan that meets your needs? We are licensed health insurance agents, and help our clients find. Connect to good Massachusetts! Our online Commonwealth Choice marketplace is the only place where you can compare plans from the state’s major insurers. Connecticare Health Insurance & Maternity Insurance – Instant Quotes. Connecticare health insurance rates – instant quotes – Connecticare HMO Maternity Insurance.
Source: averagecostofhealthinsurancediscounts.com

Medicare Advantage, Medicare « Insurance News from Crowe & Associates

Medicare Advantage plan designs are set for 2010.  The general trend was that everyone lowered benefits and raised premiums.  Some of the change can be attributed to the cut in funding for Advantage programs (approximate 4% decrease in funding vs. the traditional 4%-6% increase in funding) but some of it most surely be due to utilization and frequency.
Source: croweandassociates.com

Winners Announced “Doctor of the Year Award”

Farmington, CT – Today, ConnectiCare, a Farmington-based health plan, announced that three doctors have received the Doctor of the Year Award (based on 2011 data). Each doctor was chosen based on patient satisfaction results and their ability to provide high-quality primary care services. The doctors selected were chosen from the statewide network of physicians that participate with ConnectiCare.
Source: patch.com

Obama Sequester Speech In Virginia

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteyObama told the crowd that the effects of the sequester won’t be felt overnight, but they will become more real the longer they are allowed to stay in place. Obama warned the crowd that 90,000 workers might have to be furloughed if the sequester goes into effect, and he said it could cost more than 10,000 jobs in Virginia alone.
Source: businessinsider.com

Video: Terry McAuliffe: Expanding Medicare In Virginia ‘Right Thing To Do’

In Virginia, Cuccinelli Makes a Conservative Case for Governor

Many party leaders have disavowed Mr. Romney’s secretly recorded remark – about Americans so dependent on government they would not vote for him – as divisive and a factor in his defeat by President Obama. At recent party conclaves and in Congress, many Republicans have expressed an inclination to compromise on immigration and tax increases and to seek an inclusive tone on issues of concern to women and gay Americans, in hopes of minimizing future electoral losses.
Source: nytimes.com

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

Daily Kos: Hey, Virginia, how will Eric Cantor ‘hurt a lot of people’ with the sequester?

The sequester is coming, bringing across the board cuts to jobs and government services—and since the Republican leadership is digging in, ready to force those cuts to protect the wealthy from paying a little more in taxes, it’s time to start looking at the impact these cuts will have on individual states. Because of its large population of federal workers, Virginia will get hit especially hard by paycheck cuts due to furloughs. But that’s not all. Eric Cantor, the House majority leader and a representative from Virginia, was right when he said “we’re going to hurt a lot of people” by refusing to do anything about the sequester unless the president caved to Republican demands to replace the sequester with all cuts and no new revenue.
Source: dailykos.com

Medicaid Reforms Will Save Money, Making a Good Deal Even Better

ARRA Budget Cuts Bush Tax Cuts car tax Census CODI dealer discount domestic production deduction Earned Income Tax Credit Education Employment FAMIS Federal Tax Food Stamps Gender Pay Gap Health Benefits Exchange Health Insurance Health Reform immigration Job Losses Jobs Gap Localities Loopholes med Medicaid Poverty pre-k Rainy Day Fund Recovery Act Safety Net Shortfall SNAP State of Working Virginia Stimulus Taxes tax expenditures transportation Unemployment Insurance uninsured voter id
Source: thecommonwealthinstitute.org

Survey on Social Security, Medicare, Virginia

"The share of the budget going to entitlements has to slow down. Everybody has to give a little bit, the sooner the better, to go after the problem," said retired foreign service officer Stephen Brundage, 61, of Arlington, expressing a view shared by many Virginians.
Source: aarp.org

No ruckus about Medicare cuts in sequester

In a significant policy shift, the Obama administration said Thursday it would for the first time provide non-lethal aid directly to rebels who are battling to oust Syrian President Bashar Assad, announcing an additional $60…
Source: kttc.com

Which Are the Best Ohio MAPD’s and Med Supp’s?

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ... More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524In speaking with our agents, the majority of what they wrote in 2013 was UnitedHealthcare. A number of agents said that they felt forced to move their Anthem business based upon some of the benefit changes that were made between 2012 and 2013. Again, this differs by geography. We saw much higher sales numbers for UnitedHealthcare in the Columbus/Dayton/Cincinnati markets than we did in NE Ohio. That may be based upon network agreements as opposed to benefits. One carrier to keep in mind in NE Ohio is Coventry. They just released MA products in that market in 2013, and they also have Cleveland Clinic and University Health in their network. For a first year plan, we saw decent sales numbers from them out of that market. At the end of the day, though, it all does come down to a county by county look.
Source: insurance-forums.net

Video: Senior Advantage Medicare

Illinois Medicare Advantage Disenrollment Period

Luckily, if you’re not satisfied with your Illinois Medicare Advantage plan, you have options. Switching back to Original Medicare may make it easier to get the medical care you need by eliminating networks or restricted coverage often associated with Medicare Advantage. If you’re looking for more options that can help you pay for out-of-pocket expenses associated with Medicare, a Medicare Supplement plan may be the right solution. The right Medigap plan can also save you money. A high deductible plan F offers the same great coverage but for reduced monthly payments. That’s convenience and peace of mind that when you need medical attention, you can get it- no questions asked.
Source: ssiinsure.com

Do your team members look forward to going to work . . . . or something else?

Fast Company Co.EXIST Co.DESIGN Co.CREATE Subscribe Fast Company issue cover Subscribe to Fast Company Today! Subscribe through this offer and pay just $12.99 for one-year (10 issues). A savings of 74% off the cover price! Subscribe Now Exist Daily Exclusive Ethonomics Articles, Delivered to Your Inbox Daily. Search RSS Find Us On Facebook On Twitter Fast Company The 16-Year-Old Who Created A Cheap, Accurate Cancer Sensor Is Now Building A Tricorder With Other Genius Kids The 16-Year-Old Who Created A Cheap, Accurate Cancer Sensor Is Now Building A Tricorder With Other Genius Kids
Source: seniorhousingforum.net

Wednesday quarterfinal basketball roundup

North Cobb 68, Tift County 63: North Cobb rallied from a 52-45 deficit at the end of the third quarter behind 16 combined points in the final period from Lee Moore (9) and Jordan Neff (7). A 3-point play from Moore with 2:47 left gave North Cobb a lead it would not relinquish. Neff finished with 22 points, Jon Beausejour had 21 points and 12 rebounds, and Moore added 18. The Warriors were 15-of-15 from the free throw line and made nine 3-pointers. Brannen Green led Tift County with 22 points.
Source: scoreatl.com

Mom’s second hospital newsletter.

“The danger to America is not Barack Obama but a citizenry capable of entrusting an inexperienced man like him with the Presidency. It will be far easier to limit and undo the follies of an Obama Presidency than to restore the necessary common sense and good judgment to a depraved electorate willing to have such a man for their President. The problem is much deeper and far more serious than Mr. Obama, who is a mere symptom of what ails America. Blaming the Prince of the Fools should not blind anyone to the vast confederacy of fools that made him their prince. The Republic can survive a Barack Obama. It is less likely to survive a multitude of fools such as those who made him their President.” TWICE!!!
Source: onthenorthriver.com

Research Finds Link Between Poor Health And Seniors Switching Out Of Private Medicare Plans

A study released Thursday, by Gerald Riley, a researcher at the Centers for Medicare & Medicaid Services (CMS), adds to those concerns. The study looked at more than 240,000 people who dropped out of Medicare Advantage plans in 2007, and compared them with beneficiaries who remained in traditional Medicare the entire time. In the six months after leaving the private plans, the former Medicare Advantage patients used an average of $1,021 in medical services each month, while the patients in the control group cost Medicare $710 a month, the study found.
Source: kaiserhealthnews.org

Massachusetts Elder Law Attorney

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ... More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524The Medicare provisions in the Relief Act are not as harmful to the program as many of the dangerous proposals offered to Congress over the past few months.  There have been proposals made to double look back periods and decrease Medicare and Medicaid benefits.  Drastic cuts are still on the table as policy-makers seek to address the looming sequestration and debt ceiling with savings from health care programs. For real health savings that address the underlying problem of health care costs system wide, policy-makers and advocates should begin with solutions that improve the health and well-being of Medicare beneficiaries while preserving the Medicare program for those who depend on it now and in the future.
Source: estateplanandassetprotection.com

Video: Medicare vs Medicaid 612-309-9184 Minnesota Medical Assistance Minneapolis Elder Law Attorney

How Medicare Disrupts Personal Injury Payments

Oregon: Portland, Salem, Eugene, Beaverton, Hillsboro, Medford, Springfield, Albany, Aloha, Corvallis, Keizer, Grants Pass, Lake Oswego, McMinnville, Milwaukie, Oregon City, Roseburg, Tigard, Tualatin, West Linn, Woodburn, Troutdale, St. Helens, Vernonia, Yamhill, Hood River, The Dalles, Gresham, Ontario, Astoria, Seaside, Lincoln City Washington: Kalama, Kelso, Kennewick, King, Corner, La Center, Lake Shore, Lewisville, Little Elkhorn, Livingston, Long Beach, Longview, Lucia, Mabton, Montesano, Moxee, Naches, Napavine, Ocean Shores, Olympia, Pasco, Pioneer, Proebstel, Prosser, Ranier, Raymond, Richland, Ridgefield, Salmon Creek, Seattle, Selah, South Bend, Stevenson, Sunnyside, Tacoma, Tenino, Toledo, Toppenish, Tumwater, Twin Harbors, Union, Vader, Vancouver, Venersborg, Wapato, Washougal, West Richland, Westport, White Salmon, Winlock, Woodland, Yacolt, Yakima.
Source: nwinjurylawcenter.com

Harrisburg Ambulance Company Owner Pleads Guilty to Submitting False Statement to Medicare www.privateofficer.com

The June 2, 2011 search by the FBI and investigators from the Health and Human Services (HHS) Inspector General’s Office revealed that Sivchuk did not submit the original trip sheets to the auditors but instead submitted copies of other trip sheets that had been re-written and forged to conceal the fact the beneficiaries were able to walk and stand. During his court appearance before Judge Conner today, Sivchuk admitted he directed a subordinate to re-write and forge the signatures of two EMTs on a trip sheets pertaining to the ambulance transport of a dialysis treatment beneficiary on August 19, 2010.
Source: wordpress.com

Long Waits For Consumers When Medicare Is ‘Secondary Payer’

In one case involving an 80-year-old man who was injured in a car accident in Kentucky in November 2011, it took more than a year to get a final figure from CMS detailing how much the agency was owed, says Linda Magruder, an attorney in Louisville who was the victim’s co-counsel in the case. That amount, for treatment for soft-tissue injuries to the man’s right hip, left foot, back and neck, was $2,640. But the agency first claimed it was owed more than $26,000, she says, because it included bills for care not related to the accident.
Source: kaiserhealthnews.org

Attorney General Eric Holder Announces 91 Arrests In $300 Million Medicare Fraud Sting

Arizona BarackObama Barack Obama Blog Round Up CNN Democratic Democratic Party (United States) Florida Fox News Fox News Channel George W. Bush Glenn Beck GOP Herman Cain Joe Biden John Boehner John McCain Karl Rove Media News Michele Bachmann Mitt Romney MSNBC Newt Gingrich New York Times Obama Politics Politics News President Rachel Maddow Republican Republicans Rick Perry Rick Santorum Romney Rush Limbaugh Sarah Palin Scott Walker Tea Party Twitter United States United States Congress Video Wall Street White House Wisconsin
Source: kstreet607.com

Medicare Fraud Sting Operations by Federal Government Includes Senior Volunteers Spying on Doctors and Health Care Providers: Expect to See More National Stings and Sweeping Arrests of Medical Pros in the Future

As a part of the new resources dedicated to fighting fraud, the Obama Administration has significantly expanded funding for Senior Medicare Patrols – groups of senior citizen volunteers who educate and empower their peers to identify, prevent and report health care fraud. In 2012, the Secretary awarded 54 states and territories with funding to support the Senior Medicare Patrol programs Last year, these programs taught more than 2 million beneficiaries how to look for Medicare fraud. Local Senior Medicare Patrol offices provide assistance when such issues are identified, so that mistakes are corrected and suspected fraud referred to the appropriate authorities. Since 1997, more than 1.5 million seniors and their caregivers have contacted the Senior Medicare Patrol to ask questions or report potential fraud.
Source: dallasjustice.com

Healthcare Fraud: Conviction in $17.3 Million Medicare Case

Today’s verdict was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Kenneth Magidson of the Southern District of Texas; Special Agent-in-Charge Stephen L. Morris of the FBI’s Houston Field Office; Special Agent in Charge Mike Fields of the Dallas Regional Office of HHS’s Office of Inspector General, Office of Investigations; and the Texas Attorney General’s Medicaid Fraud Control Unit.       According to evidence presented at trial, Echols was a physician practicing in the Houston area.  The evidence showed that Echols signed plans of care for Medicare beneficiaries so that fraudulent claims could be billed by Family Healthcare Group Inc. and Houston Compassionate Care.  Echols would sign plans of care for Medicare beneficiaries who were not under his care and about whose conditions he had no knowledge.  In many instances, the evidence showed, Echols would sign plans of care even though other doctors were listed as the attending physician on the documents.
Source: lawyersline.net

What Are the Medicare Lein Laws for Personal Injury Settlements?

Your Personal Injury Attorney will report to the Coordination of Benefits Contractor (COBC) with information such as the Medicare number, injury, date of injury/loss, and other pertinent information.  Later, they must submit consent forms and proof of representation to the Medicare Secondary Payer Recovery Contractor (MSPRC).  Then you and your attorney can address any unrelated payments and dispute those payments. Finally, a settlement should be immediately reported to Medicare’s MSPRC.
Source: sandiegolegaloffice.com

Maine AG Warns of Medicare Scam

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Source: mpbn.net

Illegal Marketer of Medicare Information Admits Role in Detroit

According to court documents, Cooper and others conspired to defraud Medicare through purported home health care companies operating in the Detroit area, including now-defunct First Choice Home Health Care Services Inc. and Reliance Home Care, LLC. Cooper admitted that he sold Medicare information he obtained from Detroit-area Medicare beneficiaries to other conspirators at these and other health care companies, knowing that it was to be used to submit claims to Medicare for home health services that were not medically necessary and/or not provided. According to court documents, from 2008 through May 2012, Cooper sold co-conspirators the Medicare information of hundreds of Medicare beneficiaries, at $200 to $300 per beneficiary, and this Medicare information was used at these companies to bill Medicare for nearly $1 million in home health care services.
Source: jameshoyer.com

False Claims Act Medicare Fraud Case Against Orthofix Yields More Criminal Convictions

Last summer, we blogged about the qui tam False Claims Act case against Orthofix that resulted in a global criminal and civil settlement agreement between DOJ and the company, and several convictions of individuals. (See our blog at http://bit.ly/LYA6q8 and DOJ press release.pdf) Last month, a federal judge in Boston accepted the company’s plea to a charge of obstruction of a federal audit, ordered it to pay approximately $42 million in criminal fines and civil False Claims Act payments, and placed it on probation for five years. Prior to that, in July 2012, a physician’s assistant who pleaded guilty to accepting kickbacks from Orthofix was sentenced to six months in prison (home confinement), placed on probation probation, and and ordered to pay a fine; and then in September 2012 a former Orthofix territory manager pleaded guilty to health care fraud (see Orthofix (01-09-13).pdf). Now, this month, another federal judge in Boston has sentenced another former Orthofix employee who pleaded guilty last spring to forging patients’ medical records to justify Medicare reimbursement for procedures involving Orthofix’s bone growth products to prison (five months home confinement) as part of his two years of probation, and also ordered him to pay a fine and to forfeit certain monies. Id. The U.S. Attorney’s Office latest press release does not say if the investigation is still ongoing or if there may be more charges coming. The case and investigation are especially notable because corporate health care fraud cases seldom seem to result in individuals being convicted and sentenced to jail time or home confinement. (See our blog on this subject at http://bit.ly/SZpoDq.)  Here, so far six individuals have been convicted, making the Orthofix case a welcome change of pace.
Source: bostonwhistleblowerlawyerblog.com

D.A. Hynes Discusses Creation of Healthcare Fraud Division [VIDEO]

District Attorney Charles Hynes announced Monday that local prosecutors and city agencies will combine their efforts with the federal Health and Human Services Office of the Inspector General and the United States Attorney’s Office to investigate and prosecute doctors, pharmacists and patients who commit fraud against city, state and federal healthcare funds. 
Source: patch.com

State Roundup: N.Y. GOP Readies Medicaid Probe After Allegations

Posted by:  :  Category: Medicare

Old people read alone... by Ed YourdonSan Francisco Chronicle: Long-Term Care Rate Hike Stuns Retirees When Marie Benedetto opened her mail last week and learned her long-term care premium was going up a stunning 85 percent, she did what a retired math teacher would do. She made a spreadsheet. Benedetto calculated she’d have to spend $1,328 a month or $15,936 a year for the policy after the increase goes into effect. That added up to a 415 percent increase in premiums since she first purchased the policy in 1997. For Benedetto, the rate increase makes her policy unaffordable. … The state pension fund’s board decided in October to increase rates for the policies, which help pay for nursing-home care, home health care and other expenses not covered by Medicare (Colliver, 2/24).
Source: kaiserhealthnews.org

Video: What is the best health insurance company in New York for Medicare retirees? My

Medicare Loosens the Purse Strings

Thanks to the marvels of medical science, our parents are living longer than ever before. Adults over age 80 are the fastest growing segment of the population; most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children. In The New Old Age, Paula Span and other contributors explore this unprecedented intergenerational challenge. You can reach the editors at newoldage@nytimes.com.
Source: nytimes.com

Daily Report: Medicare Is Faulted on Shift to Electronic Records

The report says Medicare, which is charged with managing the incentive program that encourages the adoption of electronic records, has failed to put in place adequate safeguards to ensure that information being provided by hospitals and doctors about their electronic records systems is accurate. To qualify for the incentive payments, doctors and hospitals must demonstrate that the systems lead to better patient care, meeting a so-called meaningful use standard by, for example, checking for harmful drug interactions.
Source: nytimes.com

Doctors Fleeing Medicare, Moving to Direct Primary Care

Neil Sapin, a Glendale, Arizona, physician, charges less, about $1,500, but has a larger practice. He used to run himself ragged trying to keep up with the flow of patients necessary to cover all the expenses of his practice: “I used to see 18 patients per day, but [over time] I’m up to 24 or 25. It [became] difficult to give people as much time as I’d like to.” So he went private, dropping his workload from 1,600 patients to just 500. His patients have access to him any time of day or night and they can access their medical records from a home computer at any time and send him questions about their health via e-mail. Sapin says this allows him to spend more time with those who need him, and he also has time “to stress preventive health and dietary counseling.”
Source: thenewamerican.com

SteveLendmanBlog: New York Times Wages War on Medicare and Social Security

Stephen Lendman was born in 1934 in Boston, MA. In 1956, he received a BA from Harvard University. Two years of US Army service followed, then an MBA from the Wharton School at the University of Pennsylvania in 1960. After working seven years as a marketing research analyst, he joined the Lendman Group family business in 1967. He remained there until retiring at year end 1999. Writing on major world and national issues began in summer 2005. In early 2007, radio hosting followed. Lendman now hosts the Progressive Radio News Hour on the Progressive Radio Network three times weekly. Distinguished guests are featured. Listen live or achived. Major world and national issues are discussed. Lendman is a 2008 Project Censored winner and 2011 Mexican Journalists Club international journalism award recipient. His books are listed below.
Source: blogspot.com

Health Care’s Good News

This is truly a sea change. Look at Medicare: over the last 43 years, costs per beneficiary grew 2.7 percent faster than the overall economy. That’s why Medicare spending rose from $7.7 billion in 1970 (or 0.7 percent of gross domestic product) to $551 billion in 2012 (almost 4 percent of G.D.P.). But this trend has finally reversed; over the last three years, Medicare costs per person have grown 1.3 percent slower than growth in the overall economy. In January, a Department of Health and Human Services report showed that Medicare spending per beneficiary grew just 0.4 percent in 2012. And last week, the Congressional Budget Office lowered its 10-year Medicare spending projection by $137 billion, because “health care spending has grown much more slowly” than “historical rates would have indicated.”
Source: nytimes.com

Grappling With Details of Medicare Proposals

Still, it’s clear the proposed changes would shift costs from the federal government to retirees. An early version of a Republican plan would have more than doubled out-of-pocket health expenses for older adults, to $12,500 in 2022, the Congressional Budget Office estimated. “All scenarios will require seniors to pay more,” said Robert Moffit, senior fellow at the Heritage Foundation, a conservative research organization in Washington. To think otherwise, he said, “is a fantasy.”
Source: nytimes.com

Medicare Targets Health Plans With Low Ratings

Posted by:  :  Category: Medicare

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

Video: Medigap Supplements in Kentucky by Medicare Pathways

CareSource Hires Kentucky Executive Director and Medical Director

Earlier this year, the Kentucky Cabinet of Health and Family Services selected the Humana ? CareSource alliance to participate in its comprehensive managed Medicaid program in ?Region 3? ? serving Medicaid recipients who reside in a 16-county region including Louisville. Temporary Assistance for Needy Families (TANF) and Aged, Blind and Disabled (ABD) program enrollees (including individuals dually eligible for Medicare and Medicaid) are covered under the state?s managed Medicaid program.
Source: myuniversalhealthinsurance.com

Obama No Longer Open to Raising Medicare Age To Avoid Sequestration

According to data released by the US Census Bureau in 2011, the average household headed by someone 65 or older had 47 times the wealth of a household headed by someone 35 or younger–the largest gap recorded since recordkeeping began. Yet we continue to protect “vulnerable seniors” as if they were living off cat food. The poverty level for seniors is the lowest of any demographic. Yet Congress wants to enact every-higher taxes on those who are working (i.e. younger) to maintain unsustainable benefits for seniors. What’s wrong with this picture?
Source: californiahealthline.org