BBB alerts elderly to beware Medicare/Medicaid scams

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The BBB of Acadiana works for a trustworthy marketplace by maintaining standards for truthful advertising, investigating and exposing fraud against consumers and businesses. Please contact the BBB at http://www.acadiana.bbb.org or (337) 981-3497 24 hours a day for information on businesses throughout North America.
Source: wordpress.com

Video: Louisiana Medicare Supplemental Insurance

Who Pays for Louisiana Hospice Care for State Residents?

Hospice or end-of-life care is a service provided to patients in the end-stages of life with six months or less to live, who prefer to rescind medical treatment and spend the remaining months in as comfortable as possible setup, at home, with friends and families and people who care about them. Since the patient and the illness are both no longer responding to cure-oriented medical options, the patient is best cared for by specially trained healthcare professionals who render their special care and services to provide the terminally-ill patients with the opportunity to preserve the quality of life and spend the remaining days with dignity. Controlling and managing the patient’s pain and symptoms are the priority in the care plan developed for the patient. The patient is prepared for his eventual end of life and the patient’s families are also prepared to accept the sad reality of losing their loved one through professional counseling services provided by hospice care team volunteers.
Source: euphoricreality.com

Feds Make It Easier For States To Enroll Poor Under Health Law

On Friday, it informed state officials that they could simplify enrollment in Medicaid, the federal-state program for the poor, to handle the onslaught of millions of anticipated enrollees next year when the health care law expands coverage.  The administration said the changes are geared to states that are expanding their programs, but they may also be adopted by others.
Source: kaiserhealthnews.org

AIDS Healthcare Foundation

Almost immediately, Gilead also reached a price reduction agreement on Stribild with the ADAP Crisis Task Force (ACTF), of the National Alliance of State & Territorial AIDS Directors (NASTAD) on behalf of the nation’s hard-hit network of AIDS Drug Assistance Programs (ADAP). In response to the initial steep price of Stribild and the swiftness of the ADAP Crisis Task Force agreement, AHF asked Gilead to also lower the price for other private and government programs such as Medicaid, Medicare, private insurers and other payors that otherwise face Gilead’s steep price tag for the new medication. AHF officials sent letters to private insurers and state health department directors nationwide urging them to exclude Stribild from their respective drug formularies if the drug was not made price-neutral to Atripla. AHF also asked the program directors to consider placing Stribild on ‘prior authorization’ status. ‘Prior authorization’ requires that a particular prescription must be reviewed by a second medical provider for assessment of medical necessity before being filled for a drug, and the process may add a day to the timeline of a filling a particular prescription.
Source: aidshealth.org

$30.7 Million Cut to Louisiana Medicare Begins October 1st, 2012

“At both political conventions – and in health policy forums like those sponsored by AARP today in New Orleans – seniors’ Medicare-funded nursing home care and its ongoing funding adequacy has been part of a vigorous, necessary national discussion,” stated Alan G. Rosenbloom, President of AQNHC, which funded the data analysis. “The higher profile of nursing home funding in the 2012 election reflects the growing importance of ending what essentially amounts to a ‘cut now, ask questions later’ governmental funding policy. We hope to help engender a consensus that bigger-picture, systemic reforms that reduce costs, improve efficiency and optimize care quality must be pursued once the election is over.”
Source: seniorlivingcare.com

The Trouble with Medicaid

Barack Obama BESE Bobby Jindal Budget Cato Institute Charter Schools David Vitter Don Briggs Education Education Reform employment Fergus Hodgson Free Market Gov. Bobby Jindal Health Care Health Care Reform Heritage Foundation Jeffrey Sadow Labor Louisiana Louisiana Association of Business and Industry Louisiana Federation of Teachers Louisiana Lawsuit Abuse Watch Louisiana Legislature Louisiana Oil and Gas Association Medicaid Mercatus Center Moratorium National Debt Relief Amendment New Orleans Noble Ellington Obama ObamaCare oil spill Pension Reform pensions President Obama School choice Stimulus Taxes Tax Foundation teachers unions Transparency Vouchers Walter Block
Source: thepelicanpost.org

Seven Choices Medicare Plans Will Need To Make In Order To Survive

Posted by:  :  Category: Medicare

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Sales channels are a good example of this. Given the recent proliferation of channels, it is critical that MA plans optimize their mix by focusing on the needs of their customers, instead of looking at what has helped sell various Medicare products in the past. Traditional channel options include direct sales, brokers, groups, and the web; emerging channels include retail stores, payor partnerships, and private exchanges. Each avenue provides a unique experience for the customer, and the right match can determine the eventual buying decision. The range of channels increases complexity, but it also allows leading plans to tailor their engagement strategy by segmenting the customers and personalizing interactions on the basis of segment needs for sales and enrollment, as well as ongoing interactions with the member to improve experience and manage health outcomes.
Source: healthaffairs.org

Video: How to Understand Medicare Plans

Blended Medicare Plan Could Save $180B Over 10 Years, Study Finds

Both studies — the Commonwealth Fund Medicare reform proposal and the Rand analysis of others’ Medicare reform proposals — are seriously flawed and illustrate no real-world understanding of Medicare. It is good that the Commonwealth Fund includes the catastrophic coverage and annual OOP limits that are not included in Original Medicare. All Part C plans and a few Medigap plans include such protection today. In fact, the Commonwealth Fund looks like a Part C health plan — except that it costs more than the average Part C plan and does not have as many other benefits (other than the OOP limits). The one-size-fits-all drug plan proposed by Commonwealth Fund will lead many low-income seniors back to the two-tier VA-like prescription drug coverage that pre-dated Part D (one inferior tier for low-income seniors, one better plan for the rest of us seniors). Because I cannot take Essential without taking this inferior two-tier drug plan is bad news for we middle-income seniors also
Source: californiahealthline.org

Compare Medicare Plans & Providers

AAPC ACO affordable care act AWV’s CMS conference CSPI emr software exercise FHCA florida florida department of health GAO health care coverage health care laws health insurance health reform law health study healthy diet healthy eating healthy lifestyle HHS icd-10 insurance insurance subsidies medicaid medicaid services medical blog medical conditions medicare medicare advantage obamacare orlando physicians preventive care primary care physicians private health insurance recipes revenue cycle management sanford-burnham tactical management weight loss wellness welltrackmd world health news
Source: tacticalminc.com

Privately Run Medicare Plans are Really Expensive

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

When Can I Join a Medicare Part D Prescription Drug Plan?

General Enrollment Periods: Each year, there are two general enrollment periods when anyone who is enrolled in Medicare Part A or B can sign up for a Medicare Prescription Drug Plan. The first period begins in April and continues through June. The second open enrollment is in October and continues through the first week of December. This is the easiest time to plan for coverage and change your enrollment options.
Source: bradeninsurance.com

Medicare Plan Will Be Central To Ryan GOP Budget

Politico: GOP On Budget: Bitten, But Not Shy For the second year running, Republicans are betting big on the budget. Despite getting hammered by Democrats last year, the GOP is gambling that going big and bold on their fiscal blueprint — think major changes to Medicare and Medicaid — will convince voters the GOP is the nation’s responsible party, comprised of lawmakers attuned to the nation’s fiscal woes. But it’s a gambit fraught with political peril, especially in an election year. Rep. Paul Ryan’s budget last year gave Democrats an opening to paint Republicans as willing to end Medicare as voters know it and batter Medicaid — while cutting taxes for the wealthy (Sherman, 3/18).
Source: kaiserhealthnews.org

Workshop Offered to Help with Understanding of Medicare Plans, Part D

The presentation will weigh the benefits and drawbacks of Medicare Advantage plans and discuss why so many people are switching over to them. Participants also will hear a description of Medicare Part D, the different phases of coverage and how the Affordable Care Act affects the coverage gap (doughnut hole) in Part D benefits.
Source: trtnj.com

Next Steps for Some Beneficiaries In Medicare Special Needs Plans 

Series on Special Needs Plans and Medicaid Programs:  Issue Brief No. 1 “Federal Authority for Medicare Special Needs Plans and their Relationship to State Medicaid Programs.”  June 2009 at http://www.communityplans.net/Portals/0/Events/2009%20CEO%20Summit/ASPE%20Federal%20Authority%20for%20SNPs.pdf (site visited Sept. 13, 2011).  This description of disproportionate share was codified at 42 C.F.R. § 422.4(a)(1)(iv) but that section has been amended since the law changed. [5] Marsha Gold, Gretchen Jacobson, Anthony Damico and Tricia Neuman, “Special Needs Plans:  Availability and Enrollment,” Kaiser Family Foundation Program on Medicare Policy, September 2011 available at http://www.kff.org/medicare/upload/8229.pdf (site visited Sept. 13, 2011) [6] Sec. 164 of Pub. L. 110-275 (July 15, 2008) [7] Sec. 3205, Pub. L.111-148 (Mar. 23, 2010) [8] Memorandum of June 17, 2011 to All Medicare Advantage (MA) Organizations, from Anthony Culotta, Director, Medicare Enrollment and Appeals Group, Subject:  Transition Guidance for Non-Special Needs Enrollees in MA Special Needs Plans Under the “Disproportionate Share” Policy, available at  http://www.medicareadvocacy.org/wp-content/uploads/2011/09/SNP_Transition_Guidance_6-16-11-FINAL-2.pdf (site visited Sept. 15, 2011). [9] Assistance with selecting supplemental Medicare policies, known as Medigap policies, is usually offered by State Health Insurance Assistance Programs (SHIPs).  Not all SHIPs operate out of State Health Insurance offices.  For information about your state’s SHIP, go to www.shiptalk.org (site visited Sept. 15, 2011) [10] Medicare Managed Care Manual, Ch. 2 § 50.2.5, available at  http://www.cms.gov/MedicareMangCareEligEnrol/Downloads/FINALMAEnrollmentandDisenrollmentGuidanceUpdateforCY2012August192011.pdf  (site visited Sept. 15, 2011).
Source: medicareadvocacy.org

Medicare Plans to Boost Hospital Reimbursement Rates

“Dedicated professionals are working day and night in hospitals to provide the care that Medicare beneficiaries need,” Marilyn Tavenner, the acting administrator of the agency that runs Medicare, said in a statement. “The new policies in this proposed rule support hospitals’ important work and the people with Medicare who depend on them by promoting safety and care improvement.”
Source: medbill.net

Implementation of Affordable Care Act Provisions to Improve Nursing Home Transparency, Care Quality, and Abuse Prevention

Posted by:  :  Category: Medicare

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The Affordable Care Act (ACA) is the first comprehensive legislation since the Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), to expand quality of care-related requirements for nursing homes that participate in Medicare and Medicaid and improve federal and state oversight and enforcement. Despite the 1987 reforms, beginning in 1997, the Government Accountability Office issued more than 20 reports documenting serious quality of care problems in nursing homes and inadequate enforcement of federal regulations to protect residents’ health, safety, and welfare. To help address these quality problems, the ACA incorporates the Nursing Home Transparency and Improvement Act of 2009, introduced because complex ownership, management, and financing structures were inhibiting regulators’ ability to hold providers accountable for compliance with federal requirements. The ACA also incorporates the Elder Justice Act and the Patient Safety and Abuse Prevention Act, which include provisions to protect long-term care recipients from abuse and other crimes.
Source: kff.org

Video: Audio Educator: Medicare Nursing Documentation In A Skilled Nursing Facility

Reducing Antipsychotic Drug Use in Nursing Homes: Save Residents’ Lives, Save Medicare Billions of Dollars  

Cong., First Sess. (March 13, 2007), Serial No. 110-5, page 66, http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_house_hearings&docid=f:35502.pdf. [10] Duff Wilson, “Side Effects May Include Lawsuits,” The New York Times (Oct. 2, 2010), http://www.nytimes.com/2010/10/03/business/03psych.html?_r=1&scp=1&sq=%22Duff%20Wilson%22%20%22:Side%20Effects%20May%20Include%20Lawsuits%22&st=cse. [11] G.C. Alexander, S.A. Gallagher, A. Mascola, R.M. Moloney, and R.S. Stafford, “Increasing off-label use of antipsychotic medications in the United States, 1995-2008,” Pharmacoepidemiology and Drug Safety (on-line, Jan. 7, 2011), http://alexander.uchicago.edu/publications.html (click on the article). [12] Stephen Crystal, Mark Olfson, Cecilia Huang, Harold Pincus, and Tobias Gerhard, “Broadened Use Of Atypical Antipsychotics: Safety, Effectiveness, And Policy Challenges,” Health Affairs, 2009; 28:w770-w781. [13] Other approaches are discussed in CMA, “Off-Label Drug Use Is Common and Hurts Nursing Home Residents” (March 25, 2010), http://www.medicareadvocacy.org/InfoByTopic/SkilledNursingFacility/10_03.25.OffLabelDrugUse.htm. [14] Melissa L.P. Mattison, Kevin a. Afonso, Long N. Ngo, Kenneth J. Mukamal, “Preventing Potentially Inappropriate Medication Use in Hospitalized Older Patients With a Computerized Provider Order Entry Warning System,” Arch Intern Med Vol. 170 (No. 15) Aug. 2/23, 2010. [15] Patient Protection and Affordable Care Act, §6114. [16] State Operations Manual, Appendix PP, http://cms.hhs.gov/manuals/Downloads/som107ap_pp_guidelines_ltcf.pdf (scroll down to page 344 for the beginning of guidance for §483.25(l)). [17] Id. 386 (“1) wandering; 2) poor self-care; 3) restlessness; 4) impaired memory; 5) mild anxiety; 6) insomnia; 7) unsociability; 8) inattention or indifference to surroundings; 9) fidgeting; 10) nervousness; 11) uncooperativeness; or 12) verbal expressions or behavior that are not due to the conditions listed under ‘indications’ and do not represent a danger to the resident or others”). [18] ACA §6703, the Elder Justice Act of 2009, creates a National Training Institute for Surveyors.  42 U.S.C. §2041 [19] ACA §6121. [20]Ronald I. Shorr, Randy L. Fought, Wayne A. Ray, “Changes in Antipsychotic Drug Use in Nursing Homes During Implementation of the OBRA-78 Regulations,” Journal of the American Medical Association, 1994; 271:358-362.  See also Stephen Crystal, Mark Olfson, Cecilia Huang, Harold Pincus, and Tobias Gerhard, “Broadened Use Of Atypical Antipsychotics: Safety, Effectiveness, And Policy Challenges,” Health Affairs, 2009; 28:w770-w781. [21] 42 U.S.C. §1395w-104(b)(3)(G)(iv). [22] Elizabeth Hargrave, Jack Hoadley, Laura Summer, Juliette Cubanski, and Tricia Neuman, “Coverage of Top Brand-Name and Specialty Drugs,” (Kaiser Family Foundation, Medicare Part D 2010 Data Spotlight) (Sep. 2010), http://www.kff.org/medicare/upload/8095.pdf. [23] 42 C.F.R. §423.153(d).
Source: medicareadvocacy.org

Advocates Head To Court To Overturn Medicare Rules For Observation Care

When seniors call Medicare to complain about observation status, the option to appeal is rarely mentioned. According to records of 316 complaints — the total Medicare said it received from beneficiaries or their representatives about observation since 2008 — a typical response was that Medicare “cannot intercede with hospital/physician regarding change of status.” In a response to one of dozens of congressional inquiries, officials “advised senators [Center for Medicare and Medicaid Services] cannot change a hospital stay classification.”
Source: kaiserhealthnews.org

The Medicare Maze: Observation Stays, Nursing Home Costs, and “Invisible Patients”

We have all been traveling and have found ourselves party to a conversation because of proximity or bad cell phone etiquette. Some of these conversations are irritating, but I was looped into an interesting one the other day. Sitting in the Charlotte airport, two older men who looked like they were returning from a golf vacation started talking about enrolling in Medicare. One had just done it and the other had lots of questions. The recent enrollee said that he had registered through the Social Security web site; it took only ten minutes and was very easy. He told the other man that he only needed to sign up for part A, not for part B.
Source: wingofzock.org

Life Care Centers Accused of Bilking Medicare : Nursing Home Law Blog

Here’s a copy of the lawsuit referenced in the recent CBS News Piece on the lawsuit that the United States has brought against Life Care Centers, accusing them of inappropriate Medicare billing practices. 
Source: stark-stark.com

Arkansas’ Dubious Logic Regarding Their Medicaid Expansion Plan

Posted by:  :  Category: Medicare

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The one big problem with this plan is that private insurance is significantly more expensive than public insurance programs such as Medicare and Medicaid. This private option could be as much as 50 percent more expensive, but the Arkansas Department of Human Services released an analysis claiming the added cost would be much lower. They claim it may only cost 15 percent more or possibly less. One problem is their analysis seems based on some dubious and contradicting logic.
Source: firedoglake.com

Video: Medicare Arkansas

Medicaid v. Private Insurance in Arkansas

[…] The logic behind the proposed changes rests in the different needs of the “three programs” represented within Medicaid. Those covered by acute care Medicaid (45-50 million persons) most of them pregnant women and children, are relatively inexpensive to care for on a per capita basis. Increasingly, such beneficiaries have trouble finding providers who will care for them, due to a double whammy of stigma (it is insurance for persons who are poor) and the fact that it pays providers below what Medicare pays, which is less than what private insurers pay. This has lead to a systematic access problem for some Medicaid beneficiaries who have trouble finding a physician willing to treat them. There is nothing inherently wrong with the structure of Medicaid; we could decide to make it the best payer of care tomorrow, but that of course, is not going to happen. Buying them into private insurance policies will mainstream their care and remove a layer of cost shifting. [emphasis added]Source: samefacts.com […]
Source: samefacts.com

Obama administration lifts veil off Medicare hospital pricing

Even within the same region, costs can run to opposite extremes. HHS pointed out that the bills submitted for treating heart failure with some complications ranges from a low of $21,000 to a high of $46,000 in Denver, Colo., and from a low of $9,000 to a high of $51,000 in Jackson, Mississippi.
Source: investmentwatchblog.com

Should Arkansas Accept the ObamaCare Medicaid Deal?

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

Daily Kos: Arkansas legislature passes ‘private option’ Medicaid expansion

….which is that privatizing the MediCare services means that taxpayers will be paying far more, and recipients will be getting far less, than if the MediCare system itself were providing the.implementation in Arkansas, as it is in most states. This is just one more of the near-infinite flood of data-points that prove, unambiguously, unequivocally, and undeniably, that the Publicans are lying thru their teeth when they claim that their motive and goal is to save taxpayers money. Anyone who votes Publican who is not in the ownership class — the top 2-5% — is a tool and a fool, being played as such by the very elites they claim to resent, and eagerly participating in their own abuse. Friends don’t let friends vote Publican!
Source: dailykos.com

Medicare supplement plans for Arkansas

Medicare is a state funded health insurance plan offered to the person aged above 65 years of age or with some kind of disability. Medicare plans help provide assistance for covering out of pocket expenses that insurers find it very difficult to bear on their own. But there are lots of gaps in the Medicare plans and this can be filled only with a supplemental Medicare plan in Arkansas.
Source: medicarearkansas.com

Medicare Cut Threatens to Cost Arkansas Hospitals $407M

But it has done little to ease the uncertainty of how much financial pain health care providers, particularly hospitals, will have to endure in the budget process. Arkansas hospitals were bracing for $42.6 million in lost revenue during 2013 alone from the 2 percent Medicare cut. Over 10 years, lost revenue from the deficit-reducing gambit was projected to top $407 million for the state’s roster of hospitals.
Source: arkansasbusiness.com

The House approves Medicaid expansion, 77

It took a group of clever and obstinate young Republican legislators who refused to go along with Medicaid expansion but weren’t ready to close the door on other ideas. They helped force a crafty veteran Democratic governor who was eager to go forward with expansion to consider alternative approaches. Throw in tireless and creative state health officials who happened to have a cozy relationship with their federal It took a group of clever and obstinate young Republican legislators who refused to go along with Medicaid expansion but weren’t ready to close the door on other ideas. They helped force a crafty veteran Democratic governor who was eager to go forward with expansion to consider alternative approaches. Throw in tireless and creative state health officials who happened to have a cozy relationship with their federal counterparts. Probably some luck. And, among everyone involved, it took a slightly crazy, seemingly unjustified optimism that somehow a solution was possible. /more/
Source: arktimes.com

Medicare Change Threatens Ambulance Companies.: An article from: Arkansas Business book

Arkansas Ambulance Association: AAA. But he was direct when asked if Arkansas Business could get the two companies’ ambulances in a photo. Company. Highlights to Changes Under Health Care Reform;. Medicare Change Threatens Ambulance Companies. Medicare.com – Medicare Guide to Covered Products, Services and. by “Arkansas Business”; Business, regional Ambulance services Health care industry. Home – Centers for Medicare & Medicaid Services The newly named federal agency, formerly the Health Care Financing Administration, that administers the Medicare, Medicaid and Child Health Insurance programs. – Free Online Library Free Online Library: Medicare Change Threatens Ambulance Companies. WPS Medicare eNews – Staying Ahead of Medicare Changes. Pine Bluff Ambulance Companies Vie for Emergency Calls. Medicare Change Threatens Ambulance. Analysis of 2006-2007 Home Health Case-Mix Change:. Medicare.com is your gateway to Medicare covered products,. Medicare Change Threatens Ambulance Companies
Source: typepad.com

Arkansas To Replace Medicaid With Obamacare

Now I have not seen any projections of how this decision could affect health care costs, but I cannot imagine them going anywhere but down. Even though Medicaid does provide health coverage for the poor, it is notoriously inefficient, ineffective, and costly. Whether you like like health insurance companies or not, you must admit customers get more health services on the dollar than with Medicaid.  Perhaps expanding Obamacare can further reduce costs to the taxpayer by eliminating Medicaid altogether.
Source: wordpress.com

Code Key for Medicare Card Explained

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A: Social Security pays benefits to some 56 million people. They include retirees, widows and widowers, families who’ve lost their breadwinners, divorced spouses and people with disabilities. In order to keep track of such huge numbers, Social Security uses a series of codes to identify which individuals are receiving what types of benefits. The codes are assigned to people when they apply for benefits.
Source: aarp.org

Video: Using a Medicare card, Australia

Medicare Card Phone Scam Targets Senior Citizens

Callers have been asking victims to verify basic information such as a telephone number or mailing address, deluding them into providing much more private information such as a Social Security number or routing number.  This leads to subsequent unauthorized deductions from the checking account. This all comes with scammers utilizing the new changes from the Affordable Care Act as well to further confuse victims. If you have a senior whom you can warn, it is best to contact and make them aware sooner rather than later of this trending scam.
Source: pmbcgroup.com

Consumer Alert! Medicare Card Telemarketing Scam

If you become a victim of identity theft, file a report with your local law enforcement agency. The District AttorneyÕs Consumer Protection line provides assistance to victims of crime and answers questions on white collar crime issues. If you have a question or need assistance, call 720-874-8547.
Source: myprimetimenews.com

Why Medicare Cards Still Show Social Security Numbers

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

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May 21, 2013

Feds Make It Easier For States To Enroll Poor Under Health Law

Posted by:  :  Category: Medicare

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On Friday, it informed state officials that they could simplify enrollment in Medicaid, the federal-state program for the poor, to handle the onslaught of millions of anticipated enrollees next year when the health care law expands coverage.  The administration said the changes are geared to states that are expanding their programs, but they may also be adopted by others.
Source: kaiserhealthnews.org

Video: Louisiana SMP (Senior Medicare Patrol) revised

BBB alerts elderly to beware Medicare/Medicaid scams

The BBB of Acadiana works for a trustworthy marketplace by maintaining standards for truthful advertising, investigating and exposing fraud against consumers and businesses. Please contact the BBB at http://www.acadiana.bbb.org or (337) 981-3497 24 hours a day for information on businesses throughout North America.
Source: wordpress.com

Owner of Louisiana Health Care Company Convicted in Texas Medicare Fraud

Msiakii used Joy Supply’s Medicare provider number to submit claims to Medicare for DME, including orthotic devices, that was medically unnecessary and, in some cases, never provided. Many of the orthotic devices were components of “arthritis kits” and purported to be for the treatment of arthritis-related conditions; however, the devices were neither medically necessary nor appropriate for such conditions. The arthritis kit generally contained a number of orthotic devices including braces for both sides of the body and related accessories such as heat pads.
Source: redsticknow.com

The Trouble with Medicaid

Barack Obama BESE Bobby Jindal Budget Cato Institute Charter Schools David Vitter Don Briggs Education Education Reform employment Fergus Hodgson Free Market Gov. Bobby Jindal Health Care Health Care Reform Heritage Foundation Jeffrey Sadow Labor Louisiana Louisiana Association of Business and Industry Louisiana Federation of Teachers Louisiana Lawsuit Abuse Watch Louisiana Legislature Louisiana Oil and Gas Association Medicaid Mercatus Center Moratorium National Debt Relief Amendment New Orleans Noble Ellington Obama ObamaCare oil spill Pension Reform pensions President Obama School choice Stimulus Taxes Tax Foundation teachers unions Transparency Vouchers Walter Block
Source: thepelicanpost.org

Jindal versus Obama on Medicaid 

Jindal left unsaid, however, that at home, his administration plans to cut that healthcare spending drastically this spring to plug a looming $1.2 billion state budget deficit. At the same time, the Louisiana governor also left ignored an idea that a fellow GOP governor employed in Arizona. The concept could forestall this year’s cuts in the state’s healthcare budget, and meet the goal of providing health care to those up to 133 percent of the poverty level without impacting Louisiana’s budget. The excess hospital revenue could lessen this year’s cuts, and perhaps plug the funding gap endangering the construction of the new University Medical Center in Mid-City.
Source: louisianaweekly.com

Daily Kos: Louisiana Gov. Jindal cuts hospice care out of Medicaid

RichM, Thumb, Angie in WA State, coral, Radiowalla, murphy, jennybravo, Gooserock, celdd, eeff, RubDMC, Cassandra77, CatFelyne, Aquarius40, bwren, aitchdee, recontext, slippytoad, psnyder, TexDem, Eyesbright, chickeee, inclusiveheart, NapaJulie, bloomer 101, marina, Tinfoil Hat, denise b, BluejayRN, qofdisks, sc kitty, basquebob, viral, LNK, Dem Beans, ladybug53, Gordon20024, Burned, Tunk, minidriver, wbr, FindingMyVoice, fhcec, Philpm, Nance, irishwitch, myboo, sleipner, luckydog, blueoasis, wild hair, 4Freedom, shaharazade, Statusquomustgo, Little, BentLiberal, krwheaton, pat of butter in a sea of grits, pgm 01, ksp, offgrid, beth meacham, pipsorcle, lcdrrek, jedennis, yella dawg, MKinTN, revm3up, HappyinNM, Sixty Something, elwior, TomFromNJ, tofumagoo, Cassandra Waites, Gemina13, luckylizard, enufisenuf, maggiejean, prettygirlxoxoxo, Louisiana 1976, zmom, LinSea, ewmorr, shopkeeper, JesseCW, GreenMtnState, kravitz, papahaha, kevinpdx, Munchkn, porchdog1961, Amber6541, Laurilei, estreya, Polly Syllabic, mjbleo, Betty Pinson, Floande, cocinero, slice, no way lack of brain, annieli, coquiero, cv lurking gf, Mr MadAsHell, Nicci August, Teiresias70, CoExistNow, marleycat, PorridgeGun, laurnj, createpeace, wintergreen8694, peregrine kate, Andrew F Cockburn, randomfacts, Marihilda, jolux, stlsophos, DEMonrat ankle biter, Laurel in CA, Pinto Pony, GenXangster, OldDragon, Williston Barrett, Siri, IndieGuy, The Lone Apple, rustypatina, This old man, Mr Robert, hotheadCA, ivy redneck, belinda ridgewood, Canines and Crocodiles, pittie70, avsp, mythatsme, aresea, Hey338Too, pragmaticidealist, emileen, OldSoldier99, Capt Crunch
Source: dailykos.com

Medicaid expansion is a good thing. Ask Mitt Romney!

Bobby Jindal, the governor of Louisiana and one of the five republican governors to refuse Medicaid expansion, said he would rather improve the economic condition of the residents of Louisiana, so that they can purchase private insurance, than expand Medicaid. With Republican majorities in the state senate and house, I am wondering who is stopping Mr. Jindal from doing that. By the way Louisiana takes more federal dollars than it contributes to the federal government. I know he admonished the Republican Party not to be a stupid party, after the recent shellocking in the elections, but am not sure of his wisdom regarding how he is going to suddenly turn the economy around and provide healthcare coverage to citizens of Louisiana without some federal help.
Source: bitterpilldoc.com

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May 21, 2013

New CMS Website: Medicare Secondary Payer Conditional Payment Information 

Posted by:  :  Category: Medicare

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

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

A Primer on Medicare Financing

It also describes the expected effects of provisions in the 2010 health reform law on future Medicare spending. The primer reviews the financial obligations and out-of-pocket spending for people covered by Medicare, outlines several ways to assess Medicare’s long-term fiscal outlook, and discusses future financing challenges facing the program.
Source: kff.org

Sen. Grassley Pushes On In Medicare ‘Political Intel’ Probe

CQ Health Beat: Grassley Not Satisfied With Access on Medicare Advantage Probe Grassley’s staff has already twice interviewed Mark Hayes, a former Grassley staffer who now works for Greenberg Traurig, a lobby firm, about the April 1 announcement by the Centers for Medicare and Medicaid Services that it would increase rates for Medicare Advantage plans. That decision was a reversal from an earlier suggestion by the agency that rates would be reduced. Before that announcement was made public after the markets closed, Height Securities, a Greenberg Traurig client that Hayes worked with, alerted its clients to the impending announcement and health insurance stocks soared. Greenberg Traurig and Hayes have since said they did not provide any advance information to Height (Bunis, 5/2).
Source: kaiserhealthnews.org

Better Business Bureau warns elderly to beware Medicare/Medicaid scams

These people are asking for personal information such as Medicare, Medicaid, Social Security, credit card or bank account numbers in order to provide free services such as medic alert alarms, back braces, and other products that assist the elderly and infirm and are paid for by Medicare and Medicaid.
Source: bbb.org

Medicare Information Program at the Hoyt, Presented by Walgreen’s Pharmacy

Medicare provides health insurance to people 65 and older and younger people with disabilities, regardless of income or disabilities. It has been administered by the United States government and created by Congress since 1965 under Title XVIII of the Social Security Act.
Source: hoytlibrary.org

CMS Promotes Value for Seniors and Persons with Disabilities in Medicare Plans

With today’s regulation limiting overhead and profits for Medicare Advantage and prescription drug plans, the Affordable Care Act continues to promote value for consumers’ and taxpayers’ health care spending. These new requirements apply to Medicare health and drug plans offered by private insurance companies serving over 37 million seniors and persons with disabilities, and build on a similar regulation we issued last year requiring a minimum medical loss ratio for health plans serving consumers in the private insurance market. Medicare health and drug plans, beginning next year, must meet a minimum medical loss ratio, limiting their spending on non-health related items such as administrative costs, profit, or overhead. More specifically, this means that the plans must spend at least 85 percent of their revenue on direct benefits to Medicare enrollees such as clinical services, prescription drugs and quality improving activities.
Source: medicare.gov

Nationwide Takedown Leads to 89 Individuals Charged With $223 million in Fraudulent Billing to Medicare

This is the sixth national Medicare fraud takedown coordinated by the Medicare Fraud Strike Force, which was created in 2007. The Strike Force is part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT) initiative that combines the resources of the Department of Justice (DOJ) and HHS. Attorney General Holder stated that Strike Force operations over the last three fiscal years have resulted in recoupment of nearly eight dollars for every dollar spent on combating health care fraud. Additionally, he suggested that Strike Force actions have deterred illegal activity, noting that group psychotherapy bills to Medicare decreased by more than 70 percent after the Strike Force targeted group psychotherapy fraud in Detroit and that billings for home health services in Florida dropped by more than $1 billion after the Miami team targeted home health fraud. Holder expressed concern that sequestration, which cut more than $1.6 billion from the DOJ’s FY 2013 budget and is expected to continue into FY 2014, will reduce the DOJ’s ability to combat Medicare fraud.
Source: wolterskluwerlb.com

How Medicare’s drug data was analyzed

We also indicate whether the average length of a provider

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May 21, 2013

Technical Note: Are Providers Gaining Pricing Power over Medicare?

Posted by:  :  Category: Medicare

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The actuaries have concluded from this analysis that preserving beneficiary health access to mainstream health services means Medicare rates must soon increase. “Hospitals,” they say, “have been pushing back in recent years against payment reductions aimed at further reducing inefficiency, a signal that much of the achievable gains may already have been made.” If nothing else, the Alternative Illustrative Scenario illustrates how difficult it is for public agencies—especially ones steeped in the stakeholder politics of a three trillion dollar per year industry—to imagine a slowdown in private prices.
Source: cahc.net

Video: AT Network Webinar Training on Medicare Competitive Bidding for DME Providers

Changes to Program Integrity Manual May Benefit Medicare Providers

Use of templates may help providers eliminate the subjectivity in documenting medical necessity, and thus eliminate a significant number of claim denials.  It is important to note, however, that templates must be created in a way to allow providers to document all relevant elements necessary to establish medical necessity under a specific LCD.  Templates cannot merely contain check boxes, predefined answers, limited space to enter information, etc.  According to Section 3.3.2.1.1(B) these types of templates “often fail to capture sufficient detailed clinical information to demonstrate that all coverage and coding requirements are met.”
Source: dmagazine.com

Senators invite provider input on Medicare ‘doc fix’

To compensate for maintaining physician pay levels, the Centers for Medicare & Medicaid Services has had to cut spending elsewhere. This has led to reduced reimbursements for skilled nursing providers collecting on bad debt, for example. While protesting these offsets that take a bite out of their payments, long-term care providers have also expressed concern that if doctors’ pay is cut, it could negatively affect elder care.
Source: mcknights.com

Report reveals varied prices for Medicare providers

big island biif billy kenoi daniel akaka dlnr dui stats earthquake election 2012 fire fuel gasbuddy gov linda lingle halemaumau hawaii volcanoes national park hhsaa high surf advisory hilo hvo ironman kailua-kona ka‘u keaau kilauea Kohala kona lava mauna kea mauna loa missing neil abercrombie nws pahoa parker school police puna recalls traffic triathlon uh-hilo usgs volcano volcano watch waiakea waikoloa waimea
Source: hawaii247.com

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

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

Analysis Finds Lax CMS Oversight of Prescribers in Medicare Part D

Further, the data showed that 50% of the top 20 prescribers of OxyContin in 2010 have been either criminally charged, convicted or settled fraud claims, or have been disciplined by their state medical boards. Among those, eight have been charged, convicted or barred from prescribing controlled substances, or been disciplined by licensing boards. However, all but one of those doctors still are able to prescribe drugs for Medicare.
Source: californiahealthline.org

Settlement Reached to End Medicare’s “Improvement Standard” 

Since 1987, Mrs. Berkowitz, an 81 year-old woman with Multiple Sclerosis, has frequently been told that her Medicare coverage and home health services are being discontinued because her MS "is not improving."  Each time, she has called on the Center to fight for her and ensure that her care continues.  Each time, the Center has successfully advocated to keep her Medicare and home care in place. People like Mrs. Berkowitz help the Center to know first-hand how harmful this illegal basis for Medicare denial is for people with long-term and chronic conditions.   As a result of working with her, and many other people with long-term conditions, the Center has been able to seek, and obtain, systemic change to help ensure fair access to Medicare coverage and necessary health care for all beneficiaries in similar circumstances.
Source: medicareadvocacy.org

How Medicare’s drug data was analyzed

We also indicate whether the average length of a provider

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May 21, 2013

Medicare Shared Savings Program: A Road Map

Posted by:  :  Category: Medicare

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With the March 2010 passage of the ‘Patient Protection and Affordable Care Act (PPACA), the ‘follow the money’ floodgates are once again opening for hospitals, physicians, integrated delivery systems, health plans, and consultants. This time, instead of migrating ‘HMO lite’ (neither staff nor group model) platforms into mainstream medicine via IPAs, or MeSH model JV’s, we’re now talking about their ‘new and improved’ successors broadly cast as ‘Accountable Care Organizations aka ‘ACOs’.
Source: wordpress.com

Video: Medicare Shared Savings Program Overview National Provider Call 12/7/11

CMS Announces July 31 Deadline for Medicare Shared Savings Program Applications : Bridging Business & Healthcare

However, CMS has announced a July 31 deadline.  An accountable care organization intending to submit an application must file a Notice of Intent by May 31 and obtain a CMS User ID by June 10.  Failure to meet these deadlines will disqualify an organization from MSSP participation in 2014.  CMS has not yet published the Notice of Intent form or the application packet.    CMS will be hosting a national provider call regarding the 2014 MSSP application process on April 9.  A second call is scheduled for April 23.
Source: pyapc.com

Notes from the Cliff: The Deal and Its Impact on Medicare 

Cong. Tit. VI (2012) [2] Id. at  §§ 601, 603, 607, 608, 610, 621, 643 (2012) [3] For more information on the Sustainable Growth Rate See The Sustainable Growth Rate Formula and Health Reform, The Center on Budget and Policy Priorities, (April, 2010) http://www.cbpp.org/files/4-21-10health2.pdf & Mary Agnes Carey,  ‘Doc Fix’ In ‘Fiscal Cliff’ Plan Cuts Medicare Hospital Payments, Kaiser Health News, Jan. 1, 2013, http://capsules.kaiserhealthnews.org/index.php/2013/01/doc-fix-in-senate-fiscal-cliff-plan-cuts-medicare-hospital-payments/ [4] There is a separate $1,900 per year cap for occupational therapy [5] See also the Medicare Improvements for Patients and Providers Act of 2008, Pub. L. No 11-275, codified at 42 U.S.C. §§ 1320b-14, 1396u-5(a) (2010).
Source: medicareadvocacy.org

Medicare Savings Program sees enrollment rise

Enrollment increased 5.2% in 2010 and 5.1% in 2011, according to the GAO. It attributed the growth to factors including the SSA’s efforts as well as the economic downturn. The Medicare Improvements for Patients and Providers Act of 2008 requires that the SSA address the roadblocks preventing low-income beneficiaries from signing up for the savings program. Those barriers were pegged as low awareness and cumbersome enrollment processes. In addition to outreach, the SSA was also required to transfer information on beneficiaries who file a low-income subsidy application to a state Medicaid agency. Officials in 28 states reported growth in their Medicare Savings Programs as a result of Social Security Administration transfers, the GAO found. The GAO noted that the amount of additional work for states will depend on whether they decide to re-verify the information beneficiaries provided to the SSA and whether their eligibility requirements align with the federal government’s.
Source: modernhealthcare.com

Maximizing your Resources and Saving Money: Medicare Savings Program

If you are on Medicare and have a limited income you may qualify for your state to pay your Medicare Part B premium. Eligibility in the program automatically qualifies you for extra help paying your Medicare Part D premium and prescription copayments. Check with your State for the requirements. Applications can usually be obtained online or at your local Social/Senior Services Center. Here are the following requirements in the State of CT:
Source: blogspot.com

UCLA Health System chosen as a Medicare Shared Savings Program accountable care organization / UCLA Newsroom

The UCLA Health System, which comprises the UCLA Hospital System and the UCLA Medical Group and its affiliates, has provided a high quality of health care and the most advanced treatment options to the people of Los Angeles and the world for more than half a century. Ronald Reagan UCLA Medical Center, the Resnick Neuropsychiatric Hospital at UCLA, Mattel Children’s Hospital UCLA, and UCLA Medical Center, Santa Monica (which includes the Los Angeles Orthopaedic Hospital) deliver hospital care that is unparalleled in California. Ronald Reagan UCLA Medical Center is consistently ranked one of the top five hospitals in the nation and the best in the western United States by U.S. News & World Report. UCLA physicians and hospitals continue to be world leaders in the full range of care, from maintaining the health of families to the diagnosis and treatment of complex illnesses.
Source: ucla.edu

GAO: More enrollees take advantage of Medicare Savings Programs

Despite historically low numbers, enrollment for the Medicare Savings Programs is up, the Government Accountability Office reported Friday. With enrollment rising every year since 2007, the report suggests the Social Security Administration has been successful at eliminating barriers to enrollment, which could reduce Medicaid spending for certain beneficiaries. Historically, low enrollment has been attributed to a lack of awareness about the four programs (Qualified Medicare Beneficiary, Specified Low-Income Medicare Beneficiary, Qualifying Individual, and Qualified Disabled and Working Individual), as well as cumbersome enrollment processes through state Medicaid programs, GAO noted. For instance, in 2004, only a third (33 percent) of eligible beneficiaries were enrolled for the Qualified Medicare Beneficiary program, and only 13 percent were enrolled in the Specified Low-Income Medicare Beneficiary program, the report noted.
Source: fiercehealthcare.com

State Solutions: An Initiative to Improve Enrollment in Medicare Savings Programs

The five grantee states used many approaches to identify and enroll new participants in Medicare Savings Programs. Strategies included modifying the programs’ eligibility requirements, expanding outreach activities, simplifying the enrollment process, training staff and volunteers to conduct enrollment activities, forging partnerships, expanding enrollment opportunities, strengthening data collection and engaging state representatives to explore barriers to enrollment.
Source: rwjf.org

Shared Savings Program Application

The filing period for the Notice of Intent (NOI) to Apply for participation in the Medicare Shared Savings Program 2014 program starts today May 1, 2013 and expires on May 30, 2013. The completed NOI  must be submitted no later than 5 p.m. EST May 31, 2013.  CMS only accepts NOIs submitted electronically and advises that processing time may vary, so applicants are instructed to plan to submit their NOI as early as possible.  Those submitting a completed NOI will get NOI Receipt Notice by e-mail that includes the ACO identification number (ACO ID) and detailed instructions on how to get a CMS User ID. CMS states that an applicant must have an ACO ID to apply to participate in the Shared Savings Program and • You must have a CMS User ID and password to submit your application using the online Health Plan Management System (HPMS.) Additional instructions on acquiring a CMS User ID and related due dates are set forth on the web site.
Source: sascottlaw.com

HHS Names 106 New Participants in Medicare Shared Savings Program

In addition, 15 organizations in the latest ACO cohort are Advanced Payment Model ACOs, which are physician-based or rural providers granted capital to invest in electronic health record systems, staff and other infrastructure improvements. CMS will recoup the advanced payments through future shared savings (CMS release, 1/10). Another 15 Advanced Payment Model ACOs were announced in the second round of ACOs.
Source: californiahealthline.org

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May 21, 2013

Controlling Medicare Costs is Now Un

Posted by:  :  Category: Medicare

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Of course, as a number of people have pointed out, this move doesn’t prevent IPAB from working. If the Senate doesn’t confirm anyone to the board, it just means that the HHS secretary has to make cost-cutting proposals on her own if Medicare grows faster than allowed. So what’s the point? Pretty obviously, it’s to make sure that if Medicare is cut in any way, Republicans can blame it solely and completely on Democrats.
Source: motherjones.com

Video: What Does Medicare Cost?

Study Takes on the Myth of Medicare Cost Shifting

Contrary to the theory, I found that hospital markets with relatively slow growth in Medicare inpatient hospital payment rates also had relatively slow growth in private hospital payment rates during 1995–2009. Using regression analyses, I found that a 10 percent reduction in Medicare payment rates led to an estimated reduction in private payment rates of 3 percent or 8 percent, depending on the statistical model used.
Source: firedoglake.com

Best Bets for Reducing Medicare Costs for Dual Eligible Beneficiaries: Assessing the Evidence

With pressure mounting to slow the growth in federal health care spending, policymakers are exploring ways to reform the way care is delivered to the 9 million low-income Medicare beneficiaries who also receive Medicaid – a group that on average is sicker and frailer than other Medicare beneficiaries, and therefore receive significantly more care at greater cost. Major efforts are underway at the federal and state level to better coordinate care for this population and lower health care costs – with some estimates projecting hundreds of billions of dollars in savings over the next decade.
Source: kff.org

Study: Cuts to Medicare trim costs to insurers

Chapin White, a senior health researcher at the Center for Studying Health System Change, analyzed data on payment rates from 1995-2009 and found a widening gap between Medicare rates and private rates. Medicare had an average annual growth rate of 3 percent while private insurance grew more quickly — at 3.56 percent — he found.
Source: politico.com

thriftymommastips: Medicare Part D Costs #Walgreens Prescription Savings #ad

My kids, my Mom and I all have needed prescriptions often in the last decade. Prescriptions actually eat up a massive chunk of our family budget. When I was a new university graduate and my Crohn’s, an inflammatory bowel disease thought to also be an autoimmune disorder, was in full flare I frequently lost a lot of weight, watched my energy vanish, and the potential to make money sadly shrivelled up. Those days, as sick as I was, with prescriptions that cost over $500 a month and no drug plan, I was often faced with the reality of paying for medications that were needed, or getting food. Paying tuition, paying for food and drugs? Impossible. That’s a position nobody should ever have to find themselves in, especially as a caregiver, or a patient. Sadly, I am far from alone, caregivers everywhere are forced to make these terrible choices daily. Seniors, on fixed incomes, and people struggling with disability shouldn’t be forced to choose between prescriptions and groceries. Families bearing emotional and financial responsibility for caregiving shouldn’t be fearful of how to spend their money. Caregiving is hard enough, rewarding for sure, but challenging in so many ways. The stress of caregiving shouldn’t be compounded by cost of prescription drugs. 
Source: thriftymommastips.com

Trial against Da Vinci Robot, Medicare Costs and Benefits, Tough Week for Hospitals, HHS Fundraising, But there’s Plenty of Money out There

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers. To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.
Source: oconnorreport.com

How Medicare Costs Can Be $180 Billion Lower Over 10 Years

In “Medicare Essential: An Option to Promote Better Care and Curb Spending Growth”, Karen Davis, Ph.D., director of the Roger C. Lipitz Center for Integrated Health Care at The Bloomberg School of Public Health, and Commonwealth Fund scholars Cathy Schoen and Stuart Guterman, detail their proposal for a new public insurance plan choice that would simplify Medicare. By offering a comprehensive set of benefits that includes medications and lower deductibles, the Medicare Essential plan would offer beneficiaries better financial protection, a limit on out-of-pocket spending, and the opportunity for additional savings in premiums and out-of-pocket expenses for those who select high-value health care providers and hospitals that are able to provide quality care while keeping down costs.
Source: science20.com

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