Competitive Bidding for Medicare Can Save Money

Posted by:  :  Category: Medicare

Eliminate medicare advantage - Health care reform rally at San Francisco City Hall by Steve RhodesI agree with you Frank, lowering costs with same service and products, the current bid system cannot do this. How many times have you bid and then said, no I was only kidding? The bids are non-binding. 167 Economist against current bid system. http://www.cramton.umd.edu/papers2010-2014/comments-of-concerned-auction-experts-on-medicare-bidding.pdf I am for Market Pricing Program which they are trying to run through legislation now. http://www.cramton.umd.edu/papers2010-2014/market-pricing-program-legislation.pdf The goals for this CB are to lower costs, provide excellent service, provide name brand quality products and eliminate fraud. Home care is the most cost effective way to care for Medicare beneficiaries; however product and services are going to suffer under the latest round of bidding using this flawed method.
Source: patch.com

Video: Medicare HMO-POS Explained – Rob Merritt interviews Tony Prince in Laguna Woods, CA

Manning Conference III: The right's strategies for dominating cities and wrecking medicare

David Climenhaga, author of the Alberta Diary blog, is a journalist, author, journalism teacher, poet and trade union communicator who has worked in senior writing and editing positions with the Toronto Globe and Mail and the Calgary Herald. His 1995 book, A Poke in the Public Eye, explores the relationships among Canadian journalists, public relations people and politicians. He left journalism after the strike at the Calgary Herald in 1999 and 2000 to work for the trade union movement. Alberta Diary focuses on Alberta politics and social issues.
Source: rabble.ca

Medicare Trustee Warns Against State Expansion of Medicaid

Mills continued to warn about the risks to the economy of the program, but in the end, he rationalized that it would be good for the Democratic Party. He argued that Social Security itself was not sustainable and that the expansions would bankrupt the country.  Mills was correct in his analysis, although his time frame was optimistic.  He projected that Social Security, Medicare and Medicaid would cost only $12 billion by 1979.  But by 1979, the total federal cost of the Social Security Acts (including Medicare and Medicaid) topped $1 trillion (in 2010 dollars). And it is important to note that Medicaid is both a federal and state program, and federal costs represent only about one-half of actual expenditures.
Source: capoliticalreview.com

How Obamacare Will Affect Medicare Recipients in 2013

David, I sure wish you folks would come clean on the tough issues! Especially, now that you don’t have to worry about re-election again: More specifically, end-of-life treatment plans/living wills. A medicare financial expert on one of the financial news channels indicated that he suspected, "if everyone just documented their wishes for final care, we would save enough money to balance the federal budget". I believe there is fair consensus among experts that 25% of Medicare funds is spent on people in their final months of life. The suspicion is that most of us would say something to the effect: "When it’s my time just make me comfortable" versus the situation now which is, ‘without judgment, how can we keep this person alive?’. Would it be too much to ask every American to document their desires so that surviving family members don’t have feel like they are making life and death calls for a loved one?
Source: patch.com

Blog: How Medicare Works with Other Insurance

Medicaid and TRICARE (the healthcare program for U.S.armed service members, retirees, and their families) never pay first for services that are covered by Medicare. They only pay after Medicare, employer plans, and/or Medicare Supplement Insurance (Medigap) have paid.
Source: patch.com

State disability center forfeits funding over abuse

In particular, the Sonoma center had evidence of a dozen sexual assaults, but police investigators failed to order a single hospital-supervised examination for the alleged victims. Those reported assaults, all from the Corcoran unit, represent a third of the 36 documented cases of sexual abuse and molestation in the past four years at the state’s five developmental centers.
Source: californiawatch.org

Labor’s Edge Blog : State

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Source: calaborfed.org

California Medicare Coalition, CMC Meetings

The CMC holds periodic meetings and statewide conference calls. Every meeting or call features a special presentation addressing an important and timely topic in Medicare by knowledgeable experts on Medicare, managed care and health insurance issues. In addition, representatives from the Centers for Medicare and Medicaid Services (CMS) and the Social Security Administration are present to share updates and answer questions.
Source: cahealthadvocates.org

GOP plan would raise Medicare age, lower Social Security COLAs, while raising $800B in revenue

Here at Maclean’s, we appreciate the written word. And we appreciate you, the reader. We are always looking for ways to create a better user experience for you and wanted to try out a new functionality that provides you with a reading experience in which the words and fonts take centre stage. We believe you’ll appreciate the clean, white layout as you read our feature articles. But we don’t want to force it on you and it’s completely optional. Click "View in Clean Reading Mode" on any article if you want to try it out. Once there, you can click "Go back to regular view" at the top or bottom of the article to return to the regular layout.
Source: macleans.ca

Medicare reduces readmission penalties for most hospitals

The Medicare program has reduced financial penalties to more than 1,200 hospitals with excessive readmissions, Kaiser Health News reported. The reductions stemmed from a second correction of the formula for calculating penalties. Although most of the adjustments were slight, some hospitals saw significant reductions. The big winner of the latest adjustment was St. Claire Regional Medical Center in Morehead, Ky., which saw its penalty drop from 0.93 percent to 0.72 percent of every payment Medicare makes for a patient admitted to the hospital. >> Read the full article at FierceHealthcare
Source: fiercehealthfinance.com

Viewpoints: Two Views Of Medicare Equipment Bidding Changes; High Court Case May Impact FDA Approval Process

Posted by:  :  Category: Medicare

Friends of Medicare Healthcare Rally by dave.cournoyerKansas City Star: Renew KC’s Vital Health Levy For Indigent Care Compassionate Kansas City voters approved a property tax increase in 2005 to help provide medical care for thousands of indigent people and operate the city’s ambulances. The need for those crucial health care services still exists. The Star recommends a yes vote on Question 1 on April 2, to renew that property tax through 2023. … If Missouri legislators refuse to take hundreds of millions in federal funds for better Medicaid coverage — an unfortunate possibility, given GOP intransigence on the matter — Truman (Medical Center) in particular could sustain a severe financial hit. Keeping the full health levy in place would be a smart move for taxpayers and a crucial investment in better health for the entire community (3/16).
Source: kaiserhealthnews.org

Video: FLASHBACK 2010: President Obama Agrees with Rep Paul Ryan on Medicare Reform.

New AMIC Survey Data Shows 2010 Medicare Payment Cuts Forcing Physician Practices and Imaging Providers to Reduce Patient

In the past, the Obama Administration has proposed using RBMs in the Medicare program.  However, the Department of Health and Human Services (HHS)  previously weighed in on prior authorization in the Medicare program, noting in 2008 that a prior authorization program could be “inconsistent with the public nature of the Medicare program,” since such programs rely on private companies using proprietary systems to deny care prescribed by a physician.  HHS also noted that the Medicare appeals process guaranteed to every beneficiary could overturn a “high proportion” of denials, rendering the policy ineffective.  In an environment of reduced reimbursements, the AMIC survey further demonstrates that application of RBMs is an ineffective model imposing unnecessary administrative costs on practices, thereby creating artificial barriers for patients in need of care.
Source: rightscanrighttime.org

Medicare Reimbursement for Ambulance Servcies

The ambulance fee schedule system currently contains two permanent and three temporary add-on payment policies. The permanent add-on policies are written into law without an expiration date and include: 1) the rural short-mileage ground ambulance add-on payment policy, which increases the standard mileage rate by 50 percent for ground ambulance transports if the pick-up ZIP code is rural and the mileage is between 1 and 17 miles; and 2) the rural air transport add-on payment policy, which reimburses providers and suppliers 50 percent more than the urban air ambulance base payment and the mileage rate if the point-of-pickup ZIP code is rural. The temporary add-on payment policies are written into law with expiration dates and include: 1) the ground ambulance add-on payment policy, which increases the base payment and mileage rate for ground transports by 3 percent for transports originating in rural ZIPs code and by 2 percent for transports originating in urban ZIP codes; 2) the super-rural add-on payment policy, which increases the base payment for ground ambulance transports by 22.6 percent where the point-of-pickup ZIP code is designated as super-rural; and 3) the air transport rural grandfathering add-on payment policy, which extends the benefits of the 50 percent add-on payment for air ambulance transports to urban areas that were formerly designated as rural. All Medicare ambulance transports are eligible for one of the five add-on payment policies, and many are eligible for multiple add-on policies if they originate in rural ZIP codes.
Source: healthcare-economist.com

GAO finds CMS negligent in risk adjustment for Medicare Advantage plans

Risk adjustment is important to ensure that payments to MA plans adequately account for differences in beneficiaries’ health status and to maintain plans’ financial incentive to enroll and care for beneficiaries regardless of their health status. Our work confirms that differences in diagnostic coding caused risk scores for MA beneficiaries to be higher than those for comparable beneficiaries in Medicare FFS in 2010, 2011, and 2012. CMS’s decision to use a 3.4 percent adjustment to risk scores for 2010 through 2012 instead of the higher adjustments called for by our analysis resulted in excess payments to MA plans. The existence of such excess payments indicates that CMS’s adjustment does not accurately account for differences in treatment and diagnostic coding between MA plans and Medicare FFS—the stated goal of the statute that required CMS to develop a diagnostic coding adjustment. In our January 2012 report, we recommended that CMS take steps to improve the accuracy of the adjustment to account for excess payments due to differences in diagnostic coding. We noted that CMS could, for example, account for additional beneficiary characteristics, include the most recent data available, identify and account for all the years of coding differences that could affect the payment year for which an adjustment is made, and incorporate the trend of the impact of coding differences on risk scores. CMS’s adjustment for 2013 is the same as it used in 2010, 2011, and 2012. However, given our finding that this adjustment was too low and resulted in estimated excess payments to MA plans of at least $3.2 billion, we continue to believe that it is important for CMS to implement our recommendation that it update its methodology to more accurately account for differences in diagnostic coding.
Source: pnhp.org

New report shows importance of Social Security and Medicare to Hawaii’s small businesses

“Workers and their employers alike want people to have the ability to retire with dignity and independence after a lifetime of work,” said Nancy Altman, founding co-director of Social Security Works.  “The Main Street Alliance recognizes, as all Americans should, that our Social Security system is the most efficient, fair and secure method or providing retirement security for workers and their families.  Social Security works, not just for beneficiaries and their families, but for all employers, as well.”
Source: hawaiireporter.com

Projected Medicare Spending Already Came Down by Half a Trillion

That’s important to remember because it was in late 2010 — and based on CBO’s August 2010 projections — when Fiscal Commission co-chairs Erskine Bowles and Alan Simpson issued their original budget proposal, calling for slightly more than $300 billion in Medicare spending cuts through 2020. The original Bowles-Simpson proposal is often considered an appropriate starting point in evaluating whether other deficit-reduction proposals should be viewed as responsible approaches to the deficit problem.
Source: firedoglake.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

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

CBO May Have Underestimated Medicare Savings By Over $300 Billion

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Source: samuel-warde.com

Medicare Supplement GI Thread

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSRather 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

Video: Medicare Supplemental Insurance | Medicare Benefits Direct

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:   How MAny caPitaL leTTeRs arE in tHis queStioN? Agree to forum rules 
Source: insurance-forums.net

Medicare Supplemental Health Insurance Insurance Plans Are Usually Friend Of Somebody After 65

Senior citizens receive a very lot of older care benefits not to mention Social Security is actually just one out of them. Online Security is solitary of the big term benefits that experts claim the elderly are given as well simply because medicare. Finding benefits usually sets out at age over 60 and continues at some point the death from the individual. Usually this can a long times approach, being released out in long period. This network is paid over by everyone that a lot of works. Just about every paycheck has that little money harnessed out of the device and at how the age of retirement, then the person will have hard earned cash every month to live on. Consider it of adaptive energy’, traditionally called really force’, has its equivalent in Chinese medicine, namely Qi (pronounced chee’). Theory states that adequate production and additionally utilization of Chi is underpinned from body’s genetic or inherited energy, termed Jing. Herbs that increase Chi are called Chi tonics and folks who supplement Jing are Kidney-meridian tonics. Info is available by your state health insurance plan coverage assurance program together with state insurance unit. Phone numbers for these departments and / or programs in equally state can be found in the publication. The Medicare Supplements market is a powerful ever-changing one. New plans with better benefits tend to be being developed consistently. Senior citizens enrolled in the Medicare are angling towards Are Medicare Supplement Plan F Policies Now Obsolete in 2014 ?, together with Medigap, plans as well as more every day to obtain even better health coverage. With Medicare definitely covering 80% having to do with their medical expenses, Medigap plans end up being saving seniors a good number of dollars that may possibly normally be bought it for out-of-pocket. On one occasion enrolled in Treatment Part A and B, members hold the opportunity to signup for one to the secondary rrnsurance policies plans at the instant. While there is an open signing up period, it is not a requirement that one enroll at the time of that time. Our own new healthcare.laws are generally going to remodel taxes for some Americans, but for the majority of all America it definitely have a tranquilizing effect in in which it will escalate patient care, make it possible for doctors treat people and enable all the whole of American people to finally have access on the way to healthcare. Health concerns will mostly affect the highest earners in America. A married small number who earn 0,000, which is divide evenly between wages and capital gains, their total paid income would are more subject to the combined 2.9 fraction Medicare tax, which is split consistently between employer and employee. And in addition their first 0,000 in capital gains would not come under the Medicare health insurance tax; however, some couple would have to pay 2.8 percent Medicare tax on the entire ,000. Medigaps Plan A as J have raised premiums compared at K and L. there can be virtually no out-of-pocket cost. Unquestionably the basic benefits perhaps may be fewer than G and L, on the contrary the extra extra benefits are higher, regarding the likes on preventive care additionally foreign travel emergency. Similar to most countries where senior and gravely handicapped citizens are entitled to free health services, senior American citizens, the disabled and a specific class patients get limited insurance plans from the federal government. Since the criterion Medicare does not necessarily quite cover other expenditure like deductibles, Medicare supplement plans come when handy to salvage the health care needs of all of these senior citizens. For sharp contrast, a person of the finest marketing failures that many can have greatly harmful complications meant for those over sixty-five surrounds Medicare. With multiple parts, two deductibles, part coverage (only 70 percent) for doctors’ services, no cover at times (such as when you travel outside in the U.Exercise.) and no reconciliation when doctors charge ahead of what Medicare can pay, Medicare is literally a maze out of contradictions. Strategies about how do seniors determine and plan to work with their health want costs? Entirely too often seniors and disabled men or women make the gaffe of believing who Medicare is everyone the health insurance policy plan that they need to have. They include unaware of the type of benefits associated through Blue Cross related to Texas Medicare enhancers insurance. Hiring out about an gaps in Medicare coverage the laborious way provides a superb immediate root awareness to the need for supplemental insurance to help coverage the unexpected premiums of healthcare. Medicare has proven to be an actual great program and furthermore has allowed scores of individuals to receive the well care they need to in a mostly affordable way. Problems arise, however, when an individuals health care has to have go beyond exactly how Medicare covers.
Source: typepad.com

The importance of Medicare Supplemental Insurance

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Source: medicalnoises.com

Why Medicare Cards Still Show Social Security Numbers

Posted by:  :  Category: Medicare

What's In My Bag... by Amy DiannaIn a report issued in 2006, C.M.S. said it would cost $300 million to remove SSNs from Medicare cards. Then, in an updated report last November, it said it would cost at least $803 million, and possibly as much as $845 million, depending on the option chosen. Much of the cost, the agency said, was for upgrading computer systems not only at the federal level, but also at the state level, for coordination with Medicaid systems.
Source: nytimes.com

Video: The Medicare Common Access Card Explained

Warning: Medicare Card Scam Afoot

Leigh Ann Otte is a freelance writer who specializes in health and aging issues. She covers finding and paying for senior care for OurParents. If you have any questions about this post or need help finding senior-care options for a loved one, call 1-866-483-4896 to speak with a care advisor in your area.
Source: ourparents.com

Scam Targets Medicare Card Information 

badgercare plus Better Business Bureau charity scams credit card fraud credit card scams election fraud false claims act fraud fraud alert newsletter Frauds healthcare reform identity theft job scams medicaid fraud Medicare medicare fraud medicare overbilling medicare part D medicare reform mortgage fraud phishing scams podcasts prevent medicare fraud scams storm chasers storm scams telephone scams Training volunteer voter fraud wisconsin bbb wisconsin better business bureau wisconsin check fraud wisconsin child care fraud wisconsin election fraud wisconsin fraud wisconsin head start fraud wisconsin medicaid fraud wisconsin mortgage fraud wisconsin scam wisconsin scams wisconsin smp wisconsin smp training wisconsin unemployment benefits wisconsin unemployment fraud
Source: wisconsinsmp.org

Medicare Calls Fishing for Personal Information

If you’re concerned about carrying a card that has your social security number on it, you can protect yourself. Make a copy of your Medicare card and then black out the last four digits of your social security number. It’s important that you don’t harm your original card, so make sure you make a copy first. RELATED: More Reports By 4 On Your Side Consumer Investigator Jodi Brooks
Source: cbslocal.com

Don’t fall for Medicaid card renewal phone calls

Tips from a study at USC (http://n.pr/UKyFOT). • Compare reviews not only within a site, but across different websites. • Reviews by people who are verified by the site are more trustworthy than reviews by anonymous reviewers — especially when it comes to negative reviews. • Read reviews less for whether they give a hotel or a restaurant one star or five stars, but more for the specific information they give about the experience. • Reviews are very useful for information that experts or merchants might not think to provide — how late a swimming pool stays open could be useful if you are traveling with a family. • Focus on aggregates, not outliers. You can’t trust a handful of bad reviews or glowing reviews, but trends are much harder to fake.
Source: wordpress.com

Medicare fraudsters reach out to seniors

• Contact your bank or other financial institution immediately if you make a mistake and give out personal information, such as your Social Security number or bank account information. Think twice about disclosing to a stranger where you go to church or shop. A fraudster might start going to the store or church that you mention to try to take further advantage of you.
Source: triblive.com

Police: New Medicare Scams Target Seniors

Officer Tammie Colling of Northfield Township said in some instances the caller contacts a senior and claims to be with Medicare, informing the senior that they will be receiving a new Medicare card in the mail. The caller advises that a direct deposit system needs to be set up so the Medicare funds can be deposited into the victim’s bank account. The caller then requests the senior’s banking information. Another variation of the scam, according to Colling, involves callers asking the senior to verify his or her identity in order to receive the new card. The caller requests the current Medicare card number, which is the same as the victim’s Social Security number. After a few more questions regarding personal information, the caller is able to steal an individual’s identity.
Source: patch.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

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

Medicare card scam pops up in WI

Remember that representatives with the Medicare program will never call you to verify personal information.  If you receive a call about a replacement Medicare card, hang up immediately.  If you or a family member receives a similar call and turns banking information over to the caller, you should immediately contact your bank and inform them of the situation.  The bank may choose to close the account and issue you a new account number.
Source: dewittmedia.com

Medicaid Eligibility in Texas

Posted by:  :  Category: Medicare

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

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

Raising Medicare age would hurt seniors and the economy

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

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

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: 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

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

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

Seniors should tell Obama to prevent Medicare Advantage cuts

Posted by:  :  Category: Medicare

Medicare for All by juhansoninWhen 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

Video: New Medicare Preventive Services National Provider Call 8/15/12

Conservative Medicare Reform is a Must

Medicare’s current structure determines the way it functions. It also entails certain undesirable consequences. For example, it requires Medicare beneficiaries to pay additional premiums and purchase supplemental coverage; employs price controls to control costs that often result in underpayment or overpayment for medical goods and services; places massive levels of detailed regulation on doctors, hospitals, and other medical professionals; generates tens of billions of dollars annually in waste, fraud, and abuse; and uses an administrative payment system that, as an arena for special interest lobbying, results in the politicization of decisions over health care financing and delivery for America’s senior and disabled citizens.
Source: heritageaction.com

Medicare Studies Cost of Long

As a resident of Santa Cruz, and a healthcare insurance agent that networks w/ the long-term caregiving community, these numbers do feel about right. Folks in Santa Cruz have good access to palliative and hospice care. Acute care happens in hospitals and we have those, too. If these numbers are accurate, it will be instructive for us to share ways to keep Medicare and Medi-Cal functioning into the Baby Boom age wave.
Source: californiahealthline.org

CMS Issues Proposed Rule Impacting FQHC Medicare Service Rules

“Physician means a practitioner who meets the requirements of sections 1861(r) and 1861(aa)(2)(B) and (aa)(3)(B) of the Act and includes (1) a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which the function is performed; and (2) within limitations as to the specific services furnished, a doctor of dental surgery or of dental medicine, a doctor of optometry, a doctor of podiatry or surgical chiropody or a chiropractor (see section 1861(r) of the Act for specific limitations).”
Source: nachc.com

Group Recommends Replacing Medicare Fee

The Commission noted that the rising cost of health care in the U.S. can be tied to the amount that physicians are being paid. The U.S. spends more on health care than any other developed country, the Commission reported, nearly $3 trillion per year—18 percent of the domestic product or $8,000 per person. The Commission noted that spending on Medicare has risen from 3.5 percent of gross domestic product (GDP) in 1975 to 15.1 percent in 2010 and is projected to reach 17 percent by 2020. Despite this increased spending the Commission reports that the World Health Organization ranks the U.S. 37th in health status behind countries like Oman, Morocco and Paraguay.
Source: wolterskluwerlb.com

Federal Liberals to shut down Medicare Locals and cut healthcare services

Responding to a question asked by in Parliament by Mr Husic, Health Minister Tanya Plibersek confirmed that the “bureaucrats” the Liberal Party would sack from Medicare Locals include frontline health workers such as doctors, nurses, psychologists, and speech pathologists.
Source: edhusic.com

Congressman Ryan: Stop Playing Politics With Our Healthcare System

I think about last year when she fell at home. She was in hospital for a brief time and needed to regain her strength before she went back home. She was able to go for a brief stay at a nursing facility and then go back home and receive at home assistance through Medicaid and Medicare. It was really important for her to be able to live independently, and I really understand that. To her that is quality of life. I don’t know what my family would have done without those services. Even though I am a nurse, I could not provide that quality of care and still manage my job and my other family responsibilities. This is my grandmother and my story, but she is like your grandmother or a lot of the elderly patients we see in the hospital.
Source: seiu.org

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 B Rebilling: Centers for Medicare and Medicaid Services Releases Proposed Rule

The proposed rule allows hospitals to submit a Part B inpatient claim when a Part A claim is denied as not reasonable and necessary because the beneficiary should have been treated as an outpatient. The proposed rule also allows hospitals to submit a Part B inpatient claim when the hospital determines post-discharge that the patient’s inpatient admission was not reasonable and necessary.  However, hospitals must rebill CMS within one year of the date of service in order to take advantage of this Part B inpatient rebilling option.
Source: vonbriesenhealth.com

Report: Geographic Medicare Spending Gaps May Be Due to Waste, Overuse

A study by the Institute of Medicine examining geographic differences in Medicare spending found the variations may be due to waste or unnecessary procedures, but cautioned policy makers against cutting rates to high-cost regions. The report, authored by the IOM’s Board on Health Care Services and titled “Geographic Variation in Health Care Spending and Promotion of High-Value Care – Interim Report,” analyzed three decades of research into spending differences in 306 hospital-referral regions. Researchers found wide Medicare spending disparities between and even within regions that couldn’t be attributed to residents’ age or health status. Wasteful spending or unnecessary services could be the cause, which could lead some policy makers to recommend that CMS cut payment rates to regions on which it spends a disproportionate amount of Medicare dollars, so that these providers would be driven to lower costs. However, the authors of the study warned that blanket cuts to high-spending regions could penalize quality care and thrifty decision-making by some providers. Rather, the authors stated payment adjustment programs for specific high-cost providers may be more effective at lowering costs and waste instead of geographic-based payment reductions.
Source: beckershospitalreview.com

Today’s NewsStand (March 22, 2013)

Posted by:  :  Category: Medicare

DC Voting Rights by dbkingIowa’s Medicaid money runs out in June without supplemental funds State funding for Medicaid is slated to run out in early June, putting additional pressure on state lawmakers to resolve an ongoing impasse over language dealing with public funding of abortions that has stalled work on the health and human services budget piece this session, officials said Thursday. (Waterloo-Cedar Falls Courier)
Source: iowahospital.org

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

What’s The Difference Between Medicare And Medicaid?

Unlike Medicare, which is available to everyone, Medicaid has strict eligibility requirements. The rules vary by state (beyond the basics set forth in the federal guidelines), but the program is designed to help the poor, so many states require Medicaid recipients to have no more than a few thousand dollars in liquid assets to participate in the program. There are also income restrictions. For a state-by-state breakdown of eligibility requirements see these websites Benefits.gov and BenefitsCheckUp.org.
Source: investopedia.com

Los Angeles Bilingual Member Service Representative

·        *Current working knowledge of Medicare Managed Plans ·        * Commercial Insurance or Medi-Cal experience a PLUS ·        *Two years medical customer service experience ·        *Managed Care Experience a PLUS ·        * Bilingual required (Spanish) *Represents basic qualifications for the Member Service Representative.  To be considered for this position you must at least meet the basic qualifications.
Source: matfar.com

What we can do to stop Medicare waste and fraud

I don’t know how much waste there is in Pahrump on medical care, but from experience, I know there is a considerable amount. Let’s assume hypothetically that Medicare spends $100 million per year for health care in Pahrump. Then, let’s assume that $30 million is spent on unnecessary procedures. Then assume $5 million in salaries for the chief and his/her assistants.  Then let’s assume $5 million for overpricing of drugs, malpractice and fraud. According to this, and this is illustrative only, there is $40 million charged to Medicare, which is a total waste. Here is how we could save millions in Pahrump alone. We simply have a medical provider supply us with all necessary medical care for a flat rate of  $60 million per year. The doctors and staff would be paid fixed salaries regardless of the number of surgeries, regardless of the number of tests and regardless of how long the patients stayed in the hospital. No money would be spent on billing for patient services, because that would all be covered by the flat rate. We now have three times the amount of surgeries that England has. I wonder why?  There would be no financial incentive for hospitals or doctors to order unnecessary tests or surgeries. For malpractice we could eliminate  the courts and replace the system with a three-person panel: an MD for the patient, an MD for the medical provider and an independent member of the panel who would have both a license for medicine and for law like maybe Ms. Lord, here in Pahrump, who I understand has two such qualifications. Of course, a decision could have an appeal to a higher level.
Source: pvtimes.com

Personnel Requirements of a Florida Home Health Agency

Being licensed as an MD, PA or RN is easy enough to verify. However, qualifying as an Administrator by having “at least 1 year of supervisory or administrative experience in home health care” can be a fairly subjective. The Agency for Health Care Administration (AHCA) requires this experience to be demonstrated through a resume. Simply stating that the prospective Administrator was “supervisor at WYZ Home Health Agency” may not suffice. In the case of experience, more is always better, so the prospective Administrator should provide details of the type of supervision that was provided and the type of personnel supervised. Similarly, administrative experience should be clearly described. Supervision or administrative responsibility over non-direct care personnel generally will not satisfy the qualification requirements, because the Administrator of a home health agency is responsible for the daily operation of the agency. Such responsibilities include interaction with skilled medical care providers, detailed knowledge of state operational laws and rules, as well as Medicare Conditions of Participation, if the agency will provide those services.
Source: askccg.com

2012 Poverty Guidelines: How Poverty Levels Affect Eligibility for Many Federal Public Benefit Programs 

Unlike rules for Medicare Savings Programs, which allow (but do not require) states to measure income against the amount for a family unit of only one or two, eligibility rules for  Part D subsidies recognize larger family units, to the extent that those family members rely on the applicant or her spouse for one half of their financial support.  To calculate the levels for larger family units, start with the yearly amount for one ($11,170), add $3,960 for each additional family member, multiply by the applicable percentage of poverty (135% or 150%) and divide the result by 12 for a monthly amount.
Source: medicareadvocacy.org

ODs can earn dual bonuses under new Medicare EHR

Health care practitioners who qualified for bonuses through the Medicare Electronic Health Records (EHR) Incentive program during 2012 may also qualify for 2012 payment bonuses under the Physician Quality Reporting System (PQRS), if they enroll in the new Medicare PQRS-EHR Incentive Pilot Program by Feb. 28, 2013, according to the U.S. Centers for Medicare & Medicaid Services (CMS).
Source: newsfromaoa.org

Medicare Health Insurance Supplemental Insurance Is The Best Guarantee For Old Age Category

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSOne comes across all the types of insurance, Medicare supplement coverage attributes amongst these. It is forever better to be sharp when it is about the Medicare supplement health insurance because there have proven to be stable changes regarding insurance policy; ordinarily a change for better however at instances when it is not. It is significant to monitor these types of varying trends pc previously on Medigap insurance or ought to register for equivalent. There is an important in order to a plan; perhaps even since the techniques are being modified, the companies will most certainly be commencing to quote the new rates. This is the primary step among change ever since 1992.
Source: wordpress.com

Video: Medicare Supplement Quotes

Healthcare Costs in Retirement

A household may have the expense of premiums for Medicare Part B (which covers physician and outpatient services) and Part D (which covers drug-related expenses). Typically, Part B and Part D are taken out of a person’s Social Security check before it mailed, so the premium cost is often overlooked by retirement-minded individuals. The household should expect to pay for co-payments related to Medicare-covered services that are not paid by Medigap or other health insurance. The retired household should expect to pay for dental care, eyeglasses, and hearing aids, which are typically not covered by Medicare or other insurance programs.
Source: lccapital.net

Brad DeLong : Remember, the Dormouse Says Medicare Is the Best

Disenrolled from fee for service Medicare – and unable to keep the surgical follow-up appointment from a surgeon who takes Medicare assignment but does not participate in Medicare Managed Care – and moved to a Medicare Managed Care rehab funded facility, Alice was advised that this was her problem to unravel. Her new Medicare Managed Care insurance plan vacillated between advising her she was not an enrollee in their plan and advising that, even were she an enrollee, no follow up post-surgical appointment was necessary….
Source: typepad.com

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

Medicare Health Plans and Dually Eligible Beneficiaries: Industry Perspectives on the Current and Future Market

The brief is based on interviews with senior executives at 13 large firms that contract with the Medicare and Medicaid programs and finds almost all of the insurers expect dually eligible beneficiaries will become more important to their business over time. The brief also looks at how insurers currently serve dually eligible beneficiaries, particularly through Special Needs Plans that are part of the Medicare Advantage program.
Source: kff.org

Medicare Revises Readmissions Penalties – Again

The penalties have not been popular with hospital executives, with many complaining that they are excessive and unfair to hospitals with large numbers of low-income patients, who tend to be readmitted more frequently. In an article this month in the New England Journal of Medicine, two Harvard professors who have been critical of the program, Drs. Karen Joynt and Ashish Jha, urged changes, writing that the program “will penalize hospitals that care for the sickest and the poorest Americans, largely because readmissions are driven by the severity of underlying illness and social instability at home.”
Source: kaiserhealthnews.org

I’m Self Employed…Do I Have to Enroll in Medicare’s Part B? » Toni Says

Posted by:  :  Category: Medicare

In honor of Tax Day by swanksalotGreat Medicare question, Bill…Last week, I consulted with a person that is also self-employed, but was given wrong advise from a well-meaning friend about delaying his Part B.  His Medicare nightmare is now starting…Medicare does not recognize individual plans as creditable cover for delaying your Part B.  Now this fellow who is 66 will receive not only a 10% penalty for each year due to not enrolling in Part B at the right time, but a 20% penalty (2 years 65 and 66) each month for as long as he is on Medicare or should I say the rest of his life. The 20% penalty goes up as the Part B premium changes.  Stinks doesn’t it!!
Source: tonisays.com

Video: Medicare

Proposed Regulations Explain 3.8 Percent Medicare Tax on Net Investment Income : The Venture Alley : Entrepreneurs, Startups, Venture Capital, Angel Investors

These proposed regulations, released at the end of November along with accompanying frequently asked questions, provide taxpayers and their advisors much needed guidance in interpreting the statutory provisions imposing this tax. Despite application of the tax beginning in 2013, the effective date of the proposed regulations has been delayed until January 1, 2014. To assist taxpayers, the IRS has stated that taxpayers may rely on the proposed regulations for compliance purposes until publication of final regulations under Section 1411, which is anticipated to occur during 2013. The proposed regulations indicate that the IRS will closely review transactions that manipulate a taxpayer’s “net investment income” to reduce or eliminate the amount of tax imposed by Section 1411 and will challenge such transactions based on applicable statutes and judicial doctrines. Therefore, careful tax planning to accommodate this new tax is essential. Among other things, these proposed regulations provide definitions of operative phrases and terminology in the statute, indicate where definitions used elsewhere in the Code should be incorporated into the statute, identify how certain entities are treated under Section 1411, expand income categories potentially subject to the tax, allow taxpayers to regroup activities with respect to the passive activity grouping rules and describe how the tax applies to dispositions of interests in passthrough entities and income/distributions from certain foreign entities.
Source: theventurealley.com

Early Study of Outcomes From Medicare Part D Can’t Explain North

Stuart says the study team formed two preliminary “bottom lines.” First, although the researchers couldn’t find much difference in who was taking the drugs, they clearly found that among people who used them, regimen adherence was higher in the north and that made drug spending higher. “Then we asked, ‘Do people who are spending more and having higher adherence have lower spending on Part A and Part B services to treat diabetes and heart failure?’ Stuart explains. The researchers did not see that relationship, but when they looked at total Medicare costs, they found that regions in the South with lower adherence had higher average Medicare spending for all A and B services compared to northern regions.
Source: newswise.com

Daily Kos: I Hate Explaining the Medicare “Donut Hole” (Updated with explanation of donut hole)

I had a chance to talk to Tom Scully, the head of HMS at the time and the creator of Plan D and the donut hole about why he did it. There were two reasons. First, he had a budget of $400 billion over ten years for the program so he had to design something that hit his budget target and he did a great job on that. Medicare Part D is the only government health program where the ten year cost was actually under the budget estimate. I think it came in at $380 billion. The second reason was to make seniors really think about generics and switching from higher priced brand name drugs to lower cost generic substitutes. And that part worked as well. You need to remember that before Part D all prescriptions were out of pocket expenses for seniors on Medicare, so even with the donut hole Part D was a big benefit.
Source: dailykos.com

Health First Health Plans Offers ‘ABCDs of Original Medicare’ Lectures

Our four not-for-profit hospitals—Health First Cape Canaveral Hospital in Cocoa Beach, Health First Holmes Regional Medical Center in Melbourne, Health First Palm Bay Hospital in Palm Bay, and Health First Viera Hospital which opened in Viera on April 2, 2011- form the core of Health First’s family in Brevard County on Florida’s Space Coast. Other services include outpatient centers; the county’s only trauma center; home care; specialized programs for cancer, diabetes, heart, stroke, and rehabilitative services; central Brevard’s largest medical group; four fitness centers; and Medicare Advantage, commercial POS, and commercial HMO health plans.
Source: spacecoastdaily.com

Politico: Mitt Romney tries to explain Medicare stance

Those were the words he scrawled on a whiteboard at a last-minute news conference in Greer, S.C. this afternoon as he attempted to address questions about whether his plan is identical to that of Paul Ryan’s. Romney chose Ryan as his running mate last weekend, and the Wisconsin lawmaker is best known for a budget-slashing effort that would convert Medicare into a voucher program for some future seniors.
Source: laaacoalition.org

Viewpoints: Romney Needs To Explain His Medicare Plan; Ryan Plan Would End Medicaid Protections For Spouses Of Nursing Home Patients’

The Hill: Romney-Ryan Plan Would Repeal Reagan’s Spousal Safety Net One of President Ronald Reagan’s important achievements, protecting spouses from impoverishment under Medicaid, would be gutted under the plans of Gov. Mitt Romney and Rep. Paul Ryan (R-Wis.). … If a nursing home patient exhausts his or her own Medicare coverage and all of his or her personal resources, which happens to most Americans after a year or so in a nursing home, Medicaid will then cover the cost of the care. … President Reagan signed legislation that forced states to grant Medicaid coverage based on the financial condition of the patient and allowed the spouses of patients to protect enough assets and income to live with some degree of comfort and dignity (Scott Lilly, 8/14).
Source: kaiserhealthnews.org

Daily Kos: Medicare cuts: Is it about the pain, or the politics?

is that cutting the program is going to pave the way for more cuts in the future and we all know that GOP’s intentions towards Medicare (or Social Security) sure as hell ain’t pure.  It ain’t going to be a one-time “take one for the team” kind of thing either.  We may need to look at some ways to restructure the program to reflect the current reality of things and curb some of the waste, fraud, and abuse (which ACA is already doing) but simply cutting benefits for the sake of cutting benefits (which is what the GOP really seems to be for) doesn’t help anybody in the short- or long-term IMHO.  One of the biggest problems with Medicare that the “very serious people” don’t bring up often (if at all) is that one of the big drivers of Medicare costs are our country’s insane health care costs and that getting those costs under control would go a long way towards helping address the financial solvency of Medicare.  Also, given what we saw in 2010 when ACA cut out some of the Medicare Advantage program, I wouldn’t volunteer any cuts to Medicare if I were a Democrat.  Frankly, if the Republicans think that proposing cuts to Medicare and Social Security is such a brave and manly thing to do, well, why don’t they go ahead and do it????
Source: dailykos.com

Medicaid and Medicare FAQ: What do these plans offer? What are the differences?

Posted by:  :  Category: Medicare

As an alternative to Part A and B, beneficiaries can select a Part C plan, which is also referred to as a Medicare Advantage plan. Private companies contract with the federal government to offer these plans, which pay for everything covered by Original Medicare and often provide additional services.  Such as dental, hearing, vision benefits and maybe even a gym membership. Beneficiaries usually pay a monthly premium and some other fees, such as copayments and deductibles.
Source: ahealthiermichigan.org

Video: FAQ Medicare and ABN Forms

FAQ: Decoding The $716 Billion In Medicare Reductions

Ryan’s plan also calls for an overhaul of the program, offering beneficiaries a set amount of money that they would use toward buying a private plan or traditional Medicare. Democrats have argued that such a fundamental change could undermine the traditional Medicare program, because private plans might tailor their coverage to attract healthier beneficiaries, leaving sicker beneficiaries in traditional Medicare. Critics of Ryan’s plan also predict it will force seniors to eventually pay more for their health care because the federal payments will be capped at the rate of gross domestic product plus half a percentage point, an amount that may not keep up with the increase in medical costs. Under Ryan’s plan, insurers would have to provide benefits that are at least equal the value of those offered in traditional Medicare. 
Source: kaiserhealthnews.org

How does Sequestration Impact Medicare?

Additional discussions of reducing payments to skilled nursing facilities, and imposing a new 10 percent co-payment for people receiving home health care have been considered. Laboratory tests and imaging tests, such as the MRI, might have new co-payments imposed as well. Drugs and other therapies administered in the doctor’s office, such as costly chemotherapy treatments, could see increased payments.
Source: fora-costcontainment.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

Orrin Hatch warns on Medicare payment experiments under ACA

They aren’t sure that the innovation center — and its $10 billion budget and wide-ranging approach — is the answer. But they also haven’t mounted a big effort to defund or eliminate the center, unlike other hot-button parts of the health law. So at a Senate Finance Committee hearing Wednesday, there was criticism — blended with a bit of wait and see.
Source: politico.com

Daily Kos: House Republicans vote to end Medicare, again

whose memorization skills are awasome are lacking is a sense of time. There’s a clue in the fact that all economic theory is based on models that are focused on conditions at a specific point in time. That is, the models are all static. If there are series or sequences, those are still perceived as static isolated instances. For comparison, think of the frames in a moving picture or video or cartoon. In a movie, these static images move at the rate of 30 per second, too quick for the human eye to perceive as static. So, we see them as continuous motion. Now imagine a person who can’t see change — i.e. the relationship between prior, present, and later images. Or call it progression. Some brains just take snap shots and can’t register change, progress, motion. Kenneth Galbraith said the problem is an inability to model the economy as a dynamic system, which it is. Economists can’t track change over time. Meteorologists are trying to do it for the weather, with some success. But, I suspect people attracted to economics aren’t even interested in trying, either because they don’t understand what a dynamic system is or because what they’re really after is changing how people behave. If the economy isn’t working as they expect, then people’s behavior has to be changed. It doesn’t even occur to them that their models are wrong.
Source: dailykos.com

Durbin hits Ryan budget, eyes Medicare reform

“In 10, 12 years Medicare goes broke. That’s unacceptable. We want to make sure that Medicare is there for generations to come, and that means making some reforms and some constructive changes,” Durbin said. “The Paul Ryan voucher approach is destructive of Medicare, it won’t survive. Millions of Americans would lose their benefits. But there are ways to approach it, to reduce the costs of medical care and still keep our promise to seniors across America.”
Source: politico.com

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

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