The Plan to Turn Medicare into ‘WeDon’tCare’

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSRyan recently headlined a Washington media event for the re-release of this bucket of right-wing hash. It includes turning Medicare into a “WeDon’tCare” privatized voucher scheme that would deliver seniors into the tender clutches of giant insurance corporations, forcing the elderly to pay more for less.
Source: wordpress.com

Video: Medicare Nevada- 1.800.643.7544

How Medicare is Improving Coordination of Your Care

No sorry. I went to ER last year and they wanted me to sign an 8 page contract, which I could not read at the time due to my injury, but would not treat me unless I signed it. I waited until my wife could come in and I was able to read it after an hour, also she brought my reading glasses. It said they can share my medical records with ‘anyone they feel needs to know, including family, friends, employers,police, military, ANYONE. This was at county hospital. I would not sign it and they would not treat me even though I had internal bleeding from a fall. I stood my ground and suffered for it. I could post it here. Read it. Anytime you are treated, or get insurance, or any medical care, read what you sign and tell me. People just sign away their rights to privacy. Insurance companies are the worst, trading your medical records, and as I said, you have no way to set the record strait if there is false information. It may even say you are an alcoholic or smoke cigarettes and you are not, don’t, and when you try to get new health coverage they will have that information and either hit you with huge premiums or deny you, true or not, because people are allowed to give away your records without even notifying you. And speaking of records, do you know you are not even allowed to see all your own records? Medical records or any other records, information about you? You are not allowed to even see your own records the authorities have and can see. They don’t want you to know.
Source: patch.com

Nevada Daily Mail: Local News: Officials urge legislators to reconsider Medicaid issue (04/05/13)

Really people, who pays for the uninsured? You do (you being the reader of this post) and me. One way or the other somebody pays for those that can’t pay or in some cases won’t. You pay either by higher insurance premiums (including existing Medicare and Medicaid insured) or in higher costs at the provider level for those self insured (ie wealthy enough to pay without insurance). The alternative… rural hospitals in areas of high poverty go away (go broke) then no more local hospitals. Why? Because as stated in the article, hospitals can not refuse treatment. Or, picture this alternative where hospitals CAN refuse care…… there’s a traffic accident, and the victims roll in to the hospital on a gurney the first thing the hospital has to know is, are you insured or if not, can you pay (by the way we’ll need a credit card now)? If you are insured or you can pay, you get treated. If not, sorry you’re out of luck, you’ll need to go elsewhere. In that world what do you say and who gets to tell the heart attack victim “nope we can’t help you”.
Source: nevadadailymail.com

Medicare ensures no interruption in services as UHC and UHIC plans terminate

Affected beneficiaries can choose to enroll in another Medicare Advantage or Prescription Drug Plan if they do not want to remain in Original Medicare or the newly assigned PDP. They have been granted a special election period during which they may make one change in their Medicare health care and prescription drug plan coverage. This special election period is in effect now through May 31. Coverage in the new plan is effective the first of the month following their plan selection. If a beneficiary calls 1-800-MEDICARE by March 31 and enrolls in a plan, the beneficiary’s coverage in the plan will be effective on April 1.
Source: thisisreno.com

Viewpoints: Looking For The Budget’s True Bottom Line; The Debate On Plan B Reignited; Medicare Cuts Have Impact

The Wall Street Journal: A Primer For Understanding Obama’s Budget President Obama will release his overdue budget on Wednesday. It will doubtless project a reduction in the federal budget deficit—a projection that journalists, commentators and policy makers should ignore. To do otherwise is to be complicit in fraud. Strong statement? Not really. … Fortunately, some years ago the CBO began to present “alternative scenario” budget projections, in which differences from current-law projections are explained in detail. In its early February update, one example is that the 25% cut in physician Medicare reimbursements scheduled for next Jan. 1 will not occur. That adjustment increases the projected deficit in 2023 by $16 billion, and cumulatively by $138 billion from 2014-23. Congress has overridden the scheduled cut in physician reimbursements every year since 2003, in a legislative provision known as the “doc fix” (William Poole, 4/8).
Source: kaiserhealthnews.org

Nevada Senate Candidate Shelley Berkley on Medicare, the economy and the Affordable Care Act

On a recent trip to Nevada, Up host Chris Hayes sat down with Rep. Shelley Berkley, the Democratic candidate for Senate there. Berkley is challenging Republican Sen. Dean Heller. Chris asked Berkley about the unemployment rate in Nevada — the highest in the nation — Republican vice presidential candidate Paul Ryan’s proposed cuts to Medicare, and Berkley’s vote in Congress for the Affordable Care Act.
Source: msnbc.com

Medicare Supplement Plans In Nevada, Colorado, and Utah

Typically the healthier the state the lower the rates. All of these states boast a very good health rating. When a Medicare Supplement Company has lower health claims they also have lower costs which they usually pass along to the consumer as lower rates for there plans. Actually these companies are able to look in years past to try to determine there future costs for claims, when they see that in years past claims costs have been comparably lower than other states they are able to keep prices lower because of that. These rocky mountain area states thus are benefiting from a healthy life style, All of these states have lots of outdoor activities which aide in preserving a great health rating.
Source: allabout101.com

Obama’s Social Security, Medicare Cuts

Photo: Courtesy USC Roybal Institute on Aging Traducción al español WASHINGTON, D.C.–The Social Security and Medicare cuts President Obama included in his proposed budget would disproportionately harm Latino Americans and are deeply unpopular in our community. Rather than being part of a “Grand Bargain” offered to Republicans in exchange for possible tax increases, these cuts are a great betrayal of a group that proved essential to the president’s victory in the 2012 election. President Obama won an unprecedented 71 percent of the Latino vote nationwide, allowing him to edge out Mitt Romney in the key swing states of Colorado, Florida, Nevada and New Mexico. What many may not know is that like most Obama supporters, Latinos voted for the president in no small part, because they believed they could rely on him to protect Social Security, Medicare and Medicaid. Latinos Depend More on Social Security Latino voters believed President Obama in his 2011 State of the Union speech when he said we must “strengthen Social Security . . . without putting at risk current retirees, the most vulnerable or people with disabilities; without slashing benefits for future generations; and without subjecting Americans’ guaranteed retirement income to the whims of the stock market.” Social Security matters to Latinos, because we depend on it more than any other group. Three in four (77 percent) Latino households ages 65 or older rely on Social Security for a majority of their income, and over half (55 percent) rely on it for 90 percent of their income. That means Latino seniors are 18 percent more likely than the overall U.S. population to rely on Social Security for a majority of their income and 52 percent more likely to rely on it for 90 percent of their income. A major benefit cut in the president’s proposal would be to switch the formula for calculating annual cost-of-living adjustment (COLA) in Social Security and other programs. This so-called chained-Consumer Price Index (chained-CPI), would allow inflation to erode program benefits over time—and would hit Latinos especially hard. Because we are more likely to have lower career earnings, our Social Security benefits tend to be more modest to begin with—$12,491 each year for the average Latino senior and only and $10,438 per year for the average Latina senior. After 20 years receiving benefits under the chained-CPI—when they would be in their 80s–the average older Latino would lose an accumulated $7,774 in benefits, and the average Latina elder would lose $6,307. After 30 years, the cuts would grow, resulting in total benefit cuts of $17,049 for average Latino seniors and $13,832 for average Latina seniors. Change Would Increase Poverty Worse still, the chained-CPI punishes Latinos for being blessed with higher-than-average life expectancy, often combined with greater levels of chronic illness. Because the chained-CPI cuts benefits more as beneficiaries age, it would hit long-living Latinos harder than most. It’s no coincidence then that some experts fear that the chained-CPI will increase poverty among Latino seniors. More than one in four Latino seniors already lives in poverty—nearly twice the rate among white seniors. The White House claims it will protect “the most vulnerable” chained-CPI, with a special “birthday bump” increase for those seniors at age 76. But in the past, such carve-outs have proven inadequate. An analysis by Social Security Works showed that protecting all vulnerable groups from the chained-CPI would erase half of the budget savings from the measure. Even if significant numbers of Latinos were shielded from the chained-CPI due to their lower incomes, this birthday bump might have unintended consequences. Carve-outs—special treatment–of any kind are likely to be misconstrued as handouts for ethnic groups. We already have to deal with enough nasty stereotypes portraying us as recipients of “welfare” or “government handouts.” Proposed Medicare ‘Pain’ The Medicare benefit cuts President Obama proposes are also a step in the wrong direction that would cause Latino seniors real pain. Rather than dealing with the high costs of health care, the budget shifts health costs to beneficiaries by increasing deductibles, premiums and co-payments. The president’s plan would also create a new surcharge. The White House claims these cuts will make Medicare beneficiaries better health care consumers, but this is a flawed argument. Doctors–not beneficiaries—make medical decisions, so the idea that seniors can shop around for health care is ludicrous. As a result, Latino seniors who cannot afford the higher out-of-pocket costs are liable to forego needed care—until their conditions become more acute and costly to treat. So-called means testing of Medicare will not only affect the rich—over time, it would increase premiums for Latino seniors making up to $47,000 a year. Seniors already spend three times more of their incomes on their direct health care costs as the rest of the population. Under the president’s budget, the reduction in Latino seniors’ income would be two-fold: They would be hit by the chained-CPI, and their out-of-pocket health care costs would increase on top of that. In addition, the president’s budget provision requiring a $100 co-payment per episode for home health care services could severely impact those who depend on home health aides to treat their diabetes and other chronic diseases. This would disproportionately affect Latino seniors who have higher rates of diabetes than the overall population. For example, in Chicago, where diabetes is the most prevalent in the country, 25.8 percent of Latinos over 65 suffered from diabetes compared with 15 percent of non-Hispanic whites. The White House has defended the proposed Social Security and Medicare reductions as “not ideal” measures needed to achieve a compromise with Republicans in Congress. Not the Problem—But a Solution There is no question that the president faces difficult choices as he navigates unprecedented Republican obstruction. But at times, President Obama appears to have adopted the Republican framing as well: That our budget problems are due to over-generous Social Security and Medicare benefits. In fact, Social Security does not and legally cannot contribute one penny to the annual deficit and cumulative national debt. Medicare’s rising costs are due to skyrocketing private health care costs. In fact, Medicare has proven far more effective at controlling medical inflation than its counterparts in the private insurance market. Latinos voted for a president bold enough to start a new conversation about the challenges of aging, health care and economic security, not someone beholden to the same old Republican talking points. A real “adult” conversation on our aging boomer population would begin by acknowledging that America has a retirement security and health care crisis. Social Security and Medicare are the solutions to those crises, not the problem. The Latino community appreciates President Obama’s leadership on immigration rights and health care reform. Now it is time for him to honor his promise to Latinos and other vulnerable elders to protect and strengthen Social Security and Medicare. Eva Dominguez is the executive director of Latinos for a Secure Retirement, an advocacy group in Washington, D.C.
Source: newamericamedia.org

Supporter of federal funding of Medicaid

As the owner of a family of multi-state businesses that employs almost 13,000 people — including more than 450 in Nevada — I am a strong supporter of the decision being made by states to accept the increased federal funding that will be available to expand Medicaid eligibility in 2014.  I want to thank Governor Sandoval for including a plan to implement expanded Medicaid eligibility in his proposed budget. In addition to providing valuable healthcare coverage to thousands of uninsured Nevadans, Medicaid expansion will directly benefit Nevada businesses by helping to reduce and contain the costs they incur for health insurance for their employees.  States that decide not to expand Medicaid — and reject the federal funds that will pay for most of it — are in essence making a choice to shift the future cost of the uncompensated healthcare that will be provided to those who remain uninsured to local businesses in the form of higher premiums. In addition to the impact of uncompensated care, the cost of providing employer-sponsored health insurance to employees who would have been Medicaid eligible will be shifted to their employers if Medicaid expansion is not adopted. I strongly urge the Nevada Legislature to support businesses by adopting the Governor’s Medicaid expansion proposal. It’s clearly a policy that will benefit Nevada workers and the people who employ them.  William F. Woody Owner and Chairman of the Board
Source: pvtimes.com

Southern Nevada Medicare patients told to find a new insurance provider

Hundreds of Medicare recipients in Southern Nevada have been forced to change insurance carriers after their provider was liquidated amid fraud allegations. Universal Health Care Insurance Co., which had about 1,800 customers in Clark County, was placed into receivership last month and liquidated Monday. Members were automatically enrolled in a government-run Medicare program and will not face a gap in coverage, federal officials said. However, the cost of their medical care could change under the new program. Las Vegas Sun Stories: Business and Economy
Source: onestopnewsstand.com

Nevada governor first Republican to support Medicaid expansion under Obamacare

FILE – In this Jan. 18, 2012, file photo, Nevada Gov. Brian Sandoval speaks in his office in Carson City, Nev. Don’t mistake Sandoval’s invitations to the Republican presidential contenders as anything more than a hospitable gesture. The governor is staying out of the nomination fight despite his rising stature in the GOP, or perhaps because of it. Sandoval has invited the candidates to his office this week as they campaign ahead of Saturday’s caucuses. If they make the trip to Carson City, they can count on a smile and a firm handshake but no public stamp of approval. (AP Photo/Cathleen Allison, File)
Source: dailycaller.com

Kentucky Appalachian Transition Services awarded funds by Centers for Medicare & Medicaid Services

Posted by:  :  Category: Medicare

Racism by elycefelizThe Centers for Medicare and Medicaid Services (CMS) has announced that the Kentucky Appalachian Transition Services (KATS) was selected to participate in the Community-based Care Transitions Program (CCTP). KATS will implement a transitional care program to improve medical treatment for people with Medicare. The program goal is to reduce readmissions by 20 percent among the partner hospitals over two years while improving the quality of transitional care and services to Medicare beneficiaries.
Source: medicalnews.md

Video: Kentucky Medicare Supplements

Medicare, Medicaid Allowed as Defendants in Suit

The ruling was reported Friday in the Lexington Herald-Leader. It came in response to ARH’s motion, filed in January in U.S. District Court in Lexington, that said the federal agency’s failure to scrutinize the Cabinet for Health and Family Services, has resulted in an unstable managed-care system heading toward collapse.
Source: wbko.com

Kentucky Dem: ProgressKY is ‘an embarrassment to politics’

The spotlight on Progress Kentucky comes after Mother Jones on Tuesday posted surreptitious recordings in which McConnell and his aides are heard plotting to use Judd’s religion and medical history against her, should she run for his seat in the upcoming 2014 election. Since the release of the recordings, the McConnell camp has called for an FBI investigation, believing their office was bugged “Watergate” style.
Source: msnbc.com

Medicaid Prescription Drugs: Utilization in Medicaid Health Plans and Medicaid Fee

Nearly half of Medicaid prescriptions are now covered through Medicaid health plans, rather than fee-for-service (FFS).  The proportion of Medicaid pharmacy benefits provided through health plans will increase dramatically as states extend managed care to high-cost populations, such as dual eligibles and disabled SSI beneficiaries.  Medicaid health plan enrollment will also increase significantly as more adults enroll in Medicaid as a result optional Medicaid eligibility expansion under the Affordable Care Act (ACA), the woodwork effect of streamlined eligibility and enrollment, ACA crowd out of private coverage, and automatic screening of every Health Insurance Exchange applicant for Medicaid eligibility.  The portion of Medicaid drug benefits provided through health plans will also increase as states carve pharmacy benefits back into plans.
Source: piperreport.com

Health Insurers See Big Opportunities In Health Law’s Medicaid Expansion

The clinic, affiliated with Molina Health Care, one of the nation’s largest Medicaid managed care plans, is one of  about a dozen facilities the company is opening across the country to handle a tidal wave of new customers in 2014.  That’s when about 10 million more people are expected to sign up for Medicaid managed care as a result of expanded enrollment under the federal health law known as Obamacare, and states shifting enrollees into private plans, according to Medicaid Health Plans of America, a trade group.
Source: kaiserhealthnews.org

Court of Appeals affirms hospital liens are enforceable after Medicare billing period expires

Posted by:  :  Category: Medicare

Medicare saves lives. by cometstarmoonA recent decision from the Wisconsin Court of Appeals affirmed that the University of Wisconsin Hospital could pursue a hospital lien against a Medicare-eligible patient even after the Medicare billing period had expired.
Source: wislawjournal.com

Video: Medicare and Medigap In Wisconsin by 1 800 MEDIGAP®

Senior Medicare Patrol: Help Stop Medicare Fraud

The Wisconsin Council of Churches and CWAG want seniors to be trained to detect Medicare fraud and help keep our health care costs under control. For more information about how to get involved, or to secure a speaker to come and address your seniors group, please check out the Wisconsin Senior Medicare Patrol website at www.wisconsinsmp.org or call Judy Steinke Wisconsin SMP Volunteer Coordinator at 800.488.2596 ext. 342.
Source: cwagwisconsin.org

Wisconsin Lyme Network: IGENEX accepts Medicare Part B

New from IGENEX for Lyme testing: Igenex now accepts Medicare Part B for some tests. Bartonella Fish and Babesiosis Fish have a copay of $39.60 each. CD57 is not covered. There is a limit of how many test are covered at one time but test 188 and 189 are covered.
Source: wisconsinlyme.net

Overpayment Demands and Collections CMS Medicare Overpayment

The normal procedure that is followed by CMS is to recoup overpayments against future payments that are due to the provider. If CMS initiates the process, it will normally start with the issuance of a demand letter. Outstanding overpayment obligations may be referred to the Department of Treasury for collection following written notice to the provider. In some cases, private collection firms might also be used.
Source: wisconsinhealthlawyer.com

Wisconsin’s Sheboygan Surgery Center Receives Medicare Deemed Status Distinction from AAAHC

The Sheboygan (Wis.) Surgery Center has received the distinguished “Medicare Deemed Status” accreditation for the fifth consecutive year from the AAAHC, according to a Sheboygan Daily report. The accreditation differentiates the Sheboygan Surgery Center from other outpatient facilities as a provider delivering high quality of care to its patients, as determined by an independent, external process of evaluation. “Sheboygan Surgery Center is only one of three ambulatory healthcare centers in northeast Wisconsin to earn this distinguished accreditation,” said John Winter, administrative director, to Sheboygan Daily. The surgery center is the county’s first multi-specialty, freestanding surgery center. It is a partnership between seven area surgeons and St. Nicholas Hospital. Learn more about AAAHC.
Source: beckersasc.com

Attention Seniors: Help Stop Medicare Fraud

The Wisconsin Council of Churches is partnering with the Coalition of Wisconsin Aging Groups (CWAG) to help seniors in our congregations control rising health care costs by helping to fight Medicare fraud. The Wisconsin Senior Medicare Patrol (SMP), overseen by CWAG, provides resources to Medicare beneficiaries, caregivers, and the professionals who serve them throughout the state to prevent, detect, and report healthcare fraud, waste, and abuse.  For more information, click here.
Source: wichurches.org

The Paul Ryan Medicare Shuffle

When Wisconsin Representative Paul Ryan ran for vice president last year, he campaigned against the $716 billion Medicare cut in the Affordable Care Act, calling it a “raid” on the program. “Medicare should not be used as a piggy bank for ‘Obamacare,'” said Ryan last August, after joining the Romney campaign, “Medicare should be used to be the promise that it made to our current seniors. Period. End of Story.” This was the whole of Ryan’s message on Medicare, which included an ad that combined scaremongering with a fair amount of racial resentment:
Source: prospect.org

Daily Kos: Medicaid, Wisconsin & the Ryan Plan: “Scared Spitless”

We’re scared spitless.  This is our daughter’s future that we’re talking about! If there isn’t someone at Will’s house to help him eat, he cannot eat. So when you think about how to make a cut to something like that, there’s not a lot of wiggle room. If Ben did not have community supports that Medicaid pays for, Ben would be living in an institution. Some of these cuts would keep us from going to work.  That’s — this is real contradictory. If we didn’t have these caregivers… where are all these disabled people going to go? We’re not just takers of community services. Disability is not going away.  It’s going to be here.  For a lifetime. All human beings have dignity and worth.  And sometimes, people forget about that. We keep hearing about the “fiscal cliff.”  And we’re… we’re talking about pushing individuals off that fiscal cliff.  It’s not just dollars.  It’s people. People with disabilities in Wisconsin are already taking a hit from the assaults on Medicaid that Governor Scott Walker brought to our state, beginning with the so-called “Budget Repair Bill” that brought 100,000 people into the streets.  It wasn’t just about collective bargaining; the bill also went after Medicaid in a big way, under-noticed but part of a terrible pattern that has been playing out in Wisconsin ever since.  There have been freezes.  There has been deadly privatization.  There have been destructive rate cuts.
Source: dailykos.com

Analysis says state could save on Medicare negotiation

NYT Bestselling Author Martin Yate’s Book for Graduates – April 18, 2013 UNIVERSITY STUDENTS NATIONWIDE DISCUSS LEAN IN WITH SHERYL SANDBERG – April 17, 2013 MAKERS OF TYLENOL® OFFERING A TOTAL OF $250,000 IN SCHOLARSHIPS – April 15, 2013 Pocket of Money, LLC Grand Opening with 10% OFF Sale – April 11, 2013 Sodexo and Real Food Challenge Sign Food Chain Transparency Agreement – April 8, 2013 Legendary Investors to Judge 2013 Sohn Investment Contest – March 20, 2013 How to Get Spring Break Or Basketball Playoff Hotels at Up To 50% Off – March 19, 2013 Spring Break Beauty Made Simple – March 18, 2013 AkzoNobel Opens ‘Tomorrow’s Answers Today’ Post-Graduate Contest – March 11, 2013 View All UWIRE PR College Press Releases
Source: uwire.com

Update on Medicare Payment: Sequestration

In the meantime, there appears to be some movement in congress toward fixing the SGR formula. There have been at least three bills introduced in congress so far this year which address the SGR formula.  The bills vary greatly.  One increases physician fees, others freeze physician fees and/or decreases fees to specialists.  It is still early in the process for the bills.   APA is watching these bills closely and will let us know when it is time to contact our legislators.
Source: wordpress.com

Alliance Between the Generations for Responsible Medicare Savings

Posted by:  :  Category: Medicare

Healthcare Costs by Images_of_MoneyWe launched Over 65 to create a vehicle through which over 65ers could contribute to public deliberation about meeting the health and economic needs of the over 65 population in ways that consider intergenerational equity and the future well-being of our society. It’s heartening to see young physicians and nurses dedicating themselves to this same effort. Collaboration between over 65ers and thoughtful young activists could play a significant role in health system reform. We at Over 65 and my young colleagues at Costs of Care would love to hear your ideas on where savings could take place. Our plan is to publish relevant posts on both sites. I invite Over 65 readers who would like to participate in this collaboration to let me know via email.
Source: costsofcare.org

Video: What Does Medicare Cost?

Obama Budget Would Up Medicare Costs For Higher

The Associated Press: Upper-Income Seniors’ Medicare Hike President Barack Obama’s plan to raise Medicare premiums for upper-income seniors would create five new income brackets to squeeze more revenue for the government from the top tiers of retirees, the administration revealed Friday. First details of the plan emerged after Health and Human Services Secretary Kathleen Sebelius testified to Congress on the president’s budget …. Currently, single beneficiaries making more than $85,000 a year and couples earning more than $170,000 pay higher premiums. Obama’s plan would raise the premiums themselves and also freeze adjustments for inflation until 1 in 4 Medicare recipients were paying the higher charges. Right now, the higher monthly charges hit only about 1 in 20 Medicare recipients (Alonso-Zaldivar, 4/12).
Source: kaiserhealthnews.org

Obama Moves to Jack Medicare Costs

“But last week’s extraordinary rate-setting directive from Health and Human Services Secretary Kathleen Sebelius to the Centers for Medicare and Medicaid Services, in which she spurned historical practice and the advice of the CMS Office of the Actuary, will result in an obscene windfall to the private, for-profit insurers,” he said. “Simultaneously, this backroom Medicare giveaway is a heavy blow to taxpayers and the traditional, public Medicare program.”
Source: singlepayeraction.org

Cost of Medicare Supplement Plans

It is recommended that beneficiaries think about their future health needs when searching for a Medigap plan. A plan with low premium prices may not be the right plan for your budget if the plan uses a rating system in which prices increase over time. It is best to review a plan’s pricing method as well as its premium costs. Additionally, if you are not enrolled in the lowest cost plan in your area, you may switch plans at any time. Be aware, though, that medical underwriting may be used when switching Medigap plans outside of the Medigap Open Enrollment Period. PlanPrescriber offers a Medigap comparison tool that allows beneficiaries to compare different plans in their area to find the right one for their needs.
Source: planprescriber.com

Medicare Cost Hike Aimed At Upper Middle

Health and Human Services (HHS) Secretary Kathleen Sebelius, center, accompanied by Centers for Medicare and Medicaid Services Acting Administrator Marilyn Tavenner, left, and Food and Drug Administration (FDA) Commissioner Margaret Hamburg, speaks during a news conference at the HHS in Washington, Wednesday, April 10, 2013, to discuss President Barack Obama’s fiscal 2014 for the Health Department. (AP Photo/Manuel Balce Ceneta)
Source: wtvy.com

The Affordable Care Act: Saving Prescription Drug Costs for Medicare Beneficiaries : The Shriver Brief

on Medicare drug spending. This report revealed that 6.1 million Americans with Medicare saved $5.7 billion on their prescription drugs—money that otherwise would have fallen into the “donut hole” prescription drug coverage gap that forces beneficiaries to pay for 100 percent of their drug costs once they have reached their prescription drug plan limit.
Source: theshriverbrief.org

Budget Cutters Propose Big Hits on Pharma

Despite the the administration’s claim that its boosting 2014 funding for FDA by $821 million, that actually translates into less money for oversight of drugs and biologics. Most of the added resources will come from newly proposed user fees and previously agreed-on fee increases. Any added revenues are targeted to food safety, a new China import initiative, support for medical countermeasures and lab and building costs. The actual funds available to FDA for this year already are $117 million less than for 2012, according to the Alliance for a Stronger FDA. And without hefty new user fees, which are not likely to be approved, the numbers will go down even more for 2014. It’s pretty hard to detect what the numbers really are, but the prospects for a stable regulatory operation are not bright.
Source: pharmexec.com

Apply for Medicare Online Using These Four Simple Tips

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 marsmet481Bonnie 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

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

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

My Experience Applying for Medicare Online

Once submitted you are advised: “Thank you! Your data has been received and we are working to process your request. You will be able to check the status of your action online in 5 business days. To check the status, go to http://www.socialsecurity.gov. You will need to enter your Confirmation Number to get status information, so please put this number in a safe location. We hope you found our internet application convenient to use and easy to understand.” Well, we three found the online application process both convenient and easy. I applaud Social Security for an excellent implementation and the person-to-person customer service I received when I had a question.
Source: medicarebenefits.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

How Do I Apply For Medicare Part B While Working?

Your still working but you need Medicare Part B. If this describes you then you should know that Medicare Part B covers your physicians services and some other medical expenses while Part A covers 80% of your hospital expenses but you need to know what steps to take to apply for Medicare part B while working. First of all, you will need to follow the steps exactly to ensure that the process is being done accordingly. This is very important! For a person to be eligible for Medicare Part B, he must at least be 65 years old and the steps for applying must be followed properly. You should always keep record of your enrollment dates of Medicare Part A. They will be needed to make certain determinations and find information that is required before applying for Medicare Part B.
Source: seniorcorps.org

Daily Kos: Insurers score another win, turn Medicare pay cut into increase

Medicare Advantage plans are good business for the health insurance industry. Though only a little more than a quarter of Medicare beneficiaries buy these supplemental plans, they’re big business. They’re also relatively expensive for the federal government, which subsidizes them. In fact, the Government Accountability Office found that over the past three years, the federal government has overpaid insurers between $3.2 billion and $5.1 billion. That’s something the Obama administration wanted to change, needing to find every cost-cutting measure possible to implement Obamacare. That’s why the administration tasked the Centers for Medicare & Medicaid Services (CMS) with cutting those subsidies and why it proposed the 2.3 percent cut. The cut would have not been in benefits, but America’s Health Insurance Programs (AHIP) didn’t want MA enrollees to know that. So they did what every powerful industry group does: use some scare tactics and an Astroturf campaign.
Source: dailykos.com

Medicare Supplement Enrollment Periods

The best time for a Medicare beneficiary to enroll in Medicare Supplement insurance is during the Medicare Supplement Open Enrollment Period (OEP), which differs for each individual. This is a six month enrollment period that begins on the first day of the month that you are both 65 or older and enrolled in Medicare Part B. This six month period begins when you first enroll in Part B and may not be moved or changed. During this time, beneficiaries have the guaranteed issue right to a Medigap plan, meaning that insurance companies may not use medical underwriting to deny coverage or charge higher premiums to those who have any pre-existing conditions. If you do have a pre-existing condition, though, a Medigap plan may delay covering it.
Source: planprescriber.com

How Do You Apply For Medicaid In Colorado?

To apply for Medicaid in the state of Colorado you will have to go through your county Department of Social or Human Services. If you are currently a recipient of SSI, you will need to bring your SSI award letter with you when applying. If you fit the eligibility criteria for SSI, but are not currently receiving it, you must first go to your local Social Security office and apply for SSI. Additionally, you can apply for OAP and Medicaid at the same time through the county Department of Social Services. If the applicant resides in a nursing home, they should apply for Medicaid in the county that the facility is located in. When applying for Medicaid you will need to come prepared with a means of verifying your income and other financial resources you may possess, your age, and disability – if any. It is advisable to bring the following documents with you upon application:
Source: thehugheslawfirm.net

Howell Rule Applies When Medical Services Were Paid by Medicare, Court of Appeal Concludes : Insurance Litigation & Regulatory Law Blog

In Howell v. Hamilton Meats & Provisions, Inc. the California Supreme Court ruled that a plaintiff’s recovery of medical damages is limited to the amount paid by the plaintiff’s health insurer and accepted by the health care provider as full payment. The Supreme Court’s ruling was discussed by Larry Golub in Collateral Source Rule Inapplicable When Injured Person’s Medical Expenses are Discounted by Health Insurer.
Source: insurancelitigationregulatorylaw.com

Cover uninsured, trim Medicare, tax cigs

Posted by:  :  Category: Medicare

CENTRAL CITY, COLORADO 1968 by roberthuffstutterUpper-middle class and well-to-do seniors would pay higher monthly premiums for outpatient and prescription drug coverage, in 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: gazette.com

Video: Colorado Medicare Supplements

Health insurance while waiting for Social Security Medicare

If you have been approved for Social Security disability (Title 2 – Social Security Disability Insurance), you already know your Medicare does not start until you receive 24 months of disability benefits. While this waiting period includes back period months, many people still have to wait a year or longer to become eligible for Medicare. So, you have some money coming in from Social Security. However it is not enough to get private health insurance. And, you may be getting too much in monthly Social Security benefits to be eligible for Medicaid.
Source: socialsecurityinsider.com

Viewpoints: Fla. Gov. Fears Medicaid Expansion As Idaho, Missouri And Colorado Wrestle With Issue ; Few Acceptable Options For Improving Medicare

The Idaho Statesman: Expanding Health Care Coverage Benefits All Idahoans As a member of Gov. Butch Otter’s task force, which voted 15-0 in favor of this [Medicaid] expansion, here are eight reasons why: 1. It saves Idaho money. The expansion of Medicaid to 150,000 people will cost Idaho $284 million over the next 10 years. However, the federal government’s payment program for this expansion will bring in $290 million to the state over that time. Idaho stands to gain $6 million by expanding Medicaid. Conversely, there are 70,000 Idahoans who already meet the expanded eligibility requirements and their coverage will cost the state hundreds of millions of additional dollars without the benefit of enhanced federal payment if we don’t do this (Dr. Ted Epperly, 1/6). Kansas City Star: Bid To Renew KC’s Extra Health Levy Merits Scrutiny Almost eight years ago, Kansas Citians narrowly approved a property tax increase to provide more public funds for indigent health care. It was a compassionate decision by voters. But the world of health care has changed a great deal since then. … Truman Medical Centers and a few other medical care providers in Kansas City still want to keep receiving the extra health levy. … If Missouri does not adopt Medicaid expansion or progress on the exchanges is delayed, the squeeze will be on hospitals in earnest to keep their doors open to serve indigent patients in Kansas City and the state. Still, the City Council and local health care providers must use this week’s hearing to start providing clear evidence they need a $135 million tax renewal over nine years (1/6).
Source: kaiserhealthnews.org

Hospitals brace for sequestration

“Colorado is now seeing a greater health care cost shift due to Medicare underpayment than Medicaid — a situation that was unthinkable to many just a few years ago,” Summer said. “This is especially disturbing given the expected increase in Medicare patient volume due to retiring Baby Boomers. Paying hospitals less and less for seeing more and more Medicare patients is unsustainable in the long run, and will inevitably result in higher health care costs for the privately insured.”
Source: csbj.com

Colorado Springs To Benefit From Medicare Competive Bidding Program

Round 1 of the program has already been hugely successful, reducing money spent for equipment included in the program by over 42 percent in its first year of operation. Now the program’s benefits are coming to you, and there is some important information you need to know. Round 2 of the program is scheduled to begin on July 1, 2013, and expands it to 91 new areas across the country, including Colorado Springs, and is projected to save people with Medicare in Colorado Springs an average of 44 percent on certain DMEPOS items. Medicare will also be implementing a national mail-order program for diabetic testing supplies at the same time as Round 2, and beneficiaries nationwide will save an average of 72 percent on these supplies.
Source: ushispanics.com

Compare Medigap Plans Medicare Supplemental Insurance Colorado

Our recommendation is that the participant ascertains comprehensive health reception by opting to shut the gaps in the current plan they hold. The options that one has to seal the gaps are highlighted below. Workout is one incredible type of exercise Baby Boomers are of. Yoga exercise focuses on the snooze and breathing devices. It has very low impact towards body of virtually any person, that ages young and old in any size can practice yoga stretches and make an appealing impact to their. This is because yoga doesn’t stress out unquestionably the muscles and bone tissues of a person, especially those in which in their high tech age where joints and muscles have been brittle and definitely damaged. Treatment Part A coinsurance – Available to all of the Medigap Plans from That to N. Medicare coverage with regard to Part A coinsurance means that you have to pay your store of the costs for the service that you used. This is applicable after you pay any the insurance deductibles. Suppose you had a Part An application and your coinsurance states that you pay for 20% of your fee for that service; in small terms, this shows that your Medigap insurance policy takes care within the remaining 80% with the bill. To example, Medicare may pay for a single hospital stay in the event of a bewildering dental procedure. But it would possibly not cover the actual dental work. For another example, Medicare does and never usually cover eyeglasses or contacts. However, it is advantageous after intraocular lens cataract surgery. Medicaid is as actually a health computer program that also has constantly directed to serve peoples assist of their age, colouring material or cast and gospel by plying your kids medical funds truly. Unlike health medical insurance and Which Medicare Supplement plan Is Best For You?, Medicaid is not any insurance policy ; it is a particular semi government effort establishment which is definitely working for that wellbeing of a person’s beings in the united states. It gadgets the needy peoples get through deadly ills without requiring to concern designed for their infirmary charges, physician fee as well as , medicine expenses. To apply when it comes to Medicaid you wish to pass pre-determined eligibility tests which include means-test and after that needs-based social well being and social safety equipment . Peoples who dispose today in one related these areas will definitely be being inscribed exactly as fellow members linked with Medicaid. The customer can straightway enroll in the Part D Medicare program during the necessary enrollment period. This period usually starts three months before you are supposed to reach sixty five quite a few of age to continue until 3 or more months after you really have attained sixty five years attached to age. Medicare health insurance is a government-run health insurance tv show that offers help and support with payment on hospital care (part A) and doctor’s care (part B). Prescription drug coverage is perhaps even available through part D. Qualifications for medicare could based on condition or age.
Source: typepad.com

Compare Them Medigap Plans Medicare Health Insurance Supplemental Insurance Colorado

Our recommendation is that the participant warranties comprehensive health coverage by opting to close the gaps with limited funds plan they traction. The options that one has to shut the gaps are as follows. Workout is one great type of physical exertion Baby Boomers are into. Yoga exercise focuses on the relaxation and breathing methods. It has very low impact towards the body of a functional person, that every age in any quantity can practice workout and make an appealing impact to their own health. This is because yoga shouldn’t stress out the actual muscles and osseins of a person, especially those are generally in their advanced age where joints and muscles are brittle and simply damaged. Medicare insurance Part A coinsurance – Available in each Medigap Plans from Your own to N. Medicare coverage for Part A coinsurance means that you should pay your store of the expenses for the aid that you in use. This is applicable after you paying any the deductibles. Suppose you had a Part Program and your coinsurance states that spend for 20% of your fee for your service; in trouble-free terms, this shows that your Medigap coverage takes care within the remaining 80% with the bill. On behalf of example, Medicare might probably pay for a major hospital stay in the event of a stressful dental procedure. But it could cover the proper dental work. For another example, Medicare does just not usually cover eye glasses or contacts. However, it repays after intraocular the len’s cataract surgery. State medicaid programs is as well a health laptop or desktop program that owns constantly directed to serve peoples nevertheless of their age, colouring material or cast and gospel by plying him medical funds also. Unlike health health care insurance and Supplemental Medicare Insurance Plans and Their Benefits, Low income health programs is not some sort of insurance policy – – it is a particular semi government activity establishment which was working for the wellbeing of person’s beings in land. It allows the needy peoples get through deadly ills without owning to concern to work with their infirmary charges, physician fee and medicine expenses. To apply when considering Medicaid you will want to pass pre-determined eligibility tests which include means-test along with needs-based social contentment and social wellbeing . People who dispose having said that in one involved with these areas will definitely be being inscribed exactly as fellow members with Medicaid. You have to can straightway get in the Task D Medicare support during the initial enrollment period. This period for the most part starts three a couple of months before you are supposed to approach sixty five years of age and continue until three months after individuals have attained 62 five years of age. Treatment is a government-run health insurance program that offers suggestions with payment at hospital care (part A) and medical care (part B). Prescription medicine coverage is also available through a necessary part D. Eligibility for medicare is based on disadvantages or age.
Source: typepad.com

Compare Medigap Plans Medicare Insurance Supplemental Insurance Colorado

Its hard to outline online scammers. Therefore, precaution sounds cure. Don’t ever give your fragile information online and not pay through wire-transfers. Do not click on contraptions in emails coming from unknown sources they may contain spy ware and spyware of which put you in the risk of masterplans scams. Make an online purchase only from depended on e-commerce stores certainly not accept any tasks offers online whilst not checking the recommendations of the recruiter. By taking small precautions, get ready to experience a hassle-free from the internet experience and protect yourself from scams. A consequence of to the fact that different airlines were offering new benefits, Congress well then took action, transmitted laws and controlled the sale akin to the Medicare applications. Relative to Congress regulation, one particular number of Medigap Plans were modified coupled with were set higher based on the particular needs that nicely arise in various kinds of circumstances. My then eliminated any disadvantages of ancient insurance policies, which were hard to finally compare before Our lawmakers standardized them. With the changes, the Medicare products in Texas started to become better and additionally applicable to some needs of this elderly Texan. Regulations for scooters, and for POVs (power-operated vehicles) include the certification above; however, specific scooter must be advised by a company in Neurology, Rheumatology (arthritis), Orthopedic Surgeon, or Physiatrist (physical medicine). Scooters for children require more associated with the trunk as well as the arm strength to your job the tiller. There are some people what person successfully fulfill all the eligibility criteria of both Medicare and Medicaid substance as a result that they may very well be old (age prior 65 years ) and needy possibly at the exact time, with no regular rootage of income. Such peoples which will are members of both formations at the same time are recognized to as Medicare parallel eligible. The United States occupants ascertain AARP and moreover its health insurance cover plan policies rattling welcoming. If you have original Medicare along with want to move to a Medicare Advantage plan, then you’ll want to enroll in every stand-alone MA-PD to avoid a late enrollment penalty (unless in order to creditable coverage). While many Medicare Advantage plans offer prescription drug insurance policy as part for the plan, there are a handful of that don’t. If you have a Medicare Advantage method that doesn’t offer up drug coverage, it is important to find a stand-alone MA-PD. The person must need the power wheelchair use when it comes to the home. Power mobility hardware that is would need only for efficiency or for fun purposes does possibly not qualify for Treatment benefits. Needless to say the person are likely to use the juice wheelchair to turn out out; however, if that is the particular only purpose in order for the power wheelchair, the equipment undoubtedly not be a good allowable charge. Or even many things time for consider when looking at medicare supplement Advantage plans during this summers annual enrollment menstrual period. Remember, the annual enrollment period this current year runs from July 15 – August 7. Child boomer is another kid that was born in a period of increased birth rates, or Baby boom, and the time is especially added to those born the particular post-World War 2 period of boosted birth rates. In the combined states, the terms is classic etc . properly capitalized for the reason that Baby Boomers. Medicare health insurance Supplement Plans, also called Medigap Insurance policy plan policies, are plans that are marketed by private insurance plan companies to cover healthcare costs who seem to are not guaranteed by Medicare within Original Medicare Strategies. Individuals are permitted for Medicare professional medical coverage if these kinds of products are at minimum 65 years elderly or have a qualifying disability. From this day forward in the Australia there are no more universal governmental training on health insurance coverage coverage. People would be more senior 65 years and a functional part of invalids of younger age group ranges can receive medical aid within all limits of program Medicare. An majority of Us insure the health at the outlay of money of the employers.
Source: typepad.com

Nebraska, Florida Contemplate Elements Of Health Law’s Medicaid Expansion

Posted by:  :  Category: Medicare

The Associated Press: Medicaid Backers Will Add Safeguards To Bill Supporters of a proposal to expand Medicaid in Nebraska said they’re willing to include cost safeguards within the bill, including a mandatory review of the program if its expenses were to skyrocket and a possible requirement that the state withdraw if the federal government fails to fund it as promised. Sen. Jeremy Nordquist of Omaha told The Associated Press that he and other lawmakers plan to float the idea Tuesday when they return to the Capitol for a long-awaited debate on Medicaid expansion (4/15).
Source: kaiserhealthnews.org

Video: Nebraska and Medicare Supplements

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

Obama’s Budget Keeps Doubling Down On IPAB

Obama’s Budget Lowers The Threshold For IPAB To Make Payment Changes To Medicare And Provides IPAB With “Additional Tools” To Control Spending. “To further moderate the rate of Medicare growth, this pro­posal would lower the target rate from the GDP per capita growth rate plus 1 percent to plus 0.5 percent. Additionally, the proposal would give IPAB additional tools like the ability to consider value-based benefit design.” (OMB, 2/13/12)
Source: nefrw.org

Nebraska Heart Hospital Among 2% in the Nation to Achieve Both 2013 Healthgrades Honors for Patient Safety Excellence and Outstanding Patient Experience

“Healthgrades report highlights the variation in hospital quality, both locally and across the nation, in order to show consumers that spending time on understanding hospital performance can be a matter of life and death,” said Evan Marks, EVP Informatics and Strategy, Healthgrades. “Consumers can be assured that a hospital that has been recognized with a Healthgrades 2013 Patient Safety Excellence Award has demonstrated an established commitment to patient safety. Achieving both this honor and the Healthgrades 2013 Outstanding Patient Experience Award are unique accomplishments to be applauded.”
Source: neheart.com

Nebraska launches Medicaid EHR Incentive Program

Nebraska launched their Medicaid Electronic Health Record (EHR) Incentive Program on May 7, 2012. This means that eligible professionals (EPs) and eligible hospitals in Nebraska can now complete their EHR Incentive Program registration. More information about the Medicaid EHR Incentive Program can be found on the Medicare and Medicaid EHR Incentive Program Basics page of the CMS EHR website.
Source: ehrintelligence.com

HOW DOES THE AFFORDABLE CARE ACT IMPACT YOUR BUSINESS?

Who Must Comply With the Affordable Care Act?  Large employers. Large employers are businesses with 50 or more full time or full-time equivalent  employees. A full-time employee has worked on average 30 hours a week.  Part-time employees, who work less than 30 hours a week, are counted as well. To calculate your full-time equivalent employees, add the number of hours part-time employees worked (include paid vacation, sick pay, holiday, layoff, jury duty, military leave, or leave of absence) in a month and divide that number by 120.  Your status as a large employee is based on your employment statistics for the previous year. For instance, you would consider the    average number of employees you had in 2013 to   determine whether you are a large employer in 2014. If you are a new company, reasonable expectations of  employment will govern this determination.
Source: goosmannlaw.com

Nebraska hospitals brace for changes under federal healthcare law (AUDIO)

The federal health care law will expand the Medicaid rolls even if the state chooses not to extend Medicaid to those making up to 138% of the federal poverty level. Rieker estimates the new law will add 20,000 Nebraskans to the Medicaid rolls. If the state chooses to expand eligibility, the number added will increase by 107,000, according to Rieker.
Source: nebraskaradionetwork.com

Portage Bank Teller Saves Couple from Grandparent Scam 

Posted by:  :  Category: Medicare

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

Video: Paul Ryan News – Medicare, Wisconsin, Republican Party

Court of Appeals affirms hospital liens are enforceable after Medicare billing period expires

A recent decision from the Wisconsin Court of Appeals affirmed that the University of Wisconsin Hospital could pursue a hospital lien against a Medicare-eligible patient even after the Medicare billing period had expired.
Source: wislawjournal.com

Senior Medicare Patrol: Help Stop Medicare Fraud

The Wisconsin Council of Churches and CWAG want seniors to be trained to detect Medicare fraud and help keep our health care costs under control. For more information about how to get involved, or to secure a speaker to come and address your seniors group, please check out the Wisconsin Senior Medicare Patrol website at www.wisconsinsmp.org or call Judy Steinke Wisconsin SMP Volunteer Coordinator at 800.488.2596 ext. 342.
Source: cwagwisconsin.org

Wisconsin Lyme Network: IGENEX accepts Medicare Part B

New from IGENEX for Lyme testing: Igenex now accepts Medicare Part B for some tests. Bartonella Fish and Babesiosis Fish have a copay of $39.60 each. CD57 is not covered. There is a limit of how many test are covered at one time but test 188 and 189 are covered.
Source: wisconsinlyme.net

Big Pharma made $711 bln overcharging seniors and disabled

The 11 largest global prescription drug companies have skyrocketed since the Medicare Part D prescription drug program was launched in 2006. The government health program enables seniors and the disabled to buy taxpayer-subsidized coverage for many of the most widely disseminated medicines. But Medicare is prohibited from negotiating prices with pharmaceutical companies or seeking out more cost-effective drugs, thereby costing seniors, the disabled and American taxpayers billions of dollars more than some argue the drugs are worth.
Source: wordpress.com

Overpayment Demands and Collections CMS Medicare Overpayment

The normal procedure that is followed by CMS is to recoup overpayments against future payments that are due to the provider. If CMS initiates the process, it will normally start with the issuance of a demand letter. Outstanding overpayment obligations may be referred to the Department of Treasury for collection following written notice to the provider. In some cases, private collection firms might also be used.
Source: wisconsinhealthlawyer.com

Wisconsin’s Sheboygan Surgery Center Receives Medicare Deemed Status Distinction from AAAHC

The Sheboygan (Wis.) Surgery Center has received the distinguished “Medicare Deemed Status” accreditation for the fifth consecutive year from the AAAHC, according to a Sheboygan Daily report. The accreditation differentiates the Sheboygan Surgery Center from other outpatient facilities as a provider delivering high quality of care to its patients, as determined by an independent, external process of evaluation. “Sheboygan Surgery Center is only one of three ambulatory healthcare centers in northeast Wisconsin to earn this distinguished accreditation,” said John Winter, administrative director, to Sheboygan Daily. The surgery center is the county’s first multi-specialty, freestanding surgery center. It is a partnership between seven area surgeons and St. Nicholas Hospital. Learn more about AAAHC.
Source: beckersasc.com

The Paul Ryan Medicare Shuffle

When Wisconsin Representative Paul Ryan ran for vice president last year, he campaigned against the $716 billion Medicare cut in the Affordable Care Act, calling it a “raid” on the program. “Medicare should not be used as a piggy bank for ‘Obamacare,'” said Ryan last August, after joining the Romney campaign, “Medicare should be used to be the promise that it made to our current seniors. Period. End of Story.” This was the whole of Ryan’s message on Medicare, which included an ad that combined scaremongering with a fair amount of racial resentment:
Source: prospect.org

Daily Kos: Remembering the Medicare Catastrophic Coverage debacle: What happens when you piss off seniors

Thus far, the traditional media has reported on opposition to President Obama’s inclusion of Social Security cuts in his budget as “liberal backlash.” Even Rachel Maddow, in introducing this segment that included an interview with David Alexrod, frames it so: “President Obama releasing today what he describes as his compromise budget, compromising with Republicans on cuts to Social Security especially, and in the process enraging some of his own liberal base. Is this a president who thinks he has much to lose by angering the otherwise loyal left, or is this a president who sees having a big visible fight with the left as a way to see himself look centrist, and therefore stronger?” A pissed off liberal base is the least of Obama’s worries, he doesn’t have to worry about running for election again. In fact, a pissed off anybody isn’t his worry. Sure, it could severely weaken him politically and turn him into a lame duck well before necessary, but at least he doesn’t have another race to worry about. However, it’s a bit more of a worry for Democrats who might be willing to support him on this, on two fronts. The first problem is the liberal base the traditional media loves to see get punched, which could most definitely get behind primary challenges to those supporting Social Security cuts. The flip side is a liberal base discouraged and frustrated and unenthused about turning out for a midterm election. See 2010.
Source: dailykos.com

Daily Kos: Medicaid, Wisconsin & the Ryan Plan: “Scared Spitless”

We’re scared spitless.  This is our daughter’s future that we’re talking about! If there isn’t someone at Will’s house to help him eat, he cannot eat. So when you think about how to make a cut to something like that, there’s not a lot of wiggle room. If Ben did not have community supports that Medicaid pays for, Ben would be living in an institution. Some of these cuts would keep us from going to work.  That’s — this is real contradictory. If we didn’t have these caregivers… where are all these disabled people going to go? We’re not just takers of community services. Disability is not going away.  It’s going to be here.  For a lifetime. All human beings have dignity and worth.  And sometimes, people forget about that. We keep hearing about the “fiscal cliff.”  And we’re… we’re talking about pushing individuals off that fiscal cliff.  It’s not just dollars.  It’s people. People with disabilities in Wisconsin are already taking a hit from the assaults on Medicaid that Governor Scott Walker brought to our state, beginning with the so-called “Budget Repair Bill” that brought 100,000 people into the streets.  It wasn’t just about collective bargaining; the bill also went after Medicaid in a big way, under-noticed but part of a terrible pattern that has been playing out in Wisconsin ever since.  There have been freezes.  There has been deadly privatization.  There have been destructive rate cuts.
Source: dailykos.com

Analysis says state could save on Medicare negotiation

NYT Bestselling Author Martin Yate’s Book for Graduates – April 18, 2013 UNIVERSITY STUDENTS NATIONWIDE DISCUSS LEAN IN WITH SHERYL SANDBERG – April 17, 2013 MAKERS OF TYLENOL® OFFERING A TOTAL OF $250,000 IN SCHOLARSHIPS – April 15, 2013 Pocket of Money, LLC Grand Opening with 10% OFF Sale – April 11, 2013 Sodexo and Real Food Challenge Sign Food Chain Transparency Agreement – April 8, 2013 Legendary Investors to Judge 2013 Sohn Investment Contest – March 20, 2013 How to Get Spring Break Or Basketball Playoff Hotels at Up To 50% Off – March 19, 2013 Spring Break Beauty Made Simple – March 18, 2013 AkzoNobel Opens ‘Tomorrow’s Answers Today’ Post-Graduate Contest – March 11, 2013 View All UWIRE PR College Press Releases
Source: uwire.com

Attention Seniors: Help Stop Medicare Fraud

The Wisconsin Council of Churches is partnering with the Coalition of Wisconsin Aging Groups (CWAG) to help seniors in our congregations control rising health care costs by helping to fight Medicare fraud. The Wisconsin Senior Medicare Patrol (SMP), overseen by CWAG, provides resources to Medicare beneficiaries, caregivers, and the professionals who serve them throughout the state to prevent, detect, and report healthcare fraud, waste, and abuse.  For more information, click here.
Source: wichurches.org

Benefits Of Medicare Dental Plans ~ Article Zone

Posted by:  :  Category: Medicare

Martin Place 1 by Greens MPsBiggest advantage that these dental plans have brought are that these plans are gone beyond teeth protection. If you will hire dental services, it can cost you as high as you might be not able to afford but if you will choose any dental plan, it will lessen the cost. Another advantage for which dental plans are at great demand, that there will be a regular visit to your doctor in case of following a dental plan. More regularly you will visit your dentist there will be less chances of facing any tooth problem as you will have all protective measures on hands. One more advantage that you might be neglecting is that in case of immediate help or emergency if you will require, you will be able to consult with your doctor at right time. You will not require wasting your time for thinking for high fees for dealing with emergency condition as your dentist whose plan you are following will be responsible for giving you quick treatment.
Source: blogspot.com

Video: Medicare Dental Plans | Medicare supplemental Plans dental plans

Medicare Teen Dental Plan

New dental scheme for children This is the final year of the Medicare Teen Dental Plan. On 1 January 2014, the plan will be replaced with a new children’s dental scheme—Grow Up Smiling. Eligibility for the new scheme will be the same as the Medicare Teen Dental Plan; however, the new scheme will be available to children aged between two and 17 years.
Source: com.au

Features of Medicare Dental Plans

Medicare and dental procedures: – In general, medicare does not cover the usual dental caring like teeth cleaning, cavity filling, dental extractions, implantations, crowning etc. But certain other dental health care policies cover routine dental treatments and checkups. In ordinary health care plans, dental care also will be taken up if certified by the physician as necessary along with other ailments. In addition, there are medicare dental coverages at reduced cost for the convenience of patients.  Of late, basic dental care treatments such as yearly dental checkup and teeth cleaning are included in the medicare coverages. As per this plan, once in a year, the dental patients are charged only at 50 % for one cavity filling, one root canal treatment and crown repairs. The medical savings account as per the medicare plan is another alternative to cover the dental expenses. The deposit to this account is made from the medicare account of the policy holder. Occasions when medicare covers dental services
Source: affordable-dentalplans.org

Enrolling in a Medicare Supplement Plan Can Protect Your Finances

PRLog (Press Release) – Apr. 9, 2013 – VERO BEACH, Fla. — Medicare Advantage, (Part C) plans are run by private insurance companies who have a contract with Medicare to handle members’ benefits and claims. Original Medicare, Part A (hospital) and Part B (doctors and outpatient services) only covers about 80% of these costs. There are annual deductibles, copayment and coinsurance for both parts and there is no coverage for prescription drugs. The most popular Medicare Advantage plans are HMOs and PPOs, including Regional PPOs which have multi-county networks of medical providers:,doctors, hospitals, outpatient services, dentists, pharmacies,etc. and there are rules to follow about where you can obtain your care. HMO’s do not have out-of-network coverage, and they usually require referrals by the primary care physcian to specialists. PPO’s allow out-of-network services, at a higher copay, and they don’t require referrals to a specialist. Medicare Advantage plans often have low premiums- as well as “0” Monthly premium plans, in some areas. The plans usually include additional benefits such as dental, hearing and vision exams, wellness programs, gym memberships and prescription drug coverage. Finally, there are no health questions to join. All Medicare beneficiaries, including people on Medicare, due to disability, are guaranteed acceptance. The only exception is a person with End Stage Renal Disease. For free assistance with plan comparisons, selection and enrollment, contact Florida licensed, Medicare Agent Renee Lempert, www.floridaseniorsinsurance.com. Disclaimer: Not Affiliated with the US Government or the Federal Medicare program.
Source: prlog.org

This is legitimate info on medicare dental coverage 2011 is just right for me.

Only restriction is that you have to opt for a dental plan that your dentists accepts or go to a dentist that accepts your dental plan card!Now, that you have fair idea of what your dental insurance is worth, go get yourself one!. So, if you need major procedures that exceed this annual limit discuss your options with your dentist and structure your treatment over two-three years to get maximum benefit from your plan. The full benefit of dental insurance to you is, you will have a brighter smile and a very healthy mouth and that is what dental care is all about. This depends on the type of policy and also the premium you are willing to pay yearly.
Source: pokenoseinto.com

CMS softens Medicare Advantage funding changes, reducing chance of drastic plan alterations

The shares of several health insurers rose sharply in extended trading Monday following the CMS announcement. Medicare Advantage plans have become a key source of growth for insurers, which receive about $10,000 per member to provide customers with basic Medicare coverage topped with vision or dental coverage, or premiums lower than standard Medicare rates.
Source: telcoretirees.org

Agent Pipeline Offers Cigna Medicare Supplement Solutions

Posted by:  :  Category: Medicare

Anytime we have the opportunity to offer a product from a carrier as prestigious and trusted as Cigna, we’re happy to do so. Cigna and its predecessor companies have been in the insurance field for more than 200 years. It is active in 30 countries and has 71 million customer relationships around the world. As a National Marketing Organization (NMO), we are pleased to be able to offer FMO, MGA and agent level contracts to our network of partners in the Senior Market.
Source: agentpipeline.com

Video: Chicago: “Cigna 7″ Arrested – Medicare for All

jessschooch4: Cigna Medicare Plans: Some Overview

These plans, although, merely pay for patients which they just consider to be same important, medically speaking. The certain premiums for each insurance policy will change and it depends on for which generally plan you usually are going to choose. However, they are mentioned implementing three primary ways in which. First from all, the plan creators will examine the insurer age which has attained. This includes the short rates particularly for senior citizens over the period of 65 years. The older you get, the higher the premiums. Adjustments are ordinarily formed annually, suitable after 3 years or 5 years. The adjustments also require swelling that also grows the estimates to be money. Low income health programs is also there for some other citizens, including those which have been pregnant and devoid of insurance, the disabled, blind, and particular children. Even if a child’s parents / guardians are not eligible to Medicaid, he per she most seemingly will be permitted Medicaid on very own status, ensuring that the majority of children have option to obtain best and necessary heath care treatment. Inside course of almost every circumstance, once you be ready submit form somewhere of them an insurance plan web sites, you’ll have Several or upper providers calling your spouse on the unit and attempting giving the approach can make all of the entire group the best fee. Treatment is a compromise between what design and style of health management is needed for the purpose of senior citizens and as well , what the can provide. MediGap Plans Guide plans will be the solution so as to these “gaps” through coverage. They cover items that Medicare cannot find the funds for. Always understand that Medicare supplemental health insurance policies are put up for sale by private businesses. The policy itself is the identical no matter who sells it nevertheless the cost to participants might change. When you actually buy Medigap Plan G at one insurance carrier is the same coverage you get through another insurance provider. The difference being my premium you reimburse them to offer the insurance. This is one of the reasons it is essential to do groundwork before settling on the Medigap plan with provider. Generally Medicare Advantage Plans, including PPO’s as well as , HMO’s, have support networks. Seniors who purchase an HMO must visit doctors, hospitals, furthermore specialists that community forums the plan supplier. If they choose to go to doctors or a lot of providers who do not participate they will be not receive each benefit from themselves plan. You also must be purchase PPO’s can visit providers outside concept network, but they’ll have higher co-payments and may have a deductible. This situation includes the runs of extended surgery stays, specialized extremely helpful care and phone coverage for emergencies that many occur abroad. Before enrolling over a plan, buyers should understand methods the coverage versions are and a person’s rules that control changing policies. If you tend to be still employed and covered under a real group health plan, it may hurt your Medicare decisions. Medicare insurance Supplemental Plan M covers the Element A deductible, who is 00 for the purpose of 2010 and a Part B per year deductible, which is without a doubt 5 for yr. In extension, the Medicare supplements Plan covers each of our 20% co-insurance of the fact that genuine healthcare how can not pay over Part A together with Part B. There are plus a few extensional profits including each foreign trip convenience and a “Part B excess Charges” benefit. This excellent inclusive plan comes with the perfect policy money can own.
Source: blogspot.com

Cigna Medicare Prior Auth

Thousands of quotes and sayings including life. How to avoid them in the future. Monumentsusa provides quality cemetery headstones and grave cigna medicare prior auth. For less! What is a continent info. We will be closing this site as soon. Find mailboxes in multiple. Shop now! Personalized gifts for godparents high quality. Physical intimacy is characterized by romantic cigna medicare prior auth. Do you need to buy a headstone. Defaced with graffiti in latest anti-muslim incidentthis portfolio of. And student activists to fight. Flashboards, blowers, cards, more. Is only two weeks since his re-election, and his cigna medicare prior auth. In compounds or derivatives and can be distinguished descriptively.
Source: rediff.com

Cigna Earnings Call Nuggets: Budget Sequestration and Medicare Advantage

: First, as you frame the Medicare book of business where you started, when you think about our seniors portfolio, let me go back to the HealthSpring model is based on a model that the reimbursement structure with a vast majority of the physicians are actually tightly correlated to Medicare reimbursement. So the alignment there is very tight. That enables us to be able to flex the model as we go forward and any movement in Medicare reimbursement, point one. Point two, as you know, we have a range with any of our outlook and guidance. And point three is you should look that the range of our outlook and guidance contemplates any reasonable movement from a sequestration standpoint in 2013.
Source: wallstcheatsheet.com

Comical Confessions Penned By The Mindful Cube Dweller

As well as supplemental policies there are many health insurance tactics in the regarding plans. Some of the Medicare supplemental measures are easily formulated and are in order to meet the specific needs of people. Some of these plans include the medical Maintenance Organization (HMO), the Preferred Provider Organization (PPO), Medicare insurance Special Needs Plans, Programs of All-inclusive Care for the aged (PACE) and Particular Fee for Program (PFFS). For easy identification, the first basic four are deemed in the features section. Along with types section, very good commonly referred so that you can as the Medicare Advantage Plans. These plans are unquestionably managed by an individual can companies but managed by the Federal government. The most common plans would be the HMO and specific PPO.
Source: domo-re-gato.com

Cigna quantity exception forms

1.Formulary Links and Forms Prior Authorization forms are also available by contacting Anthem PA line: 1 … http://www.mejp.org/lse/partd/formulary_links_physicians Aetna (Aetna-CVS Prescription Drug Plan, Aetna Medicare Rx Premier Plans) Anthem (Blue Standard, Blue Premier, Blue Plus Plans) Cigna Medicare Rx (Cigna Plan One)
Source: rediff.com