States Opting Out of Medicaid Expansion Risk Lower Ratings, Moody’s Says

Posted by:  :  Category: Medicare

The Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148) and the Health Care and Education and Reconciliation Act (HCERA) (P.L. 111-152) require major cuts in funding for hospitals that serve a higher-than-average percentage of low-income, uninsured patients in every state. Specifically, both Medicare and Medicaid payments to disproportionate share hospitals (DSH) will drop October 1, 2013, when federal fiscal year (FFY) 2014 begins. The Medicaid expansion was supposed to make up much of the lost funding because adults with incomes up to 138 percent of the federal poverty level (FPL) would be covered, reducing the number of uninsured. When the Supreme Court decision in National Federation of Independent Businesses v Sebelius made the expansion of Medicaid optional, the plan for a continuum of affordability programs was disrupted.
Source: wolterskluwerlb.com

Video: What Is Texas Medicaid?

Protesters in Texas Demand Medicaid Expansion

Separately, hundreds of doctors in white lab coats met privately with legislators, asking for better reimbursement rates for treating Medicaid patients. Currently, the state only covers about 60 percent of the cost of treating recipients of the joint federal-state health care program for the poor and disabled. Doctors and clinics are expected to absorb the losses.
Source: news92fm.com

Texas Organizers Add Their Voice: Medicaid Matters

I am pleased to think that I will get to the bus a little early; maybe I would get an aisle seat — or even a front seat. As I pull into the parking lot, though, I see that I am among the last to arrive. As I clamber aboard the bus, I am handed a bag with a potato and egg taco and some cookies in it. Sister Phylis Peters, a Daughter of Charity, has saved me an aisle seat, for which I am grateful.
Source: equalvoiceforfamilies.org

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

Court denies appeal of Randy Halprin, one of the Texas Seven who killed Irving police officer after prison break in 2000

Two of the so-called Texas Seven who escaped prison and killed Irving police Officer Aubrey Hawkins during a robbery on Christmas Eve 2000 have been executed, including George Rivas, the man said to have plotted the prison break. Another, Larry James Harper, killed himself before they were captured in Colorado. The remaining four are on death row, awaiting the outcomes of their appeals.
Source: dallasnews.com

Charts: This Is What Happens When You Defund Planned Parenthood

The Planned Parenthood clinics that anti-choice legislators booted from the state’s Women’s Health Program serviced nearly 50 percent of the program’s patients. Along with contraceptive counseling, the clinics provided basic screenings for cancer, hypertension, and other key problems. There’s no shortage of need: women in Texas suffer high rates of STIs and unintended pregnancies compared to national figures, and the state ranks 50th for diabetes prevalence in women. Nonetheless, Republican lawmakers went after the clinics in 2011, thanks to their long-standing beef with the organization, and forfeited tens of millions in Medicaid reimbursements to the Women’s Health Program so they could defund Planned Parenthood clinics without breaking any federal rules governing how states have to spend Medicaid money.
Source: motherjones.com

Daily Kos: How the GOP gets it all wrong on Medicare in five charts

What these three charts tell you is simple: It’s all about health care. Spending on Social Security is expected to rise, but not particularly quickly. Spending on everything else is actually falling. It’s health care that contains most all of our future deficit problems. And the situation is even worse than it looks on this graph: Private health spending is racing upwards even faster than public health spending, so the problem the federal government is showing in its budget projections is mirrored on the budgets of every family and business that purchases health insurance. Klein’s warning that “private health spending is racing upwards even faster than public health spending” is especially true for Medicare. While there is heated debate about the size of the gap, there is little doubt that the administrative overhead of government-run Medicare is significantly lower than that of private insurers. That is also true of the private Medicare Advantage programs currently used by about 20 percent of beneficiaries. As it turns out, Medicare Advantage policies on average not only feature higher administrative costs, but cost the government much more in monthly premiums than the traditional “public option” Medicare. As Klein explained two years ago: The Medicare Advantage program, which invited private insurers to offer managed-care options to Medicare beneficiaries, was expected to save money, but it ended up costing about 120 percent of what Medicare costs. In 2011, Nobel Prize-winning economist Paul Krugman turned to data from the Centers on Medicare and Medicaid Services to illustrate the comparative cost-savings to the United States Treasury.
Source: dailykos.com

Medigap Plans Connecticut

Posted by:  :  Category: Medicare

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Source: croweandassociates.com

Video: Medicare Plan N

Top Ten list of Medigap plans

The list of top ten Medigap companies and plans will change for many different reasons.  First reason is the Medicare Supplement plan price is different in every zip code.  If you live in Virginia or North Carolina, the price of your Medigap Supplement Plan F is going to be different if you live in Kansas or Arizona.  In all actuality, the price of your Medigap plan is going to be different if you live in the West Chester Pa zip code of 19382 than if you live next door in Newtown Square Pa.  The difference in the price of the Medigap plans will be in the zip code, gender, age, tobacco use.  It is hard to give a top ten list of companies for Medicare Supplemental plans.  Here is a list of Medigap companies that will at least give you an idea of what is out there. If you want a complete list of companies, go to this page on our website and we list over 40 differerent companies there-
Source: medigaplist.com

What is Medicare Supplement Plan N?

The most important feature to many consumers is that the new plan does not use Medical Underwriting. Consumers who purchase this plan do not need to answer questions about their health, nor do they need to undergo a physical. Provided an insurance company offers the plan, a consumer is likely to get accepted regardless of his health. He may still have to pay premiums based on his age, depending on how he purchases his Medicare Supplement Plan N coverage.
Source: seniorcorps.org

Types of Medicare Supplements

This is the supplement that pays off all the hospital and doctor bills which are other than the maximum of $20 copayment. This also pays the Medicare Part B deductibles up to $140. The ER visitors will also benefit with a copay of $50. All these three plans are most popular and easy to understand. They offer coverage for most of the hospital costs and coverage of $140 per year is very much reasonable.
Source: szbq.org

Medicare Supplement Plans M And N Have Lower Premiums

Either Plan M or N are good options if you would like to purchase a supplement but are on a budget. If you have disposable income in reserve and you feel because of your good health that a inpatient stay is less likely, you may be able to save some money with Plan M.
Source: affordablemedicareplan.com

New Medicare Plan N takes off

But, unlike a Medicare Advantage Plan, Plan N has no network restrictions, doesn’t require referrals and has lower out-of-pocket cost-sharing. These features make it more appealing to those who are healthy and wouldn’t otherwise see the need for health insurance.
Source: outreachnc.com

Advantages And Disadvantages During Using Medicare Australia

Actually may be most of the cause, a healthcare fundraiser should information consider involving one particular community as a complete whole whilst emphasizing on individuals utilizing an interest during regular contributions and as well , focusing on general health and health and fitness related issues. Planning a fundraising event under the over the top of a well being facility is not an easy task on account of invariably it turns out to be a big event; so, opting the online fundraising tournament management solution is often a good option. Generate a good amount of statements? Make an work to cut down the claims and if attainable, don’t record any. This program is for the reason that the numbers of allegations filed play particularly significant role inside influencing the tariff of an insurance reception premium. Someone that has a lot of damages and also who files assertions on a average foundation is likely to shell out an increased premium consequently get yourself a significant automotive insurance coverage quote. On the other guitar hand, a risk-free and cautious airport taxi driver who rarely recordsdata any claims is actually going to rewarded with a lower quote. Medigaps Plan A * J have more higher premiums compared at K and L. there is virtually no out-of-pocket cost. The basic benefits are fewer than K and L, but also the extra extra benefits are higher, not to mention the likes together with preventive care in addition to foreign travel crisis. Keep in mind this is not uncommon for people in ask about their difference between an absolute medicare supplemental plan of action and a Medicare supplemental health insurance policy. These types of two terms is likely to be used interchangeably, as they refer to the exact same thing. Supplemental plans help you to pay for the exact “gaps” in unquestionably the original Medicare coverage, hence the timeframe. The gaps direct to the purchases that you can be responsible for, variety as deductibles on top of that coinsurance. This Centers for Medicare health insurance and Medicaid Business have decided regarding discontinue four plans including popular Organize J. If consumers are before now enrolled in one of these plans, they can keep their coverage they will wish. However, the insurance supplier will offer the conversion opportunity to like coverage – such as Plan F. Medicare supplemental insurance, perhaps even known as space insurance, helps avid gamers fill the voids left by Medicare insurance. Unlike Medicare insurance Part A, this process gap insurance is offered at a value to the individual. Medicare increase insurance is a puzzle in it’s poker room. Be close when purchasing policy coverage. The type of 3 Carriers Domiciled in New York Banned From Writing Medigap Insurance In California Forever market in the Texas is not just much different rather than the Medigap specialized niche in any other state. Methods of this format are standardized all over the country that they may be. What a means is this no matter in were to purchase Plan N from one rrnsurance policy company or another, the benefits offered will not wind up as any different. Unfortunately, the price levels do vary widely from one company to the there after. So, if are generally looking for an affordable Medicare insurance Supplement in Texas or any other state, it is actually important to follow some comparison browsing if you want the best price. Alien Travel Emergency (Medicare coverage outside some of the U.S.): Generally, Medicare covers probably none of these expenses. Medigap Plan E programs provide coverage of many of some of these costs, up to plan limits. Your trusty premium will be based upon your date of birth at the moments of purchase, to the premium also increases as you attach another year ; that is, if the insurance program adheres to the issue-age method. Think about when there is an emergency you do not have sufficient financial in your account, these supplement programs tend to help you out most typically associated with such scenarios. Utah Medicare extra insurance Medicare Diet supplements is an add-on to the already present coverage plans you can fill in its gaps that who’s may leave for you personally personally to pitch by.
Source: typepad.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

California Sets Benefit Standards for Health Plans in Exchange

If only we were allowed to create “standardized” plans similar to the ones offered by the Medicare Supplement people. Plans A – N where Plan A offers a stripped down model, and Plan N offers everything. Challenge? Too many mandates from the state and the Feds. Why shouldn’t the company (or individual) paying the premium be allowed to choose the coverage they want? Some may not want to pay an extra 15% for maternity, some may not want to pay an extra 6-8% to cover mental health as any illness. Nah, I guess we are just too dumb to choose…
Source: californiahealthline.org

CMS Proposed 2014 Payment and Policy Updates for Medicare Health & Drug Plans & Draft Call Letter | Crowell & Moring

The Advance Notice discusses changing CMS’s actuarial calculation and risk score models for Medicare Advantage plans to comply with the requirements of the Affordable Care Act. CMS also proposes data collection and analysis for Health Risk Assessments (HRAs), which are enrollee risk assessments done by Medicare Advantage plans. MA plans must flag any diagnoses collected in MA enrollee risk assessments, which CMS believes will encourage adequate follow-up by plans for these conditions. The Advance Notice also updates many statistical factors used for payment calculation. Updated statistical payment factors include: normalization factors for its Part C plans, normalization factors for Part D plans, and frailty factors. CMS also proposes recalibration of its prescription drug risk adjustment model (RxHCC).
Source: crowell.com

Kaiser Permanente’s Medicare Plans Get Top Ratings in Nation for Second Straight Year

Posted by:  :  Category: Medicare

2011 Health Innovation Summit 2616 by tedeytan“Kaiser Permanente is a model for health care in this country and this Medicare 5-Star rating confirms the value we provide to patients,” said Robert Pearl, MD, executive director and CEO of The Permanente Medical Group. “The combination of superb physicians and the most advanced information technology systems leads to excellence in quality and service. By providing coordinated medical care and greater ease of access, we are able to achieve outstanding outcomes both in prevention of disease and management of the most complex medical conditions. I applaud the U.S. Centers for Medicare and Medicaid Services for helping shift the focus of our country from rewarding volume to recognizing superior outcomes. If the whole nation could match this 5-star performance, thousands of lives could be saved each year.”
Source: patch.com

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

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

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

Kaiser Permanente Georgia Offers Seniors Tips for Selecting a Medicare Plan

 Kaiser Permanente is Georgia’s largest not-for-profit health plan. Its mission is to provide high quality, affordable health care services to improve the health of its members and the communities it serves. Kaiser Permanente serves more than 235,000 members in a 28-county service area including metro Atlanta with care focused on their total health and guided by their personal physicians, specialists, and team of heath care providers. Expert and caring medical teams are supported by industry-leading technology and tools for health promotion, disease prevention, state-of-the art delivery, and world-class chronic disease management. Nationally, Kaiser Permanente is recognized as one of America’s leading health care providers, serving mort than 9 million members in nine states and the District of Columbia. For more information, visit www.kp.org.
Source: patch.com

Daily Kos: Kaiser report details Medicare options

Medicare cost sharing is relatively high and, unlike most private health insurance policies, Medicare does not place an annual limit on the costs that people with Medicare pay out of their own pockets. Many Medicare beneficiaries have supplemental coverage to help pay for these costs, but with half of beneficiaries having an annual income of $22,500 or less in 2012, out-of-pocket spending represents a considerable financial burden for many people with Medicare.Cost sharing and premiums for Part B and Part D have consumed a larger share of average Social Security benefits over time, rising from 7 percent of the average monthly benefit in 1980 to 26  percent in 2010 (Exhibit I.3). Medicare beneficiaries spend roughly 15 percent of their household budgets on health expenses, including premiums, three times the share that younger households spend on health care costs. Finally, Medicare does not cover costly services that seniors and people with disabilities are likely to need, most notably, long-term services and supports and dental services. Putting the burden of saving Medicare on the beneficiaries, already paying a significant portion of their incomes on health care, isn’t a solution for saving this program, for keeping it’s promise to America’s seniors and disabled. That basic premise should be the starting point for reforms.
Source: dailykos.com

Commission urges big changes in Medicare doctor pay, like ending fee

MedPage Today: Medicaid Pay Boost Slow For Primary Care Primary care providers haven’t been receiving a boost in Medicaid reimbursements in 2013 as promised by the Affordable Care Act (ACA), doctor groups and Medicaid plans said. Instead, states are still submitting necessary amendments to Medicaid plans to the Centers for Medicare and Medicaid Services (CMS) to allow the agency to pay Medicaid primary care providers at the higher Medicare rates. The ACA provision sought to incentivize primary care physicians to see Medicaid patients, while another provision of the law was aimed at adding more than 30 million new beneficiaries to the rolls by increasing eligibility to include those with incomes up to 138 percent of the federal poverty level. States have until March 31 to file paperwork with CMS on their plans, and the agency has 90 days to respond to it (Pittman, 3/1).
Source: medcitynews.com

Kaiser named top rated Medicare plan in Hawaii

big island biif billy kenoi daniel akaka dlnr dui stats earthquake election 2012 fire fuel gov linda lingle halemaumau hawaii volcanoes national park hhsaa high surf advisory hilo hvo ironman kailua-kona ka‘u keaau kilauea Kohala kona lava mauna kea mauna loa missing neil abercrombie nws pahoa parker school police puna recalls traffic triathlon tsunami uh-hilo usgs volcano volcano watch waiakea waikoloa waimea
Source: hawaii247.com

Taking a gander back to year

Planning for Health editors ran a cover story in the winter of 1969 edition about the 1960s as the “Decade of Change for Medicine.”  The article’s author wrote: “Experimental organ transplants, Medicare and The Pill collected headlines during the past decade, but medicine made gigantic strides forward in less glamorous areas as well. . . examples are the almost complete eradication of polio through universal immunization (and) the development of vaccines for mumps, measles, and Rubella (German measles) . . . ”
Source: kaiserpermanentehistory.org

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

Insurance trainer publishes informational Medicare book

Available in paperback on Amazon.com (also for Kindle) and through the Barnes and Noble website, the 80-page book covers topics such as Parts A, B, C and D, long-term care, COBRA, TRICARE, veterans prescription drug programs, employers and union prescription drug plans, Medicaid, the Federal Employees Health Benefits (FEHB) program, and other topics.
Source: ifawebnews.com

Kaiser Permanente Medicare Plans in California Get 5

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high quality, affordable health care services to improve the health of our members and the communities we serve. We currently serve more than 3.5 million members in Southern California. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.
Source: hcimarket.com

Kaiser Permanente's Medicare Plans Earn Top NCQA Health Insurance Rankings for 2012

. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.
Source: paachamber.com

Second Guessing Medicare’s Star Rating System

But insurance executives made them a priority after the 2010 healthcare law attached large financial rewards to them. The first round of ratings last fall showed that most have a long way to go. Only 12 earned a perfect score of five, on a scale of one to five, and about 9 percent were below average. The majority received scores of three, or three and a half stars– enough to get them bonus money this year. After 2014, plans will need four or five stars to get bonuses. And if they have fewer than three stars, they won’t be allowed to enroll beneficiaries through Medicare’s website, and risk being booted from Medicare altogether, according to HHS spokesman Tony Salters. 
Source: kaiserhealthnews.org

www.noridianmedicare.com What is your Website Worth

Posted by:  :  Category: Medicare

We estimate that noridianmedicare.com makes $6 per day and is worth about $17,398. We know the site is hosted in Fargo, United States, has a Google Pagerank of 5, is active on the IP 199.253.134.44 and receive about 6,992 Page(s) View per day. The current Alexa ranking is #699,239.
Source: outlookwebsite.com

Video: Videos matching: noridian medicare

Noridian doubles its federal business volume with new contract

Noridian will be the Medicare Administrative Contractor (MAC) for Medicare Part A and Part B for California, Nevada, Hawaii, Guam, American Samoa and the Northern Mariana Islands — Jurisdiction E (JE). This area represents 9 percent of the total volume of Medicare Fee-for-Service claims administration business nationwide. Combined with its other existing Medicare claims contracts, Noridian will now administer a total of approximately 15 percent of Medicare’s national volume of business.
Source: ndakotabusiness.com

TUMT: Transurethral Microwave Thermotherapy (TUMT)

Noridianmedicare.com: “TUMT, an appropriate therapy for symptomatic benign prostatic hypertrophy (BPH), is a method of delivering microwave heating sufficient to destroy prostatic adenoma tissue without significant damage to surrounding tissue. The FDA has, on May 3, 1996, approved a device for delivering this microwave therapy. TUMT is another nonsurgical therapy for BPH, and is appropriate when the following indications are met. Indications: All of the following characteristics must be present. A. Bladder Outlet Obstruction (BOO) and Lower Urinary Tract Symptoms (LUTS) of significant degree to cause an American Urological Association Symptom Score above seven. A score from 0-7 reflects mild symptoms, from 8-19 moderate, and from 20-35 severe. A patient with mild symptoms may be treated with medicine or, appropriately, receive no treatment at all. A patient with moderate symptoms may be treated with medical or surgical procedures. Noridian leaves this decision to the physician and the patient. B. A peak urine flow rate of 15 milliliters per second or less on a voided volume of 125 milliliters or greater. Relative contraindications: A. Prostate cancer B. Neurogenic bladder C. Active urinary tract infection D. Active cystolithiasis E. Gross hematuria F. Urethral stricture G. Bladder neck contracture H. Acute prostatitis I. Cardiac pacemaker When present, active cystolithiasis or active infection should be treated prior to treatment with TUMT. When prostate cancer and urinary obstruction are both present, TUMT may be appropriate therapy for relief of the urinary obstruction. Absolute contraindication: The presence of a metallic hip replacement.”
Source: blogspot.com

Noridian Medicare Now Covers Renessa(R) Treatment for Incontinenc… ( NEWARK Calif. Feb. 24 /

Related biology technology : 1. QMed, Inc. Reports July Medicare SNP Enrollments 2. Change in Medicare and Medicaid Legislation Creates Market for Antimicrobial Coatings In the U.S. 3. House and Senate Pass Medicare Legislation to Freeze 2008 Reimbursement for Therapeutic Radiopharmaceuticals at 2007 Levels 4. Medicare Coverage Recommended for In-Home Sleep Testing 5. MedicareCRM(TM) to Speak at IIR Medicare Advantage Congress 6. STAAR Surgicals Collamer(R) IOL Designated as a New Technology Intraocular Lens by the Centers for Medicare and Medicaid Services 7. Medicare Approves in Home Sleep Apnea Testing 8. Medtronic Unit to Pay $75 Million to Settle Whistleblower Medicare Fraud Case 9. Medicare Exemplary Provider Accreditation Awarded to Regenesis Biomedical 10. Arcadian Health Plan Addresses Medicare Doctor Payment Cuts 11. Netsmart Technologies Web Seminar Helps Behavioral Health Organizations Understand Electronic Prescribing and the Importance of New Medicare-Related E-Prescribing Legislation
Source: bio-medicine.org

Claims: Multiple CPIDs: Noridian Administrative Services Changes Medicare Payer IDs

Effective 02/25/2012, Noridian Administrative Services will change the following payer IDs in Medicare A and B Jurisdiction: The Medicare Part A Payer IDs will change to 02001 for: CPID 5521 Alaska Medicare – current payer ID 00322 or 00326 CPID 5581 Idaho Medicare – current payer ID 00325 or 00326 CPID 5515 Oregon Medicare – current payer ID 00325 or 00326 CPID 5521 Washington Medicare – current payer ID 00322 or 00326 The Medicare Part B Payer IDs will change as follows: CPID 1455 Alaska Medicare – current payer ID 00831 will change to 02102 CPID 1459 Oregon Medicare – current payer ID 00835 will change to 02302 CPID 1462 Washington Medicare – current payer ID 00836 will change to 02402 The clearinghouse will convert the Payer ID sent within the claim file to the new Payer ID. Claims sent to Noridian as of 02/25/2012 will contain the new Payer IDs. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

Medicare Issues Chiropractic Software and Documentation Alert

Get a Preventative Audit. Many don’t like that term, so I prefer to call them a Documentation Review.  For those who like in far corners of the earth, can’t bear to leave the office, or get a sudden onset of ADD when they sit in a seminar, this may be a good option for you.  Essentially, you submit your notes (along with your billing and coding) and I will scrutinize them with a fine-toothed comb making sure that your services are properly documented and that you used the appropriate CPT code and bill the services performed.  Following my review of your notes, you will review a painstakingly (and perhaps, painfully) detailed written review of your shortcomings and areas needing improvement according to published guidelines and my experience as a former Insurance Claims Analyst and my training as a Certified Professional coder and Certified Professional Medical Auditor.  For more specifics on the Documentation Review process and fees, send an email to info@strategicdc.com.
Source: strategicdc.com

Regional Medicare carrier now covers non

Novasys Medical, Inc. (Newark, CA) recently announced that Noridian Administrative Services, LLC, a regional Medicare carrier, is now covering the non-surgical Renessa treatment for women with stress urinary incontinence. According to Noridian’s web site, the insurer “will now cover CPT 0193T, transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence. This includes the Renessa transurethral collagen radiofrequency denaturation procedure.” The web site also states, “Coverage will be allowed when the procedure is performed consistent with FDA labeling and in accordance with the indications supported by peer-reviewed literature.” The policy specifies that coverage only applies to cases of moderate to severe female SUI. The Renessa System includes a small probe that a physician passes through the urethra. The probe heats multiple small treatment sites in the submucosa of the bladder neck and upper urethra, denaturing the patient’s own collagen in the tissue, thereby reducing or eliminating leaks.
Source: modernmedicine.com

CMS rolls back Medicare Part D deductibles for 2014

Posted by:  :  Category: Medicare

Healthcare solution >> more doctors by / // /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

Video: Medicare Supplement plan F High Deductible Explanation

Medicare Deductibles 2013

Just as an FYI, I listed a brief summary of the deductible and coinsurance amounts. This information can be used to inform your patients about their Medicare benefits as well as collecting upfront payments from your Medicare patients.
Source: about.com

Cut Medicare Advantage plans and save money

To the group supporting keeping Medicare Advantage plans: Your group wants to continue a program spending taxpayer monies faster than regular Medicare. Each person on an Advantage plan costs the tax payer 14 to 15 percent more than one on Medicare as it was originally designed.
Source: dallasnews.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

On Health Care, Conservatives Protest Too Much

It will behoove the Obama administration and advocates of the law to actively nurture pacesetting states so that they have tangible success stories to point to in 2014 and models that other states can learn from and emulate. If even a relatively small number of states can show that uninsured people are being covered in large numbers, that federal funding is flowing as promised to the states and to individuals who qualify for insurance subsidies, that the new health insurance reforms are working as planned and that coverage is affordable and, as in Massachusetts, the public is accepting the individual mandate, then other states will take notice, whatever the ideological predispositions of their governors or legislators. It is already clear that the test in 2014 will not be whether the law is working perfectly everywhere (there isn’t time for that to happen, and it won’t be) but whether it can work as intended. If a handful of states can demonstrate that, then the others will want to follow.
Source: kff.org

DiNapoli Finds Errors in Medicare, Medicaid Billing Costing NY $26m

Posted by:  :  Category: Medicare

Record shop Ithaca, NY by exaktaThe audit looked at claims for patients who are both Medicare and Medicaid eligible, which are known as crossover claims. In December 2009, the Department of Health implemented a new payment mechanism in e-med NY to achieve greater control over Medicaid payments.
Source: cnynews.com

Video: Medicare is Battle Cries for Tight House Races in Fla., N.Y.

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

The Ryan Budget's Step Backward

There were two obvious ways that the Ryan Budget 3.0., which rolled out today, could have further improved on its predecessors. The new budget could have beefed up its Medicare proposals by phasing in reform sooner, instead of continuing to set a ten-year gap between passage and implementation and exempting everyone over 55 from the new regime. Alternatively, it could have addressed the various problems and implausibilities in the non-Medicare portions of the budget roadmap — by making fewer not-gonna-happen promises on discretionary spending cuts, by offering a real alternative to/replacement for the Obama health care bill, or by making the sketch of revenue-neutral tax reform more plausible by setting the proposed new tax rates higher than 10 percent and 25 percent. The first option would have made for trickier politics but better policy; the latter options would have made for better policy and politics alike.
Source: nytimes.com

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

San 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

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

Navigating Medicare's Open Enrollment Period

Medicare beneficiaries who are happy with their plans do not need to do anything, if they don’t want to change. But it is still a good idea to check options, Ms. Metcalf advises, to make sure a version of Medicare is the best one in terms of cost and coverage. If, for instance, you have the original version of Medicare and pay extra for prescription drug coverage (so-called Part D coverage), you may want to make sure important medications you need are still covered under your plan, to avoid having to pay more for them.
Source: nytimes.com

N.Y. doctor pleads guilty to $11.7M Medicare fraud scheme

Prosecutors said Ho Yon Kim, 86, of Flushing, N.Y., while president of URI Medical Service PC and Sarang Medical PC, both in Flushing, purportedly provided physical therapy and electric stimulation treatment. Kim admitted he exchanged spa servces to Medicare beneficiaries that allowed their numbers to be billed for services never provided, or not needed.
Source: ifawebnews.com

The Official Medicare Set Aside Blog And Information Resource: New York Plaintiffs Once Again Attempt to Avoid Medicare Part C Reimbursements and Fail

, plaintiff Rebecca Meek-Horton filed suit on behalf of herself and all similarly situated Medicare beneficiaries enrolled in Medicare Advantage plans who settled New York personal injury or wrongful death insurance claims. The New York law passed in 2009 to encourage insurance settlements presumes that any such recovery does not include any compensation for medical expenses except where there is a statutory right of reimbursement; therefore, the plaintiffs felt they have no obligation to reimburse the MAO. The MAO plans disagreed and assert a statutory recovery right expressly exempted by the state law. The Court ultimately found the plaintiffs’ arguments were defeated by the plain language of the the governing statute. 42 USC 1395w-26(b)(3) expressly preempts all but a limited number of state licensing and solvency laws and the New York law in question does not fall into those categories. Furthermore, 42 CFR 422.108(f) also expressly states that “the rules established under this section supersede any State laws, regulations, contract requirements, or other standards that would otherwise apply to MA plans.” Because the plaintiffs exclusively plead their claims under the New York state law, claiming they were not seeking benefits or reimbursement for benefits so the Medicare Act did not apply, the U.S. District Court for the Southern District of N.Y. found the federal preemption sufficient to dismiss the action for failing to state a claim upon which relief could be granted.
Source: medicaresetasideblog.com

House Oversight Committee Release Report on NY Medicaid Program

Capital Tonight is also seen on our sister stations in Texas and North Carolina. In order to allow consistent website access to all three of our websites we will be adding a splash page at our old URL, capitaltonight.com. The splash page will allow users to select their state. If your browser allows cookies that state selection will be saved.
Source: ynn.com

Medicare Service Coordinator Spanish Req’d 1250 Broadway at Visiting Nurse Service of New York (Manhattan, NY) Job

City: Manhattan, NY Job ID: 22450 Responsibilities Responsible for providing direct case management services in collaboration with case management team consistent with VNSNY Home Care policy and requirements of the Comprehensive Care… View Full Job Description
Source: healthjobsnow.com

CMS Proposes Changes to Medicare Part B Billing for Hospitals

Posted by:  :  Category: Medicare

Raging Grannies: No Private Parts by Grant NeufeldCMS has proposed two rules that would pay for more hospital inpatient services under Medicare Part B when a Medicare Part A claim is denied. The first rule would allow CMS to pay hospitals additional Part B payments when a Part A claim is denied because the Medicare patient should have been treated as an outpatient rather than inpatient. More specifically, Medicare would pay for all “reasonable and necessary Part B hospital inpatient services” if the patient had been treated as an outpatient instead of the current limit list of covered Part B hospital inpatient services. The second rule relates to the “significant” number of pending appeals of Part A hospital inpatient reasonable and necessary denials from Recovery Auditors, formerly known as recovery audit contractors, according to CMS. CMS proposed a standardized process to handle pending appeals and billing for the additional Part B inpatient services. CMS estimates the proposed rules would result in a $4.8 billion decrease in Medicare program expenditures over five years due to lower RAC appeals and other factors. In addition, CMS expects short-stay inpatient admissions to rise under the proposed rule since hospitals could rebill Part B without the expense of an appeal. However, hospitals would have to rebill Medicare within 12 months to get the additional payment. To view a fact sheet on the proposed rules, click here. Comments for the proposed rule are due by May 17.
Source: beckershospitalreview.com

Video: Parts A & B — Alphabet Soup

Medicare Drug Benefit: Formulary Oversight in Medicare Part D

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

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

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

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

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: Progress Illinois: No cuts to Medicaid, Medicare and Social Security press conference

Illinois Medicare Eligibility Requirements

“We are new to Medicare and have recently selected BCBS as our Medigap insurance. We have done so on the recommendations of friends and relatives, but also because of the wonderful informational Medicare sessions presented recently by your SSI staff here in Bloomington, Illinois. We were fortunate enough to be in sessions led by Lily and Jason Vida. We found these sessions very informative and clarifying. We had so many questions and some confusion pertaining to Medicare. We greatly appreciated the organization of the material and the visuals used in the presentations. They were clear and easy to follow and understand. We also appreciated the fact that each and every question was answered and explained to our satisfaction. We also met personally with Jason to assess our policy needs and to better understand the various Medigap plan options and Medicare Part D. Jason was so personable and easy to work with! He spent as much time with us as we needed. He was very knowledgeable and helpful. We feel assured that we can call upon him at any time if we have needs, concerns, or questions. During this time of preparing for Medicare, we have received a myriad of mailings and phone calls. However, we appreciate the fact that SSI came to Bloomington, opened an office, and held these informational sessions. Jason and SSI made all the difference to us! “
Source: ssiinsure.com

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

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 provider gives away $20 grocery cards to lure patients

Posted by:  :  Category: Medicare

GIMME SOME OF THAT GOOD 'OLE OBAMA DOUBLESPEAK by SS&SSThe Department of Health and Human Services has given qualified approval for a Medicare provider to give away $20 grocery gift cards to induce seniors to get more taxpayer-funded health screenings, despite concerns the promotion could run afoul of federal anti-kickback laws.
Source: investmentwatchblog.com

Video: Medicare Card Fraud: Protect Your Identity

Replacing Your Vital Documents

 – Go to the National Archives website for guidance on requesting personnel records for former federal civilian employees. Current federal workers can get personnel records from their human resources office.
Source: usa.gov

Best ways to do business with Social Security

Awards Bid Requests Boys and Girls Club Breast Cancer CAPITOL REPORT Celebrations Charitable Donations Charitable Event Chris Abele Compiled By Courier Staff Dr. Martin Luther King Jr. Dr Benjamin F Chavis Jr Free and Open To the Public Fundraisers George Curry George E. Curry Gwen Moore Jim Doyle Job Openings Legislatively Speaking Lena C. Taylor Lena Taylor Leon D Young Lynda Jones Lynda L. Jones Marquette University Milele A. Coggs Milwaukee Public Schools NAACP Obituaries President Barack Obama Requests For Proposals Robert Bell Photography Salvation Army Scholarships Scott Walker Shone M Bagley Sr Social Development Commission Spencer Coggs Taki S Raton Tom Barrett University of Wisconsin Milwaukee Voter ID Legislation Willie Hines Young Gifted and Black
Source: milwaukeecourieronline.com

Report: CMS Not Issuing New Medicare ID Cards to Identity Theft Victims

At a House hearing in August that looked at the use of Social Security numbers on Medicare cards, Medicare Chief Information Officer Tony Trenkle said the agency would need six more months to estimate the cost of removing the numbers from the cards. CMS could not provide a timetable for the new cards without having an accurate cost estimate, Trenkle added (California Healthline, 8/2).
Source: californiahealthline.org

How Do I Obtain A Replacement Medicare Card?

When ordering a Medicare Card you have a few options. You can do this by internet, the telephone, or you can visit one of your local Social Security Offices. To order a Medicare Card by internet you can visit www.socialsecurity.gov/medicarecard, to complete the application. To order by telephone, the toll free number is 1-800-772-1213. If you prefer to order your card in person, you can call the toll free number to find the nearest Social Security Office or go to www.socialsecurity.gov/locator and type in your zip code to find the location nearest you.
Source: seniorcorps.org

Beware of Medicare Fraud Calls

These calls are completely fraudulent. Medicare will NEVER ask for a beneficiary’s Medicare number unless the beneficiary initiates the call, and they will NEVER ask for a bank account number under any circumstances. The only beneficiaries that need to get new Medicare cards are those who are first applying for Medicare coverage, or those who have asked for a new card because their card is lost or damaged.
Source: mauryriversc.org

Understanding Medicare Part A, Part B, Part C and Part D

Posted by:  :  Category: Medicare

Naomi Wolf @ WALL ST. BAILOUT PROTEST. by eyewashdesign: A. GoldenBut as complicated as all that sounds, there’s a single key choice at the core of all your decision-making: Will you go with the Original Medicare plan, which is run by the federal government and consists of Parts A and B, or a Medicare Advantage plan (also called Part C) that is offered by a private insurer and approved by Medicare? Medicare Part A — Your Hospital Coverage When you apply to Medicare, you are automatically enrolled in the Part A plan. Part A is your hospital insurance plan. It covers nursing care and hospital stays, although not doctors’ fees. Part A also covers some home health services, skilled nursing care after a hospital stay and hospice care. You likely won’t have to pay a monthly premium for Medicare Part A, thanks in part to all the payroll taxes you paid while you were employed. You must, however, pay a yearly deductible before Medicare will cover any hospitalization costs. For 2011, the Part A deductible is $1,132.
Source: aarp.org

Video: Medicare

How Much Does Medicare Part D Cost?

Hello, I had ssi in 1997 to 2008 soc. Sec told me i wS working and hD been cut off before working. I never received a dime or med care or apied after i was cut off when i apied again i. 2008, due to denials, i went to court, and reinstated from time applied in 2008. They took money to be paid to them from 1997. From my back pay. I never once teceived one letter saying i wS on part d. I was td all benefits ceased at that time of cut. I paid my kaiser from work, and did without insurance and medical care when no insurance. Even had hospital events and medicare or no soc sec paid. Never even heRd fr
Source: seniorcorps.org

Cool Medicare Part A B C D images

Scenario Three: A primary care doctor sees a Medicare patient for an office visit. She thinks her patient has heart failure, starts the initial management. She orders labs and a echocardiogram. The echocardiogram is read by the cardiologist who recommends the patient come and see him. The primary care doctor spent around 15 minutes with patient and gets paid around for the office visit. The patient’s pharmacist later calls and says the medication that was prescribed must be changed due to insurance formulary restrictions. The doctor spends a minute or two reviewing that patients chart before deciding on an alternative medication. The doctor does not receive any additional reimbursement for this service. She was still only paid total. Later, the patient drops off some paperwork for the physician to fill out for the medical insurance. The doctor spends around 10 minutes filling out that paperwork and having his nursing staff fax the complete forms to the insurance company. The doctor does not receive any additional reimbursement for this service. She was still only paid total.
Source: coloradomedicaremedigap.com

2012 Medicare Premiums, Deductibles and Co

Enrollees in Medicare Part D prescription drug plans pay premiums that vary from plan to plan.  Beginning in 2011, Part D enrollees whose incomes exceed the same thresholds that apply to higher income Part B enrollees must also pay a monthly adjustment amount. The regular plan premium will be paid to their Part D plan, and the income-related adjustment will be paid to Medicare.  The amounts by income level are below.
Source: medicareadvocacy.org

Medicare Open Enrollment Ends Dec. 7!

BACKGROUND:  SHINE (Serving the Health Information Needs of Elders) provides free health insurance information, counseling and assistance to Massachusetts residents with Medicare and their caregivers. ABCD’s Events for Open Enrollment are continuing throughout Boston and are a chance for seniors and disabled adults on Medicare to learn about changes in Medicare Drug Plans for the 2012 year. After each presentation, FREE on-site Medicare counseling & assistance will be available!
Source: bostonabcd.org

HHS Releases Final Regulations on the Transitional Reinsurance Fee

Beginning in 2014 (and continuing for 2015 and 2016), employers and other sponsors of self-funded health plans, as well as insurance companies offering insured health plan products, are subject to the Affordable Care Act’s transitional reinsurance fee. This fee is designed to fund reinsurance payments to health insurance issuers that cover high-risk individuals in the individual market. The transitional reinsurance payments are intended to stabilize insurance premiums in the individual market during 2014, 2015, and 2016 as consumers and insurers become more comfortable with the state health insurance exchanges.
Source: jdsupra.com

Please Explain Medicare Part A B C D to Me

Medicare Part A and Part B do not cover all medical costs. There are deductibles and co-insurances required when you have a medical event. The coverage gap is the term used for the amount of out-of-pocket expenses you must pay. Private Medigap insurance came available to help fill the gap. Medigap policies are restricted to filling the coverage gap. Additional coverage for things such as hearing, vision, dental and prescriptions cannot be included with Medigap plans. Private insurance is required for these. So, to get total coverage, you would have to have three insurance plans: Medicare, Medigap and private coverage. That means for every medical episode, you could potentially file three claims.
Source: co.uk