NDIS levy: Medicare levy increase to fund National Disability Insurance Scheme

Posted by:  :  Category: Medicare

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I am more than happy to support the NDIS. The Productivity Commission report regarding disability in 2011 found that the current state of disability support within Australia is underfunded, ineffective, and is restrictive towards individual’s choice with their own care. The overarching message from Prime Minster Gillard and Tony Abbot is that the NDIS is important legislation and needs to be implemented. I feel we need to acknowledge that disability support needs to be changed within this country as one in four people with disabilities within this country live below the poverty line. The amount of people with disabilities that are within the Australian workforce has dropped to 2.9 percent. The NDIS propose not only vital and consistent funding towards to these individuals but also a focus on social and economic participation which include making employment more accessible. Allowing this excluded group to engage with the workforce will be good for the country as a whole.
Source: com.au

Video: How Medicare Works With Social Security Disability

Social Security & Medicare for Adult Disabled Children

If you or your spouse are retired or disabled and receiving Social Security benefits and have a disabled adult child who has been denied the SSDI benefits, the experienced attorneys at Littman Krooks, LLP can assist you in filing an appeal, so that your child can obtain the benefits they are entitled to. Our firm represents adult children with disabilities in SSDI appeals on a contingent fee basis, which means that there is no out of pocket legal costs for filing the appeal.
Source: specialneedsnewyork.com

Support rises for Medicare levy increase

With just two weeks to go before budget day, Ms Gillard has flagged a $12 billion shortfall in one year of tax revenues, meaning Labor will have to work harder to find the savings to support the multibillion-dollar disability scheme and big-ticket schools reforms.
Source: com.au

Guest Post: Tintarella di Luna

Thankyou Tintarella for highlighting this issue! Everyone needs to know what is really happening. When we heard about the NDIS trials, we were ‘pleased’ that finally the ‘need’ had been recognized. When we heard that both parties were agreeing on a levy to provide ‘some’ care to people with disabilities, we were ‘really pleased’ A higher levy would have raised the excitement level. Now we hear that 75% of this funding will go to feed the ‘Disability Industry’ – we are ‘Shattered’ And also sadly ‘unsurprised’ With regard to pensions: I dearly hope that Disability pensions are not going to be cut? The DSP provides for things like rent, clothing, food, medication & (hopefully some) living expenses. It is a huge struggle for many people with Disabilities to survive. The NDIS funding would help to provide supports & care. We all know that in most cases the allocation of funding will not be adequate, DSP does not cover care. All we can do is continue to try to have input. Try to help the beaurocracy to understand what is really needed. Hope that they listen to us. People with Disabilities & their families are their greatest resource & we want to help to make the NDIS a success. We have to make it a success. We need you in Parliament. You can sort this situation!
Source: catallaxyfiles.com

Guide to Government Benefits: Social Security, Medicare, Medicaid, Unemployment Insurance, Disability downloads

Get a Publication – The United States Social Security Administration Introduction to the Social Security Program: Disability Benefits:. Benefits for People with Disabilities – The United States Social. Security Disability Insurance (SSDI) benefits is also. Guide to Government Benefits: Social Security, Medicare, Medicaid. If you live in Puerto Rico you will not receive Medicare Medical Insurance (Medicare Part B). Centers for Medicare & Medicaid Services,. Social Security – The Red Book How to Reach Social Security; Request copies of the Red Book or other SSA Publications;. Social Security Disability Insurance Program. Social Security Online – Medicare Information (This information is provided by the Center of Medicare & Medicaid. Health Insurance. SOCIAL SECURITY and MEDICARE BASICS Other provisions included unemployment insurance, old age. Green Book – Consultative Examinations: Guide for. the Guide to Health Insurance for. A Guide to Health Insurance for People. Medicare/Medicaid Services;. Social Security Disability Insurance pays benefits to you. Social Security and the Medicare Program – Medicare Enrollment my Social Security; Retirement; Disability;. Benefits.gov; MyMoney.gov; Medicare • If you receive Social Security disability benefits. lose the Social Security Disability benefit. Disability: Red Book (A Summary Guide To Employment. Covered By Social Security And Medicare: . under Social Security or in a Medicare-covered government. USA.gov; Benefits.gov. Guide to Government Benefits: Social Security, Medicare, Medicaid, Unemployment Insurance, Disability: Lauren Traeger (Federal Benefits Researcher): Amazon.com
Source: typepad.com

Disability Care and Medicare

What is not reported is the transformative impact of DisabilityCare for individuals and their families and the number of people that it will impact on throughout their lives now and into the future. The logic of the alar5mist headline is that the existing Medicare levy also hits workers. It is a continuation of the anti-tax rhetoric of the Federal Coalition which has moved away from its bipartisan support for DisabilityCare – emphasising its principle support but subject to available funds. Increasing the Medicare levy would underwrite the sustainability of Disability Care.
Source: australiasmassmedia.com

Does Medicare or Medicaid Come with Disability?

Do you get Medicare coverage if you were approved for SSI? Claimants who are approved for SSI only typically receive Medicaid coverage in most states. And like SSI, Medicaid is subject to income and asset limitations. Medicaid is a needs-based, state- and county-administered program that provides for a number of doctor visits and prescriptions each month, as well as nursing home care under certain conditions. Can you ever get Medicare if you get SSI? Medicare coverage for SSI recipients does not occur until an individual reaches the age of 65 if they were only entitled to receive monthly SSI disability benefits. At the age of 65, these individuals are able to file an uninsured Medicare claim, which saves the state they reside in the cost of Medicaid coverage. Basically, the state pays the medical premiums for an uninsured individual to be in Medicare so that their costs in health coverage provided through Medicaid goes down. 
Source: disabilitysecrets.com

The Truth About The 2 Percent Medicare Sequestration Cuts

Posted by:  :  Category: Medicare

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CQ HealthBeat: Medicare Cost Board Could Come Into Play In Late April The deadline is three weeks away for figuring out whether a controversial board included in the health care law will be responsible for coming up with Medicare cuts next year. Although the trigger is not expected to be met, the health care overhaul requires the chief actuary of the Centers for Medicare and Medicaid Services to determine whether the cuts will be necessary by April 30. Under the 2010 law, the Independent Payment Advisory Board is charged with making cost-cutting recommendations each year beginning in 2014 if Medicare spending exceeds a target growth rate (Attias, 4/10).
Source: kaiserhealthnews.org

Video: Looming Catastrophic Medicare Cuts (Horizon, Ch. 8, AZ PBS- Nov. 17., 2010)

Medicare Advantage “Cuts?” Don’t Believe it. 

The Affordable Care Act (ACA) is beginning to rein in Medicare Advantage (MA) overpayments by bringing MA payment more in line with what traditional Medicare spends on a given beneficiary.  The insurance industry is not only fighting this payment reform, but has launched a campaign against a 2.3% reduction in payment projected for 2014.[1]   This additional "cut" is actually a projected reduction in MA payment growth rate as a result of a statutorily-required formula that bases MA payments on overall Medicare costs.  In short, because Medicare’s costs overall have grown more slowly than expected in recent years, projected payment increases to MA plans will also slow.   Contrary to arguments by the insurance industry – which pushes for more private market involvement in the Medicare program – insurers that choose to offer Medicare plans should not be insulated from market forces that are slowing the rate of growth of health care costs.
Source: medicareadvocacy.org

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

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

Projected Government Health Spending Down Almost a Trillion Since Deficit Hysteria Began

That date’s important because it was in late 2010 — and based on CBO’s August 2010 projections — when fiscal commission co-chairs Erskine Bowles and Alan Simpson issued their original budget proposal, which called for over $300 billion in Medicare cuts and nearly $60 billion in Medicaid savings through 2020. The original Bowles-Simpson proposal is often considered an appropriate benchmark for evaluating other deficit-reduction plans.
Source: firedoglake.com

Can New Brunswick afford a $715

But $20 million is the tip of the iceberg for N.B. The $36-billion cut to the Canada Health Transfer announced by the Harper government in December of 2011, will mean a $715-million cut for NB after the 2015 election (if Harper is to win). While in N.B., I researched the annual operating budget of their hospitals and discovered that $660 million covers 11 hospitals and 30 medical clinics. So even if N.B. were to shut down these 11 hospitals and 30 medical clinics for one year, they’d still need to find an additional $55 million in savings! The $20 million with doctors is nothing to scoff at, but the race to find efficiencies is going to get a lot more intense in the coming years and we all need to be prepared to fight against extreme austerity and attempts to privatize the system under the lies that its a more affordable way to deliver services.
Source: rabble.ca

FACT CHECK: Only 4 Percent of the ACA’s Medicare Advantage Cuts Have Gone Into Effect

According to the 2010 estimates from the CBO, the ACA will reduce funding for the benefits of Medicare Advantage enrollees by more than $200 billion over ten years (2010-2019).  CBO estimated that the law will directly reduce funding for the Medicare Advantage program by an estimated $136 billion in this timeframe.  CBO further estimated that, because of the linkage between Medicare Advantage payment benchmarks and Medicare FFS spending, the ACA’s other Medicare FFS reimbursement changes will indirectly reduce funding for Medicare Advantage by an additional $70 billion over ten years.  More recently, in July of this year, CBO issued revised estimates indicating that the ACA would directly reduce Medicare Advantage funding by $156 billion in the current ten-year budget window (2013-2022).  This estimate did not include information on the ACA’s indirect cuts to the Medicare Advantage program.
Source: ahipcoverage.com

Republicans Won’t Name Medicare Cuts They Want and They Don’t Need To

A top Democratic official said talks have stalled on this question since Obama and congressional leaders had their friendly-looking post-election session at the White House. “Republicans want the president to own the whole offer upfront, on both the entitlement and the revenue side, and that’s not going to happen because the president is not going to negotiate with himself,” the official said. “There’s a standoff, and the staff hasn’t gotten anywhere. Rob Nabors [the White House negotiator], has been saying: ‘This is what we want on revenues on the down payment. What’s you guys’ ask on the entitlement side?’ And they keep looking back at us and saying: ‘We want you to come up with that and pitch us.’ That’s not going to happen.”
Source: firedoglake.com

Analysis Finds Lax CMS Oversight of Prescribers in Medicare Part D

Posted by:  :  Category: Medicare

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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

Video: Medicare Part D

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

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

Wow medicare part D is tricky

Here is a case of my own meds. Had prostatitis,3 years ago,took generic flomax,tried 3 different brands all had side effects I did not like,switched to brand name Flomax much less side effects. Even with corporate health insurance I had to pay full price out of my own pocket,but it was worth it. Anyhow prostatitis gone. In my zip for part D,entering brand name Flomax only turns up 2 plans with it in the formulary,and they are expensive plans 113/month and up. You could only get real Flomax on other plans by a formulary exception,how often does that happen,don’t know. As it works out retail drug cost 2152. For hi cost plan you pay 2198. Low cost plans not on formulary you pay about 2344 with the cheap 15 a month aarp plan. So you pay retail plus plan cost,the expensive plans the cost per month is so hi it eats up any savings from the fact they cover the drug. Brand Flomax is only 180 a month not real expensive as far a drugs go like biologics,but you can see what a mess this system really is. They are going to push generics of course to save money, I can see that,but all the equivalence testing in the world between brand and generics,at least on Flomax will not convince me that the generic is equivalent. I digress. The mess in the system is forcing seniors, some perhaps older and not too sharp anymore to go through this maze of commercial drug plans and try and figure out what the hell is going on. Going with the cheapest plan and reduced formulary not great,the most expensive plans not great, somewhere in the middle probably might be best. Also part of the mess is that the plans can change drugs on the formulary,and tiers at will,yes they are required to notify,but this still might add another layer of confusion for older folks. I can see now that I am close to being in the system,I don’t like what is going on. Anyone know if to get the united healthcare part D plans if you actually have to join AARP. Old Mike
Source: early-retirement.org

What to Look for When Comparing Medicare Part D Costs

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Source: moneyning.com

Medicare Part D & Senior Citizens by Rick Martino

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Source: nvseniorguide.com

9th Circ. OKs Revoking Medicare Part D Insurer’s Contract

Federal regulators acted properly when they revoked the Medicare Part D contract of a prescription drug insurance provider for delaying patient access to medications for cancer, HIV and AIDS, the Ninth Circuit ruled Tuesday in the first such case to reach a federal appeals court. Read More…
Source: lexisnexis.com

Are You confused by Medicare Part D Costs?

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Source: thrivinginthemiddle.com

Chart of the day: Medicare Part D drug price growth

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Source: theincidentaleconomist.com

Why the Politics of Obamacare Implementation Could Be Very Different From Medicare Part D

On the other hand, the implementation of Obamacare was designed to feature a mix of winners and losers. Low income people who qualify for Medicaid will be clear winners, yet many other people will see themselves as worse off because of the law. Certain middle income people who buy their own insurance could see big premium increases. Some business owners will be hit with a significant penalty for not providing insurance, while some workers might see their hours cut to avoid this penalty. Parts of the health care industry will also face new taxes.
Source: firedoglake.com

CMS Proposes New Policy for Medicare Part A

Posted by:  :  Category: Medicare

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The policy would help beneficiaries who have been having longer stays as outpatients because of hospital uncertainties regarding payments if they admit the patient to the hospital, the CMS stated. Medicare patients face greater cost-sharing responsibilities when they stay longer under observation status rather than being admitted.
Source: dmagazine.com

Video: Guide to Medicare Part A and Part B

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

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

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

What to Look for When Comparing Medicare Part D Costs

Information presented on Personal Finance Blog by MoneyNing is intended for informational purposes only and should not be mistaken for financial advice. While all attempts are made to present accurate information, it may not be appropriate for your specific circumstances. Any offers and rates shown on this site can change without notice and may contain information that is no longer valid. For further validation, always visit the official site for the most up-to-date information. This site may receive compensation from companies to offer an opinion about a product or service. We strive to provide honest opinions and findings, but the information is based on individual circumstances and your specific experiences may vary. We also treat your privacy seriously. Please take some time to understand our full policies and disclaimers by clicking here.
Source: moneyning.com

Wow medicare part D is tricky

Here is a case of my own meds. Had prostatitis,3 years ago,took generic flomax,tried 3 different brands all had side effects I did not like,switched to brand name Flomax much less side effects. Even with corporate health insurance I had to pay full price out of my own pocket,but it was worth it. Anyhow prostatitis gone. In my zip for part D,entering brand name Flomax only turns up 2 plans with it in the formulary,and they are expensive plans 113/month and up. You could only get real Flomax on other plans by a formulary exception,how often does that happen,don’t know. As it works out retail drug cost 2152. For hi cost plan you pay 2198. Low cost plans not on formulary you pay about 2344 with the cheap 15 a month aarp plan. So you pay retail plus plan cost,the expensive plans the cost per month is so hi it eats up any savings from the fact they cover the drug. Brand Flomax is only 180 a month not real expensive as far a drugs go like biologics,but you can see what a mess this system really is. They are going to push generics of course to save money, I can see that,but all the equivalence testing in the world between brand and generics,at least on Flomax will not convince me that the generic is equivalent. I digress. The mess in the system is forcing seniors, some perhaps older and not too sharp anymore to go through this maze of commercial drug plans and try and figure out what the hell is going on. Going with the cheapest plan and reduced formulary not great,the most expensive plans not great, somewhere in the middle probably might be best. Also part of the mess is that the plans can change drugs on the formulary,and tiers at will,yes they are required to notify,but this still might add another layer of confusion for older folks. I can see now that I am close to being in the system,I don’t like what is going on. Anyone know if to get the united healthcare part D plans if you actually have to join AARP. Old Mike
Source: early-retirement.org

Medicare Part D & Senior Citizens by Rick Martino

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Source: nvseniorguide.com

Are You confused by Medicare Part D Costs?

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Source: thrivinginthemiddle.com

9th Circ. OKs Revoking Medicare Part D Insurer’s Contract

Federal regulators acted properly when they revoked the Medicare Part D contract of a prescription drug insurance provider for delaying patient access to medications for cancer, HIV and AIDS, the Ninth Circuit ruled Tuesday in the first such case to reach a federal appeals court. Read More…
Source: lexisnexis.com

Chart of the day: Medicare Part D drug price growth

AcademyHealth accountable care organizations Affordable Care Act announcement antitrust blogging books comic competitive bidding costs cost shifting deficit employer-sponsored health insurance health care costs health insurance health insurance mandates health reform hospital readmissions hospitals instrumental variables insurance exchange market power Massachusetts Medicaid Medicare mortality obesity On The Record physicians politics PPACA premiums premium support prescription drugs prostate cancer quality reading list reflex RWJF single payer spending substance use tax uninsured xkcd
Source: theincidentaleconomist.com

Why the Politics of Obamacare Implementation Could Be Very Different From Medicare Part D

On the other hand, the implementation of Obamacare was designed to feature a mix of winners and losers. Low income people who qualify for Medicaid will be clear winners, yet many other people will see themselves as worse off because of the law. Certain middle income people who buy their own insurance could see big premium increases. Some business owners will be hit with a significant penalty for not providing insurance, while some workers might see their hours cut to avoid this penalty. Parts of the health care industry will also face new taxes.
Source: firedoglake.com

Changes to Program Integrity Manual May Benefit Medicare Providers

Posted by:  :  Category: Medicare

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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

Video: Weekly Address: Medicare Officially Safer After Health Reform

535 people change Medicare address to ACT - Open Government

The Australian Bureau of Statistics uses Medicare addresses to count population per State and Territory. That population data is used by the Federal Government to allocate GST funding to communities. For every year that an ACT resident is not counted, the ACT Government forgoes about $2,500 per person in GST funding.
Source: gov.au

Primary Care Doctor Shortage

But in these times of shrinking federal budgets, it’s unclear how much ACA primary care money will be available as Congress juggles competing priorities. Congress, for example, already has chopped about $6.25 billion from the ACA’s new $15 billion Prevention and Public Health Fund, which pays for programs to reduce obesity, stop smoking and otherwise promote good health. In addition, federal support for training all types of physicians, including primary care doctors, is targeted for cuts by President Obama and Congress, Republicans and Democrats, says Christiane Mitchell, director of federal affairs for the Association of American Medical Colleges, who calls the proposed cuts "catastrophic."
Source: aarp.org

AARP Urges Congress to Address Medicare Physician Payments

“As you know, physicians and other health care providers are scheduled to receive a 27 percent cut on January 1, 2013, as a result of the flawed sustainable growth rate (SGR) formula.  This is in addition to the 2 percent reduction included in the planned sequestration.  Failure to adopt legislation to address the “doc fix” would create considerable instability in the Medicare program.  Such a significant reduction in reimbursement could cause providers to stop seeing Medicare beneficiaries or prevent them from accepting new ones.  We are disappointed that Congress has thus far been unable to develop a long-term solution to this perpetual problem.  However, even in the absence of a longer-term solution, the SGR cuts must not be allowed to occur.  Under current law, the Centers for Medicare and Medicaid Services may begin issuing the reduced payments on January 1.  A reduction for even a short time in reimbursement rates could disrupt access to care, as providers may delay seeing Medicare patients until updated rates go into effect. 
Source: aarp.org

Upton to Highlight Medicare Physician Payment Reform Effort WEDNESDAY During Address to American Medical Association

WASHINGTON, DC – Energy and Commerce Committee Chairman Fred Upton (R-MI) will address the American Medical Association at the 2013 National Advocacy Conference on Wednesday, February 13, 2013, at 8:00 a.m. at the Grand Hyatt Washington. Upton will discuss the health care law’s impact on physicians and patients and outline the committee’s upcoming plans to address the outdated Medicare physician payment system. Last week, Upton and Ways and Means Chairman Dave Camp (R-MI) released a framework of their collaborative efforts to repeal the Sustainable Growth Rate formula and advance a permanent solution for the long troubled payment system. On Thursday, the Energy and Commerce Health Subcommittee will hold a hearing on SGR reform.  
Source: house.gov

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

Obama attacks sequestration, Medicare payments in State of the Union address

The President said he is willing to trim Medicare outlays to align with those proposed by the bipartisan Simpson-Bowles fiscal commission in 2010. He said this could be accomplished by shifting provider reimbursement to a pay-for-performance model, reducing subsidies to pharmaceutical companies and raising fiscal obligations for the nation’s wealthiest seniors.
Source: mcknights.com

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May 23, 2013

Tufts Medicare Preferred Hosts Free Information Meeting

Posted by:  :  Category: Medicare

Representatives will be onsite to review 2013 plan benefits and Medicare Advantage enrollment periods. The meeting is part of Tufts Health Plan’s statewide effort to provide seniors with the opportunity to meet with a Tufts Health Plan Medicare Preferred representative, provide general information about Medicare Advantage-type plans, review enrollment periods and answer questions.
Source: patch.com

Video: How it Works – Tufts Medicare Preferred

Definition For HMO, History Of HMO Act Of 1973, HMO Definition, : TUFTS MEDICARE PREFERRED HMO 2012 FORMULARY

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Source: projectedu.com

Massachusetts Health Stats: Left

This blog overcomes the attempts from those on both the left and right of the political spectrum to use statistics to impose needless changes on one of the best healthcare systems in the world. Massachusetts Health Stats is an as-needed look at statistics about the Massachusetts healthcare delivery and insurance market and industry, including — occasionally — aspects of Medicare as they relate to Massachusetts seniors and the Medicare-eligible disabled. For Medicare-specific information with nationwide implications and some how-to hints for seniors see http://byrondennis.typepad.com/theabcsofmedicare/
Source: typepad.com

Tufts Health Insurance Low Insurance Rates

This section was developed to be. Welcome to Catastrophic Health Insurance! Everyone knows how important it is to have health insurance, but what about coverage for events such as a bicycle or auto. Vanguard Health Systems Inc. and Tufts Medical Center have received $88.5 million in federal funds to launch a first-of-its-kind health plan in Massachusetts that. 15 Tufts Health Plan salary reports. A free inside look at Tufts Health Plan salaries posted anonymously by employees. Health Insurance Plans Accepted by Harvard Vanguard. Harvard Vanguard accepts most health insurance plans and most indemnity and Medigap plans. (For Behavioral Health. Health Services Hours: Mon/Tue/Thu/Fri: 8:00am6:00pm Wed: 10:00am6:00pm Sat & Holidays during school year: 10:30am5:00pm More info > Aetna Insurance WAIVER. Dear Human Resources Director: I am writing to express my interest in applying for the position of Research Assistant. In May of 2011, I will graduate from Tufts. Practical information on dealing with behavior problems in children for teachers and parents. Includes behavior management strategies, home and classroom behavior. Benefit Highlights Plans as of April 2012 (Scroll down for 2011 info)
Source: individualmandatehealthcare.com

Pets Best Health Insurance health insurance companies australia

Business & Insurance. Plan is considered one of the best in the Boston area and offers multiple types of plans for individuals and families. Welcome to Catastrophic Insurance! Everyone knows how important it is to have health insurance, but what about coverage for events such as a bicycle or auto. Health Insurance Plans Accepted by Harvard Vanguard. Harvard Vanguard accepts most insurance plans and most indemnity and Medigap plans. (For Behavioral. Benefit Highlights Plans as of April 2012 (Scroll down for 2011 info) 15 Health Plan salary reports. A free inside look at Tufts Health Plan salaries posted anonymously by employees. Welcome to Tufts Plan Please complete all of the employee sections of the membership application in full. Failure to do so could delay enrollment. Welcome to the Registrars home page for the Public Health and Professional Degree Programs of Tufts University School of Medicine. This section was developed to be. Our mission is to set the standard for outstanding quality health care, service, and value. Our dedication to excellence makes us one of the leading plans in. Dear Human Resources Director: I am writing to express my interest in applying for the position of Research Assistant.
Source: individualmandatehealthcare.com

Tufts Medicare Advantage?

For a company Ive never heard of they sure do have a lot of Med Advantages in your state. Tufts Medicare Preferred HMO Basic $16.00 Tufts Medicare Preferred HMO Basic $0 Tufts Medicare Preferred HMO Basic Rx $38.00 Tufts Medicare Preferred HMO Basic Rx $22.00 Tufts Medicare Preferred HMO Basic Rx Plus $48.00 Tufts Medicare Preferred HMO Basic Rx Plus $32.00 Tufts Medicare Preferred HMO Prime $96.00 Tufts Medicare Preferred HMO Prime $72.00 Tufts Medicare Preferred HMO Prime Rx $118.00 Tufts Medicare Preferred HMO Prime Rx $94.00 Tufts Medicare Preferred HMO Prime Rx Plus $128.00 Tufts Medicare Preferred HMO Prime Rx Plus $104.00 Tufts Medicare Preferred HMO Value $58.00 Tufts Medicare Preferred HMO Value $42.00 Tufts Medicare Preferred HMO Value Rx $80.00 Tufts Medicare Preferred HMO Value Rx $64.00 Tufts Medicare Preferred HMO Value Rx Plus $90.00 Tufts Medicare Preferred HMO Value Rx Plus $74.00 Tufts Medicare Preferred PFFS Basic $50.00 Tufts Medicare Preferred PFFS Basic $45.00 Tufts Medicare Preferred PFFS Basic Rx $72.00 Tufts Medicare Preferred PFFS Basic Rx $67.00 Tufts Medicare Preferred PFFS Basic RxPlus $82.00 Tufts Medicare Preferred PFFS Basic RxPlus $77.00 Tufts Medicare Preferred PFFS Prime $111.00 Tufts Medicare Preferred PFFS Prime $92.00 Tufts Medicare Preferred PFFS Prime Rx $133.00 Tufts Medicare Preferred PFFS Prime Rx $114.00 Tufts Medicare Preferred PFFS Prime RxPlus $143.00 Tufts Medicare Preferred PFFS Prime RxPlus $124.00 Tufts Medicare Preferred PPO $87.00 Tufts Medicare Preferred PPO $82.00 Tufts Medicare Preferred PPO Rx $109.00 Tufts Medicare Preferred PPO Rx $104.00
Source: insurance-forums.net

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May 23, 2013

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

Posted by:  :  Category: Medicare

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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

Video: Stage 2 Requirements for the Medicare and Medicaid EHR Incentive Programs

Understanding Medicare Insurance › Health Insurance Quotes

There are some additional requirements that need to be fulfilled apart from these basic requirements, but they’re plentiful and they depend entirely on the plan that you’re going to use. In order to find out what the requirements are, speak with your local social security administration office or visit Healthcare.gov for more information so that you’ll know exactly what you need to do in order to meet all eligibility requirements before wasting any time on doing things that won’t make any difference at all – and to avoid simply waiting for a response due to not knowing what else you’re required to do.
Source: healthinsurancequotes.me

Medicare Advantage Fact Sheet

Since 2006, Medicare has paid plans under a bidding process.  Plans submit “bids” based on estimated costs per enrollee for services covered under Medicare Parts A and B; all bids that meet the necessary requirements are accepted.  The bids are compared to benchmark amounts that are set by a formula established in statute and vary by county (or region in the case of regional PPOs).  The benchmarks are the maximum amount Medicare will pay a plan in a given area. If a plan’s bid is higher than the benchmark, enrollees pay the difference between the benchmark and the bid in the form of a monthly premium, in addition to the Medicare Part B premium.  If the bid is lower than the benchmark, the plan and Medicare split the difference between the bid and the benchmark; the plan’s share is known as a “rebate,” which must be used to provide supplemental benefits to enrollees.  Medicare payments to plans are then adjusted based on enrollees’ risk profiles.
Source: kff.org

HHS to Scrap Outdated Medicare Regulations

In a new move towards assisting the healthcare industry, the White House recently announced its intention to work with the Department of Health and Human Services (HHS) to focus on and eliminate certain regulations for Medicare and Medicaid that are now considered to be obsolete.  This is expected to significantly impact Medicare-Medicaid Reimbursement over time, particularly for the elderly patients that will be affected the most by these changes.  In a press release from the Department, Secretary Kathleen Sebelius noted that, “We are committed to cutting the red tape for health care facilities, including rural providers.  By eliminating outdated or overly burdensome requirements, hospitals and healthcare professionals can focus on treating patients.”
Source: healthworkscollective.com

Five Ways The President’s Budget Would Change Medicare

Provider Cuts: Hospitals are none too happy about Obama’s plans to cut their Medicare payments for bad debt and graduate medical education over the next decade. Medicare now pays hospitals 65 percent of debts resulting from beneficiaries’ non-payment of deductibles and co-insurance after providers have made reasonable efforts to collect the money. Starting in 2014, the president’s plan would decrease that amount to 25 percent over three years, which the administration says would be closer to private payers that typically pay nothing on bad debt. The reductions would be in addition to those hospitals and other providers face as part of the 2010 health law.
Source: kaiserhealthnews.org

Medicare PQRS Requirements for Physical Therapy

Finally, I’ve heard considerable confusion about relationship of PQRS, the new functional limitation reporting and g-codes. PQRS and Functional Limitation Reporting have nothing to do with each other. They share only one thing, they both use G-Codes to report information to CMS. G-codes are just a set of 5 digit codes that can be submitted like CPT codes but CMS uses them to cover additional requirements. Most people are familiar with G0283 being CMS’ own code for E-stim, but now they’ve branched out and used the series for both PQRS and Functional Limitations.
Source: clinicient.com

Medicare and Medicaid: Eligibility, Coverage, and Costs

Medicare is composed of many different parts, and beneficiaries have the option to decide which plans they want to enroll in. Many eligible beneficiaries are automatically enrolled in Part A, which covers hospital care, and Part B, which covers certain medical services. Once enrolled, beneficiaries can opt to enroll in Medicare-approved private insurance plans to cover out-of-pocket costs not already covered and/or provide additional benefits. All individuals who are eligible for this program are also offered prescription drug coverage, which can be attained through a stand-alone Part D Prescription Drug Plan (PDP) or a Medicare Advantage plan with medication coverage.
Source: ehealthmedicare.com

New Medicare Requirements in 2011

Section 10501 of the Affordable Care Act adds several new preventive services to the list of Medicare-covered FQHC services. Additionally, the new law calls for the creation of a new Medicare reimbursement structure for health centers beginning in 2014. In order to create this system, the law requires health centers to begin reporting Healthcare Common Procedure Coding System (HCPCS) codes beginning January 1, 2011. These codes are used to indicate the types of services being provided at each visit. CMS has updated their Claims Processing Manual for FQHCs with the following information:
Source: nachc.com

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May 23, 2013

Extending Social Security and Medicare Eligibility Ages

Posted by:  :  Category: Medicare

In light of the increase in life expectancy after age 65 and the decline in physically demanding jobs, it would be reasonable for the eligibility age for social security to rise to 68 or 70. The average age of retirement from the labor force for Japanese males is already only a little below 70, which shows that much higher retirement ages is feasible. Persons who are physically or mentally incapable of working would then opt for disability status. This is a rapidly growing category in most developed countries, despite the increase in physical and mental health of older persons, because of a weakening of qualifying standards. With more flexible labor markets for the elderly, such as reducing the fear of companies that they will be sued for discrimination against older workers, older men and women could retire from more demanding jobs, and take jobs that are less taxing. This is what happens to older men in Japan.
Source: becker-posner-blog.com

Video: Debunking the “Raise the Medicare Eligibility Age” Argument

Viewpoints: Rising Cost Of Tricare; GOP Needs To Better Explain Medicare Eligibility Age Issue; Don’t Forget Adult Immunizations

Minneapolis Star Tribune: Mental Health Needs The Nation’s Attention Millions of people in our country are struggling every day with mental illness — but most aren’t getting help. Many don’t have a support system. They may not have parents or friends who understand or have resources to help. They may not have health insurance that covers the cost of treatment. Or perhaps they feel ashamed or embarrassed to seek help, because mental illness still carries a stigma in our society. As my family searches for some type of meaning and comfort in the depths of our grief, we hold out hope that perhaps Andrew’s story will help people have a greater understanding and compassion for those who struggle with mental illness (Chris Bauer, 3/25). 
Source: kaiserhealthnews.org

Taking Medicare’s eligibility age off the table

CARNEY: Again, as part of a big deal, part of a comprehensive package that reduces our deficit and achieves that $4-trillion goal that was set out by so many people in and outside of government a number of years ago, he would consider that the hard choice that includes the so-called chain CPI, in fact, he put that on the table in his proposal, but not in a cherry-picked or piecemeal way. That’s got to be part of a comprehensive package that asks that the burden be shared; that we don’t, as some in Congress want, ask seniors to bear the burden of further deficit reduction alone, or middle-class families who are struggling to send their kids to college, or parents of children who are disabled who rely on programs to help them get through.
Source: msnbc.com

Ryan’s Budget Proposal Could Seek Changes to Medicare Eligibility Age

House Budget Committee Chair Paul Ryan (R-Wis.) has been privately circulating the idea that his budget proposal might include changes to future Medicare retirement benefits for people who currently are as old as 59, despite GOP leaders’ pledge that the program would not be altered for people ages 55 and older,
Source: californiahealthline.org

Medicare Age Eligibility and the Fiscal Cliff Negotiations

To reduce federal spending, Congress could choose to raise the Medicare eligibility age from 65 to 67. On Nov. 28, in a segment titled "How will ‘fiscal cliff’ affect Medicare?," NBC Nightly News examined the costs of such a change to America’s current and future seniors, and others. David Certner, AARP legislative policy director, is among the experts interviewed and cautioning against this path.
Source: aarp.org

What Raising the Medicare Eligibility Age Means

Raising the eligibility age saves very little money, on the order of a few billion dollars a year. That’s because the 65 and 66-year-olds will have to get insurance somewhere, and many of them are going to get it with the help of the federal government, either through Medicaid or through the insurance exchanges, where they’ll be eligible for subsidies. However, since many Republican-run states are refusing to expand Medicaid in accordance with the Affordable Care Act, lots of seniors who live in those states will just end up uninsured, which will end up leading to plenty of financial misery and more than a few premature deaths. Put this all together, and the Center on Budget and Policy Priorities estimates that while the federal government would save $5.7 billion a year from raising the eligibility age, costs would increase by more than twice in other parts of the system—for the seniors themselves, employers, other enrollees in exchanges who would pay higher premiums, and state governments.
Source: prospect.org

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May 23, 2013

What To Expect On A Gerber Medicare Addition Plan

Posted by:  :  Category: Medicare

Nearly any changes in travel plans will you should always be covered if a traveler avails of this strategy. The insurance packages provider will often be the one which usually pays for bills that will quite possibly allow a passenger to catch in place or go house hold. For claims to assist you to be valid some reasons are possible including a the situation of illness, injury, or death. The medical expenses that won’t be protected by Medicare may perhaps be taken care of by a person’s MedicareSupplementPlanFGuide.com such as the Medicare product or service insurance which is simply also referred that can as “Medigap” mainly it fills persons gaps of locations where Medicare not able to cover the costs. Information from the look into and policy activate of America’s Overall healthiness Insurance Plans revealing premium and benefit information from 761,000 small businesses episodes the average annual deductible for PPOs have gone from 7 to 59. The selection of companies with a PPO healthiness insurance plan brings shrunk, too. Employers with less than 50 employees are shifting to be less costly The hmo group health insurance that have stronger (and smaller) providers of doctors as their employees – chose from. About 50 number of small issuers report they hold group HMO coverage, down from 41 percent in . Aetna Medicare Supplement Arrangements are offered located in almost every state, and most the public find them to allow them to be a exceptionally affordable option. In addition, Aetna’s prices hold efficient and only go up slightly to stop up with rising prices and rising will cost. This could be described as one of these reasons Aetna produces a high customer satisfaction rate combined with why thousands in seniors are awfully happy with decision to get yourself an Aetna Treatment plan. You will find a great many seniors who take being proud in knowing facts their medicare plans the actual they do on. While they may not need the minute the specifics of how their intends work, they possess a fairly good a sense what is dealt with and what isn’t. However, there are some “other” things that are coming out of your woodwork lately in which taking our elders by surprise. First these new techniques having low cost, a proposal is offered by one of numerous greatest names with regard to health insurance “blue cross blue shield” to cut that this premiums of Medicare complement insurance insurance protection the place you will find there’s biggest need. On select Medicare solution plans you might seek limited desperate care outside u . s of America and maintain some coverage, more often than not up to ,000 lifetime coverage along with a 0 deductible and 20% co-insurance paid by you. This however is a great benefit for people who travel for the reason that Medicare does but not otherwise provide every coverage for you’re medical care in the vicinity of the United Counties. Typically, Medicare just compensates financially about 80% of the the medical will cost you coverage. There after, you occur to be all personal own if someone need any friendly of lengthened protection. You can purchase a Medicare Supplement (aka Gap) policy from the government approved insurance corporation perhaps perhaps receive deeper coverage in Medicare Part C also known as Medicare profit provided by private insurance companies. Virtually all Medicare health insurance health supplements may charge a weekly payment for qualified services rendered. Take into facebook poker chips that not just about all private insurance support fees are exact identical. A number medsupp plans provide assistance for cracks in Medicare videos of skilled nursing jobs care inside of ones nursing home. The member really should enter the elderly care after a 3 day stay a great acute care emergency room and deemed clinically necessary to earn care in an experienced nursing facility. The care must ultimately be prescribed by an attending physician. Issues do not befall for custodial mind. Thus, in reality inspite of the fact much educated nursing care is supplied within nursing homes, nursing home care as most think of it is not covered. Between Medicare and offers F and G up to thousand days is included in the insurers. Some people good news about the death out of Medicare Advantage is that you will be guaranteed issue for 63 days once your policy is no for any in effect. Talk to their local health insurance agent now with plan for long term. Choose a good that knows certain Medicare inside to choose from and will grow to be able to head you through other alternatives.
Source: typepad.com

Video: Gerber Life Medicare Supplement

A Brand New Brief Overview Pointing To Gerber Medicare Medications

Reserved companies sell Medigap Plans. Hence, generally premium too typically is a bit elevated. These offers may prove quite expensive for persons so, who do not need their policies seriously often throughout these year. However, for those who really need hospitals combined with doctors more often, these plans may possibly possibly prove to try to be beneficial. It is for all of this reason that the latest person wanting to go for Medigap, should list depressed all the health care services that, he/she requires annually. Then one have got to work out, in which way many of consumers medical expenses are hands down paid by Medicare health insurance and how a lot does he/she have definitely to spend as out-of-pocket expenses.
Source: bibar.org

Medicare Supplements For Better Medical Assistance

Medicare Part A and Part B provide hospitalization and medication insurances, respectively, for immediate access of the elders aged 65. And due to increasing price of treatments for people with disabilities and severe kidney problems, these initial parts are also granted to them. Part A insurance assists in-patient fees for hospitalization and nursing facilities for eligible citizens formally enrolled in Medicare, whereas Part B accommodates outpatient doctor s services. There is also Part C, which covers Medicare advantage plan subscription, and Part D, which requires Medicare prescription plan membership.
Source: treetopinn.com

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May 23, 2013

Medicare Data Show Huge Disparity in Charges by North Texas Hospitals for Inpatient Procedures

Posted by:  :  Category: Medicare

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“The complex and bewildering interplay among charges, rates, bills and payments, across dozens of payers, public and private, does not serve any stakeholder well, including hospitals,” said Rich Umbdenstock, president of the American Hospital Association, in a statement. “This is especially true when what is most important to a patient is knowing what his or her financial responsibility will be.
Source: dmagazine.com

Video: Congresswoman Johnson leads Texas Delegation in suport of the Tornado Victims of Oklahoma

Expanding Medicaid in Texas is good for business. Here’s why.

As board chair of the Oak Cliff Chamber of Commerce, I know that my fellow business owners believe that healthy workers are necessary for sustained economic development, not only in Oak Cliff but in the entire state. Sustainable economic development will create more health care jobs and resources into our health care system, which means fewer uninsured workers that burden employers and taxpayers alike.
Source: dallasnews.com

Texas governor reiterates opposition to Medicaid expansion

“Seems to me April Fool’s Day is the perfect day to discuss something as foolish as Medicaid expansion, and to remind everyone that Texas will not be held hostage by the Obama administration’s attempt to force us into the fool’s errand of adding more than a million Texans to a broken system,” Perry told reporters at the state Capitol.
Source: medcitynews.com

Texas Medicare Supplement Insurance Plans

Make sure that you are getting the right coverage that you want. This will not be hard if you already know your options. There are ten different supplement plans that you can choose from. Taking time to carefully examine all you have to choose from will enable you to compare the gaps filled with each plan to determine the one that is going to be ideal for your needs.
Source: zambiadaily.com

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