Health Care Authority Prepares to Start Paying Medicaid Providers at Higher Rates Under Health Reform

Posted by:  :  Category: Medicare

"Every citizen should be a soldier. This was the case with the Greeks and Romans, and must be that of every free state." ` Thomas Jefferson. by eyewashdesign: A. GoldenThe website includes an explanation of the current situation, the higher rates, a list of all the eligible codes involved in the rate changes and a Frequently-Asked Questions document to address other concerns. That FAQ and the Attestation Form have been recently updated to address “how to bill” issues as well as provider questions related to mid-level providers receiving the enhanced rates. The updated FAQ explains that eligible physicians who supervise mid-level practitioners and who have submitted the form will need to fill out and submit the second page of the form only.
Source: wa.gov

Video: AARP, Medicare and DSHS ( Washington State)

Health Insurers Launch TV Campaign Opposing Medicare Advantage Cuts

The Medicare NewsGroup: Medicare’s Middlemen Await Word From CMS To Put In Play Sequesration Cuts Medicare’s middlemen, the companies that will carry out the administrative work of the automatic budget cuts set to hit Medicare providers on April 1, are waiting for directions from the Centers for Medicare & Medicaid Services (CMS) to put in play provider payment reductions. The updates to the payment systems will ultimately lead to $11 billion in reduced payments to hospitals, doctors and other health care providers for the remainder of fiscal year 2013. These middlemen are Medicare Administrative Contractors (MACs), the private companies that handle the bulk of the entitlement program’s administrative claims processes. They will implement the 2 percent across-the-board payment reductions, mandated by sequestration, which is the result of the federal government’s inability to reach a deficit-reduction deal totaling $1.2 trillion. This means a .02 cent cut for every $1 paid to health care services providers, such as doctors, hospitals, skilled nursing facilities, insurers, medical device suppliers and home health companies (Sjoerdsma, 3/6).
Source: kaiserhealthnews.org

Lawmakers must accept Medicaid expansion

Washington Insurance Commissioner Mike Kreidler says the controversial Reproductive Parity Act pending in the Legislature is not essential to have in the next two years, because the state’s health insurers that cover maternity services are locked in to also covering abortion. But Kreidler said the Legislature should write that coverage into state law this year in anticipation that things could change under Obamacare, also known as the Affordable Care Act, in the out years.
Source: theolympian.com

The next entitlement crisis: Medicaid spending threatens education

An award-winning author, columnist, and TV commentator, Nina Easton offers insights at the intersection of economics and politics. For six years she has been a regular panelist on Fox News Sunday and Special Report, and has appeared on NBC’s Meet the Press, CBS’s Face the Nation, and PBS’s Washington Week in Review and Charlie Rose. Easton is the author of the critically acclaimed Gang of Five: Leaders at the Center of the Conservative Ascendancy. Prior to joining Fortune, she won a number of national awards as a Los Angeles Times writer, and later served as the Boston Globe’s deputy bureau chief in Washington. She is a native Californian and a graduate of the University of California at Berkeley.
Source: cnn.com

Medicare and Medicaid Under

It is interesting that the news of Walgreen’s decisions in Washington State, and the Mayo Clinic’s decisions in Minnesota and Arizona, did not receive wider media attention last spring. Executives at both organizations would fully understand the potential negative publicity that would result from a decision to stop serving Medicare and Medicaid patients. Thus, the fact that these prominent healthcare providers were willing to cease serving Medicare and Medicaid patients provides powerful evidence that even some of the nation’s largest healthcare providers can no longer fully absorb the financial costs of serving patients in these programs due to inadequate reimbursement.
Source: darkdaily.com

The Medicaid Expansion and Washington State Hospitals

The incentives for states to expand Medicaid are substantial.  People who enroll in expanded Medicaid will have their health care fully funded by the federal government in the first three years, slowly declining to 90 percent funding in 2020.  The state projects that expanding Medicaid could actually save state funds because people currently enrolled in Disability Lifeline and Basic Health would be totally federally funded.  Health coverage for these enrollees is currently paid half by the state government and half by the federal government, costing the state hundreds of millions of dollars.
Source: stateofreform.com

Inslee confident lawmakers will embrace Medicaid expansion :: The Capitol Record

The Affordable Care Act calls for the federal government to pay 100 percent of the cost of the Medicaid expansion to start. It would eventually drop to 90 percent. AARP estimates the expansion will cover an additional 40,000 people over age 50 who do not yet qualify for Medicare.
Source: tvw.org

Payment Reform Models: Employers Explore Population

An expert on Medicaid, Medicare, and health reform, Kip Piper, MA, FACHE, is a consultant, speaker, and author. Kip Piper advises health plans, hospitals and health systems, states, and pharma, biotech, medical device, HIT, and investment firms. With 30 years’ experience, Kip is a senior consultant with Sellers Dorsey, top specialists in Medicaid and health reform. He is also a senior advisor with Fleishman-Hillard and TogoRun. For more, visit KipPiper.com. Follow on Twitter @KipPiper, Google +, Facebook and connect on LinkedIn.
Source: piperreport.com

Getting into Gear for 2014: Briefing, Survey Examine 2013 Data From 50

Following the Supreme Court ruling upholding the Affordable Care Act (ACA) and as 2014 approaches, many states are moving into high gear to prepare for implementation of the major provisions of the law, including a new streamlined Medicaid enrollment system and, at states’ option, the expansion of Medicaid. Nearly all states are pressing forward with information technology and process improvements to develop faster, streamlined Medicaid enrollment systems as required under the ACA, whether or not the state elects to expand Medicaid coverage under the law.
Source: kff.org

Understanding Medicare "Cuts"

Posted by:  :  Category: Medicare

Will the Lame Duck Congress Poop on Social Security? by DonkeyHoteyMedicare Advantage is a 15-year failed experiment in privatization. Running Medicare through private insurance companies was supposed to save money through the magic of the marketplace; in reality, private insurers, with their extra overhead, have never been able to compete on a level playing field with conventional Medicare. But Congress refused to take no for an answer, and kept the program alive by paying the insurers substantially more than the costs per patient of regular Medicare. All the ACA does is end this overpayment.
Source: nytimes.com

Video: How to Understand Medicare Plans

Understanding Medicare Coverage in Rehabilitation.

24 Hour Availability of a Registered Nurse Examples of nursing documentation reflecting such care may include: •Progress in bowel and bladder continence. •Skin Integrity issues, including positioning techniques •Ongoing assessment of nutritional or hydration status in patients •Ongoing assessment of safety concerns, including physical and cognitive/perceptual concerns •Educational interventions with patient and/or family including: oTracheostomy care oTube feedings oCatheterization oMedication and potential side effects oBowel bladder programs oDischarge planning
Source: helenhayeshospital.org

Understanding Paul Ryan’s Medicare reform plan in three minutes

The federal government will determine the minimum level of benefits that all plans must offer. The premium-support payment is capped at the growth of GDP, plus 0.5 percent. The subsidy will be adjusted based on the income level of the consumer.
Source: constitutioncenter.org

Understanding Medicare Supplement Plans

Scope of Coverages. Every one of the Medigap plans includes a hospital benefit to cover coinsurance payments for standard Medicare Part A benefits, and a preventative medical care benefit that covers certain preventative services not covered by Medicare, as well as 100% of the coinsurance for Part B preventative services after the deductible is paid. The plans include some combination of the following benefits: coverage for Medicare Part B coinsurance obligations; blood during hospital stays; the hospital deductible amount; coverage of nursing facility coinsurance obligations; coverage for Medicare Part B deductibles; coverage for Part B excess charges; partial coverage for foreign travel emergency expenses; coverage for certain at-home recovery costs; and coverage for coinsurance obligations for hospice care.
Source: insuranceadvice.com

Modern Aging: Understanding Medicare’s annual enrollment

As in previous years, Medicare beneficiaries have the option of making no change during the AEP, and they automatically will be re-enrolled in their existing plan for another year, along with any changes that their current Medicare plan may have made for 2013. To inform members how their plans are changing, Medicare plan carriers are required to send each member an Annual Notice of Change letter.
Source: timesdispatch.com

Understanding Medicare: Tackling End

Medicare also needs to lay some ethical groundwork if it’s to expand this much-needed benefit. The medical system has traditionally defaulted to heroic measures to treat people in their final months, even though those treatments will do little to prolong or preserve some modest quality of life. And since several diseases don’t follow a strict timeline—especially cancer and other chronic maladies—the decision timeline on when to offer hospice or palliative care (or both) is muddled. A bioethicist should be brought in to discuss the alternatives over a period of time instead of offering only the one-shot consultation. 
Source: reportingonhealth.org

Florida Hospital Repays $3M to Medicare While Overbilling Allegations Loom

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2.. Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481Florida Hospital in Orlando has repaid $3 million to Medicare, a move seen by prosecutors as corroborating overbilling allegations and by hospital officials as the result of a routine audit, according to an Orlando Sentinel report. Lawyers representing whistleblowers who filed suit against Florida Hospital in Orlando say the organization’s repayment of $3 million to Medicare shows merit to overbilling allegations, but hospital officials say the repayment was the result of a “normal and routine” audit. Florida Hospital and six other hospitals under the Orlando-based Adventist Health System face allegations of improper Medicare billing. A whistleblower complaint filed in July 2010 and unsealed in August 2012 alleges that seven Adventist hospitals routinely submitted duplicate claims or overbilled for radiology services for 15 years. A second complaint, filed in October 2012, claims fraudulent billing occurred for emergency services, as well. Marlan Wilbanks, JD, an attorney representing the whistleblowers, says Florida Hospital’s recent repayments to the Medicare program “further proves the credibility of our case,” according to the report. But hospital spokesperson Samantha O’Lenick says the repayment was based on a third-party audit’s findings. “It is not uncommon for us, as well as others in the industry, to conduct normal and routine audits because of the highly complex governmental billing rules,” Ms. O’Lenick said in the report. “Sometimes in doing so, we correct overcharges and undercharges.” A district judge has called the whistleblowers’ evidence of the alleged wrongdoing “extensive and sufficient,” and denied Florida Hospital’s first motion to dismiss the case. He also denied another motion to dismiss the second claim, which was filed more recently. A trial for the case is set for Dec. 2.
Source: beckershospitalreview.com

Video: Paul Ryan Speech on Medicare in Florida, on August 17 2012

Florida Gets Green Light For Medicaid Managed Care

TALLAHASSEE, — Federal health officials have approved a key part of Florida’s effort to transform its Medicaid program, clearing the way for tens of thousands of seniors across the state to move into managed-care plans. The approval, announced Monday, means that Medicaid-eligible seniors who need long-term care likely will start enrolling later this year in HMOs and another type of health plan known as a “provider service network.” The long-term care changes are the first phase of a controversial proposal to shift Medicaid beneficiaries statewide into managed care. A basic concept of the long-term care changes is that managed-care plans would provide services to seniors at home or in their communities, if possible. In doing so, many seniors would be able to stay out of nursing homes, or at least postpone the need to go into such facilities. Senate Appropriations Chairman Joe Negron, a Stuart Republican who played a key role in drawing up the Medicaid changes, said nursing homes will continue to play an important role in the Medicaid system. But he said seniors want to be able to “age in place” in their homes and communities and only go to nursing facilities when necessary. “Now, it gives us the ability with Medicaid to provide these options in the community for seniors,” Negron said. The senior-advocacy group AARP Florida vowed Monday to be “watchdogs” as the new system is put in place. “Florida elected officials have said they are pushing this reform effort forward because they want to assure the highest quality of care for frail and vulnerable Floridians under Medicaid,” AARP Florida State Director Jeff Johnson said in a prepared statement. “AARP Florida will hold them to their word.” Gov. Rick Scott and the Republican-controlled Legislature approved wide-ranging bills in 2011 aimed at shifting to a statewide managed-care system in Medicaid. The plan was to make the changes in two phases — first for seniors who need long-term care and then for the broader Medicaid population. While many Medicaid beneficiaries already enroll in managed-care plans, backers of a statewide system argue it would help hold down Medicaid costs and better coordinate services for beneficiaries. But critics have long argued that the shift will result in managed-care plans squeezing care provided to low-income people. Such Medicaid proposals require approval by the federal Centers for Medicare & Medicaid Services before they can take effect. The federal government faced a Thursday deadline for ruling on the long-term care proposal, after Florida gave notice late last year that it wanted to start a 90-day “clock” to compel a decision. No such deadline exists for the changes affecting the broader Medicaid population, and it remains unclear when federal officials will make a decision. State Medicaid director Justin Senior told lawmakers in December that the Agency for Health Care Administration had focused first on getting approval for the long-term care portion of the changes. Scott sent a letter Monday to U.S. Department of Health and Human Services Secretary Kathleen Sebelius expressing appreciation for approval of what is known as a Medicaid “waiver” for the long-term care changes. But he also pressed to get approval for the shift affecting the broader Medicaid population. “Now, our most urgent need is the immediate approval of our second pending waiver, which relates to the statewide Medicaid managed-care program,” Scott wrote. “This second waiver will give us additional flexibility within the current Medicaid program, and it supports our goal of improving the cost, quality and access to health care for all Florida families.” Scott met last month with Sebelius and has appeared to try to connect the state’s managed-care proposals with a separate issue about whether Florida will expand Medicaid eligibility under the federal Affordable Care Act. The federal government wants states to expand eligibility as a way to provide health coverage for more people. But Greg Mellowe, policy director for the patient-advocacy group Florida CHAIN, said it will be harder for the state to get approval of the broader managed-care proposal. That proposal would build off a highly controversial Medicaid managed-care pilot program that operates in five counties. “The fact that the managed long-term care waiver was approved in no way indicates that approval of the broader statewide Medicaid managed-care waiver can be justified or will be forthcoming,” Mellowe, whose group has been highly critical of the managed-care proposal, wrote in an email. The state Agency for Health Care Administration has already gone through a lengthy contracting process to choose health plans that would provide long-term care services to seniors. That process involved competitive bidding in 11 regions of the state and led to AHCA awarding contracts to American Eldercare, Sunshine State Health Plan, United HealthCare of Florida, Coventry Health Care of Florida and Amerigroup Florida. AHCA hopes to start using the new long-term care system as early as August in the Orlando area and gradually move into other areas of the state. But enrollment could be delayed in three regions — the western Panhandle, the Big Bend and Palm Beach County and the Treasure Coast — because of protests by losing bidders. The Centers for Medicare & Medicaid Services sent a letter to the state Friday, approving the long-term care changes effective July 1. The approval is for three years, expiring June 30, 2016, with the state able to request renewals “by providing evidence and documentation of satisfactory performance and oversight.” Michael Garner, president of the Florida Association of Health Plans, said moving to the long-term care system will require an extensive education effort for seniors and family members who will choose between managed-care plans. Like Negron, Garner said nursing homes will continue to play an important role, but he said he hopes the new system will help get people into the “lowest-cost settings that are preferable for them and their families.”
Source: kaiserhealthnews.org

Medicaid expansion: Is Florida’s Gov. Scott the new compassionate conservative?

Great insights and well presented! We owe thanks to Democrats back in the shadows that designed the ACA to be based on financial incentives to encourage the desired behavior. Republicans will always follow the money trail. It suddenly dawned on Scott that he was opening up his state for financial ruin and populist outrage if he did not comply with the obvious. The financial mechanisms are having their desired effect, especially when hospitals saw that their free gravy train from the Feds was going to be discontinued… BONG! Obamacare suddenly looked beautiful, as we already knew it was… the GOP understands money and the lack of it, so expect more states to comply, except for Texas — they were never too good at math in that state, except when counting touchdowns… hehehe… Thanks again for the excellent read!
Source: allvoices.com

Florida Medicaid Expansion Pretty Much Killed by Senate Panel

On Monday afternoon, a Senate select committee rejected moving forward with an expansion of the Medicaid program under the federal Affordable Care Act, even after Gov. Rick Scott expressed a desire to see it expanded and even though state hospitals and businesses wanted to see it expanded and even though the majority of Floridians want to see it expanded.
Source: browardpalmbeach.com

Feds approve first step of Florida’s Medicaid managed care push

2010 campaigns 2010 elections 2012 campaigns 2012 elections Alex Sink Allen West Barack Obama Bill McCollum bnblogs BP Charlie Crist Dan Gelber Dean Cannon Deepwater Horizon Ed Lynch education elections Ellyn Bogdanoff Florida House Florida Power & Light Florida Senate Florida Supreme Court FPL gambling gop2012 J.D. Alexander Jeff Atwater Joe Negron John Thrasher Marco Rubio Mike Haridopolos offshore drilling oil spill Pam Bondi prisons PSC Public Service Commission Rick Scott state agencies state budget State House State Senate U.S. Senate utilities voting
Source: postonpolitics.com

Rick Scott May Want Obamacare, But the Florida Legislature Doesn't

Elected as a fierce opponent of Obamacare, Scott last month made a complete turnaround and announced that he supported Florida’s participation in the part of Obamacare that expands Medicaid, the government health insurance for the poor, to people making up to 138 percent of the poverty line. That move would extend health care to about 1 million Florida residents. The change of heart wasn’t for humanitarian reasons. Not only might Scott need some of those uninsured people to vote for him, but he made the announcement on Medicaid just hours after the US Department of Health and Human Services said it would allow Florida to shunt most of its Medicaid recipients into private managed care plans. That change will divert millions of dollars for care of the poor into the hands of big insurance companies, many of which can be expected to ante up to support Scott’s reelection bid.
Source: motherjones.com

Miami Medicare Fraud Attorney Reveals Doubt in Florida Crackdown

More than 500 agents, including those from the FBI, Health and Human Services (HHS) and U.S. Postal Inspection Service, participated in the coordinated takedown, reported The Miami Herald.  The South Florida defendants were charged with a variety of Medicare fraud offenses including charges of paying kickbacks to recruiters and patients; charges of submitting phony claims to the Medicare program; conspiracy to pay bribes to recruiters and patients who did not need the facility’s mental health services; charges of receiving kickbacks to supply the Medicare beneficiaries; and attempting to conceal kickbacks by creating false documents, said The Miami Herald.
Source: fortlauderdalecriminalatty.com

Is Florida Medicare Insurance Different From Other States?

Florida Medicare Insurance differs because many seniors have trouble paying out-of-pocket co-pays and deductibles after their Florida Medicare Insurance Part A and B pays their share. Currently, Floridians have the highest insurance rates in the country. And, the amount they pay for their Florida Medicare Insurance depends on the county they live in.
Source: seniorcorps.org

Medicaid v. Medicare payment rates

Posted by:  :  Category: Medicare

Newsweek Magazine (February 16, 2009) ... Lenders Add Bigger Fannie, Freddie Fee – Thanks to Payroll Tax Cut (January 15, 2012) ...item 2.. Dupuy: GOP trying to sell pyrmaid scheme to voters (September 3, 2012) ... by marsmet526ACA 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 Medicaid expansion 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 Super Committee tax reform The cost of smoking
Source: wordpress.com

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

Proposed 2014 Medicare Advantage rates cut insurer payments

Should the rules become final, Skolnick said she would expect UnitedHealth to exit many Medicare Advantage markets and experience a significant or severe contraction in that business. But she said that as with past rule changes, expected lobbying over the next few weeks by insurers may affect the final rule.
Source: medcitynews.com

Would Dwindling Medicare and Medicaid Payment Rates Turn Providers to Private Insurance Beneficiaries?

While the inclusion of 77 million baby boomers into the public insurance ambit may provide voluminous clinical opportunities to doctors, the proposed cut to Medicare spending by as much as $426 billion over the next decade could drastically spoil their revenue prospects. With reimbursements revenues expected to decrease even further, physicians or hospitals may not be inclined to seeing more of Medicare and Medicaid beneficiaries. Thus, they may have to substitute their portfolio with more and more private health insurance beneficiaries. While patients with private health insurance policies may be more lucrative, there would always be the risk of dealing with private insurance carriers, who are seemingly more vigilant and stricter when it comes to reimbursements. Given the challenges of private insurance reimbursement environment, it may require an external medical billing mediation to orchestrate the entire process of billing, submitting and realizing the claims to their fullest.
Source: medicalbillersandcodersblog.com

MedPAC: Hospitals Must Have Pressure to Contain Costs

The Medicare Payment Advisory Commission has reiterated its stance and recommendation on Medicare inpatient and outpatient payment updates to hospitals, saying hospitals should only receive a 1 percent increase next year to “maintain pressure on the industry to contain costs,” according to MedPAC’s annual report to Congress. In January, MedPAC said hospital inpatient and outpatient Medicare payments should only be increased marginally in fiscal year 2014. The most recent report, which is submitted to Congress every year, detailed the commission’s rationale as to why hospitals should receive a 1 percent raise. MedPAC officials said hospitals must contain costs, and “high overall profit margins may lead hospitals to reduce their focus on cost control,” according to the report. In addition, MedPAC said hospitals can bear low Medicare payment updates because access to care, quality of care and access to capital measures are all positive for the industry. MedPAC also stated that hospitals’ documentation and coding changes in 2010 resulted in “excessive payment rates from 2010 through 2013,” meaning any rate increase for 2014 should be minimal to offset those overpayments. Officials acknowledged that most hospitals have a negative overall Medicare margin. In 2011, the average overall Medicare margin for all hospitals was negative 5.8 percent compared with negative 4.7 percent in 2010. MedPAC also projected a negative 6 percent Medicare margin for hospitals in 2013. For that reason, MedPAC acknowledged a modest increase will help offset the costs associated with Medicare patients. Also within the report, MedPAC officials told Congress there is an “urgent need” to repeal the sustainable growth rate, which dictates Medicare payments to physicians. As for the industries outside of hospitals and physicians, MedPAC had gloomier news. Officials said they recommend no increases for ambulatory surgery centers, long-term care hospitals and inpatient rehabilitation facilities, and MedPAC suggested reducing rates for skilled nursing facilities and home healthcare agencies.
Source: beckershospitalreview.com

Medicare ‘Doc Fix’ Hostage To Fiscal Cliff Negotiations

Medscape: Obama’s Fiscal-Cliff Plan Said To Repeal SGR President Barack Obama’s latest plan to save the nation from the fiscal cliff includes a repeal of Medicare’s sustainable growth rate (SGR) formula that otherwise will trigger a 26.5% cut in physician reimbursement on January 1, according to a source familiar with negotiations between Congress and the White House. The Medicare rate reduction is part of the automatic spending cuts and tax increases dubbed the “fiscal cliff” that take effect in January. … The SGR crisis, a yearly event for physicians over the past decade, is a fiscal-cliff sideshow. Most of the jawboning between Obama, Senate Democrats who rule that chamber, and House Speaker John Boehner (R-OH), has been over the expiration of the Bush-era tax cuts, which will raise everyone’s rates (Lowes, 12/19).
Source: kaiserhealthnews.org

Mass. Medicare Reimbursement Rates Draw Scrutiny

When hospital executives talk about Medicare, they often bemoan low reimbursement rates, but Massachusetts hospitals have been enjoying reimbursement rates that are now drawing protests from 21 states. Medicare regulations require that all providers in a state receive reimbursement rates that are at least as high as those given to a state’s rural hospitals. In Massachusetts, only one hospital out of 82 qualifies as rural: Nantucket Cottage Hospital. The hospital serves the island of Nantucket’s approximately 10,000 permanent residents, though that total swells to approximately 50,000 people in summer. This is due to the amount of vacation homes on Nantucket, where the median home price is over $1 million.
Source: nonprofitquarterly.org

Medicare Panel Calls for Repealing Sustainable Growth Rate Formula

Ten days after Congress voted to approve a temporary “doc fix,” the Medicare Payment Advisory Commission last week released a blueprint that calls for permanently repealing and replacing the sustainable growth rate formula — which is used to determine Medicare physician reimbursement rates,
Source: californiahealthline.org

2013 Medicare Physician Fee Schedule

I also am new to the RVU process but have a fairly good understanding of what needs to be done. However, I have been unable to find any information on what a Transitioned Non-Facility verses a Fully Implemented non- Facility is. I noticed the PE RVU is higher for the Fully Implemented non-facility. Someone told me it represents where you are at in your implementation of EHR???? I am waiting for a callback from CMS but if anyone has an answer it would be appreciated. Pat Carlson Open Cities Health Center
Source: physicianspractice.com

ICYMI: Medicare Advantage Does a Better Job Preventing Hospital Readmissions than Fee

Despite evidence of the higher-quality care Medicare Advantage plans provide, CMS recently proposed a 2.3 percent reduction in Medicare Advantage payments for 2014, at a time when medical costs are projected to increase by three percent. The new proposed payment cuts are in addition to the billions of dollars in Medicare Advantage cuts and a new health insurance tax included in the Affordable Care Act.  A new report from Oliver Wyman estimates that the cumulative impact of these cuts and taxes will result in an estimated 6.9 to 7.8 percent cut to Medicare Advantage plans in 2014, leading to benefit reductions and premium increases of $50 to $90 per month for a typical Medicare Advantage beneficiary.
Source: ahipcoverage.com

GAO: Medicare remains ‘high

“CMS has not met GAO’s criteria to have the Medicare program removed from the High-Risk List. For example, although CMS has made progress in measuring and reducing improper payment rates in different parts of the program, it has yet to demonstrate sustained progress in lowering the rates,” according to GAO’s written testimony before the House Subcommittee on Health, Committee on Energy and Commerce on Wednesday.
Source: dailycaller.com

Medicare, Medicaid & Social Security Vital To Illinois Economy, New Report Finds

Posted by:  :  Category: Medicare

Love it! Improve it! Medicare for All! by TheeErinLess contentious an issue has been the willingness of both parties to reduce government spending. The president’s plan would call for $350 billion in cuts to health programs, plus another $250 billion in other spending cuts over the next 10 years. Republicans seek to cut $600 billion from health programs and another $600 billion from other, non-specified programs over the same period.
Source: progressillinois.com

Video: Medicare Advantage Illinois

Illinois Medical Care Set For Economy Plan

More than 135,000 high-cost Illinois patients who are eligible for both Medicare and Medicaid will be assigned to a managed care health plan by early next year. The initiative is a partnership between Illinois and the federal Centers for Medicare and Medicaid Services and is designed to cut costs.
Source: cbslocal.com

Labor Conference in Chicago Sees "Medicare for All" as Best Way to Control Costs and lmprove Quality of Care

Conferees were welcomed and inspired by Karen Lewis, president of the Chicago Teachers Union, who shared lessons of her union’s recent successful strike. Lewis drew important parallels between the struggles for quality public education and quality universal health care. A second inspiring keynote came from Nicole Bernard representing the French Confederation of Labor who described the struggle by French workers to defend their national health care plan and pledged strong support for American efforts to win single payer. Congressman John Conyers (D-MI) brought delegates to their feet as he described his plan to resubmit legislation and hold hearings on improved and expanded Medicare for All.  “Health care is a right, not a privilege,” said Conyers. 
Source: pdaillinois.org

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

CMS AND ILLINOIS PARTNER TO COORDINATE CARE FOR MEDICARE

Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates.[41][42] Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases.[43] It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances. The Patient Protection and Affordable Care Act (“ACA”) of 2010 made a number of changes to the Medicare program. Several provisions of the law were designed to reduce the cost of Medicare. Congress reduced payments to privately managed Medicare Advantage plans to align more closely with rates paid for comparable care under traditional Medicare. Congress also slightly reduced annual increases in payments to physicians and to hospitals that serve a disproportionate share of low-income patients. Along with other minor adjustments, these changes reduced Medicare’s projected cost over the next decade by $455 billion. Additionally, the ACA created the Independent Payment Advisory Board (“IPAB”), which will be empowered to submit legislative proposals to reduce the cost of Medicare if the program’s per-capita spending grows faster than per-capita GDP plus one percent. While the IPAB would be barred from rationing care, raising revenue, changing benefits or eligibility, increasing cost sharing, or cutting payments to hospitals, its creation has been one of the more controversial aspects of health reform. The ACA also made some changes to Medicare enrollee’s’ benefits. By 2020, it will close the so-called “donut hole” between Part D plans’ coverage limits and the catastrophic cap on out-of-pocket spending, reducing a Part D enrollee’s’ exposure to the cost of prescription drugs by an average of $2,000 a year.[116] Limits were also placed on out-of-pocket costs for in-network care for Medicare Advantage enrollees. Meanwhile, Medicare Part B and D premiums were restructured in ways that reduced costs for most people while raising contributions from the wealthiest people with Medicare. The law also expanded coverage of preventive services. The ACA instituted a number of measures to control Medicare fraud and abuse, such as longer oversight periods, provider screenings, stronger standards for certain providers, the creation of databases to share data between federal and state agencies, and stiffer penalties for violators. The law also created mechanisms, such as the Center for Medicare and Medicaid Innovation to fund experiments to identify new payment and delivery models that could conceivably be expanded to reduce the cost of health care while improving quality. http://en.wikipedia.org/wiki/Medicare_%28United_States%29
Source: wn.com

Changes to Illinois All Kids Medicaid Program Harmful to Thousands Insurance Families.com

Families that make 300% above the poverty level will no longer be eligible to put their children into this health care program. That percentage equates to about $60,000 for a family of four. The result is that 4,300 children in Illinois will suddenly be completely without health insurance. Many of these children have cancer, or other serious health conditions. Parents, or caregivers, of these children will soon be forced to figure out how to pay for the cost of things like chemotherapy, prescription medications, and hospital visits without the help from the All Kids program.
Source: families.com

Some in Illinois worry budget deal to avoid fiscal cliff could create crisis for them

Even though Moore has trouble getting around, she made sure to get downtown for one of a series of recent protests in front of Illinois Sen. Dick Durbin’s office. A coalition called Make Wall Street Pay Illinois has organized demonstrations in recent weeks to get Durbin’s attention. On Nov. 9, several protesters were arrested in his office and in the lobby of the Dirksen Federal Building. Then on Dec. 6 they built a large shantytown named “Durbinville” in the Federal Plaza. Moore was among the protesters at “Durbinville.” Four days after that, the demonstrators had another march on his office.
Source: chicagonow.com

farmdocdaily: Farms and the New 2013 Medicare Tax Increases

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

Medicare Drug Benefit: Formulary Oversight in Medicare Part D

Posted by:  :  Category: Medicare

Senate Dems Protest Medicare Cuts by Talk Radio News ServiceAn expert on Medicaid, Medicare, and health reform, Kip Piper, MA, FACHE, is a consultant, speaker, and author. Kip Piper advises health plans, hospitals and health systems, states, and pharma, biotech, medical device, HIT, and investment firms. With 30 years’ experience, Kip is a senior consultant with Sellers Dorsey, top specialists in Medicaid and health reform. He is also a senior advisor with Fleishman-Hillard and TogoRun. For more, visit KipPiper.com. Follow on Twitter @KipPiper, Google +, Facebook and connect on LinkedIn.
Source: piperreport.com

Video: Medicare Part D

Medicare Part D and MedAdvantage Plans

I hope this is a quick question. Client I inherited from a group plan has just become Medicare eligible. He signed up for part A & B and we found him a local Medicare Advantage plan which includes part D coverage. He just got a bill from Medicare for part A, B and D. Does he really have to pay a part D premium to both the government and with his Medicare Advantage plan? I thought you could opt out and not pay part D premium to the gov. if your Medicare Advantage plan covered it instead. Please help!
Source: insurance-forums.net

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

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

For 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

Medicare Information, Tips to Help You Choose the Right Medicare Plan

Navigating your Medicare prescription drug coverage options can be challenging, but with the right information, you can make the best decision based on your unique medical requirements and preferences. Every patient that is eligible for Medicare is also eligible for prescription drug coverage. There are several plans available, including Medicare Advantage and Medicare Part D plans, so it is imperative to understand your options before making a decision. It may also be helpful to talk to an expert in the field if you have questions or concerns about which plan is right for you. Here are a few tips to keep in mind while evaluating your options for Medicare prescription drug coverage:
Source: myowens.com

Medicare Part D: A First Look at Part D Plan Offerings in 2013

NOTE: Originally released in October 2012, this data spotlight was updated in November 2012 to reflect revised data from the Centers for Medicare and Medicaid Services. 
Source: kff.org

Expert Tips to Simplify Medicare Plan D

 Part D Plan is a network pharmacy that offers covered drugs to plan members at lower out-of-pocket costs than what the member would pay at a non-preferred network pharmacy. This can make huge difference in what you’ll pay. For example, Walmart is a preferred pharmacy on multiple plans including the Humana-Walmart Preferred Rx Plan. They provide access to the top ten hypertension drugs for just one cent. So if you’re one of the 70% of Americans over the age of 65 who have high-blood pressure, you can get a month’s worth of the medication you need for just one penny!   Just one specific example of how it can pay to do your homework.”
Source: alexisabramson.com

Medicare Prescription Drug Coverage, Medicare Part D, Doughnut Hole

Medicare has an optional program — called Medicare Part D — that provides insurance to help you pay for prescription drugs. If you select to have the coverage, you pay a monthly premium. This guide explains how the program works and helps you make decisions in choosing a plan that’s right for you.
Source: aarp.org

CMS rolls back Medicare Part D deductibles for 2014

Greater Protection for Beneficiaries: CMS proposes to require Part D plan pharmacies to obtain enrollee consent prior to each delivery, unless the enrollee personally requests the refill. This proposal is in response to complaints from beneficiaries who have received and been charged for unnecessary and unwanted prescriptions because of “auto-ship” services. CMS intends to again use its authority, provided by the health care law, to protect Medicare Advantage enrollees from significant increases in costs or cuts in benefits, and, for the 2014 contract year, proposes reducing the amount of any permissible increase to $30 per member per month (down from $36 per member per month in previous years).
Source: medicarewire.com

Medicare Announces 2011 Deductible and Coinsurance Rates

Posted by:  :  Category: Medicare

Last week, Medicare announced on CMS.gov in a fact sheet titled “Medicare Premiums, Deductibles for 2011″. This fact sheet gives detailed information on the increases to the yearly premium and deductible Medicare patients will have to face in the coming year.
Source: about.com

Video: Medicare Supplement plan F High Deductible Explanation

Medicare Premiums and Deductibles 2012

MEDICARE PREMIUMS AND DEDUCTIBLES FOR 2012 MEDICARE PART A: Medicare Part A premiums will be increasing by just $1 per month, and the deductible will increase by just $24. For Medicare Part A, which pays for inpatient hospital, skilled nursing facility, and some home health care, about 99 percent of Medicare beneficiaries do not pay a premium since they or their spouses have at least 40 quarters of Medicare-covered employment. However, some enrollees age 65 and over and certain persons with disabilities who have fewer than 30 “quarters of coverage” obtain Part A coverage by paying a monthly premium set according to a statutory formula. This premium will be $451 for 2012, an increase of $1 from 2011. Those who have between 30 and 39 “quarters of coverage” may buy into Part A at a reduced monthly premium rate which is $248 for 2012, the same amount as in 2011. The Part A deductible paid by a beneficiary when admitted as a hospital inpatient will be $1,156 in 2011, an increase of $24 from this year’s $1,132 deductible. The Part A deductible is the beneficiary’s cost for up to 60 days of Medicarecovered inpatient hospital care in a benefit period. Beneficiaries must pay an additional $289 per day for days 61 through 90 in 2012, and $578 per day for hospital stays beyond the 90th day in a benefit period. For 2011, per day payment for days 61 through 90 was $283, and $566 for beyond 90 days. For beneficiaries in skilled nursing facilities, the daily co-insurance for days 21 through 100 in a benefit period will be $144.50 in 2012, compared to $141.50 in 2011. MEDICARE PART B: The standard Medicare Part B monthly premium will be $99.90 in 2012, a $15.50 decrease over the 2011 premium of $115.40. However, most Medicare beneficiaries were held harmless in 2011 and paid $96.40 per month. The 2012 premium represents a $3.50 increase for them. Medicare Part B covers a portion of the cost of physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and other items. By law, the standard premium is set to cover one-fourth of the average cost of Part B services incurred by beneficiaries aged 65 and over, plus a contingency margin. The contingency margin is an amount to ensure that Part B has sufficient assets and income to (i) cover Part B expenditures during the year, (ii) cover incurred-but-unpaid claims costs at the end of the year, (iii) provide for possible variation between actual and projected costs, and (iv) amortize any surplus assets. Most of the remaining Part B costs are financed by Federal general revenues. (In 2012, about $2.9 billion in Part B expenditures will be financed by the fees on manufacturers and importers of brand-name prescription drugs under the Affordable Care Act.) The largest factor affecting the contingency margin for 2012 is the current law formula for physician fees, which will result in a payment reduction of about 29 percent in 2012. For each year from 2003 through 2011, Congress has acted to prevent smaller physician fee reductions from occurring. The 2012 reduction is almost certain to be overridden by legislation enacted after Part B financing has been set for 2012. In recognition of the strong possibility of increases in Part B expenditures that would result from similar legislation to override the decrease in physician fees in 2012, it is appropriate to maintain a significantly larger Part B contingency reserve than would otherwise be necessary. The asset level projected for the end of 2012 is adequate to accommodate this contingency. In 2012, Social Security monthly payments to enrollees will increase by 3.6 percent. The dollar increase in benefit checks is expected to be large enough on average to cover the increase in the Part B premium of $3.50 that most beneficiaries will experience. For those who were paying the standard premium of $115.40, their benefits checks will only increase. MEDICARE PART D: The estimate for the average 2012 Part D premium for basic coverage is $30. This is slightly lower than the actual average for 2011 of $30.76. The estimate for the average 2012 Part D premium for supplemental coverage is $8. The estimate for the average 2012 total Part D premium is $38. MEDICARE ADVANTAGE PLANS: On average, Medicare Advantage premiums will be 4 percent lower in 2012 than in 2011, and plans project enrollment to increase by 10 percent. Of people with Medicare, 99.7 percent continue to enjoy access to a Medicare Advantage plan, and benefits remain consistent with those offered in 2011. INCOME RELATED ADJUSTMENT: As required in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, beginning in 2007 the Part B premium a beneficiary pays each month is based on his or her annual income. Specifically, if a beneficiary’s “modified adjusted gross income” is greater than the legislated threshold amounts ($85,000 in 2012 for a beneficiary filing an individual income tax return or married and filing a separate return, and $170,000 for a beneficiary filing a joint tax return) the beneficiary is responsible for a larger portion of the estimated total cost of Part B benefit coverage. In addition to the standard Part B premium, affected beneficiaries must pay an income-related monthly adjustment amount. These income-related amounts were phased-in over three years, beginning in 2007. About 4 percent of current Part B enrollees are expected to be subject to these higher premium amounts. The 2012 Part B monthly premium rates to be paid by beneficiaries who file an individual tax return (including those who are single, head of household, qualifying widow(er) with dependent child, or married filing separately who lived apart from their spouse for the entire taxable year), or who file a joint tax return are shown in the following table: Beneficiaries who file an individual tax return with income: Beneficiaries who file a joint tax return with income: Part B incomerelated monthly adjustment amount Total monthly Part B premium amount Less than or equal to $85,000 Less than or equal to $170,000 $0.00 $99.90 Greater than $85,000 and less than or equal to $107,000 Greater than $170,000 and less than or equal to $214,000 $40.00 $139.90 Greater than $107,000 and less than or equal to $160,000 Greater than $214,000 and less than or equal to $320,000 $99.90 $199.80 Greater than $160,000 and less than or equal to $214,000 Greater than $320,000 and less than or equal to $428,000 $159.80 $259.70 Greater than $214,000 Greater than $428,000 $219.80 $319.70 In addition, the monthly premium rates to be paid by beneficiaries who are married, but file a separate return from their spouse and lived with their spouse at any time during the taxable year are as follows: Beneficiaries who are married but file a separate tax return from their spouse: Part B incomerelated monthly adjustment amount Total monthly Part B premium amount Less than or equal to $85,000 $0.00 $99.90 Greater than $85,000 and less than or equal to $129,000 $159.80 $259.70 Greater than $129,000 $219.80 $319.70 As a result of the Medicare Modernization Act, the Part B deductible was increased to $110 in 2005 and is indexed thereafter by the annual percentage increase in the Part B actuarial rate for aged beneficiaries. In 2012, the Part B deductible will be $140, a decrease of $22 from 2011. (The actuarial rate is set by law at one-half of the total estimated per-enrollee cost of Part B benefits and administrative expenses, adjusted as necessary to maintain an adequate contingency reserve.) Those who enroll in Medicare Advantage plans may have different cost-sharing arrangements. On average Medicare Advantage premiums will be 4 percent lower in 2012 than in 2011, and plans project enrollment will increase. Beginning in 2011, the Affordable Care Act required Part D enrollees whose incomes exceed the same thresholds that apply to Part B enrollees to pay an income-related monthly adjustment amount, in addition to their Part D plan premium. The 2012 income-related monthly adjustment amounts to be paid by beneficiaries who file an individual tax return (including those who are single, head of household, qualifying widow(er) with dependent child, or married filing separately who lived apart from their spouse for the entire taxable year), or who file a joint tax return are shown in the following table: Beneficiaries who file an individual tax return with income: Beneficiaries who file a joint tax return with income: Incomerelated monthly adjustment amount Less than or equal to $85,000 Less than or equal to $170,000 $0.00 Greater than $85,000 and less than or equal to $107,000 Greater than $170,000 and less than or equal to $214,000 $11.60 Greater than $107,000 and less than or equal to $160,000 Greater than $214,000 and less than or equal to $320,000 $29.90 Greater than $160,000 and less than or equal to $214,000 Greater than $320,000 and less than or equal to $428,000 $48.10 Greater than $214,000 Greater than $428,000 $66.40 In addition, the income-related monthly adjustment amounts to be paid by Part D beneficiaries who are married, but file a separate return from their spouse and lived with their spouse at any time during the taxable year are as follows: Beneficiaries who are married and lived with their spouse at any time during the year, but file a separate tax return from their spouse: Incomerelated monthly adjustment amount Less than or equal to $85,000 $0.00 Greater than $85,000 and less than or equal to $129,000 $48.10 Greater than $129,000 $66.40 As noted above, states have programs that pay some or all of beneficiaries’ Part A and Part B premiums and coinsurance for certain people who have Medicare and a limited income. Medicare provides similar assistance with premiums and cost-sharing for low-income Part D enrollees. Information is available at 1-800-MEDICARE (1-800-633-4227) and, for hearing and speech impaired, at TTY/TDD: 1-877-486-2048.
Source: primeinsuranceservice.com

2012 Medicare Deductible Amounts

One such Medigap option available for purchase is Plan G.  Plan G covers everything that Plan F does except for the Part B deductible.  If Plan G happened to be $300 less (as can be the case) per year than Plan F and Plan F only covers $140 more in costs, then Plan G is a wise choice.  Plan N might also fall into this category if you live in a state (Ohio for instance) that does not allow for Part B Excess charges.
Source: ohioinsureplan.com

Jim Thomason’s “The Business of People”: High Deductible Plans and Medicare Part B Don’t Go Together

Now before your eyes gloss over, let’s walk through it. Medicare pays 80% (you pay 20%) after a $162 deductible. Medicare is always the payer of last resort, but it will pay its portion between the $162 Medicare deductible and the $1,200 Blue Cross deductible. That totals $830 in benefits ($1,200 – $162 deductible = $1,038 x 80%). After you’ve reached $1,200 in medical bills your Blue Cross insurance kicks in at 80%, making Medicare secondary. In the coordination of coverage rules for Medicare, it will pay whatever Blue Cross does up to the limits of Medicare’s coverage. Because Blue Cross pays 80%, and Medicare pays 80%, Medicare will pay nothing else. You pay 20% until your total out of pocket reaches $8,800 (a rarity)and then Blue Cross pays 100%. The coordination of these two coverages means that you’ll pay $567 more in Part B premium that you’ll ever receive in benefits. Bottom line: if you have Parts A and B you don’t need to elect our coverage. If you have Part A and want a Blue Cross High Deductible Plan you should not elect Medicare Part B.
Source: blogspot.com

Marshall Elder and Estate Planning Blog: Medicare Premiums for 2011 announced

For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium.  The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs.  If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month.  For additional details, see our FAQ titled: “2011 Part B Premium Amounts for Persons with Higher Income Levels”.
Source: blogspot.com

CMS Announces 2013 Medicare Deductible, Coinsurance Amounts : Health Industry Washington Watch

CMS has published notices announcing the 2013 Medicare inpatient hospital deductible and hospital and extended care services coinsurance amounts. The 2013 Part A deductible for hospital inpatient admissions for the first 60 days of care will be $1,184, followed by $296 per day for days 61-90 and $592 per day for stays beyond the 90th day in a benefit period. The daily skilled nursing facility coinsurance for days 21 through 100 in a benefit period will be $148 in 2013. CMS also released the 2013 Medicare Part A premium amounts for the uninsured aged and disabled individuals who have exhausted other entitlement. Finally, CMS published the 2013 Medicare Part B premium amounts (which vary by income from $104.90 to $335.70 per month) and the Part B deductible, which for 2013 is $147.00 for all Part B beneficiaries. 
Source: healthindustrywashingtonwatch.com

Medicare Premiums and Deductibles for 2012

[…] […] […] With a Cost of Living Adjustment (COLA) of 3.6% for Social Security income in 2012 which averages $43 more in monthly income, these Medicare cost changes will not be as painful as anticipated. The COLA allowed the cost to be distributed across all Medicare beneficiaries, not just the ones who will be new to Medicare in 2012 (as in the past 2 years when new premiums were $115.40 and $110.50). Also, surprisingly, the numbers include lower-than-expected use of medical care and spending growth in the Medicare program. Hopefully the Super Committee will notice.Source: retirementeducationplus.com […]Source: retirementeducationplus.com […]Source: retirementeducationplus.com […]
Source: retirementeducationplus.com

Blue State/Red State Difference in Drug Safety?

Posted by:  :  Category: Medicare

bags by Lori Greigbehavioral economics behavior change books I’ve been reading cancer cancer screening confirmation bias consumer psychology disability doctor-patient communication environment ethics favorite quote favorite quotes free markets government regulation health care costs healthcare costs healthcare quality health insurance health policy irrationality Medicaid medical decision making Medicare medications nudges Obamacare obesity orthopedics partisanship political psychology politics primary care public health public policy religion shared decision making STDs Teddy Roosevelt
Source: peterubel.com

Video: Florida Blue CEO Patrick Geraghty Talks Medicare on Bloomberg TV

Blue Medicare Advantage: Blue Cross Blue Shield of Illinois

In addition to your Part B premium, there are small copayments to receive care.  With copayments as low as $7 for Medicare covered primary care doctor’s office visits, $45 for Medicare covered specialist visits and $3  for generic prescription drugs, it’s easy to get the care you need when you need it. An Advantage plan includes all of your Part A and Part B Medicare benefits, prescription drug coverage and emergency care if needed for an additional $65 copayment. Coverage is convenient and hassle free, and with an extensive provider network, there are always quality doctors nearby, ready to help from a wide range of specialties.
Source: ssiinsure.com

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

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

Newsroom – Blue Cross Blue Shield of Michigan broadens Medicare options with new Medicare Advantage PPO product

October 1 is the first day BCBSM and Medicare Advantage carriers across the nation can market their Medicare Advantage products for 2010. Beneficiaries in BCBSM Medicare Advantage products will receive letters in the next 10 days about the new product line-up. "Blue Cross remains fully committed to providing products to Medicare beneficiaries and will continue to have the broadest array of Medicare Advantage products in the state," said Mark Owen, BCBSM vice president for federal and individual business. "It’s important for Medicare beneficiaries to know that there is no immediate change to their coverage. They have until the end of the year to make their selection for 2010." In addition to the three BCBSM products for 2010, seniors also can select from three Medicare Advantage products offered by Blue Care Network, the BCBSM-affiliated HMO. "We will be working with insurance agents and other groups across the state to reach out to Medicare beneficiaries to help them navigate these product and premium changes," said Owen. Seniors who meet low income guidelines can receive subsidies from the state and/or federal government to pay for all or part of their premiums. Medicare Advantage premiums vary by product and region. The new PPO product is expected to provide beneficiaries with value for their premium. For example, the BCBSM Medicare Plus Blue PPO, which includes Part D prescription drug coverage, will cost between $61 and $141 a month (premiums vary by geographic region), while traditional BCBSM Medicare Supplemental (Medigap) Plan C plans cost $183 when combined with a stand-alone Part D BCBSM prescription drug program. Medicare Advantage plans offer Medicare benefits through private health insurance plans and most include Part D prescription drug coverage. When you purchase a Medicare Advantage plan, you do not need to also purchase a Medigap policy. Medicare Advantage plans are regulated solely by the federal government, while Medigap plans are regulated by the state. The announced product changes are only for Medicare beneficiaries who directly purchase their Medicare Advantage products, not for beneficiaries enrolled in a group plan. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Source: bcbsm.com

APPROACHING MEDICARE, AMERICAN BABY BOOMERS KEEP BOOMING, ACCORDING TO NEW, NATIONAL SURVEY FROM INDEPENDENCE BLUE CROSS

“Independence Blue Cross has provided comprehensive health care options since 1938, predating the post-war baby boom,” said Daniel J. Hilferty, president and CEO of IBC. “In so many ways, IBC has been with these individuals during every step of their lives. As this influential generation becomes Medicare eligible, we want and need to know them better, especially on the cusp of health care reform, which will change the nature of health care for everybody.  For IBC, this survey enabled us to learn more about this population, their daily lives, health habits, and activities as well as their plans for the future.  Health care needs to be a more personal business and this survey will help us provide plans that serve Boomers as well into retirement as we have served them through all other phases of their lives.”
Source: cision.com

Choose from Florida Blue Medicare Options

Those people without medical insurance will have to opt for emergency room care at the very crowded facilities in your area. In this case, you could be delaying medical care for a long time and can aggravate your medical condition in to a much more serious one. Your life is a lot more precious than this and such risk taking is not warranted either for yourselves or your family members. It is not fair from a moral perspective to pass the cost of your medical expenses to your fellow citizens and force them to pay for it with their hard earned tax money. As proud Americans, you must be responsible for your actions and must purchase the necessary medical insurance cover for any potential medical treatment.
Source: yogadarsana.org

Medicare Does Not Cover Seniors Who Travel Abroad…

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

Ask The Experts: Retirement

A. While your wife could disenroll from the Federal Employees Health Benefits program and both of you enroll in Medicare Part B, what she gained by no longer having to pay premiums for the former would likely be offset by the premiums you’d both have to pay for the latter. Although each of you would have to pay $99 per month in 2013, the fact that neither of you enrolled when you were first eligible would mean that those premiums would be increased by 10 percent for every year you failed to do so.
Source: federaltimes.com

Why does an MRI cost more with No Fault than Blue Cross or Medicaid?

Auto insurance providers also claim that they pay more for medical services than other providers such as Blue Cross and Medicare and further claim that they should pay the same rate.  Some simple facts are that Blue Cross and Medicaid represent a larger scale of business to the medical industry than auto insurance.  Also, Blue Cross and Medicare provide pre-approval for medical services, allow for electronic medical billing and provide payment within several days by direct deposit.  This gives the medical providers’ confidence that they will be paid in a timely manner and reduces the cost of doing business.
Source: michiganautolaw.com

Dick And Jane Sign Up For The Exchange

Posted by:  :  Category: Medicare

The Centers for Medicare and Medicaid Services (CMS) recently released draft versions of online and paper applications which consumers will fill out to buy policies in the new health insurance marketplaces, which are slated to begin enrolling people in October.  Those applications will function as a single, streamlined entry point for  consumers, telling them what sorts of assistance they might qualify for, including Medicaid, CHIP and tax credits to help them afford private insurance in the online marketplaces.  The goal is to make enrollment as easy as possible, because the marketplaces are the chief way that as many as 27 million people are expected to get coverage under the health law.
Source: kaiserhealthnews.org

Video: Patty and Richard say, “Apply online for Medicare” (20 seconds) – Social Security

Health Insurers Launch TV Campaign Opposing Medicare Advantage Cuts

The Medicare NewsGroup: Medicare’s Middlemen Await Word From CMS To Put In Play Sequesration Cuts Medicare’s middlemen, the companies that will carry out the administrative work of the automatic budget cuts set to hit Medicare providers on April 1, are waiting for directions from the Centers for Medicare & Medicaid Services (CMS) to put in play provider payment reductions. The updates to the payment systems will ultimately lead to $11 billion in reduced payments to hospitals, doctors and other health care providers for the remainder of fiscal year 2013. These middlemen are Medicare Administrative Contractors (MACs), the private companies that handle the bulk of the entitlement program’s administrative claims processes. They will implement the 2 percent across-the-board payment reductions, mandated by sequestration, which is the result of the federal government’s inability to reach a deficit-reduction deal totaling $1.2 trillion. This means a .02 cent cut for every $1 paid to health care services providers, such as doctors, hospitals, skilled nursing facilities, insurers, medical device suppliers and home health companies (Sjoerdsma, 3/6).
Source: kaiserhealthnews.org

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

Application Process for Individual Health Insurance Options for 2014 Continues to Develop

The Notice was part of the ongoing process by CMS to develop a streamlined way to apply for health insurance starting October 1, 2013, for the 2014 plan year. CMS is working with other federal agencies, such as the Internal Revenue Service, the Social Security Administration, and the Department of Veteran Affairs, as well as state Medicaid agencies, consumer advocates, and others, in developing this process. The January 2013 Notice includes a link to a CMS web site with sample applications and guidance documents.
Source: wolterskluwerlb.com

Expanding Part D Could Save Billions for Medicare

The savings bolster the political argument for supporting Part D expansion at a time when politicians and health care experts worry about slowing the growth of the mammoth federal budget deficit. The CBO’s proof of savings is new. Previously, the “CBO found insufficient evidence of an ‘offsetting’ effect of prescription drug use on spending for medical services. But recently, more analysis has been published that demonstrates a link between changes in prescription drug use and changes in the use of and spending for medical services.”
Source: westorlandonews.com

Open Enrollment 2013: Medicare Part D Benefits Improve but Premiums an…

While Medicare Part D prescription drug plan premiums are generally expected to remain steady in 2013, this PPI Fact Sheet by Leigh Purvis and Lee Rucker finds that premiums for many popular plans will actually be considerably higher than they were in 2012. Many plans are also increasing cost-sharing and their reliance on utilization management tools for covered prescription drugs. Medicare beneficiaries should closely examine their 2013 prescription drug plan choices during open enrollment for Part D.
Source: aarp.org

AHIP Launches TV Ad Campaign to Stop New Medicare Advantage Cuts

: Current discussions about the impact on seniors of the ACA’s $200 billion in cuts to Medicare Advantage have largely ignored the fact that only four percent of those cuts have gone into effect through the end of 2012.  The Congressional Budget Office (CBO) projects that, when fully phased in, these cuts alone will result in three million fewer people enrolled in the program.  In addition, Medicare Advantage enrollees also will be impacted by the new health insurance tax established by the ACA that starts in 2014.  Oliver Wyman previously estimated that this tax alone will result in seniors facing $220 in higher out-of-pocket costs and reduced benefits next year and $3,500 in additional costs over the next ten years.
Source: ahipcoverage.com

Medicaid Expansion Puts Spotlight On Access To Primary Care

Posted by:  :  Category: Medicare

KNOW WHO YOUR CZARS ARE --ENOUGH TO MAKE YOU SICK ---ONLY OBAMA COULD CREATE POSITIONS FOR THESE INCOMPENTENT COMMUNISTS AND SOCIALISTS by SS&SSThe authors of the Affordable Care Act foresaw that there would be a growing shortage of primary care doctors for Medicaid when expansion occurs January 1, 2014. That’s why the law includes a provision that raises the Medicaid fees paid to doctors practicing primary care medicine to the same levels Medicare pays for those services. The Medicare-Medicaid match went into effect January 1 this year and will remain in effect for two years. Best of all from the states’ point of view, in most cases the federal government will bear the entire cost of that increase. (Most other Medicaid costs involve both state and federal contributions.)
Source: kaiserhealthnews.org

Video: New Mexico and Medicare Supplements

Zone 4 Program Integrity Contractor (ZPIC) for Medicare and Medicaid Programs is Health Integrity, LCC

When a physician, medical group or other health care provider receives a notice of an audit and site visit from a ZPIC, things happen fast with little opportunity to prepare. A ZPIC will routinely fax a letter to the practice shortly before the end of a business day the day before a site visit/audit to that practice. Auditors will request to inspect the premises, will photograph all rooms, equipment, furniture, and diplomas on walls. They will usually request copies of several patient records to review later. They will request copies of practice policies and procedures, treatment protocols, all staff licenses and certifications, drug formularies, medications prescribed, and medications used in the office. ZPIC auditors will inspect any medication/narcotic lockers or storage cabinets and will request drug/medication invoices and inventories. You will usually be contacted for follow-up information and documentation after the audit and will eventually be provided a report and, possibly, a demand for repayment of any detected overpayments.
Source: wordpress.com

Health coverage for many in Martinez’s hands

The New Mexico Health Policy Commission, a state agency that provided independent research and policy recommendations until its budget was eliminated in 2010, wrote a report that year detailing recommendations for addressing the health workforce shortage. Here are some of the commission’s proposals: • Increase funding for loan-repayment programs that attract providers to rural areas • Support legislation to expand the scope of practice for potential mid-level oral health providers, amend dental licensure examination requirements, and allow University of New Mexico dental residents to obtain temporary licenses • Study the feasibility of expanding New Mexico physician assistant training programs and other mid-level training programs in the state • Support legislation to create 60 lottery scholarship slots for individuals to become certified nurse practitioners or physician assistants and agree to work in New Mexico for at least three years • Seek funding for programs that create a more diverse workforce that better reflects and represents New Mexico’s population • Support legislation that would levy excise taxes on alcohol, tobacco and/or sugared soft drinks to pay for loan forgiveness, debt repayment and scholarship programs for health professionals
Source: nmindepth.com

Issue Alert: CMS’ Proposed New Medicare Advantage Cuts Will Have Devastating Impact on Seniors

Seniors and people with disabilities enrolled in Medicare Advantage plans will face higher premiums, reduced benefits, and loss of coverage options if new Medicare Advantage cuts proposed by the Centers for Medicare & Medicaid Services (CMS) take effect next year. CMS recently proposed a 2.3 percent reduction in Medicare Advantage payments for 2014 at a time when medical costs are projected to increase by three percent. The new proposed payment cuts are in addition to the Medicare Advantage cuts and the new health insurance tax included in the Affordable Care Act (ACA). To learn more about Medicare Advantage, click here.
Source: ahipcoverage.com

New Mexico Medicare Eligibility Requirements

“I recently found myself back in the U.S. after being gone for almost 20 years. While living abroad I had a totally different type of health insurance schematic to learn and live within. Landing back in the U.S. and knowing that acquiring health insurance was an important aspect to being a responsible parent and adult, I was blown over once presented with the options and information that I needed to wrap my head around. Thankfully, I came upon Marc Lallier in my research and for the first time I no longer felt overwhelmed and suffocated by it all but felt a sense of great relief. Marc presented the information to me clearly with patience and kindness and allowed me to ask many questions throughout my learning curve. Instead of overwhelming me with information, he talked me through the process and presented options to me step by step helping me to find the best fit for my family and our needs. I am truly thankful to Marc for his efforts and patience and wish to express my sincere thanks to him for an excellent job, well done. “
Source: newmexicomedicarehealth.com

CMS Names 106 New Medicare ACOs

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

Medicare Supplement GI Thread

Rather than search all through the forums and internet collecting this data, I figure I would start a thread about state GI periods. Please feel free to reply if your state has a GI period based on the client’s birthday or anniversary date. I will update this top thread as answers or changes come in. Alabama Alaska Arizona Arkansas California – 30 Days after birthday Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas – NONE Kentucky – NONE Louisiana Maine – GI at any time provided you move to plan of like or lessor value (no more than 90 break in coverage) Maryland Massachusetts Michigan – NONE Minnesota Mississippi Missouri – Annually on the Anniversary date of the supplement Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York – GI All year North Carolina North Dakota Ohio – NONE Oklahoma Oregon – 30 days after birthday Pennsylvania – NONE Rhode Island South Carolina South Dakota Tennessee – NONE Texas – NONE Utah – NONE Vermont Virginia – NONE Washington – Washington, is odd, You can change medicare supplements at any time as long as you currently have coverage. You can also switch from MA to supp. West Virginia Wisconsin Wyoming
Source: insurance-forums.net

“Come Home”: A Medicare Innovation Center Project

I have good evidence from years of data in my practice that our policies and procedures can save Medicare many millions of dollars. When the Center for Medicare and Medicaid Innovation offered grant funding to anyone with an idea of how to give better care, keep people healthier, and save money at the same time, I decided to apply. I created a company, Innovative Oncology Business Solutions (IOBS), for the purpose of transforming the ideas I had implemented in my practice into processes that could be replicated in other practices across the country. The project is called “Come Home” (community oncology medical home). New Mexico Cancer Center’s data were sent to CMS as part of the grant application, and they were impressed enough to grant IOBS $19.8 million to see if the processes are generalizable. We must now show that the seven practices involved in the project can save CMS $34 million by aggressively managing the side effects of cancer and its treatment.
Source: cancernetwork.com