Adjustments To Medicare Supplement Tasks Coming In The Year 2010

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MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSHealth and fitness care emergencies can seem to be at any time and you should power failure. The life of your spouse and children is precious and it is your responsibility to shield them, to look after them and to be sure that you have all expanding at hand when it concerns hospitalization or forking over other hefty clinical bills. Typically the lives we pursue today are profoundly stressful, and to know when you might want to call upon a doctor to treat your company.
Source: vacancescool.com

Video: Texas Medicare Supplements 2010: How to Choose a Plan.wmv

Georgia BCBS Medicare Supplement

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:   Which holiday is on Dec.25-th ? Agree to forum rules 
Source: insurance-forums.net

Modifications In Medicare Supplement Intentions Coming In 2010

For complete medical wellbeing insurance coverage, a person will definitely need to make sure you choose a medicare supplement policy. Fortunately how do the public choose the medigap policy. You may need to check with the State department of Are Medicare Supplement Plan F Policies Now Obsolete in 2014 ? insurance, as to which are some different medigap policies that are on that point there for you. You might at the same time be referred in order to the SHIP. SHIP is a great program that is generally funded by the federal government of help all all these medigap recipients in about making an wise decision. Facing making your conclusion you might yearn for to check finally out whether you exceptionally need the policy. More often than not, agents often allow or perhaps retired employee any kind of number of properly benefits. You also should be aware of all about your different plans about the supplement rrnsurance coverage quotes.
Source: blog.com

Guarantee Issue Medicare Supplement

It is extremely hard to make a blanket statement response to your question… Ultimately the answer varies from company to company and even from state to state with each given company. Also, it depends on what type ‘GI’ case you’re referring to. I don’t know that this response really answers your specific question, but I wanted to at least qualify the responses that you do get. It’s always important to check with each carrier on how they consider each individual case/situation. Senior Market Design, Inc 888-495-8038
Source: insurance-forums.net

Medicare Health Insurance Supplement Insurance In A Boon Towards Senior CitizensCanadian English

Still another thing to think of is if the doctors you at the use are inside a to be looked upon with the Medicare health insurance parts and choices you choose. For instance, which has the Medicare Comfort Plan only doctors who contract his or her services with Medicare health insurance can be deemed. These docs have pre-approved the right set dollar measure per services a Medicare has believed upon as prolonged as you observe a certain cir of doctors. This may not necessarily quite bode well assuming that you have been doing with your health-related professional for 30 plus years and are typical not wanting of these a drastic change in health be concerned providers at this type of point in available free time.
Source: canadaenglishcenter.com

Modifications To Medicare Supplement Goals Coming In The Year 2010

Manufacturer Appointments: You ought be appointed for sell at minimum 2 different companies that offer Medicare health insurance Advantage and Medicare health insurance supplement plans the actual planet area you probably will be working with regard to. As precious time goes on that it will be tips to be designed with most if, perhaps not all pointing to them but which unfortunately would be on top of that overwhelming to start. Two suppliers will get the site done in specific beginning. Again, use the world to get an idea of where companies are competitive in your areas. There remain also a information of Medicare Wholesales websites that will allow you that will help do basic evaluations in any granted zip code.
Source: blog.com

The Pros And Cons Of Medicare Supplement Insurance

In this age of changeableness and uncertainty, you surely does probably not know when depressed accidents might occur. To be on the safer side, the best far out is to take advantage of Utah Medicare supplement plans. Efforts are created for you to put people into your complete ease to make sure that no matter procedure to them or to their loved ones, there is always an action policy ready to be employed and exercised. After all, the expense of life is quite dear to american and there can be no laxity in connection with this. So, why buy Ut Medicare supplement itineraries when you already have other Medicare based primarily plans in place? Well, there are plenty of needs why, but first we must every single day understand what these supplement plans are really.
Source: wedgemusic.com

Ought To Medicare Supplement Insurance Plan Premiums Happen To Be Standardized

In this particular age of unpredictability and uncertainty, one surely does not know when less fortunate accidents might happen. To be on the safer side, the best another option is to go Utah Medicare merchandise plans. These plans are created as a way to put people into complete ease so that no matter what happens to them in order to their loved ones, there is consistently an action plan ready to use and exercised. After all, the value of life is very much dear to you and me and there could be no laxity labels on homeopathic products. So, why buy Ut Medicare supplement programs when you presently have other Medicare located plans in site? Well, there are plenty of top reasons why, but first we must work understand what many of these supplement plans are.
Source: good-date.com

Senior Benefit Services, Inc.

Maine Medicare Supplements, Medicare Supplement Rate Increases, Medigap Rate Increases, Mississippi Medicare Supplements, Mutual of Omaha Medicare Supplements, United World Medicare Supplement plans, Washington Medicare Supplement plans, Washington Medicare Supplements
Source: srbenefit.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

Medicare Targets Health Plans With Low Ratings

Posted by:  :  Category: Medicare

Newsweek Magazine (February 16, 2009) ... Lenders Add Bigger Fannie, Freddie Fee – Thanks to Payroll Tax Cut (January 15, 2012) ...item 2.. Dupuy: GOP trying to sell pyrmaid scheme to voters (September 3, 2012) ... by marsmet526Medicare officials are encouraging 525,000 beneficiaries to switch out of these 26 Medicare Advantage and drug plans that have received low ratings for three consecutive years and enroll in better plans for next year. The poor performing plans will have this warning symbol next to their names on Medicare’s plan finder website to steer shoppers to other plans.
Source: kaiserhealthnews.org

Video: Medicare Quotes

Has Anyone Heard of Pyramid Life Insurance Co.

Image: Medicare Supplement and Medicare Select Insurance to cover expenses not paid by Medicare. Medicare Advantage plans designed to provide more benefits than traditional Medicare, including preventive care. Medicare Prescription Drug Plans presenting the opportunity to reduce drug expenses by covering generic and brand name medications. Senior Dental Insurance provides dental savings. Life Insurance to protect the financial legacies of seniors. Cancer Insurance – a specified disease policy limited to cancer coverage – meets the specific financial needs of those battling the disease. Long Term Care Insurance consisting of policies which may cover all levels of nursing home care and home health care. Hospital Indemnity Insurance designed to help cover the rising cost of hospital confinement.
Source: insurance-forums.net

Cousinhood Pyramid: Life Pyramid Company Recommends Hitched Broadsword

or delayed to a specific policyholder’s lapsed policy when the disgruntled on this page to show me on paper how in theory, it works. Aetna – Health, dental, pharmacy, group life, and disability. Her commitment to be purchased under this plan, and then given their address. Prudencia Compania Argentina deNon-Quoted Public Company. Wow, just thinking of it as a mutual insurance company. The religion of life insurance plan you would like to interview or new hires. We give people a opportunity to delay or deny life insurance and annuities from a fantastic benefits package, excellent bonuses, yearly incentive trips and additional coverage for mental and nervous disorders. I called the Keystone of the calfarm life insurance vs permanent are diagnosed with a degree in nursing but this company you are mistaken on the nightly news. Medicare supplemental insurers do not have any sort of terminal illness, and a flooded marketplace. I asked myself why would they do well to incorporate this technique into their reimbursement for any opportunity to shoot such a deal, assuming that the owner of the of premium term life insurance policy receive a bonus for reaching regional sales offices. When I say professional, they are LYING to candidates. Correspondence concerning Indiana Univ. International Truck and Engine Corporation Garland, TX. Once again, this is
Source: blogspot.com

Union Bankers Health Insurance Company Review

, provides users with detailed information about Universal’s many Medicare contract program options. Each distinct plan has its own website, tools, information, and forms. Available plans and options vary from state to state so it is important to enter a current zip code so you will see the plan details and options for your city and state.
Source: healthinsuranceproviders.com

Health insurance choice may make you healthier

The performance measurements – such as for blood pressure and blood sugar – were chosen because they count things “that science says is good care,” said Andy Reynolds, vice president of the National Committee for Quality Assurance, a nonprofit organization that produces one of the rankings. The organization accredits and publishes the data that insurance companies have agreed to track and make public as an attempt to improve quality.
Source: whatis-healthinsurance.com

American Pioneer Health Insurance Company Review

The aging of the U.S. population continues, and American Pioneer Health Insurance’s potential insurance customer base increases each year. American Pioneer helps approximately 290,000 Medicare Advantage customers with fee-for-service (sold as “Today’s Options”), PPO, and HMO health care products. The company also sells supplemental Medicare insurance. In addition, the company sells annuity, life insurance, and burial insurance policies (sold as “Senior Solutions”). Sister companies sell hospitalization and disability insurance programs for self-employed customers throughout the United States.
Source: healthinsuranceproviders.com

Why Is The World Economy Doomed? The Global Financial Pyramid Scheme By The Numbers

Why is the global economy in so much trouble?  How can so many people be so absolutely certain that the world financial system is going to crash?  Well, the truth is that when you take a look at the cold, hard numbers it is not difficult to see why the global financial pyramid scheme is destined to fail.  In the United States today, there is approximately 56 trillion dollars of total debt in our financial system, but there is only about 9 trillion dollars in our bank accounts.  So you could take every single penny out of the banks, multiply it by six, and you still would not have enough money to pay off all of our debts.  Overall, there is about 190 trillion dollars of total debt on the planet.  But global GDP is only about 70 trillion dollars.  And the total notional value of all derivatives around the globe is somewhere between 600 trillion and 1500 trillion dollars.  So we have a gigantic problem on our hands.  The global financial system is a very shaky house of cards that has been constructed on a foundation of debt, leverage and incredibly risky derivatives.  We are living in the greatest financial bubble in world history, and it isn’t going to take much to topple the entire thing.  And when it falls, it is going to be the largest financial disaster in the history of the planet.
Source: theeconomiccollapseblog.com

Medicare Advantage Sees Lower Premiums

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SSRepublicans do not believe in the free market or capitalism.  They believe in rent-seeking and crony capitalism.  That is why they are afraid to let pro-profit health care compete with government run plans.  If the private sector could outcompete an inefficient government, there would be nothing to fear.  If the private sector can only win if propped up by government, and isolated from competition, it is rent-seeking crony capitalism.
Source: rollcall.com

Video: Understanding Healthcare Costs: Medicare Advantage

New Report: CMS’ Proposed Medicare Advantage Cuts Will Result in Higher Costs, Fewer Benefits for Seniors

The new proposed payment cuts are in addition to the Medicare Advantage cuts and the new health insurance tax included in the Affordable Care Act (ACA).  Only four percent of the ACA’s $200 billion in Medicare Advantage cuts have gone into effect thus far, and the Congressional Budget Office projects that, when fully phased in, these cuts alone will result in three million fewer people enrolled in the program.  The ACA’s new health insurance tax starts in 2014, and Oliver Wyman previously estimated that this tax alone will result in seniors facing $220 in higher out-of-pocket costs and reduced benefits next year and $3,500 in additional costs over the next ten years.
Source: ahipcoverage.com

Obama Admin. to Cut Medicare Advantage Reimbursements

The Obama administration is planning new cuts to Medicare, a federal regulatory filing reveals, cuts that could mean higher premiums or seniors losing their coverage altogether. The new cuts come in the form of a planned reduction in the reimbursement rates the government pays to insurance companies that operate Medicare Advantage plans, which are services administered by private for-profit or non-profit providers that offer additional services than can be found in traditional Medicare. In a Feb. 15 regulatory filing, the Centers for Medicare and Medicaid Services (CMS) announced the surprise rate cuts of 2.3 percent – meaning it would pay health care providers 2.3 percent less for providing services to patients. CMS said it was cutting payments because it foresaw the overall costs of the Medicare Advantage program shrinking by 3.2 percent, despite the fact that healthcare costs – the driver of all federal health care program costs – are only rising. Medicare Advantage is like traditional Medicare except that its plans are administered by insurance companies, who are paid a per-enrollee reimbursement fee by the government. If insurance companies can provide care to seniors at less than what the government pays them for it, they make a profit. Medicare Advantage provides coverage for approximately 28 percent of all Medicare beneficiaries, offering them higher-quality services and additional benefits, such as vision and dental care, than the traditional government program at slightly higher cost. The Obama administration already plans to cut the Medicare Advantage program by $200 billion as part of Obamacare. However, the proposed reductions it announced in February are new, and will cut the program in addition to the planned $200 billion in Obamacare cuts, most of which are delayed in 2014. The new cuts are also scheduled to go into effect in 2014, but as a function of the normal rate-setting process for that year, not a political effort to delay financial pain for seniors past an important election, as apparently was the case with the original Medicare cuts that Obama signed. In its regulatory announcement, the CMS said it was assuming that reimbursement payments in traditional, government-run Medicare will be cut, and cited that as justification for cutting Medicare Advantage. However, while those cuts to traditional Medicare have been set into law for more than a decade, Congress has never allowed them to happen, instituting what is known as the Doc Fix every year, to keep reimbursement payments the same. Senator Marco Rubio (R-FL) wrote to the CMS urging them to consider political reality and reverse their planned Medicare Advantage cuts. “This assumption is highly problematic because – even though it almost certainly will turn out to be wrong – it translates into lower funding to support the health benefits of the 14 million Medicare beneficiaries who are currently enrolled in MA [Medicare Advantage] plans,” Rubio wrote on March 8. In other words, if the Obama administration continues with its proposed new Medicare cuts, some or all of the 14 million seniors who get health care through the MA program could be negatively affected, that is, paying higher premiums or possibly losing coverage. READ FULL SOURCE ARTICLE: 03/14/2013
Source: newmediajournal.us

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

Medicare Advantage enrollees could take hit in 2014

“The Affordable Care Act helps us strengthen Medicare Advantage and Part D,” said Jonathan Blum, CMS acting principal deputy administrator and director of the CMS’ Center for Medicare in a statement last week. “We are working to ensure that people with Medicare have affordable access to health and drug plans, while making certain that plans are providing value to Medicare and taxpayers.”
Source: healthinsbrokers.com

Obama Administration Plans to Cut Medicare Advantage Reimbursements

The new cuts come in the form of a planned reduction in the reimbursement rates the government pays to insurance companies that operate Medicare Advantage plans, which are services administered by private for-profit or non-profit providers that offer additional services than can be found in traditional Medicare.
Source: cowboybyte.com

OPINION: taking advantage of Medicare Advantage

AHIP may have a hard time convincing the current Congress to take pity on insurers. Last week the Government Accountability Office released a report estimating that CMS overpaid private insurers between $3.2 billion and $5.1 billion from 2010-2012. Chances are, though, that far more people will see AHIP’s TV campaign than an obscure GAO report. And people won’t even know that insurers are behind the campaign. That’s because AHIP is using one of its front groups, the Coalition for Medicare Choices, as the sponsor of the campaign.
Source: publicintegrity.org

‘Obamacare’ Cuts $306 Billion From Medicare Advantage

DR. JIM PALERMO, EDITOR-IN-CHIEF: Dr. Palermo, a 28-year resident of Brevard County, touched the lives of countless people during his 22-year practice of general, vascular and non-cardiac thoracic surgery. In 2002 he transitioned from clinical practice and accepted a position as full-time chief medical officer and vice president of quality management of Health First, which afforded him the opportunity to serve the global community in a more meaningful way. An accomplished author and sought-after expert in the healthcare industry, Dr. Palermo is now an independent consultant focused on healthcare quality and safety, and physician leadership development.
Source: spacecoastdaily.com

Promoting Greater Value for Enrollees in Medicare Advantage and Drug Plans

New limits on overhead and profits for health plans in Medicare Advantage and Medicare drug plans will increase value for the over 14 million seniors and persons with disabilities enrolled in Medicare Advantage and over 35 million Medicare beneficiaries in drug plans offered by private insurance companies.  This step is part of the Affordable Care Act’s efforts to ensure that consumers get the most health care for their dollars.  Last year, we issued a rule to make sure that insurance companies generally spend at least 80 percent of the premiums paid by consumers in private health plans on health care or activities that improve health care quality, instead of paying for administrative costs or overhead.  Today’s proposal for people with Medicare is similar to last year’s rule benefiting consumers in the private health insurance market.
Source: cms.gov

Office of Statewide Benefits provides information on Medicare Parts A, B enrollment

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ... More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524Failure to enroll and maintain enrollment in Medicare Parts A and B upon eligibility may result in the subscriber being held financially responsible for the cost of all claims incurred, including prescription costs. Retirees and spouses enrolled in Medicare Parts A and B must provide a copy of their Medicare Identification Card to be enrolled in the state of Delaware Special Medicfill plan.
Source: udel.edu

Video: Introduction to Medicare – Data to Supplement Medicare Claims and Enrollment Information

IRS Releases New Information About Medicare Tax Surcharges

The IRS released a lovely FAQ today about the 0.9% surcharge that applies wages, self-employment earnings and other compensation above $200,000 (single filers) / $250,000 (joint filers). When this surcharge applies to wages, employers are required to withhold it, but the withholding rules are a bit strange. Taxes won’t be withheld until you receive that first dollar in compensation in excess of $200,000; taxes might be withheld even if the surcharge won’t ultimately apply to you because your spouse is not employed; and taxes might not be withheld even if the surcharge will apply to you, because you and your spouse together earn more than the threshold. The FAQ explains these peculiar rules, both from the employee’s and the employer’s perspective.
Source: perkinsaccounting.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

New CMS Website: Medicare Secondary Payer Conditional Payment Information 

[1] Title II of H.R. 1845, entitled "Strengthening Medicare Secondary Payer Rules," amends 42 U.S.C. §1395y(b)(2)(B) of the Medicare Statute, Pub. Law No. 112-242 (January 10, 2013).  See http://beta.congress.gov/bill/112th-congress/house-bill/1845/text. The Bill Summary and status report are available at: http://thomas.loc.gov/cgi-bin/bdquery/z?d112:h.r.1845. The current Medicare Secondary Payer Recovery Contractor (MSPRC) website is located at www.msprc.info. Title I, Section 101 of H.R. 1845, sets out a demonstration project under Medicare Part B for the payment of supplies and services related to the administration of Intravenous Immune Globin (IVIG) for the treatment of primary immune deficiency diseases. [2] The Medicare Secondary Payer program is set out at 42 U.S.C. §1395y(b)(2). [3] The Center’s work on MSP matters can be accessed at: http://www.medicareadvocacy.org/medicare-info/medicare-secondary-payer-program/. In addition, the Center led a task force of the Public Policy Committee of the National Academy of Elder Law Attorneys (NAELA) (www.naela.org) on the use of set-aside arrangements involving future medical expenses. The task force made recommendations on how attorneys might approach "future medicals" pending guidance from the Medicare agency. See: http://www.naela.org/App_Themes/Public/PDF/Home%20Page/ISSUE%20Medicare%20Set%20Aside%20TF_2%20(2).pdf.  [4] See, for example, the joint findings and recommendations, sent to the Medicare Agency, by the Center for Medicare Advocacy, the Medicare Rights Center, and California Health Advocates, available at http://www.medicareadvocacy.org/2011/05/12/medicare-secondary-payer-practices-that-harm-medicare-beneficiaries/. [5] See §201of the Act.  Note, the term "website" includes any successor technology that might be developed. Id., at subclause (VII). [6] See §201of the Act, ("VI") Effective date. [7] See §201of the Act. [8]Id., amending §1862(b)(2)(B) of the Social Security Act, 42 U.S.C. §1395y(b)(2)(B), adding a new clause: (vii) use of website to determine final conditional reimbursement amount. [9] Id. [10] See §204, amending §1862(b)(8)(B) of the Social Security Act, 42 U.S.C. §1395y(b)(8)(B). [11] Id. [12] Id., at subclause "(III)." [13] Id., at subclause "(IV)." [14] Id. [15] Id. [16] Id. [17] Id. [18] Id., at subclause (V), protected period. [19] Id. [20] Id. In addition, the Secretary shall promulgate final regulations to carry out this clause not later than 9 months after the date of the enactment of this clause. Id. [21] Id., §202(a)(2) of the Act. [22] Id., §202(b). [23] Id., subclause "(D)"Report to Congress. [24] Id. [25] See §203, amending §1862(b)(8) of the Social Security Act, 42 U.S.C. 1395y(b)(8)( Required submission of information by or on behalf of liability insurance (including self-insurance), no fault insurance, and workers’ compensation laws and plans). [26] Id. [27] See §205, amending §1862(b)(2)(8)(iii) of the Social Security Act, 42 U.S.C. §1395y(b)(2)(8)(iii).
Source: medicareadvocacy.org

Senators Urge CMS to Provide Information about Medicare and Medicaid Reimbursement for Compounded Drugs

Public Citizen, a consumer advocacy group, has written a letter to HHS Secretary Kathleen Sebelius, asking her to direct the HHS Office of the Inspector General (OIG) to conduct an investigation into CMS’ policies with respect to reimbursement for compounded drugs. Public Citizen cited conflicting provisions of the Medicare Benefit Policy Manual that, on the one hand, instruct carriers to deny coverage for drugs that have not been approved by the FDA and, on the other hand, direct carriers not to deny coverage for such drugs unless directed to by CMS. Public Citizen also noted that CMS is aware of the dangers posed by compounded drugs. In 2007, its four regional Durable Medical Equipment (DME) Medicare Administrative Contractors (MACs) denied coverage for compounded inhalation drugs administrated via nebulizers, noting that the drugs were not FDA-approved and citing safety concerns. The senators, Public Citizen, and the public await the agencies’ response.
Source: wolterskluwerlb.com

The Official Medicare Set Aside Blog And Information Resource: CMS Changes Select NGHP MMSEA Reporting Fields from “Required” to “Optional” Effective 04/22/13

An ICD-9-CM External Cause of Injury Code (E Code) is currently required in order to classify the Alleged Cause of Injury, Incident or Illness for the claim that has been reported. In the past this field posed a problem, especially for RREs reporting liability TPOCs for which there was no physical or mental injury alleged, but required reporting because all medical claims were being released as part of the settlement. CMS created a no injury code (NOINJ) to address this situation. There were some reports that the NOINJ code was being overused and we can only assume that this field has continued to be problematic. It is also possible that the pending shift from ICD-9-CM to ICD-10-CM coding plays a role in this change as E codes will no longer be separated out as a supplementary classification under ICD-10-CM. Instead, they are incorporated under each main classification category and will no longer be prefaced with an E. Perhaps these factors combined led to CMS’ determination to eliminate the required reporting in this field. Regardless of the reason, it is favorable news for RREs.
Source: medicaresetasideblog.com

North Carolina Medical Society

While Congress’ action to avert the fiscal cliff at the ninth hour is good news, the decision may have a slight impact on Medicare claims and payments. Palmetto GBA posted this useful article that provides some useful, early guidance. A few quick highlights:
Source: ncmedsoc.org

Medicare Tax Update and Information for 2013

Earned income is defined as the money that you are paid from an employer including tips. The Medicare tax on that income is 2.9 percent. The taxes are withheld from your check by your employer at the rate of 1.45 percent from your pay and the employer pays another 0.9 percent on your earned income. For those who fall into the new Medicare surtax threshold, this means that you will owe another 0.9 percent of your earned income that you must pay out of pocket. Once your earned income reaches the MAGI threshold, your employer must begin withholding the additional 0.9 percent from your earned income, but it will not be enough to cover the amount that will be owed on income earned before the threshold was met.
Source: medicarebenefits.com

Biden offers senior Floridians misguided information on Medicare

Under President Obama, that coverage for the screening procedures was expanded as a result of new directives forcing insurers to cover only those preventive services recommended by the United States Preventive Services Task Force. These mandates are another symptom of the centralized control that Obamacare exerts over the practice of medicine. But under Mr. Obama, the colonoscopies have faced offsetting new restrictions that mostly make it harder for seniors to access many of the tests.
Source: aei-ideas.org

How To Get Information About Medicare Insurance Families.com

The My.Medicare.gov section is an internet portal where registered beneficiaries of Medicare benefits are able to view their current eligibility and entitlement information. Review their enrollment information and prescription drug plans, deductible and address of record information. Members are also able to order replacement Medicare cards, obtain online forms and a wide variety of other information. There is also an option for web chat assistance for any technical questions.
Source: families.com

Amerigroup Medicare Tai Chi

Posted by:  :  Category: Medicare

If you have Amerigroup Medicare as your insurance coverage you should be able to take Tai Chi here at no cost to you. Classes are on Wednesdays from 6-7pm and Sundays from 11:30am-1pm with Steve Miller, who teaches the Yang Style Short Form. This form of Tai Chi has been proven in a clinical trial to relieve the pain of arthritis and fibromyalgia.
Source: midwoodmartialarts.com

Video: Real Stories: Amerigroup Texas, Dual Eligible

WellPoint reorganization will help integrate Amerigroup, expand in Medicaid market

Deanna Pogorelc is a Cleveland-based reporter who writes obsessively about life science startups across the country, looking to technology transfer offices, startup incubators and investment funds to see what’s next in healthcare. She has a bachelor’s degree in journalism from Ball State University and previously covered business and education for a northeast Indiana newspaper. More posts by Author
Source: medcitynews.com

Medicare Targets Health Plans With Low Ratings

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

WellPoint Bets On Medicare And Medicaid

WellPoint should be able to leverage (CUT) some SG&A expenses and benefit from increased negotiating power with hospitals. The firm has already announced that it expects the Amerigroup acquisition to be accretive to earnings in 2013 (assuming the deal closes in the first quarter) and to add at least $1 per share in earnings in 2014. Though the transaction faces regulatory approval, the current administration will likely be in favor of anything that could lower healthcare costs.
Source: seekingalpha.com

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

Posted by:  :  Category: Medicare

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

Video: Medicare Part D and Prescription Drugs

Getting Part D With A Medicare Advantage Plan

If you are new to Medicare it helps to know the ins and outs of getting your Part D through a Medicare Advantage plan. Watch the following video to learn about the types of plans available and the pros and cons of getting your Part D in this way.
Source: medicareprofs.com

Medicare Drug Benefit: Formulary Oversight in Medicare Part D

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

Medicare Part D and MedAdvantage Plans

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

Democrats Push To Negotiate Medicare Part D Prices

Title: Biotech Sales SpecialistReports to: Area Business ManagerFunctional Area: Sales OrganizationBasic FunctionAs members of the area sales team, individuals in this position are responsible for the promotion of MedImmune products and achievement of assigned sales goals. Biotech Sales Specialists are expected to be…
Source: pharmalot.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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

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

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

Medicare Part D, Prescription Drug Plan Coverage, PDP

It is best to sign up for a Part D plan as soon as you become eligible. In some circumstances, members may be charged a penalty or face higher premiums if they sign up after their initial eligibility. If necessary, you can make changes to your plan in the fall when providers announce upcoming changes during the Annual Election Period (AEP). Few exceptions allow enrollments outside of an enrollment period, but it is important to enroll as soon as possible to avoid potential penalty fees.
Source: bradeninsurance.com

Privately Run Medicare Plans are Really Expensive

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

Part D Politics: Medicare Drug Rebates or Price Controls?

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

What on Earth is the Donut Hole? A Brief Explanation of Medicare Part D and the “Donut Hole” » The NeedyMeds Blog

In 2013, you get out of the coverage gap when you have paid $4,750 out-of-pocket for covered drugs since the start of the year. When you reach this out-of-pocket limit, you get catastrophic coverage. The costs that help you reach catastrophic coverage include what you spent on drugs while in the donut hole and most of the discount on brand-name drugs you received in the coverage gap. If someone else pays for your drugs on your behalf, this will also count toward getting you out of the coverage gap. This includes drug costs paid for you by family members, most charities, State Pharmaceutical Assistance Programs, AIDS Drug Assistance Programs and the Indian Health Service. You continue to pay your drug plan’s monthly premium during the gap, but the premium does not count toward the $4,750 out-of-pocket limit. The amount your drug plan paid for your drugs in your initial coverage period also does not count.
Source: needymeds.org

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

Posted by:  :  Category: Medicare

Newsweek Magazine (February 16, 2009) ... Lenders Add Bigger Fannie, Freddie Fee – Thanks to Payroll Tax Cut (January 15, 2012) ...item 2.. Dupuy: GOP trying to sell pyrmaid scheme to voters (September 3, 2012) ... by marsmet526CHOPPED – 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

Video: Medicare Provider Enrollment 3.wmv

Medicare Payment Rates Should Not Be Based on Region, IOM Panel Says

As long as FFS mentality drives reimbursement, this problem will simply waffle from one inintended consequence to another. Regions with much higher cost of living will have higher baseline hospital costs and physician overhead. Abrupt rate cuts there will predictably drive providers out of Medicare…and Medicare patients into trouble. On the flip side, waste in excessive admission rates and excessive procedures in low cost areas already hides behind geographic indices. You can’t solve both problems with one switch. Some regional adjustment coupled with palpable risk may solve it. It works here for Medicare Advantage. Meanwhile, the disconect between hospital regional rates and individual provider rates has been known for a decade…and stonewalled.
Source: californiahealthline.org

Implementation of Medicare Ordering/Referring Provider Edits (March 20 Call) : Health Industry Washington Watch

Effective May 1, 2013, Medicare contractors will activate edits that will deny claims for Medicare Part B (including imaging and lab services), DME, and Part A home health agency (HHA) services if the ordering/referring physician or other professional is not identified, is not in Medicare’s enrollment records, or is not of a specialty type that may order/refer the service/item being billed. Concerns have been raised by physicians and suppliers that they could experience claims denials and delays after May 1 based on discrepancies between the names of the ordering physician on the 1500 claim form and in Medicare’s enrollment records. CMS is holding a March 20, 2013 National Provider Call to discuss these new requirements.
Source: healthindustrywashingtonwatch.com

South Jersey Doctor Admits Making Half

TRENTON, NJ—A physician who was the owner and founder of Visiting Physicians of South Jersey—a Hammonton, New Jersey provider of home-based physician services for seniors—pleaded guilty today for charging lengthy visits to elderly patients that they did not receive, United States Attorney Paul J Fishman announced. Lori Reaves, 52, of Waterford Works, New Jersey, entered her guilty plea to an information charging her with one count of health care fraud before United States District Judge Freda L Wolfson in Trenton federal court. During her guilty plea, Reaves admitted lying in Medicare billings about the amount of face-to-face time she spent with patients, which led to her receiving at least $511,068 in criminal profits. Reaves was the highest-billing home care provider among the more than 24,000 doctors in New Jersey from January 1, 2008 through October 14, 2011, according to court documents. “Today, Lori Reaves, a South Jersey physician, admitted intentionally overbilling Medicare and pocketing more than half a million dollars she didn’t earn,” United States Attorney Fishman said. “The Medicare system depends on doctors and other medical professionals truthfully billing for services they actually provide. Here, Dr. Reaves chose to lie about the major service she was providing to her homebound, elderly patients: her time.” According to documents filed in this case and statements made in court: Visiting Physicians of South Jersey (VPA) provided home-based physician health care for elderly and homebound patients in New Jersey, offering services throughout South Jersey. As part of her responsibilities at VPA, Reaves was responsible for VPA’s Medicare billings as a Medicare-approved provider. The claim submitted by the health care provider requires a physician to state a diagnosis and provide a procedure code—called a Current Procedural Technology (CPT) code—identifying services rendered. Medicare regulations require that each provider certify that the services rendered were medically necessary and were furnished by that provider. A warning at the bottom of the form specifically states that any false claims or statements in relation to the submission of a claim for reimbursement are prosecutable under federal or state law. In most instances during the relevant time period, Reaves submitted forms that falsely claimed she had provided prolonged service visits to her patients in order to induce Medicare to make payments to her that were significantly higher than the payments she should have received. Reaves routinely billed Medicare using codes that would have required her—under Medicare regulations and depending on the corresponding service—to spend between 60 and 150 minutes with a patient. Many of the claims Reaves submitted would have required her to spend a minimum of two-and-a-half hours of face-to-face time with her elderly clients, when she actually spent far less. As a result, Medicare reimbursed Reaves more than $511,068 for the fraudulent prolonged service visits Reaves claimed to have made. Reaves faces a maximum potential penalty of 10 years in prison and a fine of the greatest of $250,000 or twice the gross gain or loss caused by her offense. She will also be required to forfeit the proceeds of her crime. Sentencing is currently scheduled for July 13, 2013. United States Attorney Fishman credited special agents of the FBI in Newark, under the direction of Acting Special Agent in Charge David Velazquez, and special agents of the Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Tom F O’Donnell of the New York Regional Office, with the investigation leading to the guilty plea. The government is represented by Assistant United States Attorneys Deborah J Gannett and R David Walk Jr of the United States Attorney’s Office Health Care and Government Fraud Unit in Newark. Reported by: FBI
Source: 7thspace.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

UPDATE: Medicare Revalidation: What FQHCs Need to Know

after such providers or suppliers receive notification from their MAC.  Once contacted by a MAC, suppliers and providers have 60 days from the date of the letter to submit complete enrollment forms. Please note that failure to submit the enrollment forms as requested may result in the deactivation of Medicare billing privileges. Additionally, the $505 Medicare enrollment fee that we told you about here also applies to revalidation.
Source: nachc.com

Sequestration’s Impact on Healthcare Providers Set to Take Hold

It appears that all entities both provider and beneficiary will end up experiencing reduction through this sequestration initiative.   The largest impact will be felt by those hospitals and practitioners that deal with large Medicare populations.  Estimates from various entities including the governmental OMB, estimate sequestration cuts related to Medicare could
Source: edelbergcodes.com

Savvy Senior: How Medicare covers diabetes

Posted by:  :  Category: Medicare

Screenings: If you don’t have diabetes, but you do have pre-diabetes or some other health conditions that put you at risk of getting it – such as high blood pressure, high cholesterol and triglycerides, are overweight, or have a family history of diabetes – Medicare will pay 100 percent of the cost of up to two diabetes screenings every year.
Source: bradenton.com

Video: Medicare Diabetes Screening Project – Savannah, Georgia News Coverage: WTOC 11

Medicare Coverage Changes

I see wal mart is stepping in and filling the gap where insurance is leaving people hanging. It takes one company to step in and drive cost down. I sometimes don’t like how wal-mart operates to drive prices down but I give them credit on low cost diabetic supplies. The relion prime test strips are 9 dollars for 50. I have compared them against accu-check and other expensive test strips and the results were very accurate. I think other companies will have to bring cost down and get rid of those insane markups since Walmart now sees a way to bring testing cost down. Here is the link. http://www.walmart.com/ip/ReliOn-Prime-Blood-Glucose-Test-Strips-50…
Source: tudiabetes.org

Can we make it about care again?

For instance… when you’re newly diagnosed, Medicare approves 10 hours of Diabetes self-management training in the first 12 months. Also, you get this training if you’ve already been diagnosed, but you’re going from oral medication to insulin therapy for the first time. I got about an hour’s worth of training back in 1991. What’s covered in the training? The basics about managing your BGs, your diet, and exercise. Also, these interesting bullet points: How to adjust emotionally to having diabetes, and the use of the healthcare system and community resources. By the time I’m eligible for Medicare, I hope this includes finding online support. In addition to the initial training, Medicare recipients are eligible to receive 2 hours of training per year after the initial training. Not sure what’s covered in that.
Source: happy-medium.net

Diabetes and Medicare have You Confused?

Remember Medicare Part B has a deductible ($140 in 2012) and 20% coinsurance that you must pay.  Some Medicare Advantage plans or Medicare supplemental health plans may cover more, but you have at least 80% coverage after the deductible.  Remember that is 80% of the Medicare-approved amount.  In Minnesota a physician may not charge more than the Medicare-approved amount, but this limiting law may not necessarily apply to supplies.  In any state if the supplier accepts Medicare assignment, they can only charge the Medicare-approved amount.  It might be worth your time to find a provider who accepts assignment.  Sometime in the future (possibly July 2013) if Health Care Reform still exists, you may only be able to get Medicare coverage for these supplies from Medicare-approved suppliers.
Source: retirementeducationplus.com

Medicare Diabetes Screening Project

2012 about Aquarium Atlanta Attractions Beautiful best business cities City College Colleges Cool county find Football from Georgia good Health Home images insurance Jobs lawyer License Loans Military Nice North Payday photos pics pictures road School schools small some State take Tech Technical Universities University
Source: wordwd.com

Medicare has Limited Vision Coverge

• Medicare Advantage Plans: These plans are run by private insurers that receive money from the government to provide Medicare-equivalent benefits, such as hospitalization, doctor visits and prescription drugs. Unlike traditional Medicare, some Advantage plans typically cover routine exams and eyeglasses. But their network of participating hospitals and providers can be limited in some areas. If you have a significant vision problem, make sure that the specialists and facilities that are important to you are in the plan.
Source: insuranceconnectionusa.com

The Fleecing of Americans not Covered by Medicare

firm McKinsey & Co., the United States spends more on health care than the next ten biggest spenders combined—Japan, Germany, France, China, Italy, Canada, Brazil, Australia and the U.K. In another study in 2011 by the consulting firm Milliman, the annual healthcare costs for an American family of four covered by a PPO is a whopping $19,393, and between 2002 and 2011 the average cost of their care doubled—60% of all personal bankruptcies is caused by medical bills. In short, our healthcare system is a mess, and if its present course is not abated, will suck the life out of the American economy.
Source: joearrigo.com

MEDICARE DASHBOARD ADVANCES ACA GOALS FOR CHRONIC CONDITIONS (CMS

anthonyssong.blogspot.com www.4wardfast.com Please support our advertisers by viewing their ads. The AARP Public Policy Institute (PPI) and the United Hospital Fund (UHF) recently released a new report that finds 46 percent of family caregivers perform medical and nursing tasks for care recipients with multiple chronic physical and cognitive conditions. The report, “Home Alone: Family Caregivers Providing Complex Chronic Care,” explores the complexity of tasks that caregivers provide. The PPI and UHF report is based on a national survey of 1,677 family caregivers who were asked about the medical and nursing tasks they perform. Of the 46 percent of family caregivers performing medical and nursing tasks, three out of four provided medication management — including administering IVs and injections — for a loved one. Further, more than a third of these caregivers providing medical and nursing tasks reported doing wound care. Other tasks included operating specialized medical equipment and monitors. Interestingly on the same day I received this notice, the National Council on Aging sent information on how to obtain assistance in managing multiple chronic conditions. Their Center for Healthy Aging will provide technical support to 22 states that have received more than $8.5 million to educate older adults on how to live better with chronic conditions. The new federal grants will help 87,000 seniors access evidence-based self-management programs to help them manage arthritis, diabetes, chronic pain, and more. Assistant Secretary for Aging and Administrator of the Administration for Community Living Kathy Greenlee said, “We know these programs work. These funds help empower individuals so they can take better care of themselves, feel better, and perhaps avoid extra doctor visits and trips to the emergency room.” These grants will help more people access tailored workshops to help them manage their conditions and help states embed the programs into their public health and wellness infrastructures. Two-thirds of Medicare spending is for beneficiaries with five or more chronic conditions. The new grants build on the Recovery Act’s Chronic Disease Self-Management Program grants awarded in March 2010, which had an initial goal of reaching 50,000 older adults. As of August 28, 2012, 47 of those first-round states had reached 111,272 seniors. The 22 states awarded the competitive cooperative agreements are: Alabama, Arizona, California, Colorado, Connecticut, Georgia, Kentucky, Massachusetts, Maryland, Michigan, Missouri, New Jersey, New Mexico, New York, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, Washington, and Wisconsin. The funding will support a variety of programs, all evidence-based and licensed from the Stanford University Patient Education Research Center. The Stanford programs emphasize the individual’s role in managing their health and improving their quality of life. The grants will also support evidence-based self-management programs for people with diabetes, arthritis, HIV/AIDS, and chronic pain, including internet-based courses and programs specifically developed for Spanish-speaking adults with chronic conditions. To learn more about the Stanford University Chronic Disease Self-Management Program, go to http://patienteducation.stanford.edu/programs/. To find workshops, visit the NCOA Center for Healthy Aging at http://www.ncoa.org/improve-health/center-for-healthy-aging/chronic-disease-1.html. As the holidays approach, many new caregivers will be born as typically visits home to mom and dad are when you start to notice that living conditions and health conditions might have changed, particularly if you only visit occasionally. Take a breath. And know that there are support mechanisms out there for you.
Source: wn.com

Medicare and CGMS Coverage

My pump, cgm, and supplies for both are currently covered by the insurance policy I am covered under by my employer. But I am planning on retiring in a few month and will be under COBRA for the next 14 month. So far so good, I will still have all my diabetic supplies covered. However when I turn 65 (July 2013) and go under Medicare it seems I will no longer be covered. Based on your post it seems an appeal letter would be my next step. The problem I have is that I have been fanatical about controlling my blood glucose for twenty plus years and have never had an A1C over 6.2. I exercise several hours every day (100 plus miles a week on my bike, tennis five days a week, one hour plus walking my dogs every day). I have always tested my BG ten times a day and now with pump and cgm I am down to about seven samples a day. Blood work, eye exams, physicals will all show I am basically not diabetic. But because of this effort to maintain such tight control of my BG I am now asymptomatic for hypoglycemia. My endocrinologist is very cooperative but I do not see how I could make a case of medical necessity, even though it is because of all the technology that I am able to maintain my BG control.
Source: kellywpa.com

Diabetes Supplies and Medicare

Different plans as well as your geographical location will determine how much coverage seniors receive for diabetic supplies. Medicare will pay for supplies that aren’t mentioned in a doctor’s prescription, so only order supplies that have been approved by the doctor. Seniors should also know that ongoing requests for supplies will be necessary, and shipments that are automatically sent from suppliers won’t be paid for.Seniors themselves can’t send claims to Medicare. Such claims have to be submitted through a pharmacy enrolled in the Medicare program or an approved supplier enrolled in the Medicare program.
Source: boomers-with-elderly-parents.com

ICYMI: New Report Confirms CMS Can Base Medicare Advantage Payments on Likely Congressional Action

Posted by:  :  Category: Medicare

BITCH ... Allen West calls Wasserman Schultz ‘vile’ and ‘not a lady’  (7/20/2011) ...item 2.. FSU News -  Yo Mama's Big Fat Booty Band grooves at Sidebar (Mar. 29, 2013) ...item 3.. Chaos - Doin' It Hard by thebootyband ... by marsmet522In comments submitted to the agency, AHIP also raised concerns about CMS’ assumption about the SGR: “Our key issues and recommendations…begin with a discussion of the Sustainable Growth Rate (SGR). To prevent the MA program from going into a tailspin, the agency needs to implement a solution that will be big enough to solve the problem. Without beginning here, no consideration of other strategies on their own will be enough to prevent major cutbacks that seriously jeopardize beneficiary access to the coordinated systems of care provided by Medicare Advantage plans.”
Source: ahipcoverage.com

Video: New West Medicare .mov

Pharmacist Jobs in Montana: Various Positions career at New West Medicare in Helena

More complete informations about this career opportunity kindly see the descriptions. Looking for Energetic Individuals to join our Medicare Excellence Team! New West Health Services, a community based not-for-profit health insurance company focused on Medicare excellence is looking for self motivated! energetic members to join our Medicare Team in Helena, MT. Part D Clinician/Pharmacist This pharmacist serves as the leader in operating managed Medicare Advantage Part D clinical programs, contributes to product development, manages all aspects of PBM relationship, provides formulary oversight, and ensures regulatory compliance with CMS. The position requires a Bachelor’s degree in Pharmacy, or a Doctor of Pharmacy (PharmD) degree from an accredited college of pharmacy, and licensure as a pharmacist in the State of Montana. Minimum of five years pharmacy experience required, preferably in either Retail or Managed Care environment. Certification in geriatric pharmacy required, though candidate may work towards such certification in a defined timeframe. Knowledge of Medicare Advantage plan preventive benefits and CMS regulations required. Nurse Case Manager – responsibilities include: “Utilization Management and Case Management “Claims review that may require clini! cal determinations “Researching data, documenting decisions an! d communicating with providers and members. The successful candidate must have a current Montana RN license plus 5 years nursing experience; a working knowledge of Medicare regulations preferred; efficient Microsoft application ability and excellent communication skills are essential. Fraud Waste and Abuse/Medicare Compliance Specialist The Fraud Waste and Abuse Compliance Specialist is responsible for the day-to-day management of the organization’s Fraud Waste and Abuse program and offers support to the Compliance Officer in the administration of the organizational Compliance Program. The position requires a minimum of 5 years experience in the health insurance industry, 2 years experience with Fraud Waste and Abuse programs, 1 year of health care coding and billing experience or an equivalent combination of education and experience. An associate degree in a health related field, business, paralegal, nursing, or other related field is preferred. Familiari! ty with Centers for Medicare and Medicaid Services rules and regulations regarding Fraud Waste and Abuse is strongly desired. National certification in Fraud Waste and Abuse (FWA) is required at the time of application. EXCELLENT BENEFITS, HOURS & WORKING ENVIRONMENT For detailed position description information or to obtain an application, please visit: www.newwesthealth.com Send your completed application, resume and cover letter to Human Resources at: hrdept@nwhp.com , or fax to: (406) 457-2255; or mail to: New West Health Services, Human Resources 130 Neill Avenue, Helena, MT 59601 – . If you were eligible to this career, please deliver us your resume, with salary requirements and a resume to New West Medicare.
Source: blogspot.com

MATR News: Montana Career Opportunities

New West Health Services https://www.newwestmedicare.com/ , dba New West Medicare, is Montana’s not-for-profit, provider sponsored health plan offering Medicare Advantage and Medicare Supplement plans. New West has been in operation since 1998 and is a licensed health services corporation, holding a Centers for Medicare and Medicaid (CMS) contract since 2005. Our Medicare Advantage plans are offered in 28 Montana counties with future plans to expand into more counties in 2014.
Source: matr.net

Obama planning to Cut Medicare Advantage Reimbursements

The new cuts come in the form of a planned reduction in the reimbursement rates the government pays to insurance companies that operate Medicare Advantage plans, which are services administered by private for-profit or non-profit providers that offer additional services than can be found in traditional Medicare.
Source: westorlandonews.com

Medicare 101 for HR Professionals

Description: Medicare 101 for HR Professionals presented by Bonnie Anzick, New West Medicare. Link: http://gvhra.shrm.org/ Age Group: 21+ Venue: Holiday Inn Address: North 7th Avenue Phone: N/A Save Event Google Calendar Yahoo! Calendar iCal Download Outlook (vCalendar)
Source: bozemanevents.net

Medicare Advantage, enrolling on

Posted by:  :  Category: Medicare

Bill called me, and we couldn’t know how his mother got enrolled in a Humana devise since she is not authorised to change her devise during this time of year. Even yet Bill finished a mistake by submitting an on-line application, it should have been deserted since his mother does not have a “special choosing period” (SEP) to change her plan. Humana should have satisfied this and deserted a application. Additionally, Medicare should have deserted a application.
Source: ahipcup.net

Video: Health Net Medicare Advantage – Compare to over 180 Compani

Medicare imposes marketing and enrollment suspensions on HealthNet, Arcadian and Universal American (Today’s Options).

Arcadian had their webinar today as well. On the call the moderator did not and would not discuss the other companies. It was very refreshing for me to see that respect for the competitors. One of the things we did discuss was the sanctions, while marketing practices were a component, a large part of the sanctions revolved around Rx administration. The Rx vendor is not specifically mentioned nor will I name them. I am however disappointed that no specific action is to be taken when this vendor is responsible for issues with ALL the companies receiving sanctions. All of the companies/MAPD Plans are working hard with the CMS to correct the issues and will be back to marketing in 4 to 6 months. My feelings go out to all of the beneficiaries that will miss out on these plans. In some markets, the sanctioned plans are the most intelligent option.
Source: wordpress.com

Arizona Health Net Medicare HMO Customers Fraudulently Transferred to United Health’s AARP Medicare HMO as of 12.07.2011

I was told by another person from Health Net that this appears to have been the work of one sales person. I said I wanted the person’s name and other information because I plan on suing them. He said that he would give me that information after the investigation was over. I’m not going to hold my breath. In reality I doubt they can point to one person as the supervisor I last talked with told me the applications were filed online. A sales person would only be responsible if they’d personally signed people up for AARP. Did one salesperson submit hundreds (or more) fraudulent applications online? Did one salesperson process all of the fraudulent online applications? Neither scenario seems likely. Or were they submitted by phone or mail as others first told me?
Source: wordpress.com

CMS Announces Marketing Sanctions for Three Medicare Advantage Carriers: Health Net, Arcadian and Universal American

[…] CMS isssued a press release on Friday afternoon announcing these marketing sanctions.  The sanctions for Health Net took effect at mid-night last Friday, so as I write this, they are currently unable to take an new enrollments.  The sanctions for Arcadian Management and Universal American Corp will not take effect until Sunday, December 5th, so agents will be allowed to enroll new members in these plans for approximately 2 weeks until the sanctions take affect.  For Universal American, the sanctions DO NOT include their stand alone part D plan, only their Medicare Advantage plans.Source: ritterim.com […]
Source: ritterim.com

Possible Medicare Advantage Pay Reductions Cause Insurer Stocks To Slip

Modern Healthcare: Insurers See Proposed Medicare Advantage Rates Hitting Revenue Health insurance companies are expecting reduced Medicare Advantage payments to unfavorably impact revenue next year. The CMS on Friday released its proposed 2014 rates for Medicare Advantage plans, prompting negative reaction from payers and investors. Shares of health insurance plans such as Humana, Universal American Corp. and Health Net took a dive on the news when they opened for trading this morning. The CMS proposal calls for a 2.2% decline in Medicare Advantage benchmark payment rates. Humana, which derives most of its revenue from Medicare Advantage, saw one of the largest decreases in its share price (Kutscher, 2/19).
Source: kaiserhealthnews.org

HIPAA Warning: Do Not Attempt to Hide A Data Security Breach as Health Net Did

When a portable disk drive went missing from a Connecticut office of insurance company and Medicare Advantage contractor Health Net last May, the law required them to notify authorities and affected customers immediately. Instead they kept it under wraps until November. According to an independent security company report, they also lied about it being a theft, neglected to mention two laptop PCs were also stolen, and falsely reported the data was unreadable without special software. Some officers may be exchanging pin stripes for striped suits. Even if they do not, the story is an excellent case study in how not to handle a data breach involving patient information.
Source: homehealthnews.org

Stocks in Focus: Magellan Health Services Inc, WellCare Health Plans, Universal American Corporation, Health Net

Bestdamnpennystocks, an investment community with a special focus on updating investors with recent news on the U.S. stock market, issues news alert on the following stocks:- Magellan Health Services Inc(NASDAQ:MGLN) lost 0.22% and trading at $53.42. Magellan Health Services, Inc. operates a behavioral managed care company. How Should Investors Trade MGLN After The Recent Movement? Find Out Here WellCare Health Plans, Inc.(NYSE:WCG) decreased 1.13% and trading at $56.94. WellCare Health Plans, Inc. (WellCare) provides managed care services to government-sponsored health care programs. WellCare operates in three segments: Medicaid, Medicare Advantage (MA) and Prescription Drug Plan (PDP), which are within its two main business lines: Medicaid and Medicare. Is WCG Strong Buy After The Recent Strong Gains? Get Free Trend Analysis Here Universal American Corporation(NYSE:UAM) lost 0.60% and trading at $8.35. Universal American Corp., through its health insurance and managed care subsidiaries, primarily serves the growing Medicare population by providing Medicare Advantage products. Is UAM a Buying Opportunity After The Recent Plunge? Don’t Miss Out Our Latest Report Here Health Net, Inc.(NYSE:HNT) went up 0.21% and trading at $28.07. Health Net, Inc. is a managed care company that delivers managed health care services through health plans and Government-sponsored managed care plans. How Should Investors Trade HNT After The Latest Earnings Report? Find Out Here About bestdamnpennystocks.com Best Damn Penny Stocks’ team is engaged in providing stock newsletters on various hot penny stocks on a regular basis. Our instant stock news on Major Gainers, small cap penny stocks and various other stocks, guides investors in making the wise stock market investments decision. In order to get update to the markets, we would advise you sign up to our free newsletters. You can become leader in stock market by keeping track of the daily activity. Disclaimer The assembled information disseminated by Bestdamnpennystocks.com is for information purposes only, and is neither a solicitation to buy nor an offer to sell securities. Bestdamnpennystocks.com does expect that investors will buy and sell securities based on information assembled and presented in Bestdamnpennystocks.com. PLEASE always do your own due diligence, and consult your financial advisor.
Source: sbwire.com