Medicare Secondary Payer: The Shape of Things to Come

Posted by:  :  Category: Medicare

H.R. 1063, the Strengthening Medicare and Repaying Taxpayers (SMART) Act, had gained a significant amount of bipartisan support in both the House and Senate; however, with the election pending, the outlook seemed bleak that it would be passed by the 112th Congress. Well, on September 13, 2012, the Energy and Commerce Subcommittee on Health met in an open markup session and made certain adjustments to the bill to implement more automated functions to the conditional payment recovery process. The committee met again on September 20, 2012, and again made minor adjustments to the bill, then favorably forwarded it to the full committee and sent it back to the CBO for scoring. There was no further indication of progress until on December 19, 2012, a lesser version of the SMART Act emerged as Title II of the Medicare IVIG Access Act [H.R. 1845]. H.R. 1845 proposed a $45 million dollar demonstration project to study providing Medicare coverage for in-home administration of intravenous immune globulin (IVIG) to patients suffering from primary immune deficiency disease. Despite the sympathetic appeal of helping the bubble boy, H.R. 1845 needed to be off-set by a bill such as the SMART Act, which proposed to coincidentally save Medicare $45 million dollars over ten years, and the match was made. The new combined bill was nearly unanimously passed by the House on December 20, 2012, and passed by the Senate on December 21, 2012. On January 10, 2013, President Barack Obama signed the legislation, making it
Source: lexisnexis.com

Video: What is the best health insurance company in New York for Medicare retirees? My

Primary Insurance Change, Late Filing, Unpaid Claims, Collections Threat

Since 2000 I have had medical insurance with GHI with no problem. In April 1st of 2011 I acquired Medicare due to my disability. Now I have two medical insurances (GHI and Medicare). At this time I was unaware that Medicare took over as my primary insurance. In the end of the year 2012 my doctors sent my claims to GHI and GHI paid the claims. Then GHI realized that my primary insurance was Medicare. So they sent a collection notice to the doctors to reclaim the money. They also sent notice that they should re-file the claims with Medicare. By the time they figured all this out Medicare is denying some of the claims due to late filing. Now my Doctor is threatening me with collections and adding interest – and ruining my credit. I just find it odd … with two insurance coverages and no laps in insurance I’m being charged almost $2000. How Can I Fix This? Thanx a bunch ,,,,,,,,,,,,,,, Peter Q Response: Peter, What you’ve run into we see occasionally in billing for our providers – and it’s really not that uncommon. Here’s how we handle it – First the provider reimburses the payer that was mistakenly billed as primary – in your case this was GHI. We then submit the claims to Medicare with an explanation that these claims were mistakenly submitted to the secondary payer who has since been reimbursed. In these situations we would file an appeal with Medicare which typically requires we submit additional proof such as the original Explanation of Benefit’s (EOB) and other documentation to clear up the late filing denial from Medicare. Claims are then submitted to the secondary payer once the primary payer (Medicare) has paid on the claim(s). Really the providers I’ve worked with don’t threaten their patients with collections. We just work it out between the payer as I described above and bill the patient for the amounts they are contractually responsible for. Hopefully your doctor will not follow through with collection efforts. And really I don’t think that they would be very successful in doing so given you have adequate insurance coverage and have been cooperative in helping to figure all this out. You also may want to talk to Medicare and describe the situation and find out exactly what your rights are. Hope this helps answer your question.
Source: all-things-medical-billing.com

Roofer tooday: Best Roofers In Queens Ny

Enjoy free performances by the Metropolitan Opera in Parks throughout New York City. Brooklyn Bridge Park in Brooklyn, Socrates Sculpture Park in Queens, Clove Lakes Park in Staten Island and Crotona Park in the Bronx. Travel; Best of New York City; New York City for Beginners; Things to Do In NYC;
Source: blogspot.com

Emdeon Current: New Payer Transactions

Claims Management Services, Payer ID: 39141 Clarian Health Plans Inc., Payer ID: 95444 Connecticare – Medicare, Payer ID: 78375 CoreSource Little Rock, Payer ID: 75136 DiaTri LLC, Payer ID: 36439 Employee Benefit Systems, Payer ID: 42149 Fallon Community Health Plan, Payer ID: 22254 GHI – Medicare Private Fee for Service, Payer ID: 22937 GHI – New York (Group Health Inc.), Payer ID: 13551 GHI HMO, Payer ID: 25531 Geisinger Health Plan, Payer ID: 75273 Group Health Cooperative of South Central Wisconsin, Payer ID: 39167 Group Health Inc., Payer ID: 22937 HIP – Health Insurance Plan of Greater New York, Payer ID: 55247 Harrington Health-Kansas (formerly known as Fiserv Health-Kansas), Payer ID: 62061 Harvard Pilgrim Health Care, Payer ID: 4271 ISLAND HOME INSURANCE COMPANY, Payer ID: IU Medical Group Primary Care, Payer ID: SX172 Integra Group, Payer ID: 31127 LIFE Pittsburgh, Payer ID: 25181 Landmark Healthcare Inc, Payer ID: LNDMK MED PAY, Payer ID: 88058 MEDICA HEALTH CARE PLAN INC., Payer ID: 78857 March Vision Care Inc., Payer ID: Call Meritain Health / Agency Services, Payer ID: 64158 Meritain Health/North American Administrators, Payer ID: 64157 Metropolitan Health Plan, Payer ID: 10850 Montefiore Contract Management Organization, Payer ID: 13174 Network Health, Payer ID: 4332 Network Health Insurance Corp-Medicare, Payer ID: 77076 North American Administrators Inc., Payer ID: 64157 North American Health Plan, Payer ID: 64157 North American Preferred, Payer ID: 64157 Northstar Advantage, Payer ID: 60058 ODS Health Plan, Payer ID: 13350 PacificSource Health Plans, Payer ID: 93029 Paragon Benefits Inc., Payer ID: 58174 Prism-First Health, Payer ID: 37303 Screen Actors Guild, Payer ID: 99289 Touchstone Health PSO, Payer ID: 23856 Trellis Health Partners, Payer ID: 36397 Vytra Healthcare, Payer ID: 22264 Weyco Inc., Payer ID: 38232 Wisconsin Department of Corrections, Payer ID: 74101 Anthem Blue Cross, Payer ID: 47198 Associated Benefits, Payer ID: 50266 Blue Cross Blue Shield of New Mexico, Payer ID: SB790 Blue Cross Blue Shield of Oklahoma, Payer ID: SB840 Illinois Medicaid, Payer ID: SKIL0 Nebraska Medicaid, Payer ID: SKNE0 New Hampshire Medicaid, Payer ID: SKNH0 Eligibility Inquiry and Response Ameritas Group, Payer ID: AMERITAS Ameritas Life Insurance Company, Payer ID: 425 CoreSource – FMH, Payer ID: CORSE00204 CoreSource – FMH, Payer ID: CRSKC CoreSource – Little Rock, Payer ID: CORSE00205 CoreSource Little Rock, Payer ID: CRSAR Coresource – FMH, Payer ID: 204 Coresource Little Rock, Payer ID: 205 First Ameritas of New York, Payer ID: 426 First Ameritas of New York, Payer ID: AMTAS00426 First Reliance Standard Life Ins Co., Payer ID: 428 First Reliance Standard Life Insurance Company, Payer ID: AMTAS428 MMSI, Payer ID: 85 MMSI, Payer ID: MMSI Medica, Payer ID: 404 Medica, Payer ID: MEDIC Medical Mutual of Ohio, Payer ID: 211 Medical Mutual of Ohio, Payer ID: MMO00211 Nippon Life Benefits, Payer ID: NIPON Peoples Health, Payer ID: PPLSH Reliance Standard Life Insurance Company, Payer ID: 427 Reliance Standard Life Insurance Company, Payer ID: AMTAS00427 SAMBA Health Benefit Plan, Payer ID: SAMBA Standard Insurance Company, Payer ID: 429 Standard Insurance Company, Payer ID: AMTAS00429 Standard Life Insurance Company of New York, Payer ID: 430 Standard Life Insurance Company of New York, Payer ID: AMTAS00430 ameritas, Payer ID: AMTAS00425 Blue Cross Blue Shield of Pennsylvania (Highmark), Payer ID: BCPAC Blue Cross Blue Shield of Pennsylvania – Highmark, Payer ID: 440 Mountain State, Payer ID: MTNST Affinity Health Plan, Payer ID: AFNTY New Jersey Medicaid, Payer ID: AID19 New Jersy Medicaid, Payer ID: NJ South Dakota Medicaid, Payer ID: AID28 South Dakota Medicaid, Payer ID: SD Claim Status And Response: Ameritas Group, Payer ID: AMERITAS Ameritas Life Insurance Company, Payer ID: 425 CoreSource – FMH, Payer ID: CORSE00204 CoreSource – FMH, Payer ID: CRSKC CoreSource – Little Rock, Payer ID: CORSE00205 CoreSource Little Rock, Payer ID: CRSAR Coresource – FMH, Payer ID: 204 Coresource Little Rock, Payer ID: 205 First Ameritas of New York, Payer ID: 426 First Ameritas of New York, Payer ID: AMTAS00426 First Reliance Standard Life Ins Co., Payer ID: 428 First Reliance Standard Life Insurance Company, Payer ID: AMTAS428 MMSI, Payer ID: 85 MMSI, Payer ID: MMSI Medica, Payer ID: 404 Medica, Payer ID: MEDIC Nippon Life Benefits, Payer ID: NIPON Peoples Health, Payer ID: PPLSH Reliance Standard Life Insurance Company, Payer ID: 427 Reliance Standard Life Insurance Company, Payer ID: AMTAS00427 SAMBA Health Benefit Plan, Payer ID: SAMBA Standard Insurance Company, Payer ID: 429 Standard Insurance Company, Payer ID: AMTAS00429 Standard Life Insurance Company of New York, Payer ID: 430 Standard Life Insurance Company of New York, Payer ID: AMTAS00430 For all payers, visit https://access.emdeon.com/PayerLists/
Source: blogspot.com

Medicare MSPRC contract change

Although there has not  been a formal announcement  it appears that the new contactor to perform recovery activities on behalf of Medicare will be Group Health Incorporated (GHI).  GHI is a familiar entity to Medicare as GHI has been the Medicare Coordination of Benefits (COB) since 1999. Under the new contract GHI will expand its role to include the recovery portion of the Medicare process.
Source: lienresolutiongroup.com

Delay in Electronic Remittance Advice (ERA) for Multiple CPIDs

Due to a payer processing issue, there has been a delay in some Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates 06/29/2012 through present: CPID 3533 and 1452 Connecticut Medicare CPID 3519 and 4442 New York Empire Medicare CPID 7401 New York GHI Medicare CPID 1463 New York Upstate Medicare CPID 3500 Indiana Medicare CPID 1445 Indiana Medicare CPID 5506 Illinois Medicare CPID 3515 Michigan Medicare CPID 5530 West Virginia Medicare CPID 5536 Virginia Medicare CPID 5512 Wisconsin Medicare CPID 1947 RHHI Home Health Region V-Service Area 7 The clearinghouse is working with the payer to receive all outstanding ERA files as quickly as possible. Additional updates will be forwarded as more information becomes available. Please be aware of a delay in the delivery of ERA files for the dates above. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

Phone Scams Target Medicare Beneficiaries in California

Posted by:  :  Category: Medicare

"We hang the petty thieves and appoint the great ones to public office." ~AESOP. by eyewashdesign: A. GoldenCallers claiming to be with the Medicare program tell their targets that a replacement Medicare card is coming in the mail but a bank account number is needed first, according to a press release from Ramsey’s office. Sometimes, the caller will ask for a Medicare card number, which can be used for identity theft since it’s tied to a Social Security number.
Source: medbill.net

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

NYC Cardiologist Admits Faking Diagnoses to Collect Medicare Money

In court, Katz told the judge as a doctor he had "done everything he could to help patients."  The judge told him he would have time to speak at sentencing set for July 23. After the court hearing, Katz and his attorney, Blair Zwillman, left the courthouse admitting mistakes were made but insisting Katz always cared for his patients.    
Source: nbcnewyork.com

Competition and free market principles are saving Medicare

The Congressional Budget Office keeps finding cost savings in Medicare Part D – Medicare’s Prescription Drug Benefit Plan. That’s good news for the about 900,000 Illinois seniors who have Part D plans. Unlike other parts of Medicare, Part D is run entirely by private insurance companies who compete to sign up seniors and then bargain hard with drug companies for the best price on lifesaving drugs. Seniors get to choose what works best for them, and the competition keeps costs in check.
Source: typepad.com

The Medicare Free Wellness Visit: I’d Rather See a Veterinarian

s Beth Israel Hospital. She was an instructor, then Assistant Professor of Anesthesiology and Critical Care Medicine at Johns Hopkins Hospital in Baltimore, Maryland before returning to California for private practice. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law. She interned at the National Health Law Project and practiced insurance and health law. She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers. Dr. Singleton recently returned from El Salvador where she conducted make-shift medical clinics in two rural villages. Her latest presentation to physicians was at the AAPS annual meeting about challenging the political elite.
Source: ppjg.me

Taking Sides: Should the U.S. have a civil service requirement?

Two summers ago, I worked in the District Office of my congresswoman, assisting mostly with Medicaid and Social Security casework. I learned a lot about what government can and cannot do. For example, if people living the poverty line had surgery and Medicaid had neglected to pay the hospital, they might find themselves hounded by calls for the payment, for which they weren’t responsible. In that case, we could call the hospital and tell them to lay off, while also telling the local Medicaid office to pay up.
Source: collegemedianetwork.com

U.S. Cancer Treatment Sector Appealed to Congress March 13, To Stop Medicare Cuts

Over the past four and a half years, 241 community cancer clinic sites have closed and 442 practices (often with multiple clinic locations) are struggling financially. As community cancer clinics close their doors, access to cancer care is compromised for cancer patients, especially vulnerable seniors covered by Medicare. Additionally, 392 clinics have consolidated into the hospital, with consolidation driving up costs to cancer patients and payers. (1) According to recent studies by Milliman (2) and Avalere (3), cancer patients, Medicare, and private insurers pay substantially less for cancer care when chemotherapy is administered in the physician community cancer clinic setting. Unfortunately, this cancer care crisis will seriously worsen with the sequestration-mandated cuts to Medicare effective April 1—access problems will multiply and costs will increase for both Medicare beneficiaries fighting cancer and taxpayers.
Source: larouchepac.com

Daily Kos: Obama budget cuts Medicare benefits and provider payments

On the other hand, the proposals for seniors aren’t a positive move. At least Obama didn’t include the hike in the Medicare eligibility age that he had previously offered to Boehner, but what he does include could be another hit for seniors, on top of the chained CPI. Cutting out Medigap policies would increase out-of-pocket costs for seniors. Those costs have been steadily and steeply rising [pdf] for seniors already over the past two decades. Adding more means testing to the program (wealthier individuals already pay higher premiums for Part B, the part that covers physician services and supplies) shifts the program further from from universal coverage and opens it up to more and more means testing, and toward a stigmatized and politically vulnerable poverty program.
Source: dailykos.com

Obama Administration to Cancer Clinics: We Won't Alter Medicare Chemo Cuts

The principle was expressed most strongly in the 1946 "Hospital Survey and Construction Act," known as Hill-Burton, for its bipartisan Senate sponsors, Lister Hill (D-Ala.) and Harold Burton (R-Ohio). It mandated Federal/state/local collaboration for a nationwide hospital-building program, designed to provide the necessary number of staffed hospital beds per 1,000 people throughout the nation, ranging from 4.5 beds per thousand in urban areas to 6 in rural locations. By 1950, plans for new hospitals, or expansions of existing facilities, were underway across the nation. In the 1930s, out of 3,076 counties in the U.S., there were 1,282 with no hospitals at all, plus many in operation were sub-standard. This was all corrected by the 1970s.
Source: larouchepac.com

Sequester Fallout: Where Will Medicare Patients Get Chemo?

The process has begun, reports the Washington Post’s Sarah Kliff: “If we treated the patients receiving the most expensive drugs, we’d be out of business in six months to a year,” said Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates in New York. “The drugs we’re going to lose money on we’re not going to administer right now.”
Source: aarp.org

Obama Moves Forward with Cutting Social Security and Medicare as We Lecture Europe Otherwise

Many will claim that Obama was stymied by a Republican Congress. But the primary policy framework Obama put in place – the bailouts, took place during the transition and the immediate months after the election, when Obama had enormous leverage over the Bush administration and then a dominant Democratic Party in Congress. In fact, during the transition itself, Bush’s Treasury Secretary Hank Paulson offered a deal to Barney Frank, to force banks to write down mortgages and stem foreclosures if Barney would speed up the release of TARP money. Paulson demanded, as a condition of the deal, that Obama sign off on it. Barney said fine, but to his surprise, the incoming president vetoed the deal. Yup, you heard that right — the Bush administration was willing to write down mortgages in response to Democratic pressure, but it was Obama who said no, we want a foreclosure crisis. And with Neil Barofsky’s book ”Bailout,” we see why. Tim Geithner said, in private meetings, that the foreclosure mitigation programs were not meant to mitigate foreclosures, but to spread out pain for the banks, the famous “foam the runway” comment. This central lie is key to the entire Obama economic strategy. It is not that Obama was stymied by Congress, or was up against a system, or faced a massive crisis, which led to the shape of the economy we see today. Rather, Obama had a handshake deal to help the middle class offered to him by Paulson, and Obama said no. He was not constrained by anything but his own policy instincts. And the reflation of corporate profits and financial assets and death of the middle class were the predictable results.
Source: nakedcapitalism.com

YOUR SOCIAL SECURITY AND INCOME TAX

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 marsmet526The tax money collected is reimbursed to the Social Security system.  It is Social Security’s third income stream (the other two are payroll taxes and interest on SSA’s bond portfolio), and comprises 3% of Social Security’s budget. http://www.ssa.gov/policy/docs/chartbooks/fast_facts/2012/fast_facts12.html#page10
Source: retireusa.net

Video: Social Security Disability tip: Functional Report Forms -3d parties

Listing Forms for Social Security Disability Evaluation

If your doctor says that your medical condition meets the criteria of a listing from the Social Security Blue Book, you should be able to get approved for Social Security disability benefits, as long as the medical evidence backs up the doctor’s opinion. In order to provide Social Security with your doctor’s opinion, we’ve created “listing forms” for the most common medical conditions that Social Security sees. This form can help you at the initial application phase and the appeal phase.
Source: disabilitysecrets.com

Identity Theft: What to Do if Someone Has Already Filed Taxes Using Your Social Security Number

The above article is intended to provide generalized financial information designed to educate a broad segment of the public; it does not give personalized tax, investment, legal or other business and professional advice. Before taking any action, you should always seek the assistance of a professional who knows your particular situation for advice on your taxes, your investments, the law or any other business and professional matters that affect you and/or your business.
Source: intuit.com

Daily Kos: Social Security expansion idea gaining steam

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Source: dailykos.com

Obama Moves Forward with Cutting Social Security and Medicare as We Lecture Europe Otherwise

Many will claim that Obama was stymied by a Republican Congress. But the primary policy framework Obama put in place – the bailouts, took place during the transition and the immediate months after the election, when Obama had enormous leverage over the Bush administration and then a dominant Democratic Party in Congress. In fact, during the transition itself, Bush’s Treasury Secretary Hank Paulson offered a deal to Barney Frank, to force banks to write down mortgages and stem foreclosures if Barney would speed up the release of TARP money. Paulson demanded, as a condition of the deal, that Obama sign off on it. Barney said fine, but to his surprise, the incoming president vetoed the deal. Yup, you heard that right — the Bush administration was willing to write down mortgages in response to Democratic pressure, but it was Obama who said no, we want a foreclosure crisis. And with Neil Barofsky’s book ”Bailout,” we see why. Tim Geithner said, in private meetings, that the foreclosure mitigation programs were not meant to mitigate foreclosures, but to spread out pain for the banks, the famous “foam the runway” comment. This central lie is key to the entire Obama economic strategy. It is not that Obama was stymied by Congress, or was up against a system, or faced a massive crisis, which led to the shape of the economy we see today. Rather, Obama had a handshake deal to help the middle class offered to him by Paulson, and Obama said no. He was not constrained by anything but his own policy instincts. And the reflation of corporate profits and financial assets and death of the middle class were the predictable results.
Source: nakedcapitalism.com

Open Letter to NPR from Former SSA commissioners

Approximately 1 in 5 of our fellow Americans live with disabilities, but only those with the most significant disabilities qualify for disability benefits under Title II and Title XVI of the Social Security Act. Title II Old Age, Survivors, and Disability Insurance (DI) benefits and Title XVI Supplemental Security Income (SSI) benefits provide critical support to millions of Americans with the most severe disabilities, as well as their dependents and survivors.  Disabled beneficiaries often report multiple impairments, and many have such poor health that they are terminally ill: about 1 in 5 male DI beneficiaries and 1 in 7 female DI beneficiaries die within 5 years of receiving benefits.  Despite their impairments, many beneficiaries attempt work using the work incentives under the Social Security Act, and some do work part-time. For example, research by Mathematica and SSA finds that about 17 percent of beneficiaries worked in 2007.  However, their earnings are generally very low (two-thirds of those who worked in 2007 earned less than $5,000 for the whole year), and only a small share are able to earn enough to be self-sufficient and leave the DI and SSI programs each year.  Without Social Security or SSI, the alternatives for many beneficiaries are simply unthinkable.
Source: wordpress.com

Tax Returns with Perfect Execution of Expertise From Enrolled Agent Training Don’t Get IRS Processing When Taxpayer Names Are Inaccurate

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Source: fastforwardacademy.com

Social Security Disability Benefits: Now Access Your Social Security Account Online

There is also a section called My Social Security. You must register to be able to use this facility. Even if you do not receive social security benefits, you can register for this facility. If you are receiving benefits, you can get your verification letter online, access your payment records, change your contact details and payment methods. If you do not receive benefits, you can use this facility to access your earning records, the amount of social security taxes you have paid till date and estimate your benefits. At the time of registration, you will be required to provide certain personal information but your personal information is safe with the agency.
Source: socialsecurityexpress.com

Social security number – 5 Places to avoid sharing it

In a recent study, it was noticed that hackers stole the Social Security numbers (SSN) of around 36,000 people including intelligence officers. The details of various celebrities, political leaders, defence personnel, etc were also hacked by the thieves. The study also revealed the fact that thieves have inappropriately accessed more than 600 million consumer files since 2004. A recent report by Javelin Strategy & Research states the fact that those consumers whose Social Security number was exposed in a data breach are more likely to become victims of fraud. So, BEWARE! Don’t share your social security numbers with anyone, unless it becomes necessary to do so.
Source: mortgagefit.com

Retire Overseas: Will Your Social Security Follow You?

Unlike Medicare, your US Social Security benefits will be available to you in most countries as long as you continue to be eligible for benefits. However, the Social Security Administration is prohibited from mailing payments to you in certain countries. You will not receive Social Security payments when you live in Cambodia, Vietnam or countries that were in the former Soviet Union (some exceptions may apply). The Social Security payments that cannot be mailed to you while you are in one of these prohibited countries will be sent to you after you leave that country and go to a country where payments are not prohibited.
Source: tropicaldaily.com

Women and Social Security

If expanding your family is in your plans, it’s a good idea to apply for a Social Security number for your baby in the hospital, at the same time that you apply for your baby’s birth certificate. Social Security will mail the card to you. If you wait, you must then separately provide evidence of your child’s age, identity and U.S. citizenship status, as well as proof of your identity. Then, we must verify your child’s birth record, which can add 12 weeks to the time it takes to issue a card.
Source: hometownargus.com

Report: Many Maine Small Businesses Rely on Social Security & Medicare

“When the wealthy and large corporations avoid their tax responsibility through the use of offshore tax havens, it robs the country of the resources we need to rebuild the economy, create jobs, and support small businesses and our customers,” said Kevin Simowitz, director of the Maine Small Business Coalition. “To support small businesses, Congress should close the offshore tax loopholes, not cut Social Security and Medicare.”
Source: maineinsights.com

How to apply for the Medicare ACO program

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2.. Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481The second call will be held April 23 from 1:30 – 3:00 p.m. CMS subject matter experts will cover tips on completing a successful application, including information on how to submit an acceptable ACO Participant List, Participation Agreement Sample, Executed Participant Agreement pages, and Governing Body Template for the Shared Savings Program application. A question-and-answer session will follow the presentation.
Source: poweryourpractice.com

Video: Medicare Enrollment | Medicare Sign Up | Apply for Medicare

President’s Proposed Budget Would Boost Mental Health Programs, Inspection of Imported Food and Drugs, Stabilize Medicare Pay to Physicians

Two changes to Medicare cost sharing reflect both policy and budget decisions. Inappropriate billing for home health services is more frequent when the services have not been preceded by an episode of inpatient care. In addition, the administration says, research has shown that beneficiaries with first-dollar or near-first-dollar coverage have little incentive to consider the cost of services. Therefore, beginning in 2017, some Medicare beneficiaries would be required to make “modest copayments” for home health services. In addition, a surcharge would be imposed on Medigap policies that provide first-dollar coverage in order to give beneficiaries an incentive to consider the cost of services. In order to direct Medicare dollars where they are most needed, the Part B deductible would be modified to reduce the subsidy for beneficiaries who have less financial need.
Source: wolterskluwerlb.com

Ask The Experts: Retirement

Q. I will apply for Medicare Part A when I reach 65 as a FERS retiree. My wife will not be eligible for eight years after, and I will retain my federal Blue Cross/Blue Shield family policy. She also has a state BC/BS policy in which I am included. Her policy does not carry over into retirement, so I will keep mine until she is eligible for Medicare. If I wait until she no longer has me under her policy, will I be entitled to then apply for Medicare Part B without penalty under the Substantially Equal Periodic Payment exception, or do I need to do it when I am eligible for Medicare to avoid the 10 percent-per-year penalty?
Source: federaltimes.com

Medigap Guaranteed Issue Rights & Protections

Because Medicare Supplement is an enhancement to Original Medicare, guaranteed issue rights only apply to those seeking Medigap coverage to complement Medicare Parts A and B. We have covered previous Medicare Supplement Insurance topics on the PlanPrescriber blog, including an introductory post, a discussion on the cost of Medigap plans and an examination of Medicare Supplement Insurance vs. Medicare Advantage plans.
Source: planprescriber.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

Application of Medicare Contribution Tax of 3.8% to Certain U.S. Persons Owning Stock in A Controlled Foreign Corporation or Passive Foreign Investment Company : Federal Taxation Developments Blog

As mentioned, a U.S. shareholder of a CFC is required to include certain amounts in income, i.e., Subpart F income to the extent of earnings and profits, under Section 951(a). The Preamble to the Section 1411 proposed regulations states that constructive or pass through income includible under Section 951 will generally not be treated as dividends in computing NII as dividend income unless expressly provided for in the Code. Still NII treatment will result to the extent the Subpart F income is derived from a trade or business to which the tax applies as provided in Section 1411(c)(1)(A)(ii)(trading trading in financial instruments or commodities) and Prop. Treas. Reg. § 1.1411-4(a)(1)(ii)). As to PFICs, a U.S. person is required to income in income amounts described under Section 193 if the taxpayer makes a QEF election under Section 1295.. Section 1293 inclusions also are not treated as dividends unless expressly provided for in the Code, and, therefore, also are not taken into account for purposes of calculating net investment income (unless the amount is derived from a trade or business to which the tax applies as provided in Section 1411(c)(1)(A)(ii) and Prop. Treas. Reg. §1.1411-4(a)(1)(ii)).  This difference in timing for reporting income for chapter 1 (regular income tax) and chapter 2A (Section 1411), as well as other overlapping provisions, will require a taxpayer to compute separate stock basis for chapter 1 and chapter 2A, subject to making an election under Prop. Reg. §1.1411-10(g) which seems to only be available after 2013 although the Preamble to the regulations when read with the proposed regulations is not entirely clear on this point, i.e., whether such election can be made for a taxable year beginning in 2013.
Source: foxrothschild.com

When should I apply for Medicare?

If you’re not receiving Social Security benefits, however, consider signing up soon. As does the Social Security Administration, Long recommends that you apply three months before your 65th birthday to ensure your coverage begins the month you turn 65.
Source: cnn.com

Apply for Medicare Online Using These Four Simple Tips

Bonnie Gortler (@optiongirl) is a successful stock market guru who is passionate about teaching others about social media, weight loss and wealth. Over her 30-year corporate career, she has been instrumental in managing multi-million dollar client portfolios within a top rated investment firm. Bonnie is a uniquely multi-talented woman who believes that honesty, loyalty and perseverance are the keys to success. You will constantly find her displaying these beliefs due to her winning spirit and ‘You Can Do It’ attitude. Bonnie is a huge sports fan that has successfully lost over 70 pounds by applying the many lessons learned through her ongoing commitment toward personal growth and development while continually encouraging others to reach their goals & dreams. It is within her latest book project, Journey to Wealth, where Bonnie has made it her mission to help everyone learn the steps needed to gain sustainable wealth and personal prosperity. Look for Journey to Wealth later in 2013!
Source: bonniegortler.com

Competition and free market principles are saving Medicare

The Congressional Budget Office keeps finding cost savings in Medicare Part D – Medicare’s Prescription Drug Benefit Plan. That’s good news for the about 900,000 Illinois seniors who have Part D plans. Unlike other parts of Medicare, Part D is run entirely by private insurance companies who compete to sign up seniors and then bargain hard with drug companies for the best price on lifesaving drugs. Seniors get to choose what works best for them, and the competition keeps costs in check.
Source: typepad.com

How to apply for Medicare Health Insurance

Part D (Prescription Drug Plan) Offers special assistance to beneficiaries with limited income, and a choice of prescription drug plans (PDP) to anyone enrolled in Part A and Part B. Medicare prescription drug plans (PDPs) cover only outpatient drugs for people in original Medicare who have no other drug coverage. You can not enroll both in a Prescription Drug Plan and in a Medicare Advantage plan. When you enroll in a Medicare Advantage plan, you will automatically lose your current PDP coverage, even if the Medicare Advantage plan does not cover drugs. Every year Medicare has an enrollment period from November 15 through December 31 when it is possible to change prescription drug providers. Medicare imposes penalties if you want to enroll in a prescription drug plan and you were not previously enrolled in a creditable drug plan. The long list of Part D providers, and the many options for monthly fees, types of coverage, and deductibles make it very difficult to choose. It is important to think carefully before making a selection because the wrong choice can cost you hundreds of dollars more in out-of-pocket expenses. Medicare has an interactive Prescription Drug Plan Finder in its Prescription Drug Coverage web page.
Source: scientificpsychic.com

WASHINGTON: Budget: cover uninsured, trim Medicare, tax cigs

Upper-middle class and well-to-do seniors would pay higher monthly premiums for outpatient and prescription drug coverage, a significant expansion of a policy already in effect. The current premiums would be boosted, and the share of beneficiaries exposed to the higher rates would keep growing until it reaches one-fourth of all those in the program. Now, only about 6 percent of Medicare recipients pay higher “income related” premiums.
Source: bradenton.com

How to Apply for Medicare Part B

There are also circumstances sometimes where people do not apply for Part B. . . Usually, it’s because they are still covered by their employers’ health insurance. If this is the case, you have different options. You can apply while still employed or wait and apply after your employment ends. You must do this during the special enrollment period. If you sign up at this time, you will not have to pay any extra fees on top of the premium like those who apply during the general enrollment period.
Source: waysandhow.com

Medigap Guaranteed Issue Rights & Protections

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CareBecause Medicare Supplement is an enhancement to Original Medicare, guaranteed issue rights only apply to those seeking Medigap coverage to complement Medicare Parts A and B. We have covered previous Medicare Supplement Insurance topics on the PlanPrescriber blog, including an introductory post, a discussion on the cost of Medigap plans and an examination of Medicare Supplement Insurance vs. Medicare Advantage plans.
Source: planprescriber.com

Video: Medicare Plan Finder Lesson 3: Selecting Pharmacies

IF I Drop Medicare Select Can I Get A Medicare Supplement Plan?

Dropping a Medicare Select plan does not mean a person has to go with a Medicare Supplement Plan. It just means he has to go with one of the standardized plans, provided he can find one. The Medicare select plans were offered prior to 1998. The process of getting the new plan is the same as it would be for someone else. Dropping one plan means he must go through the Medical underwriting process and he does not have a guaranteed issue rights, unless the company dropped him from a Medicare Select plan for any reason.
Source: seniorcorps.org

UPDATED: Elmhurst Memorial Healthcare’s Financial Health in Question as its Rating is Downgraded Again

EMHC is holding nearly $500 million in debt, secured by a pledge of gross revenue. The article states that the downgrade “reflects EMH’s continued weak operating performance and debt service coverage levels compared to Fitch’s expectations outlined in the February 2011 surveillance review.” In July 2012, Fitch downgraded EMHC from A- to BBB+. The A-, or stable rating, was awarded in February 2011. In October of that year, EMHC announced plans to merge with Northwestern Memorial Healthcare, but that venture was abandoned in June 2012. EMHC is currently in merger talks with Edward Hospital and Health Services. Fitch will assess any financial impact of that merger, should it be completed. Generally speaking, the news for EMHC’s near-term financial health is not good, according to Fitch. Also contributing to the downgrade is EMH’s weak cash-on-hand position and negative future outlook. “Liquidity is not expected to improve, as EMH is constructing a $21 million cancer center, which will mostly be funded from cash flow,” according to Fitch. Additionally, the hospital has not seen the volume of patients that had been expected, according to Fitch. “Patient volumes continue to lag expectations since the move to the new facility, reflecting overall softness in the service area.” The article also cites high expenses, although EMH has been working to reduce staffing and expenses, and a highly competitive market, with Good Samaritan Hospital (rated AA), Alexian Brothers (rated A-), Westlake and Hinsdale hospitals nearby. Fitch expects EMH to improve its financial outlook and “stablize operations.” For the full report, click here. Earlier this month, Moody’s Investors Service revised the hospital’s outlook from stable to negative. Said Moody’s:
Source: patch.com

How Does Medigap Work? Medigap 101

At one time, you could buy a Medigap policy that included drug coverage, but this is no longer the case. If you would like drug coverage (highly recommended) you will need to enroll in a stand-alone Part D plan.
Source: medicareprofs.com

Medicare plans on the rocks

The debate over the expansion of Medicaid, now raging in many states, illustrates the dangers of moving too quickly on some healthcare reforms linked to the Affordable Care Act. Poll after poll in states embroiled in controversial expansion efforts show that public opinion is sharply split over most all the plans for adding to the Medicaid rolls, even if the federal government pays the bills initially. [cont.]
Source: opiniontoday.com

Need Help Selecting a Medicare Prescription Drug Plan?

Does just thinking about selecting the right Medicare prescription drug plan send you into a panic? You’re probably not alone as over 100,000 Granite Staters wander through this process every year during Open Enrollment. See Also: 8 Things You Can Do During Medicare Open Enrollment   Medicare Open Enrollment – October 15 through December 7 – is the one time each year when ALL people with Medicare can see what new benefits Medicare has to offer and make changes to their coverage for Part C (Medicare Advantage health plans) and Part D (Medicare prescription drug coverage.) “Open enrollment is a good time for people to review their current plans,” said AARP New Hampshire State Director Kelly Clark. “Insurance plans can change their prescription coverage and out-of-pocket costs. We want to make sure AARP members and others get the best coverage at the best price.” For those wanting assistance in finding the right choice for their particular health needs and preferences, help is just a phone call away. New Hampshire ServiceLink’s Medicare specialists are available to offer free, confidential and unbiased assistance. Make an appointment online for the ServiceLink office nearest you, call toll-free at 1-866-634-9412. ServiceLink Resource Centers and Medicare Specialists can be found in several locations:
Source: aarp.org

Medicare Open Enrollment: last chance to review and compare plans

With the holiday season upon us, it’s easy to get busy this time of year. Some pretty important tasks can get left to the last minute. One of those important tasks is ensuring you are in the right health insurance plan in Medicare.  Selecting the right plan is a personal choice, and a lot of thoughtful consideration goes into finding the right match.  But just like the holidays, those key dates come whether or not you are ready.
Source: medicare.gov

Kaiser Permanente Georgia Offers Seniors Tips for Selecting a Medicare Plan

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

A Health Insurance Disaster: Falling Down the Medicare Donut Hole

Furiously logging into my insurance account did not, in fact, reveal a way for me to submit a claim for reimbursement. It revealed the fine print that I’d conveniently ignored. All of my prescriptions for the rest of December cost me hundreds more than I normally paid, because I’d reached the coverage gap in my insurance. Had I paid attention to the details, I’d have planned for this expense. Instead, I was sideswiped by massive added expenses at the worst possible time of the year. Ultimately, this mistake cost me $1,362.
Source: thesimpledollar.com

Medicaid expansion debate breaks out after study released (AUDIO)

Posted by:  :  Category: Medicare

It began with a news conference scheduled by the Platte Institute in the Capitol Rotunda.Platte Institute Executive Director Jim Vokal outlined the findings of a study of Medicaid expansion. The study questions the optimistic projections provided by proponents of Medicaid expansion. It claims the economic realities of states that have expanded on their own undermine that optimistic assessment.
Source: nebraskaradionetwork.com

Video: Nebraska Medicaid Take Medicaid away From Chronic Sick ChildDD.wmv

Medicaid Expansion in Rural Nebraska

The report finds that over 49,000 households under 65 in these rural legislative districts would qualify for LB 577’s new Medicaid initiative. This represents over 19 percent of the total households with residents under 65 in those districts. The greatest proportions of qualifying households exist in districts containing a mid-size city (Norfolk, District 19; Grand Island, District 35; and Kearney, District 37). However, most other legislative districts comprised entirely of rural cities, small towns and rural areas also have nearly 20 percent or over 20 percent of households that would qualify for the new Medicaid initiative under LB 577. The new Medicaid initiative that LB 577 would implement is provided for by provisions of the federal Affordable Care Act that passed in March 2010. Initially, the Act created a network of coverage options intended to create the opportunity for virtually all Americans to access health care coverage that would be affordable for their income and circumstance… Medicare for seniors; Medicaid for low-income children and the disabled; the new Medicaid initiative for working adults under 138 percent of federal poverty; and subsidies or tax incentives through health insurance exchanges for working adults from 138 to 400 percent of federal poverty. The Supreme Court decision last year, however, said that states could not be compelled to participate in the new Medicaid initiative, making that provision of the law voluntary. Nebraska’s participation in the new Medicaid initiative, therefore, requires passage of legislation such as LB 577.
Source: cfra.org

HELP STOP OBAMACARE IN NEBRASKA

THE BILLS.  The following liberal bills would expand Medicaid services in Nebraska: LB 8: Krist.  To expand Medicaid to licensed childrens’ day care health services for eligible recipients and obtain a federal waiver to offer such services.  LB 270: Campbell.  To require the state welfare dept. to apply for a federal waiver, so that Medicaid will pay for medical assistance for home and community services for kids between 4 and 21 with serious emotional disturbances. The bill would expand Medicaid services and add hundreds more clients.  Those eligible would receive personal attendant care and additional services.  Leftist NE Appleseed Center supports the bill.  LB 276: Nordquist. To require the state welfare dept. to apply for a federal waiver, so that Medicaid will pay for school district provision of occupational and physical therapy, speech, vision, and audiology services, counseling, behavior services, nursing, nutrition, personal assistance, and transportation, huge expansion of welfare and public school services.  Cost: $3 million annually.  LB 577: Campbell.  To extend Medicaid ObamaCare health care coverage to 55,000 additional Nebraskans.  Adults without children, from 19 to 65, with incomes up to $15,856, would qualify, as would parents with disabled adults.  The bill would force coverage of mental health, addiction, and rehab services.  1/5 of Nebraskans would qualify.  Federal funds would pay 100% of costs from 2014 through 2016, declining to 90% by 2020, costing Nebraska millions more annually.  The state would pay $116 million for 7 yrs.  State taxpayers would pay $500 million from 2013 through 2020.  The feds never fulfill their financial commitments.  Washington pledged to fund special ed in states at 40%; it pays only 18% of costs.  Passage would mean less state funding for K-12 education and higher taxes.  Limited access to quality care would occur, because many providers accept only a quota of Medicaid patients because of low reimbursement rates.  Other mandatory provisions of ObamaCare will force 48,000 additional Nebraskans onto Medicaid rolls. 
Source: netaxpayers.org

New bill would expand Nebraska’s Medicaid program

Leadership – Brad Ashford has 25-years of experience bringing all parties to the table to negotiate sensible solutions. read more Public Safety – No mayoral candidate has more experience in or made more contributions to public safety than Brad Ashford. read more Economic Development – Brad Ashford has created more jobs and supported more economic development projects and legislation than any other mayoral candidate. read more Education – No mayoral candidate has more experience with the challenges of inner-city schools, keeping kids in school and working with disadvantaged youths than Brad Ashford. read more Taxes & Government – No mayoral candidate has more experience or proven ability to be effective in state government than Brad Ashford. As a state senator, Brad supported the largest tax cut and largest spending reduction in the state’s history. read more
Source: bradashford.com

Medicaid Expansion Would Hurt State Priorities

The Nebraska Legislature recently held a public hearing on LB 577, a bill to bring President Obama’s massive unfunded Medicaid expansion to Nebraska. To no one’s surprise, liberal advocacy groups have voiced support for the optional expansion, but ultimately it would be at the expense of our state priorities, including education. What you don’t hear from them is a discussion about the enormous and unsustainable costs of this expansion and who’s going to pay for it.
Source: dcrponline.com

Keeping kids enrolled in Medicaid

We appreciate that this fiscal note on this bill is significant and would like to draw the committee’s attention to a couple of factors which could reduce it.  Studies from other states have found that children moved off the program often re-enroll in a few months.  In a three-year period, California spent an estimated $120 million to re-enroll 600,000 children who left Medicaid and then returned; most of them returned to the program within four months of leaving.[1]   Another analysis found that the longer children were enrolled in Medicaid, the lower their average monthly expenditures were, partly because they had more regular preventive care and partly because new enrollees may have pent-up demand for services that are more expensive than regular care.[2]  Early analysis of 12-month continuous eligibility has found reduced administrative costs, increased average months of coverage for enrolled children, reduced average monthly costs per enrollee, and delayed disenrollment.[3]
Source: voicesforchildren.com

Nebraska Did Not Expand Its Medicaid Program Insurance Families.com

Many states have accepted federal funding that will be used to expand their Medicaid programs. Nebraska is not among those states. The Governor of Nebraska, Dave Heineman, is opposed to the portion of the Affordable Care Act that allows states to expand their Medicaid programs with the use of this funding. This means that adults who live in Nebraska who are not pregnant, who are not disabled, who do not have dependent children living with them, and who are younger than 65 years of age, will not be eligible for Medicaid in Nebraska.
Source: families.com

Q&A: Nebraska Governor on Tax Cuts, Medicaid

Few governors are in as enviable a position as Nebraska’s Dave Heineman. The Republican has one of the highest approval rates of any governor in the country, and his state has one of the lowest unemployment rates. After winning four-year terms with more than 70 percent of the vote in both 2006 and 2010, last month he became the longest-serving governor in Nebraska history. As Stateline recently reported, however, Heineman’s test this year is whether he’s popular with the 49 Nebraskans who matter most: the members of the state’s one-chamber legislature. The governor is trying to persuade lawmakers to make Nebraska the first state since Alaska more than 30 years ago to end its income tax. Plus, he’s hoping to convince them not to expand Medicaid under the federal Affordable Care Act. Stateline staff writer Josh Goodman asked Heineman about these two issues. Below is an edited transcript that explores in more detail his thinking on the topics. Q: Tell me about the tax plan — what you’re hoping to achieve and why you’ve designed it the way you did. A: What our tax reform package is all about is to be more tax competitive to create more jobs and higher-paying careers. So, it’s not just about more jobs. We want to create more jobs that pay $60,000-a-year, $70,000-a-year, $80,000-a-year — middle-class family incomes. To be competitive in today’s marketplace both domestically and internationally, I think we’ve got to have a better tax system than we have. What we’re proposing is to eliminate the individual income tax and the corporate tax. When you do that, working Nebraskans would no longer pay income taxes. Small businesses would no longer have their income taxed because they primarily pay through the individual income tax. Social Security income that we’ve never been able to find a way to exempt would now be exempt. Military retirement income would be exempt. We’re proposing to do it in a way that is revenue neutral and budget neutral and that is to eliminate some of the sales tax exemptions that we’ve granted in the past. They have had a purpose, but our tax system was basically designed back in the 1960s. We didn’t even have computers then. We live in an electronic age and a technology-driven global free market economy. We need a modern, fairer and simpler tax system. Q: Tell me what your thoughts are on sales tax exemptions. Some of the business inputs (such as raw materials in manufacturing or farm equipment in agriculture) ones might be of concern. There are other things like medicine that could create some controversy. What are you looking at? A: We collect about $4 billion (a year) in current revenues: $2.4 billion from the income tax system, about $1.5 billion from the sales tax and a little bit of miscellaneous. But we exempt $5 billion. We exempt more than we collect. What I’m trying to suggest to everybody — and I’ve talked to a number of business leaders who agree — would you be willing to give up some of your exemptions to get to this more favorable tax climate? They say yes because they’re tired of telling their accountants and their lawyers to mine the tax code for exemptions to make a profit, instead of doing it in the marketplace. I’ll be the first to admit when you talk about business inputs or any of the rest, there are legitimate reasons why we did the exemptions, but that was 30 or 40 years ago. Now…if everybody says I won’t give up my exemption, then I’m going to tell them you’re for the status quo. You’re for losing our sons and daughters to other states that are going to give them better-paying jobs. I think most of us care about our sons and daughters and our grandkids, and we want a better Nebraska. Q: Is there any part of you saying, “I don’t like the health care law, I don’t really like the Medicaid expansion, but in at least the first couple of years it’s such a good deal that we need to take it and we can see later.” Anything like that? A: I’m not in favor of the president’s health care law, but I raise my right hand like every other elected official. It’s the law of the land. It’s been tested in court. He’s won reelection. It’s going forward. So, I’m going to implement it in the most efficient and effective manner I can. I studied the exchange — whether to do a federal or state exchange — much more extensively than most states. I started out thinking I was going to do a state exchange. It was contingent on two things: We had operational control and it was going to cost less money. Neither turned out to be true. It cost $470 million more to do a state exchange, so it just made sense to do the federal one. That’s exactly where I’m at on the Medicaid expansion. If it’s too costly, it doesn’t make sense. We’ve calculated that it’s hundreds of millions of dollars long-term that we can’t afford that will take away from the education of our children. Obamacare goes into effect January 1, 2014. I had to put $72 million in my budget for the growth of the current Medicaid program when that kicks in. Let’s talk about the expansion. That’s your tax money and my tax money. That’s not free federal dollars. Secondly, once you give people health insurance — because it’s too important — you expand this program, you can’t go back. My attitude is right now we can’t afford it. I’ll also make the point that the federal government said on special education, “We’ll fund it at 40 percent.” They’re doing about 18 or 19 percent. They’re broke. Do you think they’re going to hold at 90 percent to10 percent (for the Medicaid expansion)? There’s no way they can. But even that 10 percent costs us too much money. Now, if someone can prove to me that’s not true, I’ll listen. But right now the math doesn’t add up. ___ Distributed by MCT Information Services
Source: hispanicbusiness.com

What is Medigap Insurance

Posted by:  :  Category: Medicare

Gravel MediGap by Mike Licht, NotionsCapital.comMedicare has defined, and standardized, each type of Medigap Insurance policy that can be sold. The various types have a one letter designator that runs from A through N. The most popular is Medicare supplement Plan F. It is important to know that every company selling a Medigap Insurance plan has to sell the same standardized product. Some differences exist in Medigap coverage from state to state. Before purchasing any Medigap Insurance policy you should check with your state Medicare office. In general Medigap policies never cover long term, or assisted living care expenses. They also do not cover vision or dental expenses. If you are offered a Medigap Insurance policy, you should clearly understand exactly what you do not get under the policy. Then you can compare to verify what original Medicare covers. This will show you if there are any remaining gaps in your coverage.
Source: theglossy.com

Video: Learn About Medigap Plans

Medigap Plans Guide on Introduction of Medicare Plan Coverage

If we are retirees and not covered by medicare fully then medical cost then it is impossible to meet the medical costs out-of-pocket and it is best to have a look at website http://www.medigapplansguide.com and get professional help and proper guidance. It is easy and simple to operate but most comprehensive and analytical in the content it provides. It is best to the different insurance companies in the area you live, their plans, amount of coverage and what premium one has to pay, also taking into account, the pre-existing health conditions and the ones that may eventually occur at that age. After comparison, choose the best quote and secure your health with supplement benefits like AARP.
Source: theshakyhands.net

Medigap vs Medicare Advantage

Rather than being subject to the standard Part A deductible for instance, you may have a copayment required for a defined number of days. Additionally, rather than the 20% coinsurance amount required by original Medicare for outpatient services, you will generally have varying copayment or coinsurance amounts for different services.
Source: medicareprofs.com

5 Things You Need to Know About Medigap Insurance

Either Plan A, Plan C or Plan F Medigap policies must be made available by insurance companies who sell Medigap policies. Plan D and G policies issued before or on June 1, 2010 and Plan D and G policies prior to that date have different benefits. If you happen to have an older policy, such as Plan E, H, I, or J, you don’t have to purchase a new one, however, they are no longer sold. Medigap plans are regulated by the government. If you buy a California Medicare supplement, it will give you identical coverage as the same Florida Medicare supplement. In other words, Medigap Plan A is the same no matter where you reside, as is Plan B, Plan C, and so on.
Source: leerogers2012.com

How To Enroll In A Medicare Supplement Plan F Insurance Policy

Finally, be sure to review your coverage each year. All Medigap policies are subject to inflation, just like any other insurance. Most people will see an increase once a year, although some carriers also have “birthday increases,” which means the policy costs will increase slightly whenever your turn a year older. The good news is that you can always shop your policy when rates go up. It’s very easy to change insurance companies as long as you can pass the medical health underwriting. By shopping your policy annually, you can be sure to get the most out of your healthcare insurance dollars each and every year.
Source: return2writing.com

Medicare Supplement Plans For A Retirement

Included as well in Medigap Plans is an element B excess levies benefits. That available at one hundred percent for plans F, I, and J, and 80 portion for plan T. Emergency care outside of the U.S acquired to cover 80 % of the care costs during the first 60 days of each trip. Diane puttman is hoping available for systems C through J. At home recovery effect is available in plans D, G, I, and C. It covers up in order to certain amount during every custodial cleaning visit after an surgery, injury, plus illness for up to a whopping a certain maximum benefit.
Source: espaigessap.com

2013 Version of the Medigap Guidebook

Thanks for posting that. Perplexing that it’s not available on Medicare.gov yet. Also, we’ve had a couple threads about GI where we couldn’t nail down whether Plan N is or is not GI. This 2013 version does not include Plan N in the list of GI plans (the 2012 version did but only in one or two situations). Edit: I just went to Medicare.gov and while the version of Choosing a Medigap they have still shows 2012 on the first page and "Revised December 2011" on the last page, Plan N is now missing from the GI list. I know it was there before. [need a facepalm smiley]
Source: insurance-forums.net

Report Shows Value of Medigap for Rural and Low

A joint letter to the NAIC from a variety of consumer groups said that these proposals “are based on the false assumptions that beneficiaries with supplemental coverage use more Medicare services than necessary and that additional cost sharing will result in federal health care savings.” Moreover, the groups said, “We remain deeply concerned that any attempt to add cost sharing in Medigap plans will cause disproportionate harm to beneficiaries with low and modest incomes, those who are chronically ill and those living in rural communities.”
Source: ahipcoverage.com

Medigap Guaranteed Issue Rights & Protections

Because Medicare Supplement is an enhancement to Original Medicare, guaranteed issue rights only apply to those seeking Medigap coverage to complement Medicare Parts A and B. We have covered previous Medicare Supplement Insurance topics on the PlanPrescriber blog, including an introductory post, a discussion on the cost of Medigap plans and an examination of Medicare Supplement Insurance vs. Medicare Advantage plans.
Source: planprescriber.com

A Look At AARP Medigap Insurance Rates

Medigap insurance policies are basically Medicare Supplement insurance policies you can purchase for the purpose of enhancing your health insurance cover. They are insured by United Healthcare Insurance Company and are designed to provide healthcare coverage for retirees aged 65 years and above who are already enrolled in Medicare Part A and B healthcare plans. Although enrolling for a Medigap supplement policy requires that you be a member of AARP, the company can pay for your membership for the first year, depending on your location.
Source: themevillagegroup.com

The Importance Of Medigap Plans

Keep in mind that a Medigap policies are sold by private insurance companies. They are looked upon as Medicare Supplement Insurance. Depending on the Medigap plan you choose, will determine how much you will pay for the policy and what the policy will cover. There are various benefits of Medigap policies such as medical costs, inpatient hospital care, blood that you might need and other additional benefits such as emergency care and preventative care.
Source: iirojappinen.com

Cost Cutting as a Result of Medicare Competitive Bidding

Posted by:  :  Category: Medicare

Part of the Medicare Modernization Act of 2003 (MMA) required that the Medicare program keep the costs of Durable Medical Equipment (DME) down. The result was the establishment of an open-bidding system enabling Medicare to reduce equipment costs. This open-bidding system encouraged competition between DME suppliers to produce the lowest prices without sacrificing the quality of product. Under this section of the MMA, contract suppliers are required to comply with Medicare enrollment rules, as well as to be licensed and accredited. The underlying goal is to reduce the out-of-pocket costs for both beneficiaries and taxpayers.
Source: ehealthmedicare.com

Video: Medicare Competitive Bidding Fiasco

CMS: Medicare competitive bidding program for durable medical equipment expanding after successful first year

CMS hailed the first round as a success during a call with reporters Wednesday. By replacing fee schedules with prices determined through competition, the bidding process resulted in savings for beneficiaries, taxpayers and the Medicare program, said Jonathan Blum, deputy CMS administrator and director of the CMS Center for Medicare.
Source: mcknights.com

New suppliers expected to save 45

“CMS’s top priority is to ensure beneficiaries maintain access to high quality equipment and supplies at a fair price,” said Jonathan Blum, deputy CMS administrator and director of CMS’s Center for Medicare.  “Medicare contract suppliers signed contracts that included protections to ensure that they will furnish beneficiaries with necessary equipment and quality customer service. And, our extensive monitoring in Round One showed that competitive bidding reduced spending without jeopardizing access to medical equipment and supplies.”
Source: thisisreno.com

U.S. Medicare Competitive Bidding Program is causing fears of loss of liquid oxygen availability among Alphas and other COPD patients

Anyone who is experiencing problems with access to liquid oxygen because of the new competitive bidding process is also encouraged to call the C.O.P.D. Information Line at 1-866-316-2673. This is a toll-free number for peer-to-peer information about COPD by patients and caregivers. Information Line staff will collect information about problems with the Competitive Bidding Program and forward it to advocates for better patient access to care.
Source: alpha-1foundation.org

Medicare Expands Competitive Bidding Program

Medpage Today: Medicare Panel Pans Alzheimer’s Test A Medicare advisory panel expressed little support Wednesday for the idea that an imaging technology for the beta-amyloid protein tied to Alzheimer’s disease changes health outcomes. Using a scale of 1 for “low confidence” and 5 for “high confidence,” the 12-member Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) responded with an average vote of 2.1667 on how confident they were that PET scans to detect beta-amyloid protein in the brain improved health outcomes in patients who show early signs of cognitive dysfunction. Panelists expressed their concerns that the benefits of a Medicare patient knowing they tested positive for beta amyloid were outweighed by the possible false positives and other issues that come with that knowledge (Pittman, 1/30).
Source: kaiserhealthnews.org

Daily Kos: A Medicare voucher by any other name, still a bad deal for seniors

Proposals floating around Congress these days call for privatizing Medicare via vouchers, but they don’t use the term. In general, the proposals would encourage insurance companies to bid against each other, to produce the lowest-cost policies in the private market. Customers would receive a sum of money—aka a voucher— to help defray the cost. Tennessee Sen. Bob Corker introduced his “Dollar for Dollar Act,” and a good chunk of it deals with what he calls structurally transforming Medicare by “keeping fee-for-service Medicare in place, competing side-by-side with private options that seniors can choose instead. Utah Sen. Orin Hatch used the term “competitive bidding” and said allowing health plans “to compete with traditional fee-for-service Medicare” would reduce costs and preserve the quality of care. The plans would allow people to choose between these voucherized plans and traditional Medicare, preserving the notion of choice. Foes of our social insurance programs have gotten savvy enough to realize that they can’t privatize Medicare in one fell swoop, as Ryan’s original budget (back before “vouchers” were a dirty word) envisioned. So in the next iteration, they employed the idea of “choice,” of competition with traditional Medicare. That allows them to chip away at it, pulling away younger, healthier patients who might be able to get good private insurance deals and leaving the older, sicker, more expensive patients in traditional Medicare to sap the program more quickly and make killing it off entirely that much easier.
Source: dailykos.com

Information Alert: NCIL Deeply Concerned About Medicare Competitive Bidding Program

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

Competitive Bidding for Medicare Can Save Money

I 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

Medicare Competitive Bid Coming soon….for better or for worse.

Section 302 of the Medicare Modernization Act of 2003 (MMA) established requirements for a new Competitive Bidding Program for certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). Under the program, DMEPOS suppliers compete to become Medicare contract suppliers by submitting bids to furnish certain items in competitive bidding areas, and the Centers for Medicare & Medicaid Services (CMS) awards contracts to enough suppliers to meet beneficiary demand for the bid items. The new, lower payment amounts resulting from the competition replace the Medicare DMEPOS fee schedule amounts for the bid items in these areas. All contract suppliers must comply with Medicare enrollment rules, be licensed and accredited, and meet financial standards. The program sets more appropriate payment amounts for DMEPOS items while ensuring continued access to quality items and services, which will result in reduced beneficiary out-of-pocket expenses and savings to taxpayers and the Medicare program.
Source: timesunion.com

Suppliers, experts dispute savings claims from Medicare competitive bid program

Blackburn’s medical supply warehouse assembly technician Ken Knepshield checks over a finished Pride Quantum 600 power wheel chair at the warehouse in Tarentum.” src=”/csp/mediapool/sites/dt.common.streams.StreamServer.cls?STREAMOID=3PjXIlwAeGiEFmhOt$56Cs$daE2N3K4ZzOUsqbU5sYtpc4XUjFW5xUYbn8sHnx2sWCsjLu883Ygn4B49Lvm9bPe2QeMKQdVeZmXF$9l$4uCZ8QDXhaHEp3rvzXRJFdy0KqPHLoMevcTLo3h8xh70Y6N_U_CryOsw6FTOdKL_jpQ-&CONTENTTYPE=image/jpeg”> Jason Bridge
Source: triblive.com

CONTRACT SUPPLIERS SELECTED UNDER MEDICARE COMPETITIVE BIDDING PROGRAM (CMS

Hi I’m Bob Levin, CEO of and founder of Create a Profitable DME. Thanks so much for visiting our website. Script It’s 2011 and the DME business has changed dramatically Lets look at the FACTS •A sluggish economy has affected everyone •Reimbursements are down •Health Care law reform has changed how you do business •There is aggressive poaching of customers •Competitive bidding narrows your margins, So what’s a DME executive supposed to do? You can’t control the economy, You can’t regulatory environment You can’t control reimbursement schedules BUT You can control how you run your business. How can you do what you are already doing more efficiently? Take a look at your company’s practices. Look for ways to save on expenses. Bringing down your cost of sales is EQUL to making more money on each product: YOU GET TO KEEP MORE OF WHAT YOU MAKE! One of the biggest expenses in any service industry is staff cost. Even if you think you are doing well containing expenses — Have you factored in the cost of benefits such as: •Unemployment taxes •FICA •Workmen’s comp •Cost of computers and equipment? •Rent •YOUR TIME? How much time do you or others in your firm spend interacting, managing, hiring or disciplining your staff? Can you account for all of the time your firm spends managing your staff? For example, if you value your time at $100.00/hr and you spend 30 minutes talking to a $8.00/Hr employee, you just spent $58.00 not including any of the other overhead mentioned above! Maybe it is time to consider outsourcing? Looking at your organization, WHICH FUNCTIONS ARE OUTSOURCABLE Telemarketing Lead Generation Enrollment New Customer Acquisition Billing Collections A/R Reconciliation A/R Posting Win Backs 90 Day compliance calls Physician Order Retrieval Medical Notes Retrieval If you perform medical billing, then you understand the headaches and expense associated with Accounts Receivables management. You understand the effort associated with charge entry, entering demographics, calling insurance payers and the headaches of managing employees. AllegraMD makes handling all of these jobs easy and inexpensive by offering you a complete and easy to use staff outsourcing solution. Working with you, we help you transform your company into a more efficient and profitable organization, allowing you to focus on your customers and growing your business.
Source: wn.com

Medicare Announces Substantial Savings For Medical Equipment Included In The Next Round Of Competitive Bidding Program

Medicare thoroughly vets all suppliers before awarding them contracts in the program. Suppliers must be accredited and meet stringent quality standards to ensure good customer service and high quality items. We have also monitored the program areas extensively, and real-time monitoring data have shown successful implementation with very few beneficiary complaints and no negative impact on beneficiary health status based on measures such as hospitalizations, length of hospital stay, and number of emergency room visits compared to non-competitive bidding areas.  CMS will employ the same aggressive monitoring for the MSAs added in Round 2.
Source: cms.gov

Congress Reps. Clear the Air on Competitive Bidding

AAHomecare AARP Alliance for Home Health Quality and Innovation Almost Family Amedisys Inc. American Association for Homecare American Association for Long Term Care Insurance Apria Healthcare Group Brookdale Senior Living Care.com Center for Medicare Advocacy Centers for Medicar & Medicaid Services Centers for Medicare & Medicaid Services CMS Emeritus Senior Living Ensign Group featured First Care Home Health Care Gentiva Health Services Gentiva Health Services Inc. Genworth HHS Home Health Depot Home Health International Humana IntegraCare Intel-GE Care Innovations Jordan Health Services Kindred Healthcare LHC Group Inc MedPAC NAHC National Association for Home Care & Hospice National Hospice and Palliative Care Organization New York Times Paraprofessional Healthcare Institute Partnership for Quality Home Healthcare PHI ResCare HomeCare Scripps Health Sentara Healthcare The Ensign Group VA Visiting Nurse Association Visiting Nurses Association
Source: homehealthcarenews.com

U.S. expects big Medicare savings from competitive bid program

Wednesday’s announcement illustrates the savings that traditional fee-for-service Medicare could achieve at a time when analysts, policymakers and lawmakers are considering ways to reduce spending as part of deficit reduction. Some have recommended broad use of the competitive bidding process for a host of private operators that do business with Medicare, including private insurers.
Source: medcitynews.com

FREE Medicare Cost Report Webinar

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSProgressive Provider Services recently added an innovative new feature to our HHA Form 1728 software.  Instead of tediously plotting the information from the PS&R into the Cost Report, we now offer a feature that allows for all of the information to be imported straight into the software with the touch of a button.
Source: ppsassistant.com

Video: Medicare Cost Reports

Calculating Cost to Charge Ratios (RCC) from the Medicare Cost Report

First , much like the calculation for the operating cost to charge ratios, we start with the D worksheets. In this, case we need to go back to the capital costs we eliminated from line 53 on D-1. Our first step is to obtain the routine and ancillary provider capital costs from D, Part I and D, Part II.
Source: costreportconsulting.com

Research Roundup: Hospitals Will Benefit From Medicaid Expansion; Medicare’s Rising Costs

Urban Institute/Robert Wood Johnson Foundation: Uninsured Veterans And Family Members: State And National Estimates Of Expanded Medicaid Eligibility Under The ACA – According to the authors, just over a half million U.S. veterans have incomes below 138 percent of the federal poverty level (FPL), making them eligible for Medicaid coverage under the efforts of the health law to expand Medicaid. But that expansion is voluntary for states and many have expressed reluctance to go along, even though the federal government will pay the total cost of the additional beneficiaries in the beginning of the program. In states that do not expand, residents with incomes between 100 and 138 percent of the FPL could still get help through federal tax subsidies to buy private policies on the exchanges, or insurance marketplaces, being set up in each state. “Most of these uninsured—414,000 veterans and 113,000 spouses—have incomes below 100 percent of FPL, and will therefore only have new coverage options under the ACA if their state expands Medicaid,” the authors write. “However, fewer than half live in states in which the governor supports their state participating in the expansion, while the majority live in states that have chosen not to expand Medicaid or have not yet decided whether to expand.” The authors conclude that “as is the case for the rest of the nonelderly uninsured, the Medicaid expansion could help address coverage gaps for veterans and their family members in many states” (Haley and Kenny, 3/25).
Source: kaiserhealthnews.org

What To File A Functional Medicare Cost Report

There are hundreds of extraordinary plans, with an average premium of involving a month. If you’re under a several income level, you are able to qualify for no-cost coverage. Strategies some people who can successfully fulfill the main eligibility criteria coming from all both Medicare moreover Medicaid substance as a result that they are probably old (age on top 65 years ) and needy possibly at the matching time, with n’t any regular rootage of revenue. Such peoples which one are members in both formations in the same time recognized as Medicare two times eligible. The United States occupants in the room ascertain AARP yet its health insurance policies rattling worthwhile. Looking for the best Medigap supplemental insurance policy coverage is just as tricky as calculating out if somebody can buy this can. The a thing that stays on true no matter where you buying the insurance from is that for the reason it is regulated by the policies of the claim and Federal state and federal government the benefits to be found are the extremely same to everyone. Although the coverage remains the same no matter the provider there will most certainly be differences amongst each of our insurance companies as well. The discrepancies will be all over price, administrators of the plan coupled with the available Medicare supplement options. medicare supplement plan f is divided into four parts. Part A talks about home health care, hospice, hospital, and simply skilled nursing care to. Part B handles doctors’ services, other medical services, and supplies not covered by Role A. Member C allows in order to definitely receive Medicare bonuses through private insurance plan (Medicare Advantage Insurance) in place linked to Parts A furthermore B. Part D provides narcotic deaths coverage. Baby Boomers.have acquired so a number life experiences that can soon be reflected in their grown communities. Release difference is that they’ve adopted what they’ve got learned. Take for example fitness issues. Boomers parents wouldn’t incorporate fitness in their lifestyle considering it as a boring regime. So, the entire exercise trend was started in the baby boomers. It is not only a turnoff for people today because they surely have accessed it throughout their lives. Therefore, adopting it within their adult communities as part of their design is not an issue. Developers are earning adult communities highlighting their rich middle-agers history. Take advantage plans are not ever standardized like Medigap Plans, so it’s important to understand individual organize rules before your family enroll. Discover finding out that prescription drugs get covered. When you have the name and address at the doctor you actually plan to visit, check with their State Board linked with Medical Examiners. It’s easy accomplish it online by entering your shape name and Forum of Medical Investigators in the search engine results. The State Barrier allows you to appear at a existing or a chance doctor’s profile. You’ll be proficient to check which can see things such as if the doctor has previously been disciplined or that used to be accused of wrongdoing, convicted of the latest felony, had benefits revoked or if there are any pending actions or lawsuits against your pet. Cms estimates that 209,000 eligible professionals might be subject into the 2012 payment change if they do not become eligible providers – or maintain exemptions — centered around claims data. In 2010, however, 100,444 professionals participated in the eRx Benefit Program. Pc or google tv has certainly taken hold in some specialties.
Source: typepad.com

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

Which Way To File Some Medicare Cost Report

Medigap insurance plans were standardized by the govt many years ago. This means that no appear insurance company acquire it from, valuable will be drinks as well .. When it comes to help Medigap policies, they all are selling the ditto. A plan F for ABC Company is the similar to a plan F from Xyz Company, or any other insurer for where matter. Certain makes shopping for such insurance plans much easier because you learn you’re getting a single apples to apples comparison between corporations. However, the insurance companies can charge WHATEVER premiums they for these Medigap Plans. So looking is critical. ‘If the request is based on a law or regulation proscribing eRx, the physician must cite experienced legal provision and as well describe how thought restricts his as well as her ability in order to e-prescribe. Till recently, medicare reward coverage was thought of primarily in terms of hospital insurance and helath insurance. Medicare part A covers surgery visits and breastfeeding your baby home stays, in contrast to medicare part N pays for outpatient care and services, including doctor’s visits, xrays, and exploration reports. However, the medicare tool was recently updated to include a functional prescription drug positive aspect. This is known as medicare feature D. Over exterior, only my similarities of each Baby Boomers can rise above the crowd evidently. For instance, they almost lived by means of the civil the law period and the Vietnam War. Their generation were the initial an individual to develop plan televisions. During the same way, if the your money that politicians defrauded from all workers, old and young, could be brought back it should stay returned to every one of the workers in the effort to render them whole. Getting qualification for medicaid health benefits on the structure of disability status, of course, utilizes that a distinct person file an application, or initial claim, for title 2 benefits with a social security administration. Title Two benefits are dictated under title second of the web 2 . security act and then title II benefits are commonly introduced to as interpersonal security disability benefits, or SSD. As it is known, inhabitants of that USA often experience hurricanes, a tornado, flooding and earthquakes. Besides, in the USA the actual amount of fire in houses is very great. According to the exact official statistics, all the way through 2006 412500 condos have suffered from fires. For fires was puzzled more than twenty five hundred persons, fire destroys property for all the sum of 10 billion dollars. What Exactly Does Medicare Supplement Insurance Cover? regulations are ensure you subject to shift. Indeed, an organization called RAMP (Restore Access to Mobility Partnership) is at the lobbying for alteration of the Medicare natural laws that would be sure those who need such equipment are certain to get it. Finally, to complicate things even more you throw in the life insurance gap, enrollment periods, and a fee. A separate article could always be written on wedding users and attendents subjects, so I’ll just mention them here. However, the federal government does not even provide this coverage. Prescription drug coverage for medicare part And is provided by independent drug desires that are reality operated by individual health insurers, though, legally, such recommendations are regulated while the federal government, i.e. a person’s medicare program.
Source: typepad.com

Which Way To File A Functional Medicare Cost Report

All Tax Lady Roni Deutch and your wife’s law firm Roni Deutch, A Veteran Tax Corporation have been helping taxpayers in the united states find IRS duty relief for for seventeen years. The firm contains experienced tax lawyers who can cope with IRS tax liens on your account. Treatment is the Us all health insurance plan for seniors and disabled people. It provides base medical coverage, and as a consequence it really is useful our seniors and as a result disabled pay for health care. But original Treatment does not pay for everything, in addition dental or vision benefits are limited. Regular people search at my photos of seniors like monoliths characteristically. Having said that, all through fact, the Baby Boomers are distinctive brought on by each other more. On behalf of example, Medicare perhaps pay for a hospital stay in the event that of a difficult dental procedure. But it may not cover the real world dental work. For another example, Medicare does not usually cover eyeglasses or contacts. However, it is beneficial after intraocular the len’s cataract surgery. Using recent years, however, issues involving supplemental medicare insurance.have risen. Concerns about funding and then universal health concern coverage plagued Treatment. There are plus issues that full coverage could be sought with Medicare insurance. Even the facts involving the quality of health treat that Medicare tops have become the actual source of inquiries from citizens. Such issues come to the rise in popularity regarding Medicare supplement plans, which are really offered to Us by private insurance plan coverage providers. Advantage plans are not standardized like Medigap Plans, so it’s vital that understand individual design rules before clients enroll. Come about finding out which probably prescription drugs are perhaps covered. We all all concerned who have our eyesight while teeth. Unfortunately these services can be expensive. It may wind up as time to find out some alternatives before you have the actual emergency need. In the absence of usually the insurance you risk to be added to compensate price of repair of most another’s car expenses on rehab of the casualty. Therefore try to realize the good autoinsurance in the online business with high standing. The good variant of the insurance can you side benefits, for example, possibleness of free towage of the substandard car. The first of the clean proposed exemptions, participation in one of these two EHR Incentive Courses and adoption of a certified EHR system, is a respond to critics who pointed out CMS that there a conflict concerned with the requirements of the most important eRx and this EHR Programs. Until there remain Medicare-certified EHRs when it comes to anesthesia services, brand new exemption will not be of much use to the specialty. Pain physicians may have adopted registered EHR technologies, however, and if so, this exemption shield them using the 2012 eRx consequence. Content management system estimates that 209,000 eligible professionals might be subject towards 2012 payment correction if they do not become eligible offerings – or get exemptions — by considering claims data. In 2010, however, 100,444 professionals took part in the eRx Encouragement Program. The technology has certainly acquired hold in some specialties.
Source: typepad.com

Daily Kos: Kaiser report details Medicare options

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

Peter Orszag: Medicare cost slowdown could close U.S. budget gap

Since continuation of the recent slowdown would almost eliminate the projected increase in Medicare spending as a share of the economy, it’s crucial that we monitor closely the pickup in spending growth. And as I have emphasized previously, there is plenty more we can do to improve value and constrain cost growth in health care. Peter Orszag is vice chairman of corporate and investment banking and chairman of the financial strategy and solutions group at Citigroup Inc., and a former director of the Office of Management and Budget in the Obama administration. The opinions expressed are his own. To contact the writer of this article. email Peter Orszag at orszagbloomberg@gmail.com.
Source: politicsinminnesota.com

New CBO Report Shows Medicare Leading the Way on Lowering Costs

[1] Congressional Budget Office, The Budget and Economic Outlook: Fiscal Years 2013 to 2023, available at http://cbo.gov/publication/43907. [2] http://www.healthcostinstitute.org/news-and-events/press-release-2011-health-care-cost-and-utilization-report [3] Washington Post, Wonkblog: Three Ways CBO Expects Health Spending to Change. Available at http://www.washingtonpost.com/blogs/wonkblog/wp/2013/02/05/three-ways-cbo-expects-health-spending-to-change/ [4] Center for Medicare Advocacy, Medicare Facts and Fiction: Costs and Spending Edition, available at http://www.medicareadvocacy.org/2013/01/10/medicare-facts-and-fiction-costs-and-spending-edition/ [5] Kaiser Family Foundation and Harvard School of Public Health: The Public’s Health Care Agenda for the 113
Source: cmahealthpolicy.com

Area Wide News: Local News: Unexpected debt and upset employees mar hospital board meeting. (04/03/13)

Later, administrator Thompson said five new nursing staff members were recently hired and are undergoing orientation. Thompson said staffing levels the weekend of March 22 and 23 were based on past weekend censuses of just six or seven patients. He said it was his fault the hospital was not able to better respond when it filled up with patients. Thompson said a new incentive program was being launched to insure that there is adequate staff on duty and on call to respond to such situations in the future. According to Thompson, CEO Zechman told the local hospital board and OMC’s board that OMC remains committed to fulfilling its three year contract to manage the Fulton County Hospital, and allegations that OMC is plotting to close the local hospital are unfounded.
Source: areawidenews.com

OIG Report: Medicare Part B Overpaying for Infusion Medications

OIG recommended that CMS “seek legislative change” over reimbursement policies or include the devices used with such drugs in the next round of competitive bidding. According to “RegWatch,” CMS “partially” has agreed to ask Congress to change the rules and said it will go forward with the competitive bidding suggestion (Wilson, “RegWatch,”
Source: californiahealthline.org

What happened to Highmark Medicare Services?

Posted by:  :  Category: Medicare

Physicians and medical billing companies should not face many disruptions as a result of this transition. According to Novitas Solutions, the current Highmark Medicare website will be fully transitioned to the new Novitas site by March 30, 2012. During the transition, visitors to the old website (https://www.highmarkmedicareservices.com) will be automatically re-directed to the new Novitas Solutions website (https://www.novitas-solutions.com), where a new header and page logo can be seen. Bookmarks that users may already have for the Highmark website will purportedly still work with the new page. The Electronic Payer ID has not appeared to change, so claims submission and processing should remain unaffected by the transition. For more information, see the Informational Alert here: https://www.novitas-solutions.com/partb/info-alerts.html.
Source: healthcarebiller.com

Video: 2011 HEAT Provider Compliance Training – Overview of Centers for Medicare and Medicaid Services

New Medicare Administrative Carrier for Jurisdiction 12 Highmark Medicare Services Acquired by Diversified Service Options Inc

Diversified Service Options (DSO) acquired Highmark Medicare Services (Highmark) on January 1, 2012. DSO is a holding company and a wholly-owned subsidiary of Blue Cross and Blue Shield of Florida, Inc. (BCBS Florida). Highmark had the contract with the Centers for Medicare & Medicaid Services (CMS) to be the Medicare Administrative Contractor (MAC), formerly known as a “Carrier” or “Fiscal Intermediary,” for Jurisdiction 12, which includes Delaware, New Jersey, Pennsylvania, Maryland and Washington, D.C. For Part B services, Jurisdiction 12 also includes the counties of Arlington and Fairfax in Virginia and the city of Alexandria in Virginia.
Source: thehealthlawfirm.com

Novitas Solutions, formerly called Highmark Medicare Services, announces hundreds of health care jobs coming to Harrisburg, Pittsburgh areas

The prospect of new jobs arises from a large, new contract that was in limbo at the time of the sale. The contract, which involves administering Medicare claims for seven Southwestern states, was expected to create 500 new jobs in Pennsylvania, with about 260 coming to the Harrisburg area.
Source: pennlive.com

Highmark Medicare Services Changes Name to Novitas Solutions, Inc.

Please read the following bulletin from Highmark Medicare Services. The affected payers are: CPID 2456 Delaware Medicare CPID 5912 Delaware Medicare CPID 3677 J12 Mutual of Omaha DC,DE,MD,NY,PA CPID 7402 Maryland Medicare CPID 5554 Maryland Medicare CPID 2464 Maryland Medicare (MONTG,PRINCE GEORGE) CPID 1465 New Jersey Medicare CPID 5503 New Jersey Medicare CPID 5598 Pennsylvania Medicare CPID 2457 Pennsylvania Medicare CPID 2461 Virginia Medicare (ALEX,ARLGTN,FAIRFAX) CPID 1522 Washington DC Medicare CPID 2459 Washington DC Medicare Reported by Highmark Medicare Services: As announced March 1, 2012, Highmark Medicare Services is changing its name to Novitas Solutions. Effective March 10, 2012, Highmark Medicare will begin migrating the current Highmark Medicare website to our new Novitas Solutions website. We are targeting completing our name change to all active webpage content by March 30, 2012. The new Novitas Solutions website URL will be https://www.novitas-solutions.com. Additional details, including Frequently Asked Questions, are available at https://www.novitas-solutions.com/partb/info-alerts.html. Re-enrollment is Not required. The clearinghouse will continue processing as normal. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

Highmark Medicare Services Teleconference On Billing Of Time Units For Physical And Occupational Therapy Services : Med Law Blog

Highmark Medicare Services will be hosting a teleconference on May 15, 2009 at 12:00 p.m. Eastern to discuss the billing of time units for physical and occupational therapy services. The teleconference may reference issues such as CMS Online Manual, Pub. 100-2, Chapter 15, Sections 220 and 230; Change Request CR6321; Frequently Asked Questions; Social Security Act, Section 1862(a)(1)(A) of the Social Security Act, Exclusions from Coverage; and PT/OT modalities is Local Coverage Determination (LCD) L27513, Physical Medicine and Rehabilitation Services, PT and OT. To participate in the teleconference, the dial-in number is 1-888-276-8689 and the Access Code is 487794. Highmark Medicare Services has indicated that the teleconference does have limited capacity.
Source: medlawblog.com

Insurer Highmark selling Medicare services

Details of the deal were not disclosed in a joint news release from the two companies. The sale is expected to close in early January, and Highmark Medical Services will continue to operate as a separate organization.
Source: thedailyrecord.com

Highmark gets Medicare contract for seven more states

Under the five-year contract, the company will handle both Medicare Part A and Part B fee-for-service claims for hospitals, physicians and other healthcare practitioners in Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma and Texas, according to a Highmark Medicare Services news release. It already serves as the Medicare administrative contractor for Delaware, Maryland, New Jersey, Pennsylvania and Washington, D.C. Highmark Medicare Services has offices in Camp Hill, Pittsburgh and Williamsport, Pa., and in Hunt Valley, Md., and is a wholly owned subsidiary of Highmark, which is a Pittsburgh-based licensee of the Blue Cross and Blue Shield Association. The company recently reached an agreement to acquire West Penn Allegheny Health System, a struggling five-hospital system based in Pittsburgh.
Source: modernhealthcare.com

Diversified Service Options to acquire Highmark Medicare Services

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Source: creditcardsindex.net

Healthcare BPO News: Highmark Medicare Services to Begin Processing Claims in New Jersey

In fiscal year 2007, Highmark Medicare Services processed about 48.8 million claims and served approximately 2.3 million beneficiaries and 57,000 providers. As the MAC for J12, Highmark Medicare Services is expected to process approximately 131 million claims annually, accounting for more than 11 percent of the national Medicare fee-for-service workload. Highmark Medicare Services will be working on behalf of approximately 4.2 million beneficiaries and 137,000 physicians and practitioners.
Source: blogspot.com

Highmark Medicare Services Awarded New Contract from Centers for Medicare & Medicaid Services

Highmark Medicare Services administers contracts on behalf of the Federal government and is a wholly owned subsidiary of Highmark Inc.  Highmark Medicare Services’ mission is to provide quality services and innovative solutions in the administration of our government contracts, according to our core values (fiscal responsibility, operational excellence, customer focus, continuous improvement, and commitment to integrity), in support of stakeholder goals.
Source: virtualizationconference.com

Linda Joy Adams: Highmark Medicare Services Inc Becomes Novitas Solutions Inc

An informal news letter of all kinds of news and comments on the news. Specific intent is to ‘track’ mergers and acquisitions at the highest levels in our world and the impact these have on individual rights. This blog was started to aid me keep track for my personal benefit. It evolved into a shared content with anyone interested.
Source: blogspot.com

Ask A Medical Biller: New Jersey Medicare transitioning to Highmark Medicare Services November 14

Tags: Medical billing, switching contractors, look for possible glitches during the transition and be patient, electronic claim submission, EDI agreements required for New Jersey Medicare, Reports, EDI processing, transition, physician billing, medical billing, claims billing, health insurance, collections, billings, billers, medical industry, claim billing software, electronic medical claim billing, lytec medical billing software, medical billing schools, medical coding and billing schools, medical billing schools online, medical coding and billing schools online, medical billing classes online, online medical billing school, medical billing and coding courses online, courses online, medical billing classes, on line medical billing, medical billing programs
Source: blogspot.com