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

Posted by:  :  Category: Medicare

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

Video: What Is Medicare Part-C and Part-D?

Annual Enrollment for Medicare Advantage (Part C) & Part D: October 15 – December 7 

Even beneficiaries who were satisfied with their 2012 plans need to review their plan options for 2013.  Part D and MA plans may have made changes to their coverage, provider networks and other plan features.[3] Plan information for 2013 will be available on the Medicare Plan Finder at www.medicare.gov.[4]  For the computer-savvy, the Medicare Plan Finder is an excellent plan comparison tool, allowing users to enter all their drugs and drug dosages, compare up to three plans at a time, save their drug information for later use, and actually enroll in a plan on-line.  This is the best – if not only – way to truly compare the many plans available to choose from.  People who cannot use the Plan Finder themselves may contact 1-800-Medicare, or their State Health Insurance Assistance Program (SHIP), for assistance with evaluating, selecting, and enrolling in a Part D plan.
Source: medicareadvocacy.org

Register For Medicare EHR Incentive by Feb 28th

Posted by:  :  Category: Medicare

San Diego, CA by Oggie DogMeasure: conduct/review a security risk analysis, implement security updates and correct security deficiencies.  Risk analysis includes collecting data, identifying  potential threats and vulnerabilities, determining likelihood of threat occurrence and potential impact, assessing current security measures, determining level of risk , documenting final assessment , reviewing and updating risk assessments.
Source: 1sthcc.com

Video: The Australian Childhood Immunisation Register

Why today's seniors object to the dissolution of Medicare

Privatization / corporatization of health care in the U.S. is the reason why our health care is prohibitively expensive, and can boast of only mediocre outcomes, at best. Nowhere else in the industrial world do citizens find themselves going bankrupt over medical care, and most industrial countries achieve substantially better health outcomes, and at lower cost, than we do. All Mr. Ryan’s plan will do is perpetuate our current dysfunctional system, with CEOs of health insurance companies being paid 7-figure salaries while nameless clerks deny coverage and the people they ostensibly “serve” find themselves having to choose between paying for food, or the mortgage, or clothing on the one hand, and paying off that hospital or doctor bill on the other, knowing that the “non-profit” hospital or physician may well take them to court if they choose to eat rather than pay for medical care.
Source: minnpost.com

Medicare Payments to Providers Are Carved, Sliced and Chopped by Sequestration

CHOPPED – Sequestration will have a huge impact on healthcare chopping up reimbursements. Now more than ever before, providers must look for every dollar of reimbursement they can find. In most cases, the low-hanging fruit has already been picked. Today, forward thinking healthcare executives must move quickly to make the decisions which will positively affect reimbursements. Investments in brand new technologies and reinvented processes, which offer an ROI of less than 12 months will be the most attractive moves executives can make. There are several “Blue Diamond” technologies entering the marketplace every day. These new avenues for reimbursement recovery are available to help offset the reimbursements that has been carved up, sliced off and hacked to pieces by sequestration.
Source: healthworkscollective.com

Obama Cuts Medicare – Again!

When President Obama signed the Affordable Care Act into law, he simultaneously authorized $200 billion in cuts to the Medicare Advantage program. At the time, the Congressional Budget Office projected that the health care reform law’s cuts would result in three million fewer Medicare Advantage enrollees. Moreover, actuaries at Oliver Wyman predicted that the cost of the health insurance tax would mean an additional $3,500 in out-of-pocket expenses for seniors over the next ten years.
Source: townhall.com

Seniors should tell Obama to prevent Medicare Advantage cuts

When President Obama signed the Affordable Care Act into law, he simultaneously authorized $200 billion in cuts to the Medicare Advantage program. At the time, the Congressional Budget Office projected that the health care reform law’s cuts would result in three million fewer Medicare Advantage enrollees. Moreover, actuaries at Oliver Wyman predicted that the cost of the health insurance tax would mean an additional $3,500 in out-of-pocket expenses for seniors over the next 10 years.
Source: dailycaller.com

Take Social Security and Medicare Off the Bargaining Table

A little noticed fact exposes the grotesque hypocrisy of claiming to “fix the debt” by cutting entitlements. Billionaire Pete Peterson’s front, called “Fix the [National] Debt,” provides a teachable moment. It’s been possible for 51 years for individuals to make donations to a Treasury Account titled “Gifts to Reduce the Public Debt.” It’s even tax deductible. Yet in all that time only $85 million has been donated (see online: CNN Money, 11/20/12, “Americans Donate $8 million to cut national debt.”) Peterson and Fox owner Murdoch, with tools and dupes, grossly exaggerate the import of the national debt. If it’s so dangerous, where are their own example – setting, magnificent, patriotic donations? Didn’t they benefit at all in wealth – making from the $ trillions of dollars expended on infrastructure and on “defense” to protect them from USSR communists taking over and socializing their property? Main Street unemployment and personal debt are painfully slow in receding and debt peonage looms for college students. Government spending does, in fact, create or support millions of private industry jobs in defense and elsewhere. So spending cuts kill jobs and retard recovery more. Peterson, tools and dupes; on this national debt: PAY UP OR SHUT UP!
Source: prospect.org

This spring, put prevention into practice

If you have Medicare, then you have access to a variety of preventive tests and screenings, most at no cost to you. If you’re new to Medicare, your “Welcome to Medicare” preventive visit is now covered for free during your first 12 months of Part B coverage. This visit includes a review of your medical and social history related to your health and education and counseling about preventive services, including certain screenings, shots, and referrals for other care, if needed.
Source: medicare.gov

Low Volume Adjustment & Medicare Dependent Hospital Extension Rules

A number of MDHs that requested SCH status or dropped their rural classification did so with the proviso that if MDH status was reinstated, they wanted to remain MDHs. This question was raised in the FY 2013 final IPPS rules. A comment was made to CMS that hospitals should be allowed to retroactively rescind their request for SCH status and have MDH status seamlessly reinstated. CMS responded that if the MDH program was extended, it would “develop policy to implement the specific provisions of such legislation.” Many read that to mean CMS would allow MDHs to retroactively rescind SCH status. However, CMS does not state this in the final IPPS rules; it leaves the matter open to “the specific provisions” of the legislation that is passed. The taxpayer relief act simply changed dates, so in CMS’ interpretation there are no specific provisions in the law allowing hospitals now carrying the SCH or urban designations to be seamlessly returned to MDH status.
Source: healthcarereforminsights.com

ABOUT MEDICARE: Getting what you need from your Medicare drug plan

Posted by:  :  Category: Medicare

open enrollment by MedicareMallDavid Sayen is Medicare’s regional administrator for California, Arizona, Hawaii, Nevada and the Pacific Trust Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).
Source: times-standard.com

Video: The Path to Prosperity (Episode 2): Saving Medicare, Visualized

Are you confused about Medicare or Health Care?

Willowick Library 7:00 pm – 8:30 pm 263 E. 305th Street Willowick, OH 44095 440-943-4151     Monday, April 8, 2013 Peninsula Library & Historical Society 6:00 pm – 8:00 pm 6105 Riverview Rd. Peninsula, OH 44264 330-657-2291     Tuesday, April 9, 2013 Lorain County Community College Elyria Campus 2:00 pm – 4:00 pm 1005 N. Abbe Road Elyria, OH 44035 440-366-4148     Wednesday, April 10, 2013 Chagrin Falls Community Education Class Location:  Chagrin Falls Middle School Library 7:00 pm – 9:00 pm 342 E. Washington Chagrin Falls, OH 44022 440-274-5375     Thursday, April 11, 2013 SELREC – Hillcrest YMCA 11:00 am – 12:30 pm 5000 Mayfield Road Lyndhurst, OH 44124 216-382-4300     Thursday, April, 11, 2013 Polaris Career Center Berea High School 6:30 – 8:30 pm 165 E. Bagley Road, Room 102 Berea, OH 44017 440-891-7600     Tuesday, April 16, 2013 Kenston Middle School 6:30 pm- 8:30 pm 17425 Snyder Rd. Betty Patton Room 229 Chagrin Falls, OH 44023 440-543-2552 Call to register and for fee information     Wednesday, April 17, 2013 Euclid Library 7:00 pm – 8:30 pm 631 East 222nd Street Euclid, OH 44123 216-261-5300     Thursday, April 18, 2013 Lakeland Community College 6:30 pm – 8:00 pm 7700 Clock Tower Drive Kirtland, OH 44094 440-525-7116     Thursday, May 2, 2013 Andover Library 10:00 am – 12:00 pm 142 W. Main St. Andover, OH 44003 440-293-6792
Source: mutskoinsurance.com

10 things to know about Medicare

If you really want to improve your game as an investor, read Bobby Knight’s “The Power of Negative Thinking: An Unconventional Approach to Achieving Positive Results.” He knows “winning favors investors who make the fewest mistakes.” Bobby Knight’s March Madness investing advice.
Source: marketwatch.com

FBI raid more about Medicare fraud than Sen. Bob Menendez.

“Any allegations of engaging with prostitutes are manufactured by a politically motivated right-wing blog and are false,” Menendez’s office said in a statement Wednesday, following the raid on Melgen’s clinics in West Palm Beach and two other South Florida locations.
Source: typepad.com

The Medicare Newsgroup’s coming out

The Medicare News Group is an independent resource for Medicare news, policy and legislation with original and curated content. It is designed for reporters, writers, bloggers and editors who produce news and commentary on Medicare. MedicareNewsGroup.com aims to be a digital encyclopedia of Medicare that organizes past, current and future information, news, events, research and legislation relating to the topic.
Source: disruptivewomen.net

Why today's seniors object to the dissolution of Medicare

Privatization / corporatization of health care in the U.S. is the reason why our health care is prohibitively expensive, and can boast of only mediocre outcomes, at best. Nowhere else in the industrial world do citizens find themselves going bankrupt over medical care, and most industrial countries achieve substantially better health outcomes, and at lower cost, than we do. All Mr. Ryan’s plan will do is perpetuate our current dysfunctional system, with CEOs of health insurance companies being paid 7-figure salaries while nameless clerks deny coverage and the people they ostensibly “serve” find themselves having to choose between paying for food, or the mortgage, or clothing on the one hand, and paying off that hospital or doctor bill on the other, knowing that the “non-profit” hospital or physician may well take them to court if they choose to eat rather than pay for medical care.
Source: minnpost.com

Dueling Budgets Will Show Partisan Differences On Medicare And Medicaid

The New York Times: Cuts Give Obama Path To Create Leaner Military But the next set of cuts will be much harder, because they involve huge constituencies — in Congressional districts, inside the military services and among veterans’ groups. “The problem is that the biggest, most-needed cuts are in programs that also have the broadest set of defenders,” said Maren Leed, the director of the defense policy studies group at the Center for Strategic and International Studies in Washington and a former top aide to Gen. Ray Odierno, now the Army’s chief of staff. The most obvious examples of those problems come in base closings and higher co-payments or premiums for the beneficiaries of Tricare, the military’s sprawling health care program, which costs upward of $51 billion a year (Sanger and Shanker, 3/10).
Source: kaiserhealthnews.org

Information Alert: NCIL Deeply Concerned About Medicare Competitive Bidding Program

Although legislation can help eliminate the dangers created by this program, it will never pass unless members of the House and Senate understand that it is actually reducing access and support for their constituents with disabilities. Members of Congress are not hearing about the issues that people with disabilities are having under this program, which is why NCIL’s focus is encouraging our members and individuals who are suffering as a result of this program to contact their lawmakers and tell them what is really happening.
Source: advocacymonitor.com

HHS figures tell 2 stories about Medicare drug spending

A Department of Health and Human Services (HHS) report says Medicare recipients have saved $5.7 billion on prescription drugs in the last two years since the new healthcare law added benefits to close the so-called "doughnut hole." That gap is the place where drug coverage used to fall off until Medicare users spent enough to again recover costs. In 2012, the savings were $2.5 billion–$706 a person–up a bit from the $2.3 billion in 2011, USA Today reports, citing the HHS stats.
Source: fiercepharma.com

Important Information to Know About Medicare Coverage of Hospital Stays & Skilled Nursing Care

Most people assume that when they are admitted into a hospital they are automatically considered an inpatient. However, this is untrue. The physician or practitioner decides whether to list the patient as an inpatient or put them on “observation status.” CMS defines observation status as, “a well-defined set of specific, clinically appropriate services, which include ongoing short term treatment, assessment, and reassessment before a decision can be made regarding whether patients will require further treatment as hospital inpatients or if they are able to be discharged from the hospital.” The problem with observation status is that Medicare Part A will only pay for hospital inpatient care. If you are listed as on observation status Medicare Part B will pay for care provided by the hospital physicians, and normally supplemental insurance policies will pay for the additional costs such as hospital deductibles, copayments, and Part B cost sharing. This is an issue for beneficiaries who opted out of Medicare Part B and also for those who require care in a skilled nursing facility upon discharge from the hospital. Medicare Part A will only cover skilled nursing care in a facility if the patient had been admitted to a hospital as an inpatient for three days prior – this is called a “qualified stay.” This means that if you were on observation status, even if you stayed at the hospital for three days, Medicare will not pay for the skilled nursing facility rehabilitation you need as that was not a qualified stay..
Source: newyorkelderlawblog.com

A plain blog about politics: Elsewhere: Medicare, ACA

Two today on Medicare, based on the latest evidence that the health care cost curve could be flattening. At Greg’s place, I asked: what if there’s no deficit problem? At PP, I argued that the national press has basically been telling us a completely backwards story about Medicare reform. I thought that one was pretty good, actually. Oh, and yesterday I had fun at the expense of Eddie Haskell because he apparently still believes both that “repeal and replace” is still a thing — and that Republicans should and will get credit for the “replace” part of it.
Source: blogspot.com

Medicare Supplemental Insurance Comparison Releases New Article "Five Tips for Saving on Medicare Supplemental Insurance"

Posted by:  :  Category: Medicare

“I wanted to create a website that can help people just like me and my wife,” says Stephen pewter, Medicare member and founder of MSIC. “Just six months ago we were searching for this kind of information and it was a very frustrating process. I created the website at first to help my friends and family, but then it gained popularity and took off on its own. Now we are just trying to provide the most up-to-date information for people like us who want to learn more about Medicare supplemental insurance.”
Source: virtual-strategy.com

Video: Medicare Supplement Insurance Shopping

When Should I Buy A Medicare Supplement Insurance Policy?

The best time to purchase a Medicare supplement insurance policy is during your open enrollment period. Your open enrollment period lasts for six months. It begins the first day of the month in which you are the age of 65 and enrolled in Medicare Part B. Some states offer additional open enrollment periods under state law. You will want to examine the laws that pertain to your state for any exceptions. The advantage of purchasing a Medicare supplement insurance policy during the open enrollment period is that insurance companies are not allowed to use medical underwriting for your application.
Source: hijcenter.org

Texas Medicare Supplement Insurance Plans

Make sure that you are getting the right coverage that you want. This will not be hard if you already know your options. There are ten different supplement plans that you can choose from. Taking time to carefully examine all you have to choose from will enable you to compare the gaps filled with each plan to determine the one that is going to be ideal for your needs.
Source: zambiadaily.com

The importance of Medicare Supplemental Insurance

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Source: medicalnoises.com

Medicare and Medicare Supplemental Insurance

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

Medicare Advantage Plans vs. Medicare Supplemental Insurance Plans

Medicare Advantage Plans are private insurance companies that receive subsidy from Medicare Insurance. Medicare pays the private insurance company a premium to cover the individual. Medicare is essentially selling your insurance to the private insurance company. Your Medicare Advantage Plan is then liable to pay all of your covered benefits. All Medicare Advantage Plans are required to provide the same coverage as Medicare-covered benefits. Medical Advantage Plans include Health Maintenance Organizations (HMOs), Private Fee-for-Service Plan (PFFS) and Preferred Provider Organization (PPOs). Since these plans are private owned companies they have their own network of doctors and facilities. If you choose to use a provider out of network you may have to pay out of pocket costs. These cost are usually deductibles, co-pays and unreasonable charges incurred by non-participating doctors and facilities. Therefore, it is wise to find and establish doctors within your network. The biggest advantage to choosing a Medicare Advantage Plan is that the average premium is approximately $50 per month and sometimes free. The disadvantage is not every Medicare provider accepts these plans.
Source: maxinevoyance.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 – NONE 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 – Birthday Wyoming
Source: insurance-forums.net

New WordPress Medicare Supplement Site for Sale

Are you an Insurance Forums member yet ? To sign up for your FREE INSTANT account, please fill out the form below ! Username:     Password:   Confirm Password:     E-Mail:   Confirm E-Mail:     Question of the day:   Type the result for 11 x 3 Agree to forum rules 
Source: insurance-forums.net

Medicare Supplement Insurance Plans Must Be Present For Every Old Aged People

At the time you are coming straight into the different territory it is really complicated. Approach has become popular never truer when compared to when beginning how the enrollment operation with regard to Medicare and Interesting New Details Released 4/11/13 Concerning Medigap Plan Deductible Maximums Insurance. Medicare supplement plans can remain perplexing. It is valuable to seek info on Medicare health insurance Supplemental where hand calculators analyze the coverages obtainable and currently the unknown rates accused for the cover. Choosing the wrong Medigap policy will likely end up squandering your more than money wise. Imagine choosing not to have an activity done because aftercare or the very operation itself was not covered. The advent of Internet has made it possible to find for leads easy. All you’ve got to do would be contact interested people and make them aware of facilities they can take advantage and then obtain them to leads. It is found these types of conversions are extremely in the on-line medium than out in the open. Another way of to make conversions is to explain them about ones deductibles they appear forward through these supplement leads. Most of associated with deductibles are as such not a a part of general Medicare tips. Agents can also check the Internet searching for people are usually looking for health services. Of those ingredients the people which usually more often nada do not may have medical policies these. Our own list of all companies is extensive, which means you will probably have just a few companies to buy from in place. Although medicare Part A as Part B include many of i would say the primary expenses the actual planet event of a particular catastrophic illness in addition to unexpected emergency, there are a bunch many “gaps” that can relate to every day health care needs, such as being co-payments for physician’s visits, prescriptions in addition diagnostic tests. Lastly, medicare supplements cost must be gathered long before electing what plan to obtain. This will give the owner a longer full stop to decide available on things. Auto racing on a course of action and overspending on the wrong insurance intend can be shunned if the particular individual has lots of time to decide on which plan is splendid to answer the health insurance needs. The Top 5 VC funding deals throughout the 2012 were: Castlight Health, a provider of healthcare planet and mobile-based visibility solutions that make it possible comparisons of doctors, hospitals and medicinal procedures based on price and quality, which raised 0 million, 23andMe, a personal genetics contractor that helps sufficient reason for the understanding of wellness and cancer prevention through that it is personal genome service, which raised million, GoHealth, some online portal that do helps compare also shop health insurance policy coverage, which mentioned million, Kinnser Software, a website of clinical technical support to home medical care companies, which farmed million, as well as a Practice Fusion, a provider of without charge web-based electronic med records (EMR), that typically raised squillion. You really may ask unique why there is regarded as an open signing up period if require to not have you can enroll during that time. The great improvement to enrolling through open enrollment could be the you are actually able to to avoid specialized medical underwriting. Only just put, medical underwriting is done when insurance companies gather information on your past and existent health history solution to to potentially expand your monthly prime amount. However, if you were definitely to enroll during the open enrollment period, insurers would not normally be allowed in order to really use that to fight you. Your site are only exposed to medical underwriting if you enlist outside of which will allotted time stage. The open enrollment season lasts for 6 weeks months from which the date of the best Medicare enrollment in both Part An actual and Part B. You could possibly ask yourself an individual would need alternative coverage if you already have a great method like Medicare. So many individuals are oblivious to the fact that Medicare does not really cover everything. Traditional Medicare definitive takes care using 80% of allowed medical expenses. The other 20% is often nonetheless left out-of-pocket to the product’s members. In times like this where our economy is not by its best, mature adults are looking entering Medigap policies towards saving them as much money as possible.
Source: typepad.com

What is Medicare Supplemental Insurance Open Enrollment, And Why Is It Important For Me?

During open enrollment, your right to purchase a Medicare supplement policy is guaranteed, no matter your health condition or past medical history. Insurers cannot refuse to offer you a policy. You also cannot be asked to pay a higher premium because of insurance risks you may bring to the table. For example, a smoker will pay the same premiums as a non-smoker. There is no medical screening for applicants during the open enrollment.
Source: kurafire.net

Medicare Supplement Insurance Plans Are Almost Always Friend Of Your Corporation After 65

Assurance is another critical factor that donrrrt want to be overlooked any kind of time given time. You should continually be comfortable with its Medicare supplement insurance that you have a tendency for because created by a number of things. First along with foremost it will be based on on your getting older and the illness that you are enduring. If the individual are 65 years of age and above you have to should settle available for the rightful insurance policy for your mature. If you have always been disabled then these cover should really fixate on your incapability and how to cater for ones expenses incurred as a result of treatment. Specified therefore that you are most comfortable with the Medicare supplement insurance you are going for when you need to avoid any mistakes.
Source: fitnesstraininghq.com

Senate Hearing on Modernization Efforts for Medicare and Medicaid

Posted by:  :  Category: Medicare

Save Medicare.... by Glyn Lowe PhotoworksJonathan Blum, the acting principal deputy administrator and director of the Center of Medicare at the Centers for Medicare and Medicaid Services, testifies before the Senate Finance Committee on a progress report on the modernization of Medicare and Medicaid.
Source: c-span.org

Video: What Is Medicare Part-C and Part-D?

Medicare Payments to Providers Are Carved, Sliced and Chopped by Sequestration

CHOPPED – Sequestration will have a huge impact on healthcare chopping up reimbursements. Now more than ever before, providers must look for every dollar of reimbursement they can find. In most cases, the low-hanging fruit has already been picked. Today, forward thinking healthcare executives must move quickly to make the decisions which will positively affect reimbursements. Investments in brand new technologies and reinvented processes, which offer an ROI of less than 12 months will be the most attractive moves executives can make. There are several “Blue Diamond” technologies entering the marketplace every day. These new avenues for reimbursement recovery are available to help offset the reimbursements that has been carved up, sliced off and hacked to pieces by sequestration.
Source: healthworkscollective.com

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

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

Free information session on navigating Medicare March 21

Confused about Medicare and your health insurance options? You’re not alone! Join Human Resources for a free information session from 1:30 to 2:30 p.m. Thursday, March 21, in Light Hall, Room 202. The session is directed to employees aged 62 and older, but all are welcome to attend. No registration is required.
Source: vanderbilt.edu

D.C. panel on Medicare’s future: Dr. Pescovitz highlights key role of academic medicine

• Tom Scully, former director under George W. Bush of the Centers for Medicare and Medicaid Services, the federal agency that oversees the Medicare system • Robert Berenson, senior fellow, Urban Institute and former vice chair of the Medicare Payment Advisory Commission • Susan DeVore, president and chief executive officer of the Premier hospital alliance • Sally Greenberg, executive director of the National Consumers League • Michael McCallister, chairman of the board, Humana Inc. • Gail Wilensky, senior fellow at Project HOPE and former administrator at the Health Care Financing Administration (now Centers for Medicare & Medicaid Services.)
Source: umhsheadlines.org

Annual Enrollment for Medicare Advantage (Part C) & Part D: October 15 – December 7 

Even beneficiaries who were satisfied with their 2012 plans need to review their plan options for 2013.  Part D and MA plans may have made changes to their coverage, provider networks and other plan features.[3] Plan information for 2013 will be available on the Medicare Plan Finder at www.medicare.gov.[4]  For the computer-savvy, the Medicare Plan Finder is an excellent plan comparison tool, allowing users to enter all their drugs and drug dosages, compare up to three plans at a time, save their drug information for later use, and actually enroll in a plan on-line.  This is the best – if not only – way to truly compare the many plans available to choose from.  People who cannot use the Plan Finder themselves may contact 1-800-Medicare, or their State Health Insurance Assistance Program (SHIP), for assistance with evaluating, selecting, and enrolling in a Part D plan.
Source: medicareadvocacy.org

The A, B, C and D of Medicare

These plans change every year and it is expected that the monthly premium for part D of a basic plan will be about $30, which is no change from this year.  If you are not settling for a basic plan, review your options.  Some plan premiums have risen dramatically from last year and there are also more bargain plan options.  If you are already enrolled in a plan, you may want to give it a once over to ensure there is no premium hike on it and then compare it to some of the bargain options.  Also before you make your final decision on which drug plan you would like to go with ensure that the deductible is not too high that it may be well worth paying a higher premium elsewhere.  Plans, for 2013, can tack on deductible of up to $325.00.4
Source: fiohinvestments.com

Medicare Health Insurance Supplement Insurance To A Boon Relating To Senior Citizens

Company Appointments: You have got to be appointed to help you sell at minimum 2 different companies that offer Treatment Advantage and Treatment supplement plans in the area you be working in. As moments goes on it again will be tips to be assigned with most if, perhaps not all within them but who would be effectively overwhelming to begin the process. Two business owners will get it again done in the beginning. Again, use the world to get an idea of in which companies are very competitive in your locality. There remain also a phone number of Medicare Wholesales websites that will surely allow you so as to do basic quotes in any assigned zip code.
Source: wearewildeyes.com

Raising Medicare age would hurt seniors and the economy

Posted by:  :  Category: Medicare

The much-touted Republican plan to raise the eligibility age of Medicare would raise health care costs for seniors, hurt the overall economy, and put increasing pressure on older Americans, a study by the Kaiser Family Foundation found. “This is a policy change that seems straightforward, but has surprising ripple effects,” Tricia Neuman, Medicare specialist with Kaiser, said. “It’s a simple thing to describe … but I don’t think people have thought through the indirect effects.” The idea of raising Medicare’s eligibility age became a national demand of Republicans after House Budget Chair and vice-presidential candidate Paul Ryan put forward his budget, which called for massive cuts to Medicare, Social Security, Medicaid and other federal programs that help poor and working Americans, while pushing continued huge tax cuts for the wealthy. Among the indirect cost shifts the Kaiser study identified are the following; * Higher Medicare premiums for those on Medicare because younger (and healthier) 65- and 66-year-olds would be kept out of the program, raising Medicare’s insurance costs.  Kaiser said the cost increases for seniors could top three percent due to this change. * An increase in costs for companies providing health care to their workers due to older workers staying on company health care plans instead of going onto Medicare at that age. * Higher premiums for those on private insurance programs across the board as older, and less healthy, workers are forced to stay with private insurance rather than moving onto Medicare, as they now do. * Much higher out-of-pocket expenses for more than two-thirds of older adults, as they are forced to wait two years longer to be Medicare-eligible. * Kaiser and the nonpartisan Congressional Budget Office (CBO) projected a huge increase in uninsured Americans if Medicare eligibility is raised by two years. Texas and other states where Republican administrations have said they will refuse the federal increase in Medicaid under the Affordable Care Act are expected to be particularly hard hit. Republicans, led by House Speaker John Boehner of Ohio, continue, even after suffering a historic defeat in the recent elections, to make the change in Medicare eligibility a centerpiece in their campaign to slash federal spending for poor and working Americans while keeping major tax cuts for the wealthy. While President Obama is taking a tougher post-election position in budget talks, some Democrats appear ready to accept raising the Medicare eligibility age. Steny Hoyer, leading Democrat from Maryland, said last week that the Medicare eligibility shift is “clearly on the table.” The AFL-CIO, AARP, Alliance for Retired Americans and other organizations representing working and retired Americans are working hard at mobilizing their grassroots base, demanding “No cuts to Medicare, Medicaid, and Social Security – have the wealthy pay their fair share.” “These vital programs have not caused the deficit,” ARA President Barbara Easterling said in a recent public letter. “Instead, reckless tax cuts and loopholes for the wealthy and greedy Wall Street behavior have. Make those who caused the deficit pay for it.” Tim Burga, president of the Ohio AFL-CIO, in a radio interview last week, compared the so-called “fiscal cliff” to the Mayan Cclendar, which some alarmists have stated sets this year as the “end of the world.”   “I think we’ll be here the day after both of these phony, made up, so-called ‘crises’,” he said. ” The point is that we can’t let self-promoting corporate snake oil salesmen stampede us off of a real cliff, destroying real programs that really help real people and our real economy.”
Source: peoplesworld.org

Video: Dual-Eligible Budget Cut Crushing Patients, Doctors Across Texas

Physicians Can Now Apply for Higher Medicaid Rates

The higher payments will benefit physicians who participate in both Medicaid fee-for-service and Medicaid HMO plans, said Helen Kent Davis, Texas Medical Association director of government affairs. Further, the rate increase will significantly help those physicians hurt by the cut in payment for the Medicare Part B coinsurance enacted in 2012. For those patients, Texas will not pay the 20-percent coinsurance if what Medicare pays is more than the Medicaid allowable for the same services. However, once the rate increase takes effect, eligible physicians will be paid the full coinsurance because the Medicare and Medicaid allowable for the service will be the same.
Source: dmagazine.com

Daily Kos: Open thread for night owls: Raising Medicare eligibility age would hurt minorities most

un-Constitutional, since illness and injury are not age-dependent. Separating populations by age and income is little more than a sop to segregationist sentiments — sentiments which, in turn, merely satisfy an ideological commitment to hierarchy as a fundamental principle of society. Ranking humans in order to give some more or less authority over others is not natural. If humans are equal, admittedly an ideological commitment, but one that is enshrined in our organizing document, then hierarchy is in basic conflict. Insisting on it merely serves to undermine our democracy. Of course, we have a long history of not living up to our aspirations. But, that’s what moving forward is about. If we are going to make progress, then irrelevant distinctions have to be removed. Medicare should be an option for all, especially now that all income earners are paying into it. Money, btw, is a social utility. People who use it incur some obligations for our communal certification that their IOUs are good. If some people get along with handshakes, more power to them. We won’t expect them to pay in.
Source: dailykos.com

Daily Kos: Are Democrats abandoning raising the Medicare eligibility age?

Meteor Blades, skybluewater, SME in Seattle, bink, Renee, Angie in WA State, cslewis, Sylv, chuck utzman, Irfo, hester, slinkerwink, Gooserock, PeterHug, Andrew C White, eeff, willyr, TX Unmuzzled, Duncan Idaho, jancw, expatjourno, eyeswideopen, bronte17, cyberKosFan, Einsteinia, susakinovember, whenwego, pedrito, Nate Roberts, Eddie C, revsue, psnyder, figbash, 2laneIA, defluxion10, RebeccaG, grrr, lcrp, inclusiveheart, ybruti, lonespark, Wife of Bath, Sybil Liberty, Skennet Boch, drofx, radarlady, 3goldens, ichibon, irate, sc kitty, Alice Venturi, wallys son, Flint, dewtx, Dobber, Laurence Lewis, ratzo, bleeding blue, Sun Tzu, skyounkin, markdd, Ozzie, spunhard, xaxnar, Jim R, splashoil, Jim P, begone, Born in NOLA, velaski, Patriot Daily News Clearinghouse, vigilant meerkat, Kimball Cross, rl en france, martyc35, kestrel9000, DarkestHour, triv33, twigg, real world chick, el cid, sceptical observer, Timothy J, Clive all hat no horse Rodeo, bstotts, ms badger, sea note, BentLiberal, ammasdarling, Tamar, One Pissed Off Liberal, phonegery, fabucat, Habitat Vic, tgypsy, puakev, beth meacham, dclawyer06, deepeco, jedennis, leonard145b, madgranny, trueblueliberal, JDWolverton, MKinTN, CroneWit, mconvente, TruthFreedomKindness, also mom of 5, HappyinNM, wayoutinthestix, zerone, prettyobvious, Involuntary Exile, elwior, treesrock, KJG52, jamess, Therapy, Lujane, tofumagoo, petulans, venger, Tonga 23, JamieG from Md, Nica24, Mike Taylor, maggiejean, prettygirlxoxoxo, Rhysling, cybrestrike, J M F, Throw The Bums Out, Scott Wooledge, Alex Budarin, maryabein, Zotz, mkor7, papahaha, kevinpdx, sfarkash, Lacy LaPlante, emptythreatsfarm, FogCityJohn, flitedocnm, Crabby Abbey, Progressive Pen, Polly Syllabic, sunny skies, ATFILLINOIS, melpomene1, gulfgal98, Lady Libertine, ItsSimpleSimon, Puddytat, Egalitare, sharonsz, addisnana, Betty Pinson, ericlewis0, cocinero, Oh Mary Oh, fiercefilms, stevenaxelrod, Onomastic, mama jo, Liberal Capitalist, Mr MadAsHell, BlueJessamine, OhioNatureMom, smiley7, marleycat, thomask, Wolf10, whaddaya, ratcityreprobate, stlsophos, Willa Rogers, Mentatmark, SouthernLiberalinMD, allergywoman, SycamoreRich, wolf advocate, Cordyc, anodnhajo, SparkyGump, cwsmoke, pistolSO, Siri, Citizenpower, IndieGuy, rustypatina, S F Hippie, effervescent, Trotskyrepublican, JGibson, congenitalefty, Mr Robert, BobSoperJr, geojumper, radical simplicity, MartyM, pittie70, Vote4Obamain2012, avsp, marty marty, dotdash2u, George3, wasatch, Marjmar, fauve, Sue B, simple serf, Illinois IRV, jbob, Linda1961, Panama Pete, goodpractice, The Hamlet, alice kleeman, Jollie Ollie Orange, marcr22, chicklet, pragmaticidealist, MBishop1, Catkin, Chas 981
Source: dailykos.com

National Journal calls Rick Perry “the presidential candidate ahead of his time”

Rejecting the federal money might not pose an immediate political threat to Texas Republicans, whose coalition revolves around white voters responsive to small-government arguments. But renouncing the money represents an enormous gamble for Republicans with the growing Hispanic community, which is expected to approach one-third of the state’s eligible voters in 2016. Hispanics would benefit most from expansion because they constitute 60 percent of the state’s uninsured. A jaw-dropping 3.6 million Texas Hispanics lack insurance.
Source: dallasnews.com

Medicaid Eligibility in Texas

Following an initial check of the information, all applicants are required to visit a Health and Human Services Commission Benefits office. This visit interviews the applicant to ensure all information is present and correct – forming the final part of the application. Applicants who have specific reasons why they cannot travel to the Health and Human Services Commission Benefits office may be able to complete the review by telephone, or a representative may make a home visit.
Source: tex.org

Listen Up, White House! Take Medicare Eligibility Age Off The Table NOW.

…with the electorate. Act 1. A disaster scenario (created by the WH & Congress) aptly named a ‘fiscal cliff’ MUST be solved by Dec. or we’ll all die. Both parties posture and pose and pretend to hold out for a deal their base supports. Act 2. Media run non-stop stories about the fiscal cliff ‘disaster’. Theme: If no compromise is reached before (artificial) deadline life will end for us all. Good cop, bad cop drama ensues. Act 3.The WH/Congress leak Pete Peterson’s plan to a couple of insiders to float. Outrage from both bases. Media frenzy. WH/Congress wait out the storm. Act 4. Float a slightly more palpable plan with “tweaks”. Media insiders in both parties give it a tepid thumbs up claiming it was the best they could do given the intransigence of the other party. Act 5. Tweaked entitlement “reform” bill gets bipartisan support. Act 6: The public finds out 9 mos later about the poison pills lobbyists for Pete Peterson wrote into the bill. Act 7. Medicare age raised to 67. SS cola ‘tweaked’. Taxes raised 2% on millionaires. Captial Gains tax untouched. Defense cuts- not so much.
Source: crooksandliars.com

Raised Medicare Eligibility Age, and Other Links

American Medical Association cancer CBO consumer driven health care diabetes doctors drugs electronic medical records email emergency room EMR ER exercise FDA genetics Health Care Access Health Care Costs health care quality health insurance health IT health policy Health Reform Health Savings Accounts heart disease hospital HSA insurance life expectancy Massachusetts Medicaid Medicare medicare advantage NHS ObamaCare obesity pay for performance public option SCHIP seniors socialized health care Social Security stimulus tax unemployment Uninsured
Source: ncpa.org

Iowa Patch Poll: Is Gov. Branstad Wrong to Oppose Medicaid Expansion?

Posted by:  :  Category: Medicare

The PARTY Is OVER ...item 4.. Today, Mitt Romney Lost the Election (Sep 17, 2012 6:02 PM ET) ...item 5.. James Brown - Get On The Good Foot, Soul Power, Make It Funky Soul Train 1973 ... by marsmet471"A classic explanation for why free markets produce prosperity and socialism does not is that individuals benefit in government-run markets by taking from someone else. In free markets, individuals benefit as a result of serving others, making everyone better off. Medicaid violates basic management principles. There is no clear institutional responsibility. It has grown through funding from both state and the federal government. Anyone who has ever run an organization knows that absence of clear responsibility produces bad results. Medicaid spending has grown from 0.5 percent of GDP in 1970 to 2.7 percent of GDP in 2010, and according to Medicaid’s chief actuary, "From program inception, the cost of Medicaid has generally increased at a significantly faster pace than the U.S. economy." And there is no individual responsibility. Medicaid is a pure welfare program. Participants have 100 percent of their costs covered by the government. Once you have qualified, there is no time limit. There are no incentives to behave and spend efficiently. The only direction of Medicaid is to spend more and more money less and less well."
Source: patch.com

Video: Medicare Information for Iowa by Medicare Pathways

Loebsack: Tell House Republicans Not To Slash Medicare

Thousands of you signed our petition telling House Republicans not to slash Medicare. Thank you for that.  But our work isn’t done yet. GOP leadership is bringing that devastating budget to the House floor for a vote tomorrow.
Source: blogforiowa.com

Iowa governor rolls out alternative to Medicaid expansion

“Gov. Branstad’s proposal is a step forward in terms of providing health coverage to all Iowans. What Iowa needs now is clarification from the federal government on whether the Centers for Medicare and Medicaid Services is in a position to approve the major aspects of the plan as presented,” Child and Family Policy Center executive director Charles Bruner said in a statement Monday. “Iowa cannot afford to spend time preparing a waiver proposal that can’t be approved.”
Source: thegazette.com

Medicaid Expansion : Hagenow for Iowa House

If the federal government should choose to go to a blended rate or reduce their part of Medicaid funding, Iowa taxpayers would have to pick up the difference. For instance, the Federal Medicaid Assistance Percentage (FMAP) was 63.8% in 2004 and by 2014 it is estimated to be down to 58.4%. This decreased federal percentage means that over the past ten years, Iowa has had to pay up to $192.5 million in additional benefits that the federal government was no longer covering.
Source: chrishagenow.com

Pawlenty touts Medicare proposal during Iowa trip

Former Louisiana Gov. Buddy Roemer, considered to be another possible GOP presidential hopeful, joined Pawlenty at the Waukee event, laying out a detailed plan to create jobs by overhauling the nation’s trade, energy and tax policies. He said America is addicted to Middle Eastern oil, corporations that don’t back taxes and special interests that have cost the nation jobs.
Source: publicradio.org

Iowa, Michigan, New Hampshire, and West Virginia Receive Conditional Approval to Run State Partnership Marketplaces

HHS continues to offer states its support to help ensure they have everything they need to establish their marketplaces. HHS’ goal is that consumers in every state will be able to buy insurance from qualified health plans directly through the marketplace. In some cases tax credits and cost sharing assistance will be offered to eligible consumers to help lower their costs. The plans are also intended to guarantee consumers are no longer denied coverage because of a pre-existing condition.
Source: wolterskluwerlb.com

14 Recent Medicare, Medicaid Issues

Here are 14 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent. 1. CMS selected that it has selected 20 new organizations to participate in its Community Care Transitions Program. 2. CMS announced that Medicare incentive payments for meaningful use of electronic health records will undergo a 2 percent cut under sequestration. 3. Sequestration’s 2 percent cuts to Medicare should not hinder the growth of for-profit hospital chains, according to reports from Standard & Poor’s Ratings Services and Moody’s Investors Service, but non-profit hospitals will likely see more challenges. 4. Most hospitals and hospital associations have advocated for the expansion of Medicaid under the Patient Protection and Affordable Care Act because it would help boost revenues in a time when uncompensated care continues to grow. But some new findings suggested Medicaid expansion could actually hurt some hospitals’ bottom lines, particularly in New Hampshire. 5. Many health systems behind CMS’ 32 Pioneer Accountable Care Organizations wrote to CMS, disagreeing with the Patient Protection and Affordable Care Act’s approach to quality measurement and  demanding changes to the Pioneer program. 6. Sen. Tom Harkin (D-Iowa) said HHS Secretary Kathleen Sebelius told him that Iowa Gov. Terry Branstad’s plan to expand Medicaid would not meet eligibility requirements for increased federal funding. 7. Sharon (Conn.) Hospital CEO Kimberly Lumia spoke out against Gov. Dannel Malloy (D), who plans to convert a provider tax for Medicaid funds established last year into a straight tax. 8. The Indiana Senate has unanimously approved a bill that requires the Indiana Medicaid program to pay home health agencies, rural health clinics and federally qualified health centers for telehealth services. 9. Although Virginia passed a budget recently that opens an avenue for lawmakers to discuss the option of expanding the state’s Medicaid program, Gov. Bob McDonnell (R) wrote a letter to HHS Secretary Kathleen Sebelius confirming he would make no decision on the matter in his tenure, which ends this year. 10. House Republicans vowed not to force hospitals to pay for the party’s plan to repeal Medicare’s sustainable growth rate, an annual source of legislative ire that would drastically cut physician pay that Congress has overridden every year since 2003. 11. A study in Health Affairs found hospice care can yield significant cost savings to Medicare, even for patients enrolled one to seven days before death. 12. CMS extended, through October 2013, the Medicare-Dependent Hospital Program for rural hospitals, as well as payment increases to low-volume hospitals prescribed by the American Taxpayer Relief Act of 2012. 13. The Government Accountability Office said CMS overpaid private Medicare Advantage plans by at least $3.2 billion from 2010 through 2012. 14. The National Commission on Physician Payment Reform, a panel of physicians and healthcare experts assembled by the Society of General Internal Medicine, made bold recommendations to fix Medicare’s sustainable growth rate by saving money through ending the increased payments hospitals receive for outpatient services and incorporating quality metrics in all physician reimbursement within five years.
Source: beckershospitalreview.com

Obama Cuts Medicare – Again!

Posted by:  :  Category: Medicare

Record shop Ithaca, NY by exaktaWhen President Obama signed the Affordable Care Act into law, he simultaneously authorized $200 billion in cuts to the Medicare Advantage program. At the time, the Congressional Budget Office projected that the health care reform law’s cuts would result in three million fewer Medicare Advantage enrollees. Moreover, actuaries at Oliver Wyman predicted that the cost of the health insurance tax would mean an additional $3,500 in out-of-pocket expenses for seniors over the next ten years.
Source: townhall.com

Video: Medicaid News – Rick Snyder, Congressional Budget Office, Harry Reid, Medicare

GRAY MATTERS: HICAP can help with Medicare

A series of free Medicare workshops is offered in Eureka and Del Norte County on a rotating basis. Workshops cover Medicare basics, supplemental Medicare and the Medicare Prescription Drug Plans. No registration is required. In Eureka, workshops are typically held the second Thursday of the month from 4 to 5 p.m. at the Area 1 Agency on Aging office and at the Del Norte Senior Center at various times. HICAP counselors are also available to make presentations to community groups about Medicare programs.
Source: times-standard.com

AMBULANCE SERVICE OWNER CONVICTED OF MEDICARE FRAUD

In response to the audit Sivchuk provided Medicare with dozens of ambulance Trip Sheets, which are prepared by Emergency Medical Technicians (EMTs) at the time of each ambulance transport. The Trip Sheets contain a narrative section that describes the patient’s physical condition and ability to ambulate. The Trip Sheets serve as the primary support document for each ambulance transport claim for which Medicare was billed. The June 2, 2011 search by the FBI and investigators from the Health and Human Services (HHS) Inspector General’s Office revealed that Sivchuk did not submit the original trip sheets to the auditors but instead submitted copies of other trip sheets that had been re-written and forged to conceal the fact the beneficiaries were able to walk and stand. During his court appearance before Judge Conner today, Sivchuk admitted he directed a subordinate to re-write and forge the signatures of two EMTs on a Trip Sheet pertaining to the ambulance transport of a dialysis treatment beneficiary on August 19, 2010.
Source: dmnewsi.com

Owner and Operator of Houston

WASHINGTON DC March 8 2013—The owner and operator of a Houston-area ambulance company was convicted by a federal jury in Houston of multiple counts of health care fraud for submitting false and fraudulent claims to Medicare, Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Kenneth Magidson of the Southern District of Texas, Special Agent in Charge Stephen L. Morris of the FBI’s Houston Field Office, and Special Agent in Charge Mike Fields of the U.S. Health and Human Services Office of Inspector General-Office of Investigations Houston Office announced today. Olusola Elliott, 44, of Fort Bend County, Texas, was convicted late yesterday by a federal jury in U.S. District Court in the Southern District of Texas of one count of conspiracy to commit health care fraud and six counts of health care fraud. Elliott was the owner and operator of Double Daniels LLC, a Texas entity that purportedly provided non-emergency ambulance services to Medicare beneficiaries in the Houston area. According to evidence presented at trial, Elliott and others conspired from April 2010 through December 2011 to unlawfully enrich themselves by submitting false and fraudulent claims to Medicare for ambulance services that were medically unnecessary and not provided. Evidence showed that Elliott falsified patient records in order to fraudulently bill Medicare on behalf of beneficiaries who were not in need of ambulance services. During the course of the scheme, Elliott submitted and caused the submission of approximately $1,713,716 in fraudulent ambulance service claims to Medicare. According to court documents, Elliot transferred the proceeds of the fraud to himself and others after Medicare payments were sent to Double Daniels. Elliot is scheduled for sentencing on May 31, 2013, in Houston. The six health care fraud counts and the conspiracy count each carry a maximum potential penalty of 10 years in prison and a $250,000 fine. This case is being prosecuted by Trial Attorneys Christopher Cestaro and Laura M.K. Cordova of the Criminal Division’s Fraud Section, with assistance from former Special Assistant U.S. Attorney James S. Seaman. The case was investigated by the FBI, HHS-OIG, and the Texas Attorney General Medicaid Fraud Control Unit. The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section. Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers. To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to http://www.stopmedicarefraud.gov.
Source: wordpress.com

Happy Anniversary, Affordable Care Act 

[1]  Health Care Reform consists of two separate laws, the Patient Protection and Affordability Care Act of 2010 (PPACA), Pub.L. 111-148  (March 23, 2010),  and the Health Care and Education Reconciliation Act of 2010 (HCERA), Pub. L. 111-152 (March 30, 2010).  The laws often are collectively referred to as the Affordable Care Act (ACA). [2] Centers for Medicare and Medicaid Services, available at http://www.cms.gov/apps/files/MedicareReport2012.pdf. [3] Department of Health and Human Services, available at http://www.healthcare.gov/blog/2013/03/anniversary-consumer-protections.html. [4] See, e.g., MedPAC Report to Congress: Medicare Payment Policy (March 2010) noting that in 2010, overall payments to plans average an estimated 113 percent of original Medicare fee-for-service (
Source: medicareadvocacy.org

How to Avoid Being Banned from Medicare

1. Result in the individual or entity also being barred as a participating provider with private health insurers.   2. Trigger breaches of employment agreements, and may jeopardize a provider’s clinical privileges.   3. Result in the individual or entity being terminated from Medicaid programs.     Steps to prevent exclusion   Organizations can take steps to minimize the likelihood of ending up on the LEIE. While the OIG has posted extensive guidance on this, the key strategy is developing and implementing an effective compliance program. According to the OIG, there are seven hallmarks of an effective plan:   Audits.  An effective program will include periodic audits to monitor compliance with, and the effectiveness of, the plan. This will include auditing charts to confirm that services being provided are reasonable and necessary, as well as auditing coding and billing to ensure proper billing for services.  This needs to be done periodically.   Written standards.  The plan should be written, and include readily identifiable standards and procedures.  This will include identifying potential areas of risk to the organization, and then identifying the standards to be followed (whether they relate to proper billing or identifying what are reasonable and necessary medical services).   Oversight.  An effective plan will be overseen by one or more persons designated as compliance officers.  The organization should provide a detailed description of the officer’s duties and conduct periodic evaluation of the officer’s performance.   Education. Ongoing training and education is critical to ensuring that providers and staff understand the plan, its standards, and the protocols that are in place to ensure compliance.  Training will encompass not only the plan, but also the key areas of the organization’s operations (for example, training on proper coding/billing protocols).  As with other aspects of the plan, the organization should review and update its training and education.   Responsiveness.  An effective plan includes procedures to timely and effectively investigate and respond to incidents of fraud, including notifying the appropriate governmental agency(ies) of such incidents.  An organization may want to consider identifying in its plan red flags that may indicate fraud, as well as specific timelines for investigating incidents.   Communications.  Open lines of communication within an organization will ensure that providers/staff remain aware of the plan and its requirements, and also foster an environment where members of the organization feel comfortable sharing information about potential fraudulent conduct.   Discipline.  Well-defined standards for how discipline will be meted out will help impress upon the organization’s members the serious repercussions should there be non-compliance.  Discipline can include a multi-step approach, from warnings to (in serious cases) immediate termination.   It is up to each organization to incorporate these features into its plan. Smaller organizations, given their limited resources, have more flexibility. Larger organizations, on the other hand, are expected to have a more comprehensive plan in place.
Source: medicalofficetoday.com

ARRA News Service: Medicare Needs More Competition Not Less

by Phil Kerpen, Contributing Author: Senate Democrats are finally beginning the process of writing a budget after four years of dereliction. They will almost certainly include some changes to Medicare, the largest driver of federal spending and debt. But unfortunately, there are indications that they intend to focus on the small piece of Medicare (10.6 percent in 2012) that is actually working well: the Medicare Part D prescription drug program. The drug companies cut a deal with the White House early in Obama’s first term to provide the funding for pro-Obamacare TV commercials and street organizing in exchange for favorable treatment in that bill. But that’s the past, and now they are fair game. President Obama telegraphed it when he attacked drug companies in his State of the Union. And why not? The idea that life-saving medicines are sold for a profit rather than given away as part of a humanitarian mission seems intuitively wrong to many Americans. So bashing drug companies is a great way to score political points. But it is a proven fact that the profit-motive is the most efficient and effective way to allocate resources ever devised. New miracle cures can cost billions of dollars to bring to market. Without a return on investment providing a return on capital that justifies those huge investments, many fewer cures will be developed and we’ll all be worse off. I opposed the Medicare prescription drug benefit bill. It largely displaced a well-functioning private market and there were no offsetting spending cuts to pay for it. It created a huge new unfunded liability for federal taxpayers. But it did successfully avoid one of the biggest dangers in a large government-run prescription drug program: the temptation to dictate below-market prices and risk undermining the profit-motive that incentivizes the development of new cures. It does that by relying on competing private plans. The plans compete intensely to sign up seniors. The incentives are aligned to avoid administrative waste and keep costs down, including negotiating for the best prices on drugs. An amazing 90 percent of seniors are satisfied with their coverage according to a recent survey. The latest cost estimates from the Congressional Budget Office (CBO) show that over the next 10 years the program will spend 45 percent less than the original estimate. And the premiums paid by seniors are also much lower, about $30 per month for the past three years, which is less than half the original projection. Yet Democrat Amy Klobuchar of Minnesota has introduced legislation that would require the Secretary of Health and Human Services to negotiate prices directly with drug manufacturers. A version of it is likely to be included in the Democrats’ budget and endorsed by the president. This is despite the fact that CBO director Doug Elmendorf shot down the idea in 2009 when he said “granting the Secretary of HHS additional authority to negotiate for lower drug prices would have little, if any, effect on prices for the same reason that my predecessors have explained, which is that private drug plans are already negotiating drug prices.” So there’s no reason to have HHS “negotiate” unless the word actually means something stronger and more dangerous. The only way centralized, government-controlled negotiations could lower prices further would be to restrict the availability of drugs or to impose price controls, which would undermine the incentives for research and development in the next generation of cures. Which means worse health outcomes and higher costs for the rest of Medicare. Instead of trying to bring more centralized control to the part of Medicare that’s actually working, Congress should focus on bringing the principles of competition and choice to the rest of Medicare. —————— Phil Kerpen is president of American Commitment  and and the author of Democracy Denied: How Obama is Bypassing Congress to Radically Transform America – and How to Stop Him. Phil Kerpen is a contributing author for the ARRA News Service.
Source: blogspot.com

Panel Calls For ‘Drastic Changes’ In Medicare Doctor Pay

The panel also took on the powerful Relative Value Scale Update Committee, (RUC) which is managed by the American Medical Association. The RUC influences how physicians are reimbursed through its recommendations to Medicare, which sets reimbursement rates and often follows its advice.  The panel joined a chorus of criticism that expensive, technology-heavy procedures such as surgery and imaging are overly encouraged by high payment rates. The report said the RUC’s dominance by specialists and the secretive way it operates are “seriously flawed.”
Source: kaiserhealthnews.org

FBI raid more about Medicare fraud than Sen. Bob Menendez.

“Any allegations of engaging with prostitutes are manufactured by a politically motivated right-wing blog and are false,” Menendez’s office said in a statement Wednesday, following the raid on Melgen’s clinics in West Palm Beach and two other South Florida locations.
Source: typepad.com

Why today's seniors object to the dissolution of Medicare

Privatization / corporatization of health care in the U.S. is the reason why our health care is prohibitively expensive, and can boast of only mediocre outcomes, at best. Nowhere else in the industrial world do citizens find themselves going bankrupt over medical care, and most industrial countries achieve substantially better health outcomes, and at lower cost, than we do. All Mr. Ryan’s plan will do is perpetuate our current dysfunctional system, with CEOs of health insurance companies being paid 7-figure salaries while nameless clerks deny coverage and the people they ostensibly “serve” find themselves having to choose between paying for food, or the mortgage, or clothing on the one hand, and paying off that hospital or doctor bill on the other, knowing that the “non-profit” hospital or physician may well take them to court if they choose to eat rather than pay for medical care.
Source: minnpost.com

Medicare Marketing on the Horizon

Posted by:  :  Category: Medicare

THE PEOPLES LEADER by SS&SSMany thanks to the Council on Aging of Greater Nashville for this alert:  The Open Enrollment Period for Medicare, including Medicare Part D (Prescription Drug Benefits) and Medicare Advantage Plans, has started. That means that seniors will be receiving information on the many available plans.  Seniors should stay alert for information that will be mailed about possible changes to their current Medicare plan. 
Source: wholecareconnections.com

Video: Airport Assistence – New Horizon Medicare India

Medicare: Did You Really Pay for That?

The amount that American workers have paid and are paying into Medicare isn’t enough to fund all the benefits that are being paid out to seniors under Medicare. The trustees of Medicare have stated that the promises they have made exceed their projected revenues by tens of trillions of dollars. Senator Tom Coburn (a physician in private life) has estimated that the average American couple contributes approximately $110,000 to Medicare over their working careers and receives over $330,000 of Medicare benefits. On Feb. 20, USA Today cited Urban Institute data pegging those same figures at $88,000 and $387,000, respectively. There are differing estimates of the size of the gap, but clearly Medicare suffers from an unsustainable funding deficit.
Source: catholicexchange.com

Ellison: Republicans Are Committed to Undermining Medicare

Only on Fox News could an elected official who embodies vox populi vox Dei get demeaned as the stereotypical “angry black man.” That’s what Sean Hannity tried to do, anyway. He didn’t succeed, though, because Keith Ellison refused to defer to him and his emotionally loaded questions. Rep. Ellison wouldn’t go along to get along.
Source: patch.com

CrummeyService.com Accepts Equity Investment

In order for a gift to a trust to qualify for the annual gift tax exclusion, currently $13,000 per beneficiary, the IRS requires trust beneficiaries to be given formal written notice of their right to withdraw the gifted amount if they choose to do so (Crummey v Commissioner, 397 F.2d 82 (9th cir 1968)). CrummeyService.com technology reminds the grantor to make the gift to the trust, notifies the beneficiaries of their right to withdraw the gifted amounts, and provides an independent third-party record of the entire process.
Source: lifesourcedirect.com

Potentially good news on the Medicare horizon : Getting Paid

Among the proposals that CMS estimates will have a positive impact on family physicians, two are most significant. One is that CMS proposes to use more current physician practice cost data in its calculation of practice expense relative value units. The other is that CMS proposes to increase the relative values of office visits and initial hospital visits in conjunction with a proposal to no longer recognize and pay consultation codes. CMS estimates that the impact of these changes would result in approximately an 8 percent increase in Medicare allowed charges for family physicians in 2010. Not surprisingly, the AAFP has commented in support of both proposals.
Source: aafp.org

Utah Medicare Plans….changes on the horizon?

Are there really changes on the horizon, did the recent legislation upheld by the Supreme  Court affect you. These are questions that I am afraid there are no current answers to at the moment, but I feel any and all changes to Utah Medicare rules and procedures will occur after the elections. As always we recommend you have a competent agent who specializes in Utah Medicare coverage to help answer your questions as they arise. Of course we are biased, but a good agent is always better than no agent.
Source: utahseniorservices.com

Our Health Policy Matters: Is Medicare for All on the Horizon?

This year, these and other states are proposing disturbing cuts to safety net health services.  Florida is considering a proposal to turn most state health services over to counties .  The Governor of Maine wants to remove 65,000 adults from the Medicaid program.  Louisiana just announced a new round of cuts to local mental health providers.  And Connecticut has begun denying some Medicaid coverage to kids with disabilities.
Source: blogspot.com

Why Private Medicare Plans Don't Cost Less

Posted by:  :  Category: Medicare

BITCH .. beautiful individual that causes hardons ...item 1.. Allen West calls Wasserman Schultz ‘vile’ and ‘not a lady’  (7/20/2011) ... by marsmet522Many contend that the government “overpays” for people enrolled in private plans, since traditional Medicare could have covered these patients for less money. But the reason it would have cost less is partly that the government has done a woeful job in figuring out how much to pay the private plans. The government compensates insurers based on the health of their enrollees at the start of the year. Plans with healthier patients receive less money than those with sicker ones to reflect the likelihood that healthier people will use less care. Healthier patients enroll in Medicare Advantage plans, so in, principle, plans should be reimbursed less by the government for enrolling these patients (the technical term for this process is “risk adjustment”). But for decades, the government has failed to determine who is healthy and who is sick with any precision, with the result that private plans receive larger payments to cover their patients’ costs than necessary. This botched payment system gives insurers an incentive to spend more time selecting the healthiest patients, and less time treating them more efficiently.
Source: nytimes.com

Video: How Much Does a Medicare Advantage Plan Cost?

A Plan To Fix Cancer Care

Written with: Amy P. Abernethy, M.D., Duke University; Justin E. Bekelman, M.D., University of Pennsylvania; Otis W. Brawley, M.D., American Cancer Society; Robert L. Erwin, Marti Nelson Cancer Foundation; Patricia Ganz, M.D., U.C.L.A.; James S. Goodwin, M.D., University of Texas Medical Branch; Robert J. Green, M.D., Palm Beach Cancer Institute; Jesse Gruman, President, Center for Advancing Health; J. Russell Hoverman, M.D., Ph.D., Texas Oncology, United States Oncology; John Mendelsohn, M.D., MD Anderson Cancer Center; Lee N. Newcomer, M.D., UnitedHealth Group; Jeffrey M. Peppercorn, M.D., M.P.H., Duke University; Scott D. Ramsey, M.D., Ph.D., Fred Hutchinson Cancer Research Center; Lowell E. Schnipper, M.D., Beth Israel Deaconess Medical Center; Frederick M. Schnell, M.D., Central Georgia Cancer Care; Deborah Schrag, M.D., Dana-Farber Cancer Institute; Ya-Chen Tina Shih, Ph.D., University of Chicago; John D. Sprandio, M.D., Consultants in Medical Oncology and Hematology; Thomas J. Smith, M.D., Johns Hopkins University; Arthur P. Staddon, M.D., Pennsylvania Oncology Hematology Associates; Jennifer S. Temel, M.D., Massachusetts General Hospital
Source: nytimes.com

Why today's seniors object to the dissolution of Medicare

The motives of Ryan and his supporters are transparent. Under the guise of mitigating the deficit, they are attempting to make serious and significant social reforms in our country by eliminating government programs they dislike, and privatizing all that they are able to.  Medicare seems an easy target. Yes, it has some fiscal challenges, but the Ryan solution to destroy it in favor of a private program is not only less desirable to seniors but also had it own suspect cost projections; and it did not fly with those whom the program now serves.  Instead, today’s seniors bought into the better idea of not only preserving Medicare, but accepting tweaks and changes that would make it more fiscally viable for the future.
Source: minnpost.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

NAIC Cautions Obama Administration Against Added Cost Sharing in Medigap Plans 

“One in five people with Medicare choose a Medigap plan to help cover Medicare cost-sharing and other health care costs not covered by Medicare. Most of these beneficiaries have modest incomes. Many are poor. Introducing further cost-sharing in Medigap plans would create a significant financial burden, but that’s not all. When required to pay beyond their means, people skip needed medical care and treatment, leading to poor health outcomes, increased emergency room visits and hospitalizations,” said Judith Stein, Executive Director of the Center for Medicare Advocacy, Inc.
Source: medicareadvocacy.org

Automatic Budget Cuts Lead GOP To Sharpen Focus On Medicare Cost

The Medicare NewsGroup: Automatic Cuts Are Underway: A Primer On Sequestration And The Impact On Medicare Doctors, hospitals, insurers and other health care providers will be subject to the cuts starting April 1. Some parts of the government are subject to bigger cuts, while others, such as Medicaid, are exempt. But if a deficit reduction deal is eventually reached it could still result in cuts to Medicare. Providers may not escape unscathed in such a deal and it could have a direct impact on beneficiaries. President Obama is open to increasing the Medicare Part B and D premiums paid by higher-income beneficiaries, while House Speaker John Boehner proposed raising the Medicare eligibility age from 65- to 67-years-old during the fiscal-cliff standoff last December (Sjoerdsma, 3/1).
Source: kaiserhealthnews.org

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

Obama's Medicare Cost

“They’ve planted a thousand seeds and are hoping one or two of them will bloom,” said Marc Goldwein, senior policy director for the Committee for a Responsible Federal Budget, a nonprofit Washington group. To contact the reporter on this story: Mike …
Source: newamerica.net

Massachusetts Elder Law Attorney

The Medicare provisions in the Relief Act are not as harmful to the program as many of the dangerous proposals offered to Congress over the past few months.  There have been proposals made to double look back periods and decrease Medicare and Medicaid benefits.  Drastic cuts are still on the table as policy-makers seek to address the looming sequestration and debt ceiling with savings from health care programs. For real health savings that address the underlying problem of health care costs system wide, policy-makers and advocates should begin with solutions that improve the health and well-being of Medicare beneficiaries while preserving the Medicare program for those who depend on it now and in the future.
Source: estateplanandassetprotection.com