Immigrants Contribute More To Medicare Than They Take Out, Study Finds

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Between 2002 and 2009, immigrants generated a cumulative surplus of $115 billion for the trust fund, the study found. Most of the surplus contribution came from noncitizens. The immigrants created a net gain primarily because of demographics: There are 6.5 immigrants of working age for every one elderly immigrant, but only 4.7 working-age native citizens for every one retiree. Although that ratio could change in the future, the report notes that the Census Bureau projects that the share of immigrants in the United States will increase for the next 18 years.
Source: kaiserhealthnews.org

Video: The Future of Medicare: Policy Options and Political Realities

Immigrants add billions to Medicare, study finds

How do you get an illegal immigrant to become a citizen that pays taxes when he is already making money selling drugs and working for cash? This article is about immigrants (legal), no where it says illegal immigrants. Of course immigrants pay into Medicare and Social Security we are all or our family members were immigrants. This has to be the stupidest article I’ve ever read. The problem isn’t the legal immigrants its the illegal’s with anchor babies that are in our welfare offices everyday looking for food, housing and medical hand outs. Next time you have a day off go to your local Welfare office and see for yourself or go to your Social Security office and see who is there with their new born asking for Spanish speaking personnel. I live in rural Ohio, Fairfield and there isn’t a farm within 20 miles but yet we have hundreds if not thousands of illegals and a very bad drug problem. They have literally kicked everyone else out of the poor part of Hamilton and started their own city. And it’s not looking any better because of it. There are parts you can’t go into at night. We are not talking about some big city we are talking about a city of maybe 100,000. The sheriff of Hamilton has even been sued by an Illegal for asking him for his green card. This needs to stop I have children and my friends have children that are suffering at school with class rooms that are over crowded and not enough buses. If we don’t step up and put an end to this our government will not do anything. They are already trying to give illegal’s amnesty or green cards without checking to see who they are, where they are from or what they are doing here. I’m sick of it and I’m doing my part by calling INS and ICE when I see something is not right. An example is a child telling me he has nothing to eat because his father did not get paid on Friday and then a month later I see another family member smoking crack/meth on his back patio (via a spotting scope and my son). Now do your job and keep this from your kids!
Source: nbcnews.com

Spillover Benefits From Medicare Advantage

[I]ncreasing MA monthly payments by $100 (about one standard deviation) would increase the share of beneficiaries in MA by just under 5 percentage points…This would increase total MA spending by $100 per month for the existing and new enrollees, or almost $5 billion in total for these states. Overall costs of hospital care is estimated to go down by something like 2% when MA penetration increases by 5 percentage points, off a base of total hospital costs for the [traditional Medicare] population remaining in these states (after the implied shift to MA) of just under $30 billion, or about $600 million. Hospital costs for those in [traditional Medicare] would thus go down by upwards of 10% of the increase in spending on MA.
Source: ncpa.org

Immigration Reform And The Financial Health Of Medicare

Our study, published today as a Health Affairs Web First article, examines these variables as they relate to the Medicare program and finds evidence that contradicts the pervasive wisdom. We calculated the total dollars contributed to and received from the Medicare Hospital Insurance Trust Fund (“Trust Fund”), which pays primarily for inpatient care, for both immigrants and U.S. born citizens. We found that between 2002 and 2009, immigrants contributed $115.2 billion in excess of what they utilized. During this same time frame, US born persons withdrew $28.1 billion more than they contributed. Although we could not measure the contributions to the Supplementary Medical Insurance Trust Fund (which primarily pays for outpatient care), we examined average expenditures by immigrants and US-born persons to this fund and found that immigrants spent less than US born persons: $175 per year less on average.
Source: healthaffairs.org

Get ready for your summer trip

You have Medicare, so your health care services and supplies are covered when you’re in the U.S., which includes Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. But, if you plan to travel overseas or outside the U.S. (including to Canada or Mexico), it’s important to know if your Medicare coverage will be different.
Source: medicare.gov

Immigrants subsidize our Medicare program

Many immigrants in the United States are working-age taxpayers; few are elderly beneficiaries of Medicare. This demographic profile suggests that immigrants may be disproportionately subsidizing the Medicare Trust Fund, which supports payments to hospitals and institutions under Medicare Part A. For immigrants and others, we tabulated Trust Fund contributions and withdrawals (that is, Trust Fund expenditures on their behalf) using multiple years of data from the Current Population Survey and the Medical Expenditure Panel Survey. In 2009 immigrants made 14.7 percent of Trust Fund contributions but accounted for only 7.9 percent of its expenditures—a net surplus of $13.8 billion. In contrast, US-born people generated a $30.9 billion deficit. Immigrants generated surpluses of $11.1–$17.2 billion per year between 2002 and 2009, resulting in a cumulative surplus of $115.2 billion. Most of the surplus from immigrants was contributed by noncitizens and was a result of the high proportion of working-age taxpayers in this group. Policies that restrict immigration may deplete Medicare’s financial resources.
Source: pnhp.org

A Viable Medicare Physician Payment Policy’ that Will Repeal SGR

ACP, Dr. Cutler noted, strongly believes that the patient-centered medical home (PCMH) and PCMH-Neighbor models are ready to be a part of this new, value-based health care payment and delivery system

REGION: Sen. Emmerson announces mobile office hours

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“It’s crucial that I hear from my constituents about the issues that concern them most,” Sen. Emmerson said.  “By holding mobile office hours, constituents will have more opportunity to voice their opinion or share their concerns regarding any state matter.”
Source: pe.com

Video: The Real Deal: United Healthcare Medicare Patients, Out-of-Network at Albany Med

Social Security and Medicare tax rates

Alabama    Alaska    Arizona    Arkansas    California    Colorado  Connecticut    Delaware    Florida    Georgia    Hawaii    Idaho    Illinois    Indiana    Iowa    Kansas    Kentucky    Louisiana    Maine  Maryland    Massachusetts    Michigan    Minnesota    Mississippi    Missouri   Montana    Nebraska    Nevada    New Hampshire    New Jersey    New Mexico    New York    North Carolina    North Dakota    Ohio    Oklahoma    Oregon    Pennsylvania    Rhode Island    South Carolina    South Dakota   Tennessee   Texas    Utah    Vermont    Virginia    Washington    West Virginia    Wisconsin    Wyoming
Source: socialsecurityoffices.us

DMEPOS Round 2 Competitive Bidding and National Mail

CMS will now begin mailing contract offers to winning bidders.  14,654 contract offers will be made to 867 Round 2 bidders.  The winning suppliers have 3,109 locations to serve Medicare beneficiaries in the competitive bidding areas.  CMS will offer 15 contracts for the national mail-order program; the national mail-order program winners have 48 locations.  CMS expects to complete the contracting process in time to announce the contract suppliers in the spring of 2013.  Bidders that are not offered contracts will be notified of the reasons why they did not qualify for the program when the contracting process is complete. Suppliers that are not contract suppliers for this round of the DMEPOS Competitive Bidding Program may bid in future rounds.
Source: hallrender.com

Controlling ER, Hospitals Admissions A Challenge For Medicare

Kaiser Health News: Medicare Effort To Cut Readmissions Isn’t Counting Patients Who Come Back To ER A study published Tuesday says Medicare may be missing factors that lead to post-hospital health problems because it isn’t counting many discharged patients who come back to the emergency room but aren’t admitted. … 54 percent of those visits to the emergency department (ED) did not lead to a readmission and thus would not have shown up in the statistics when Medicare calculated the hospital’s readmission rate. (Rau, 4/9).
Source: kaiserhealthnews.org

CMS Awards Round 2 Medicare Contracts to Medical Suppliers

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

CMS Finalizes Rule to Ease the Burden on a Variety of Providers

Under a current Medicare condition for payment, CMS may deactivate the Medicare billing privileges of a provider or supplier that does not submit any Medicare claims for 12 consecutive calendar months.  This deactivation authority is discretionary.  In an October 24, 2011 proposed rule, CMS proposed to revise this condition for payment so that Medicare billing privileges could not be deactivated for physicians and non-physician practitioners failing to bill for 12 consecutive months.  The purpose of the proposed rule was to decrease the burden on physicians and non-physician practitioners who may treat mostly non-Medicare patients or who may have multiple separately-enumerated practice locations and mainly provide services at one of them.  After consideration of multiple comments, CMS opted not to finalize the proposed rule at this time.  Failure to bill Medicare raises questions as to whether the provider is compliant and still operating.  Further, an idle provider number potentially can lead to fraudulent billing activity/program integrity risks.  CMS intends to study this issue further and may consider other approaches, including future rulemaking to address the concerns of providers/suppliers regarding deactivation for failure to bill for 12 consecutive months.
Source: hallrender.com

Free program to protect yourself against Medicare fraud

Medicare beneficiaries: Have you noticed that your Medicare Summary Notice has changed? The North Carolina Senior Medicare Patrol Program is holding free events to help you protect yourself from Medicare fraud, waste and abuse. “Medicare Summary Notices: Are Those Charges Really Mine?” is being held at two locations in Currituck County: May 14
Source: ncsu.edu

89 Individuals Charged With About $233M in Alleged Medicare Fraud

The Strike Force is part of the Health Care Fraud Prevention & Enforcement Action Team, a joint initiative between HHS and the Department of Justice. Since its inception, the Strike Force’s operations — in nine locations — have charged more than 1,500 individuals for defrauding Medicare of more than $5 billion through false billing (HHS release, 5/14).
Source: californiahealthline.org

Medicare Part D and Dual Eligibles: Prescription Drug Formularies and Drugs Used by Dual Eligibles

Posted by:  :  Category: Medicare

Medicare drug plans may exclude drugs from formularies or may control drug use in an effort to contain costs, but they must meet certain criteria in doing so.  Each PDP and MA-PD drug formulary is reviewed by staff in the Centers for Medicare and Medicaid Services (CMS).  Generally, Part D plan formularies must cover at least two drugs in every theraputic class.  Under CMS rules, Part D formularies must also include all or substantially all drugs in six protected classes: immunosuppressant (for prophylaxis of organ transplant rejection), antidepressant, antipsychotic, anticonvulsant, antiretroviral, and antineoplastic drugs.
Source: piperreport.com

Video: Medicare Part D Formulary

Part D Formulary Is Key To Choosing The Right Plan

My dad had to move from Ky to GA so my sister and I could take care of him. Humana (his Part D) just terminted him for the month of Dec because he moved out of his service area. They mailed us a letter on 11/25/10(Thanksgiving) and it stated as of 11/30/10 he would no longer have Part D coverage. I spent almost all day last Friday talking to Humana and got no where. They did deduct his payment from his SS??? Any suggestions? Is there a plan that would cover him in GA and KY should he decide to move back and stay with my other sister???
Source: affordablemedicareplan.com

Medicare Part D Guidance: Medication Therapy Management, Formulary Submissions : Health Industry Washington Watch

In addition, CMS has issued guidance to Part D plan sponsors on the process for CY 2012 medication therapy management program submissions and related change requests. CMS also has issued a memo on CY 2012 formulary submissions, including timelines. 
Source: healthindustrywashingtonwatch.com

Medicare Part D, formularies, competition, pricing leverage and getting it all wrong

Medicare Part D has long presented a controversy because the law prevents direct negotiation by the government with drug companies for lower prices and rebates; something common in the private sector via pharmacy benefit managers (PBMs). Rather, each Part D provider must negotiate on its own, but with so many vendors offering Part D benefits their negotiating power is limited. In New Jersey for example there are eighteen different vendors offering Part D plans to 1,336,988 Medicare beneficiaries. That is an average of less than 74,277 individuals per vendor (some beneficiaries have private drug coverage through previous employers). How much more pricing leverage would there be if there were only three or four Part D insurers in NJ (or nationally)? In addition, these vendors are prevented from limiting their formulary drugs.
Source: quinnscommentary.com

Medicare Supplemental Insurance, Medicare Supplements, Medigap

So what does this mean for beneficiaries that are new to Medicare A and B who are getting a Medicare Supplement/Medigap Plan for the first time?  You really should find a Medicare Supplemental Advisor that will do this work for you.  Why? Because it can be a frustrating and time consuming venture at the Medicare web site.  Just ask the wives of beneficiaries that have to listen to their husbands complain about the Medicare or other third party Part D web site.  This is very similar to “tax time rage.”  What I am referring to is the frustration that comes with “Medicare Part D Rage.”  And, even when you figured out how to get this valuable information one year, web sites change enough so that when next year comes around you can’t find it so easily again.  So, if you are new to Medicare A and B, or, or if you already have a Medigap plan, then find a reputable advisor that will go through this information for you.  As part of Medicare Supplemental Advisors’ Medigap plan enrollments, we provide this type of Medicare Insurance Report to our new and current clients each year.
Source: medicaresupplementaladvisors.com

Important Changes to the Essence 2011 Standard 4

Effective 1/1/11 all propoxyphene-containing products have been removed from formulary due to safety concerns noted in a recent FDA Drug Safety Communication (http://www.fda.gov/Drugs/DrugSafety/ucm234338.htm).  Per CMS regulations regarding removal of drugs due to safety concerns, we are providing retrospective notice to our members.  Notification is being mailed to members who have filled prescriptions for propoxyphene-containing products in the past 6 months.  The searchable formulary on the Essence website has already been updated to reflect the change, and the pdf formulary posting on the website will be updated as soon as possible.  Information about the formulary deletion will also be included on the Explanation of Benefits mailed to all Essence members for 2 months.
Source: momedaff.com

Insurance: Pradaxa® (dabigatran etexilate mesylate) Capsules Gains Preferred Formulary Status with AARP®, Nation's Largest Provider of Medicare Part D Coverage

ADVERSE REACTIONS In the pivotal trial comparing PRADAXA to warfarin, the most frequent adverse reactions leading to discontinuation of PRADAXA were bleeding and gastrointestinal (GI) events. PRADAXA 150 mg resulted in a higher rate of major GI bleeds and any GI bleeds compared to warfarin. In patients =75 years of age, the risk of major bleeding may be greater with PRADAXA than with warfarin. Patients on PRADAXA 150 mg had an increased incidence of GI adverse reactions. These were commonly dyspepsia (including abdominal pain upper, abdominal pain, abdominal discomfort, and epigastric discomfort) and gastritis-like symptoms (including GERD, esophagitis, erosive gastritis, gastric hemorrhage, hemorrhagic gastritis, hemorrhagic erosive gastritis, and GI ulcer). Drug hypersensitivity reactions were reported in
Source: blogspot.com

Medicare Open Enrollment Changes for 2011

[…] Medicare Open Enrollment Changes for 2011 (fpaforfinancialplanning.org) Eco World Content From Across The Internet. Featured on EcoPressed European Debt Crisis and Sustainability Share this:FacebookTwitterLinkedInStumbleUponMoreEmailRedditPrintDiggLike this:LikeBe the first to like this post. This entry was posted in Health Insurance and tagged Insurance, United States, Patient Protection and Affordable Care Act, Medicare, Medigap, Houston, Texas, Prescription drug, Annual enrollment, agent, TX, sugar land, richmond, katy, insurance agent, rosenberg, Wharton, fort bend, formulary. Bookmark the permalink. ← Part 2 of 2: Health Insurance For People Age 65-69 […]
Source: fpaforfinancialplanning.org

medicare supplemental insurance comparison: it is medicare formulary finder

Nobody can be no healthy problem in his life. Ill condition infulences the charge a lot. So far, people are insterested in medical treatment insurance. A long time ,people hesitate go or not go to hospital ,but now ,they don’t,cause they have medical treatment insurance. Look ,the medical has no shortage, only is good for all the people.. i like medical insurance because it could give us more happyness and safety once you get sick you can ask your insurance company for part of your money expense or even all your medical expense. you know unexpected emergencies happen like car accidents, unexpected injuries and serious dieases. the medical could save most part of the money and help people give them a hand. medical insurance plays a key rule for the old people who has no children and give them free treatment. The health care insurance coverage that beared with the place out division has benefited most males and females in most countries. We choose commercial health insurace companies to get more services. There are many notes we should follow. The company is legally registered or not. It is very important weather the company has enough money to pay for accident insurance or not. Does the company has a high integrity? By the way, both the company’s health insurance products and insurance costs are taken into think. According to the survey ,it’s about 90% of Americans are enjoying the new medical insurance that the government adopted in 2010. The introduction of the new medicare insurance benefit for most Americans, and increased the confidencethe index of people living. Finland has also just adopted a new medical insurance reform program. Good medical insurance is one of the government reliability standards which people evaluate their government.
Source: blogspot.com

Medicare Phone Presentations

Posted by:  :  Category: Medicare

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so as a newly independent agent im looking to transition into selling over the phone instead of the old fashioned f2f meeting. im just looking for some pointers and a general script outline for how the presentation should go. thanks in advace!
Source: insurance-forums.net

Video: How to get data for Medicare Supplement Marketing

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

The Ins and Outs of Medicare Supplemental Insurance

Yes! So how does this relate to Medicare’s coverage? There is a general rule of thumb that is called the “80/20 rule.” Outside of some of the preventative items like mammograms, colorectal screenings, and some psychiatric care, Medicare covers the first 80 percent of medical bills, leaving you to cover the last 20 percent. Medicare will also cover certain medically-necessary pieces of equipment like seat lift mechanisms and diabetic shoes (fitted by a specialist, of course). It doesn’t seem so bad at first, especially if you’re a healthy individual, but if something happens that requires you to need urgent medical care or even an operation, you may have to spend tens- to hundreds-of-thousands of dollars. A June 2011 report from the Kaiser Family Foundation predicted that by the year 2020 the median out-of-pocket spending for seniors with Medicare is projected to reach 26 percent of all income, with the most money being spent in the last five years of their life. This is why supplemental Medicare insurance is a necessity for every senior. Not only do you really need Medicare supplemental insurance, you need it before something happens to you, and you likely won’t use it much until the last 5 years of life. So two points to keep in mind 1) If you wait until a procedure is needed or something unexpected happens to you, you’ve waited too long, and 2) Don’t make the mistake of cancelling your Medicare supplement policy because you’ve’ paid in more than you use. It’s health insurance and in this case it works best if it’s held to its natural end point.
Source: insideeldercare.com

Does Medicare Call Your House? » Toni Says

            **I have been invited to participate in a panel discussion about small businesses and healthcare reform.  Westchase Biz Zone is sponsoring a healthcare reform workshop for small businesses at West Houston Medical Center on Tuesday, June 11th from 9:30 AM to 12:30 pm. Small business owners nearing retirement or Medicare eligible should attend. $10 advance reservations only.  Seating is limited. For more information, contact Theresa Allen at 832-495-9934 or email theresa@westchasebizzone.com.
Source: tonisays.com

Phone Scams Target Medicare Beneficiaries in California

Callers claiming to be with the Medicare program tell their targets that a replacement Medicare card is coming in the mail but a bank account number is needed first, according to a press release from Ramsey’s office. Sometimes, the caller will ask for a Medicare card number, which can be used for identity theft since it’s tied to a Social Security number.
Source: medbill.net

Medicare Fraud via Phone Calls are affecting Seniors in 2013

The first thing to know is that Medicare will never call you. In the rare occasion that they may, they will never request sensitive information of you. Never carry your Medicare card in your wallet. Instead, keep it in a safe and secure spot where you’ll remember. If you have to carry your Medicare card on your person, make a copy of it and black out all but the last four digits with a marker. These cards do not expire. You are issued one as soon as you enroll and it never needs to be renewed. If you happen to lose it, contact Medicare directly in order to report a missing card. If you ever question the validity of a phone call, tell the caller you would like to call them back and ask for their direct number. This will usually make them hang up. A good rule of thumb is not to give out potentially sensitive information over the Internet, on the phone or to unsolicited strangers.
Source: ehealthmedicare.com

Medical company declines to answer Senate questions on Medicare billing

JOIN THE DISCUSSION We welcome comments. To post one, you must sign in using either your McClatchyDC login or your login for Facebook, Twitter or Disqus. Just click the appropriate box below. Please keep your comment civil, short and to the point. Obscene, profane, abusive and off topic comments will be deleted. Repeat offenders will be blocked. If you find a comment abusive or inappropriate, please flag it for the moderator by placing your cursor on the comment, then clicking the “flag” link that appears. Thanks for your participation.
Source: mcclatchydc.com

Equitable Life Final Expense By Phone Product | Medicare Agent Training

AIC Leads cancer insurance cigna closing CMS CMS data conference call dental Draft Dates e-app electronic application equitable equitable life final expense final expense by phone gerber life guaranteed issue guarantee issue hearing Heartland National Hospital Indemnity Interview life insurance medicare medicare advantage medicare supplements medico Missouri mutual of omaha New Era New Era Life objections orlando event phoenix life Plan F Plan F vs. Plan G Plan G predictive dialer stonebridge training Triad of Awesomeness Underwriting vision webinar where to market
Source: medicareagenttraining.com

A guide to RR Medicare’s voice

You need to know more about your Railroad Medicare benefits or specific claims.  Sometimes you’d like to find the information on your own, and other times, you want to speak with a Customer Service Representative (CSR).  Railroad Medicare, administered by Palmetto GBA, gives you the best of both of worlds. 
Source: utu.org

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

Stealth Dental Clinic Operator Pleads Guilty to Health Care Fraud www.privateofficer.com

Posted by:  :  Category: Medicare

Bridgeport CT June 5 2013 Deirdre M. Daly, Acting United States Attorney for the District of Connecticut; Susan J. Waddell, Special Agent in Charge of U.S. Health and Human Services, Office of Inspector General for New England; William P. Offord, Special Agent in Charge of IRS-Criminal Investigation in New England; and Kimberly K. Mertz, Special Agent in Charge of the Federal Bureau of Investigation, announced that Gary F. Anusavice, also known as “Gary Andrews,” “Gary Andrus” and “Gary Francis,” 60, of North Kingstown, Rhode Island, pleaded guilty today before United States Magistrate Judge William I. Garfinkel in Bridgeport to health care fraud and tax evasion offenses stemming from his involvement in a $20 million Medicaid fraud scheme. “This defendant’s illegal operation of three Connecticut dental clinics and his failure to pay income on the substantial amount of money he received from his involvement in this scheme have siphoned millions of dollars from the Medicaid program and the U.S. Treasury,” said Acting U.S. Attorney Daly. “Health care fraud increases costs and threatens the integrity of our health care system, and we are committed to protecting American taxpayers by prosecuting these crimes. I want to thank HHS-OIG, IRS-Criminal Investigation, and the FBI for their investigative efforts, and thank the Connecticut Attorney General’s Office, which has provided important assistance during the course of this investigation.” “Although this defendant was barred from Medicaid and other government health programs after his health care fraud conviction in 1998, he continued to bill these programs using an elaborate scheme to conceal his involvement,” said HHS-OIG Special Agent in Charge Waddell. “Working with federal and state partners, our investigators effectively penetrate such schemes and help bring suspects to justice.” “When a health care provider steals from the government via Medicaid Fraud, the money is part of the untaxed underground economy,” said IRS-Criminal Investigation Special Agent in Charge Offord. “Gary Anusavice admitted his guilt today and also agreed to forfeit significant assets that he purchased with the proceeds of the Medicaid fraud scheme.” “Despite being excluded from participating in both Medicare and Medicaid, Mr. Anusavice devised and orchestrated elaborate schemes to defraud these government-sponsored health care programs with undaunted avarice and greed,” said FBI Special Agent in Charge Mertz. “His frauds not only greatly undermined the financial security of these vital programs but also impacted the ability of legitimate medical professionals to provide important health services to those truly in need.” According to court documents and statements made in court, in July 1997, Anusavice was convicted in Massachusetts state court for submitting false health care claims in relation to his involvement in dental clinics. He subsequently surrendered his dentistry licenses in Massachusetts and Rhode Island for five years. After additional investigations, Anusavice surrendered his right to practice dentistry in Rhode Island for 18 months in 2005, and the Massachusetts Board of Registration in Dentistry permanently revoked Anusavice’s license to practice dentistry in Massachusetts in 2006. As of May 1998, Anusavice has been excluded from participation in Medicare and state health care programs, including Medicaid. From 2008 to April 2011, Anusavice owned and operated several dental clinics in Connecticut but used a licensed dentist to act as the nominal head of the clinics. The clinics included Landmark Dental in West Haven, Dental Group of Connecticut in Trumbull, and Dental Group of Stamford. Anusavice and the licensed dentist provided false Medicaid Provider Enrollment Applications to DSS that did not disclose Anusavice’s controlling interest in the clinics or his disciplinary history. As a result of this fraud, the Connecticut Medicaid program reimbursed Anusavice’s dental practices nearly $21 million. Anusavice actively managed the dental clinics, recruited dentists, and oversaw their hiring. At various times, he trained personnel on Medicaid billing codes and procedures and also determined salary and compensation for the clinics’ doctors and support staff. Anusavice attempted to conceal his involvement in these dental practices by establishing multiple nominee entities, including AMZ Consulting, Inc., Haven Consulting Inc., and New England Preservation Services Inc., and he directed his business partners and employees to make checks payable to these entities. Anusavice deposited the checks into bank accounts he opened for the entities and then used the funds to purchase assets for his personal use, including a residence in North Kingstown, Rhode Island, a 33-foot yacht and a Mercedes Benz. Anusavice received $3,325,272 in income from the dental clinics but did not file federal tax returns for the 2008 through 2011 tax years, resulting in a tax loss to the government of more than $1.2 million. Anusavice pleaded guilty to one count of health care fraud, which carries a maximum term of imprisonment of 10 years, and one count of tax evasion, which carries a maximum term of imprisonment of five years. He is scheduled to be sentenced by United States District Judge Vanessa L. Bryant in Hartford on August 23, 2013. Anusavice has agreed to forfeit his Rhode Island property, yacht, and Mercedes Benz, as well as $91,700 in cash that was seized from his residence on May 24, 2012. He also has agreed to pay back taxes in the amount of $1,894,258.71, plus applicable interest and penalties. The tax loss figure includes more than $600,000 in federal taxes that Anusavice failed to pay from 1990 to 2003. In a related matter, the Connecticut Attorney General’s Office today announced that it has reached a settlement with Anusavice and six of his management and consulting companies. Under the terms of the settlement, Anusavice has agreed to pay the state $9.9 million, which represents treble damages under the Connecticut False Claims Act and restitution under the Connecticut Unfair Trade Practices Act. Anusavice was arrested on May 24, 2012, and has been released on a $500,000 bond since October 2012. This matter is being investigated by the U.S. Department of Health and Human Services-Office of Inspector General, the Internal Revenue Service-Criminal Investigation, and the Federal Bureau of Investigation. The Connecticut Attorney General’s Office provided assistance and cooperation throughout the investigation. This case is being prosecuted by Assistant United States Attorneys Susan Wines and Richard Molot and Trial Attorney Sean Beaty of the Tax Division of the Department of Justice. Acting U.S. Attorney Daly encouraged individuals who suspect health care fraud to report it by calling the Health Care Fraud Task Force at 203-777-6311 or 1-800-HHS-TIPS.
Source: wordpress.com

Video: Does Medicare Cover Dental? What About Dental Crowns And Dentures?

Health Insurance Information Related To Medicare Dental Benefits

You can in fact look for a number of medicare supplemental insurance leads online when just go with the search performed by people regarding enjoying medical insurance. The best facet that any medicare health insurance agent can do is try to look for some of these types of medicare insurance heads and MedicareSupplementPlanFGuide.com results. Even if you go through searching for most of the medical insurance sales leads you can always try sorting obtainable people who perhaps may be of age through sixty five as well as get them to consider medigap plans. Most of these products leads are likely to convert into medicare supplement leads as most people’s simply are unaware of it. Trying to find for a premium is merely portion of the way. It’s in addition significant in order to find an organization with the benefit of will seem present for the public. Obtaining their agent at your side that was well-informed to Medicare insurance is the element. They can find up with everyone to be to no doubt you in spite related to everything obtained the most important finest policy created for your will need and finances. Staying on peak of what is very much going on through Medicare and the government is the perfect chief priority pointing to Medigap Select related to Texas for where it reason you just by no means attain to be concerned that you are perhaps not taken good. Performing per annual review because of you as definitely ensures that you are holding your greatest product for your budget. Medicare also has make certain deductible on organizations from doctors and other non-hospital providers, remember, though , that Part Y simply deductible is simply just 5 per 12 at this enough time. After you’ve met that deductible, Medicare cover may be bills? It pays for 80 percentage points of a pre-determined amount. No matter what your doctor charges, Medicare sets the limit for corporations. Incredibly and foremost, you must decide regardless of whether you can justify the more comprehensive doctor/hospital coverage that can comes with a Medicare Supplement routine. These options are more high price than Medicare Positive aspects plans, some at which have incredibly low premiums. However, if your corporation have any sustained or potential fitness problems, the Sc Medicare Supplement could very well save you much, much more money than it is priced at you over the course of the particular year. This is important to you due to the fact means that you can’t be denied coverage, have pre-existing terms excluded or have to pay a steeper premium due to your current or further than health conditions, providing that you are 1 of these periods. A lot seniors that are just becoming recipients of Original Medicare do not realize the social bookmark creating supplemental medicare plans needed for 2012. For those in perfect health, you never know the need during extensive surgery, as well as the need for visiting the emergency room plus some science laboratory work might add in tons related to debt. As can be predicted, for those with an exiting medical problem just as arthritis, cancer, diabetes, or high familiy line levels, not using a medicare supplement project will end ” up ” costing your a lot more then any insurance premium that you possess paid. Far more mistake to escape from is thinking your neighbor’s Texas Medicare insurance insurance will bestow you the coverage you need. One of their more popular supplement options is Plan F. The house covers almost each of the deductibles, coinsurance, and copayments it you end up dealing with within Medicare Parts A good and B. But, if you will have other insurance premiums coverage, you may perhaps well not need each of the the coverage produced by Plan F, for that concern you may actually need Medigap plan at all. Many retirees attain some insurance for their former executive managers or through a retirement plan. Those plans may perhaps possibly cover some of the out of pocket expenses not considered covered by Medicare insurance. That means you can get at a distance with another compliment policy. Yes, I know, real confusing. You’ll find it’s enough for your business to have if you want to get your take effect together to tackle a move of one state on another. The list of tips to do is endless and regularly the last thing that gets dealt out with is those things to do utilizing your health be concerned insurance. The actions you have throughout the one state may not fit what you need in your new abode. The right time for premium payments may change, etc., and the list goes on.
Source: typepad.com

Cigna Dental Providers Seattle

The Health Maintenance Organization or the HMO plans are known to be the least expensive. But, they provide restricted health facilities. There is a list of doctors covered under such policies. Should you visit a doctor who is not a part of this family, you need to bear the expenses for the same. Fees for regular visits to the doctors are covered under this plan and you need not pay any extra amount for the same. These Cigna medicare plans cover both regular and preventive care. There is a designated network of specialist doctors who are referred to in the event of injuries and illnesses or related emergencies. For regular medical care, you need to choose a PCP or a Primary Care Physician who would look after your general health-related matters on a regular basis. However, medications for commonplace illnesses like drug pressure or diabetes is not included in these Cigna medicare plans and you would be completely responsible for the bill, should you require them.
Source: dentalr.com

Health Insurance Information Exactly About Medicare Dental Benefits

Those are the only premiums shell out for Medicare. Most people just pay .40 for a Medicare which is quite cheap insurance and it is pretty decent insurance. You are required to have a very Medicare Prescription Medication plan. When you purchase not to you have to pay a penalty in the future if you intend to enroll in a plan. Joanna was quiet seriously happy now. Lady advised some pertaining to her friends along the different medicare plans and helped them in understanding the Medicare regulations. As she had a fair understanding of the various guidelines so she commenced working as a Medicare consultant additionally helped lots people today that in selecting an increased plan. Payments for lost belongings, flight insurance, tailored liability insurance, daily life allowances, not to mention emergency evacuation input can all participate in with a comprehensive travel insurance policy. Regular traveling may require purifies extensive insurance quote. Different policies have varying variables as explained down further. N . c . Medicare Supplement products are required when Federal statute offer you certain “Guaranteed Issue” periods to individuals whose existing insurance plans are ending or shifting in some . These “Guaranteed Issue” situations allow you to decide a Medicare Supplement plan of selection without answering practically health questions plus having a Physicians’ Information Bureau history check. MedicareSupplementPlanFGuide.com also known by means of medigap policies are created to pay what the government operated medicare insurance unit does not. The plans can be found generally listed faraway from Plan A that will help Plan L in which they each have pre set benefits set mass popularity by the medicare insurance system. Every one of the plans are Identical from crate to carrier yet somehow the rates are not, so elements to do a little shopping around to make sure that you obtain the best policy for the investment. The maximum popular plan is probably probably Plan Fahrenheit because it goes over all most of each of our benefits at a single reasonable rate bear in mind Plan J is quickly becoming more popular as of late for your additional benefits preventative care and the type of at home recovery benefits. To obtain about pertaining to each 0 of coverage, insurance for cancellation and interruption is going to be good coverage in the instance that you’re making excessive advance deposits together with if your holiday break arrangements require you actually to keep to specified dates. Even with neo refundable payments travelers can have the entire travel rate reimbursed when these companies experience cancelled or possibly delayed flights. When a passenger needs to vary reservations from any kind of double to a person accommodations if a companion can not at all longer join the main trip so here is a policy that can shoulder such expenses. Overall, the bankruptcy among Guardian Healthcare is a problem for many providers, members and remaining affected groups. However, because Medicare health insurance has granted this kind of SEP, which makes it possible to choose a most recent plan without charges or underwriting, you can take advantage of this one-time opportunity with the idea to select a many more comprehensive Medicare Assist plan or get a new Advantage plan. If you have Medicare compared with your old more traditional major medical policy there is the case limit on just how much money you could very well owe during when you really of a calendar year. On traditional giant medical policies techniques annual spend limits, typically separate each in and associated with network care. With Medicare then you face out at network costs on top of that unlimited cost sharing. A lot of the costs will depend how much you use care but they still exist. Keep in mind Medicare was hardly intended to spend more all of your bills. It is there to a person to afford the amounts that you need to have. You may be eligible for low income assistance for your prescription drug payment or even most other premiums as well. Check to see if you have state programs, go to seminars, stop across at your nearby senior center or the centers on finding.
Source: typepad.com

Dental insurance and Medicare – the Medicare Dental & Vision Benefits

Medicare is health insurance plan in US for the seniors as well as disabled people. It gives the basic medical policy, and really helps the seniors & disabled pay for the health care. However, original Medicare doesn’t pay out for everything, as well as dental and vision benefits are limited. The routine care, such as checkups, fillings or glasses, aren’t generally covered in dental insurance and Medicare. The services are covered in case, they are linked with the medical issue such as illness and injury. For instance, dental insurance and Medicare might pay for the hospital stay in case of the complicated dental method. However, it might not at all cover actual dental work. For other example, the Medicare doesn’t generally cover the eyeglasses and contacts. But, it can pay after cataract surgery.
Source: cryonicssocietyofcanada.org

Dental Insurance for Those on a Budget

Individuals who are on Medicare are often surprised that the government program does not provide adequate coverage for dental care. Currently, Medicare only features limited coverage and will not cover any routine care. Specifically, Section 1862 (a)(12) of the Social Security Act prevents Medicare from covering any dental care “where such expenses are for services in connection with the care, treatment, filling, removal, or replacement of teeth or structures supporting teeth.” The vast majority of individuals that use these plans are forced to pay out of pocket for 100% of their dental care needs. However, this has led to the creation of discount plans that focus on Medicare patients and their need for dental care. Many healthcare providers offer discounted dental plans for individuals enrolled in Medicare as well as for those who are 65 years and older. These plans start at low prices and focus on providing highly discounted and affordable dental care for individuals who are eligible for government aid.
Source: financeguider.com

Oral Health and Medicare Beneficiaries: Coverage, Out

This brief describes the oral health of Medicare beneficiaries, examines sources of dental coverage for the Medicare population, and examines the utilization of dental services, out-of-pocket spending on dental care, and access problems. This analysis uses data from the National Health and Nutrition Examination Survey (NHANES), the Medicare Current Beneficiary Survey Cost and Use file (MCBS), the National Health Interview Survey (NHIS) and the Kaiser Family Foundation Survey of Health Care Among Nonelderly People with Disabilities and Seniors on Medicare, 2008.
Source: kff.org

First dentists in the state get THOUSANDS from Medicaid for using TeamLINKS EHR System

Until Monday, only medical professionals and hospitals had met the necessary requirements for the second year of Meaningful Use in the State of Arkansas.   Executives for U.S. HealthRecord cite the use of the TeamLINKS ® system, which is designed specifically for dentists, and the support of Excellence in Healthcare, a firm of industry experts that provide guidance and training to healthcare professionals attempting to achieve Meaningful Use, for the success.
Source: teamlinks.com

R.I. Firm Settles Medicaid Fraud Claims In Connecticut For $9.9 Million

The state’s complaint alleges that Anusavice also violated his program exclusion by actively managing the practices, which received millions of dollars in Medicaid reimbursements. Although Anusavice was no longer licensed by any state to practice dentistry, he was involved in reviewing patient charts, suggesting dental procedures to be performed, reviewing billing records, reviewing income reports, interviewing and hiring dentists, and providing overall management direction to the offices.
Source: ctwatchdog.com

You Might Be a Medicaid Provider in Trouble…

Section 6401 of the Affordable Care Act made clear that compliance programs are now a requirement for physicians and other healthcare providers enrolling or revalidating in the Medicare, Medicaid and SCHIP programs. While the Centers for Medicare and Medicaid Services (CMS) has yet to implement this requirement imposed by the ACA, it is no longer a question whether a compliance program will be needed but rather when. It therefore behooves healthcare practices to be prepared for the upcoming change.
Source: dentalcompliance.com

Medicare Supplement Plans

Posted by:  :  Category: Medicare

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Healthcare costs that are not covered by standard Medicare plans are not left uncovered with Medigap, also known as Medicare Supplement plans. Seniors, you are eligible for Medicare coverage if you are at least 65 years of age and/or have a qualifying disability. As the policies currently stand, there are 12 Supplement plans assigned the letters A through L. Each plan is important to consider for certain benefits relevant to your current situation, geographic location and health conditions. A basic change is occurring to all current plans with an addition of hospice care. Plan G will be undergoing a further alteration, that of a boost from 80 percent to 100 percent coverage for excess charges.
Source: allabout101.com

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

benjidervis: So Why Medicare Supplement Plan N Might Usually Right For Your Needs

May differ Medicare Part B deductible for the 2010 season is 5, which means a one purchases a Medicare Supplement Plan that cover the Part B deductible will pay the first 5 every august for Doctor and Urgent Care prearranged appointments until their Medicare Supplement Plan sees the remaining cost. Medicare Enhance Plan N does not cover ones Part B deductible, and neither absolutely does Medicare Supplement Plan G. LTCI plans are there to cover custodial care or nursing home care for you are no medical needs being removed. LTCI plans are subject to full underwriting in organize to have one issued. The actual price for the plan varies based from age at issue, coverage levels, as medical status. These policies will cover many different needs related for the ADLs so an LTCI should never be thought of as only nursing condo care since in reality, they place home care and assisted care too. Again all of these are convalescent or custodial care situations where Medicare does certainly offer any benefits. Very of the elderly people believe that may Medicare would cover all their health care expenses. They rely solely to do with them and feel that it are likely to take care of their medical service fees in their senior years. If you think you ask them to buy Medicare insurance supplement leads, they might consider this item to be a waste. Them to might feel that these leads were rather a burden for them. Prior to going to shop for the Medicare Booster insurance one should know about an facilities that can be covered by general Medicare plan Is Medicare Supplement Plan F really worth the cost?. It may be the first step to understand what involving supplement he/she needs after Medicare subjection. The services one may get from a definite Medicare are the doctor costs and other charges (part B), hospital costs (part A), at home recovery, emergencies all through foreign travel, costs of skilled caregiving home, blood bank services, prescribed prescription drug costs and for the costs about preventive care. It’s wise realize and shop the best Medicare Capsule plan according to the need. N individual sector companies shifted health care amounts to workers as premium payments rose, deductibles fell, and co-pays rose for your worker who had to live by less and try to buy higher. Not many private employers provide fully-paid health benefits quickly after retirement (or even before). Each and every company eliminates health coverage for senior citizens and tells them to use Medicare, the workers know Medicare won’t fork out their realistic health expenses as these products age. And Medicare keeps parenting premiums on senior citizens of which generally 25% are totally dependent only in social security income which averages surrounding ,000 monthly, yet many still acquire much less. Medicare insurance Supplement Plan F is still much less and away the most popular Medicare insurance Supplement Plan as it is our own most comprehensive plan offered and some of the price is very affordable. Through Medicare Supplement Plan F, you can see almost no out of bank expenses (no co-payments and no deductibles) except for your monthly payment. Medicare Supplement Plan G is a single great option and is exactly how the same as Plan F, except then you will have to pay the One aspect B deductible, which is 5 to have 2010. However, Medicare Supplement Scheme G is cheaper than Medicare Supplementation Plan F on a monthly routine. The various types of Medicare supplement policies pretty much all offer the same basic benefits in addition , insurance companies cannot change these protocols. Typically, the only variation between policies through different insurance providers is the cost of the coverage. Strict regulation through federal and state laws governs repairs are covered in these Medicare supplement policies, and those regulations are designed to protect people who receive Medicare.
Source: blogspot.com

MSN Premium Member Center, Medicare Premiums, MSN Premium Download, : 2010

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Source: projectedu.com

Getting Medicare Supplement Insurance

Treatment Supplement Plan F is still significantly and away the most popular Medicare insurance Supplement Plan as it is the entire most comprehensive plan offered and any price is very affordable. Now with Medicare Supplement Plan F, you does indeed see almost no out of wallet expenses (no co-payments and no deductibles) except for your monthly payment. Medicare Supplement Plan G is a single great option and is exactly the type of same as Plan F, except you actually will have to pay the Step B deductible, which is 5 when considering 2010. However, Medicare Supplement Prepare G is cheaper than Medicare Vitamin and mineral Plan F on a monthly structure.
Source: gigglesclubs.com

Ways To Choose A Medicare Supplement Insurance Insurance Option

Let me focus on F and G quality policies because they are among typically the most popular Medicare Supplement (often called a medsupp) policy. Also, these two programs are virtually identical, with F making payment on the Medicare Part B deductible and S not paying that hole. Associated with these plans are the most comprehensive medsupp plans, plugging virtually all holes got out of by Medicare alone. Although offer you protection for emergency care outside spain not covered by Medicare, neither F, G, or any other medsupp touches on nursing home care when it is without question custodial in nature.
Source: huffpozer.com

Medigap vs. Medicare Advantage Plan

Medicare Advantage comprises a variety of private health plans — most often HMOs and PPOs — that Medicare offers as a coverage alternative to the traditional program. Every plan must cover all the same benefits that traditional Medicare covers. But the plans can charge different copayments (often lower than the traditional program but not always) and offer extra benefits. Most charge a monthly premium in addition to the Part B premium, but some don’t. Most include prescription drug coverage at no additional cost. Some cover routine hearing and vision services, usually as a separate package for an additional premium. Another difference from the traditional program is that most plans require you to go to doctors and other providers within their service network or pay higher copays for going out of network.
Source: aarp.org

Plenty Of Interesting Facts About Medicare Supplement Strategy

Medicare health insurance Supplement Plan F is still totally and away the most popular Treatment Supplement Plan as it is our own most comprehensive plan offered and its price is very affordable. By way of Medicare Supplement Plan F, you will be able to see almost no out of money expenses (no co-payments and no deductibles) except for your monthly payment. Medicare Supplement Plan G is a person more great option and is exactly the type of same as Plan F, except your corporation will have to pay the Area B deductible, which is 5 to gain 2010. However, Medicare Supplement Prepare G is cheaper than Medicare Supplemental Plan F on a monthly routine.
Source: arhavitso.org

Medicare Insurance Changes For 2011

May total four levels of Medicare (Type A, B, C and D) that go over different feature of medical coverage Medigap Plans Guide Medicare Supplement Plan F. Medicare type A pays off your individual hospital expenses during your overnight trip there. Medicare type B will take care of your medical expenses for routine medical expert fees and tests. Medicare enter C is an optional coverage. Medicare type D covers your services for buying the prescribed drugs. All these variations have their actually limitations which will exhaust all this coverage.
Source: jimm-skachat.com

Choosing the Right Medicare Supplement Insurance Policy

You pay a monthly premium for Medicare Supplement insurance, and the costs can increase as you get older – although this can vary, based on the way a policy is issued. For example, if a policy uses something called “issue age,” this means that the insurance company cannot increase your premiums as you get older. So in essence, you are locking in a rate based on your age when you purchased the policy. Traditionally, issue age plans are more expensive up front. But, in the long run this could work out better as you won’t experience any rate increases over time.
Source: mypolicybroker.com

Medicare Supplement Sales Grew in 2010

Donahue also breaks down the Medicare Supplement market by company.  UnitedHealthcare owns a surprisingly high 32% of the market share.  When you add in Mutual of Omaha, these two companies own 43% of all Medicare Supplement polices.   What is the saying?… “So go these companies, so goes the market”.  As these two companies make changes to rates, underwriting and commission other companies are surely to follow.
Source: agentpipeline.com

Medicare Targets Health Plans With Low Ratings

Posted by:  :  Category: Medicare

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

Video: Medicare Supplement Insurance Shopping

Senior Healthcare Consultants (SHC) and Pyramid Life Team Up to Serve the Midwest Senior Market

Pyramid Life, a subsidiary of Universal American Financial Corp. (UAFC), and Senior Healthcare Consultants (SHC), of Dallas, TX, have announced an alliance. Pyramid Life specializes in Medicare products, annuities, and senior life insurance. SHC is one of the nation’s largest and most successful independent career-marketing organizations. It offers an exceptionally high level of marketing support and comprehensive training for its captive field agents. It is the only organization of its kind to provide daily preset sales appointments for its exclusive staff of agents in their senior health division, as well as their senior life division. Senior Healthcare Consultants (SHC) and Pyramid Life Team Up to Serve the Midwest Senior Market Source: PR Newswire
Source: blogspot.com

Has Anyone Heard of Pyramid Life Insurance Co.

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

Cousinhood Pyramid: Life Pyramid Company Recommends Hitched Broadsword

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

Why is Medicare shutting down one of the most effective health

We think of the hospital as a place people go to get better. At Health Quality Partners, the view is that a hospital is a place where seniors get worse. “Being in the hospital for three days or five days sets them back to a point where they’ll never regain what they were,” says Sherry Marcantonio, chief program architect of HQP. “That’s where the scales tip. That’s where people end up needing a nursing home.” Keeping seniors out of the hospital, which is a core focus of its program, cuts costs and saves lives, but it also preserves quality of life — a measure often ignored in these discussions. There’s a good argument to be made that if a program like HQP cost slightly more than traditional Medicare but cut hospitalizations by a third, it would still be worth it. The point of health care, after all, is to keep people healthy. But HQP saves money — and lots of it.
Source: bangordailynews.com

Union Bankers Health Insurance Company Review

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

Health insurance choice may make you healthier

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

American Pioneer Health Insurance Company Review

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

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June 07, 2013

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

Posted by:  :  Category: Medicare

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

Video: Understanding Healthcare Costs: Medicare Advantage

Medicare Advantage Plans are Changing

The days of paying a $0.00 premium and receiving a rich Medicare Advantage Plan are ending soon. However, when you compare the benefits and premium of a Medicare Advantage Plan to an Employer or Private insurance Plan, Medicare Advantage Plans are still typically going to offer better coverage. Medicare Advantage Plans over the next few years should still offer good benefits for a low monthly premium.
Source: srhealthcaredirect.com

Medicare advantage costs often exceed traditional Medicare costs

Using newly available government data, Marsha Gold, a senior fellow with Mathematica Policy Research, found that risk-adjusted MA plan costs in 2009 were, on average, 4 percent higher than those for traditional Medicare. Among plan types, only health maintenance organizations (HMOs) had lower average costs, while costs for more than 75 percent of local preferred provider organizations (PPOs) and private fee-for service plans exceeded traditional Medicare’s. According to Gold, the wide variation in MA plan costs relative to traditional Medicare suggests there is room for many of these plans to deliver care more efficiently and keeps costs down.
Source: wordpress.com

Medicare Advantage Cuts and Coverage Update

The Centers for Medicare and Medicaid Services report applications are up almost fifty percent from last year for requests from private insurers vying for a position in the Medicare market. Large national insurance companies continue to see a large part of their business profitability and growth projections being met with Medicare Advantage. Private insurance companies believe that the growing baby boomer market will bring exponential enrollment numbers to the senior insurance market. Proponents of Medicare worry that the viability of the Medicare Advantage model may become threatened with the Obama Administration’s proposals to cut Medicare Advantage payments by up to eight percent in 2014.
Source: medicarebenefits.com

Medicare Advantage Sees Lower Premiums

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

Chart of the day: Medicare’s administrative costs, explained

If by “premium collection” Klein meant taxes, he was wrong; a portion of IRS costs are allocated to Medicare’s overhead by OACT [CMS’s Office of the Actuary]. If by “premium collection” Klein meant Part B premiums, he was wrong on two counts: (1) the Social Security Administration, not the IRS, calculates and collects Part B premiums for the vast majority of Medicare enrollees, and the Railroad Retirement Board does so for former railroad workers; and (2) a portion of the SSA’s and the railroad board’s costs are allocated to Medicare’s overhead by OACT. Klein’s statement that the cost of processing claims for the traditional Medicare program does not appear in Medicare’s administrative expenditures is also incorrect. OACT does include the cost of claims processing, which is done by what used to be called “carriers” and “intermediaries” and are now called “Medicare administrative contractors.” […]
Source: theincidentaleconomist.com

Model for a Lower Priced Medicare Program

You also have to look into the process of seeking specialist care under the plans you are considering. A majority of these managed care plans would require you to seek a referral from a primary care physician first before being able to see a specialist. It may pose problems if you need to see a specialist immediately but is forced to wait to secure an appointment with the primary care physician. You should also consider the plan’s claims process. If you wish to appeal a denied procedure under your Medicare Advantage plan, the review will be conducted based on the guidelines set forth by the private plan provider, as they are the ones running the plan after all. So if you plan to acquire alternative treatment procedures, make sure the plan you are considering covers these procedures.
Source: medicare-providers.net

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June 07, 2013

Could Your Medicare Part D Costs Be Reduced? (infographic)

Posted by:  :  Category: Medicare

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Thank you to Walgreens, who has provided editorial sponsorship for the writing of this article.  Walgreens  is in the network of hundreds of Medicare prescription drug plans and participates in the preferred networks of four national Part D sponsors. They offer savings of up to 75 percent on prescription co-pays over select pharmacies for a number of plans in which they are a preferred pharmacy so that is why we felt it was important to bring you this information.
Source: intentionalcaregiver.com

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

Health Informatrix: Important Payment Adjustment Information for Medicare EPs

EPs who first demonstrate meaningful use in 2014 must demonstrate meaningful use for a 90-day reporting period in 2014 to avoid payment adjustments in 2015. This reporting period must occur in the first 9 months of calendar year 2014, and EPs must attest to meaningful use no later than
Source: healthinformatrix.com

Illinois Federal Judge Orders Government To Provide Information In Medicare Suit

CHICAGO – An Illinois federal judge on May 6 partially granted a defendant’s motion for an order directing the federal government to file a bill of particulars in its case against him for Medicare fraud (United States of America v. Robert Kolbusz, No. 12-782, N.D. Ill.; 2013 U.S. Dist. LEXIS 64043).Full story on lexis.com
Source: lexisnexis.com

Medicare Questions? Livingston MMAP has answers

As the Livingston County Site Coordinator for the Michigan Medicare/Medicaid Assistance Program (MMAP), one of my goals is to increase the visibility of MMAP so we can better serve the over 25,000 Medicare beneficiaries in Livingston county. MMAP is a non-profit program providing unbiased healthcare counseling by certified and background checked counselors at no cost to Medicare beneficiaries. MMAP also provides presentations on several topics including: Healthcare Fraud, Medicare Basics, Medicare Changes, Part D. Please see the MMAP Introduction letter attached for more information.
Source: wordpress.com

Definitions Of The Most Common Medicare Terms

Enrollment period – the limited time period that an individual can enroll in a health care plan or switch to a different one. Grievance – a formal complaint made to Medicare when your health care plan or the person administering medical treatment to you has treated you improperly or poorly. Home health care – short-term care provided while you are recovering at home from an illness or injury. Occasional part-time skilled care as well as some medical equipment, services, and supplies are included in a home health care plan. Hospice care – care administered to those individuals with a terminal illness or medical condition (covered in Part A). Counseling and physical care are included. Long-term care – Medicare does not cover ongoing health or personal care that an assisted living facility or a nursing home would provide. Medicaid – federal and state programs that are separate from Medicare. This assists those individuals with limited assets and low incomes to pay for their medical expenses. Medicare Advantage – alternative health care for Parts A and B that are provided by a private insurance carrier. Medicare Part A – pays for hospice care, hospital stays, and some home health care. Medicare Part B – pays for lab tests, medical equipment, physician visits, and some medical services. Medicare Part D – coverage that is provided for some brand name and generic medications. Medigap – private insurance that covers the gaps in Part A and Part B coverages. It is also sometimes referred to as Medicare Supplement Insurance. Out-of-pocket expenses – those expenses that you are responsible for and are not covered by Medicare insurance. Premiums – payments for health care coverage that is usually made on a monthly basis. Skilled nursing care – medical care provided by licensed LPN’s (Licensed Practical Nurses) or RN’s (Registered Nurses). For more information, the entire Medicare glossary is available online at the US Government Site for Medicare or you can click Medicare supplement information.
Source: blogspot.com

Good Health Insurance Information Almost Medicare Dental Features

Those are the only premiums get yourself a for Medicare. Most people pay just .40 for a person’s Medicare which is rather cheap insurance which is also pretty decent insurance coverage. You are required to have the right Medicare Prescription Remedy plan. If you choose not to you should pay a fine in the life if you decide to enroll in a blueprint. Joanna was quiet exciting now. You advised some at her friends regarding the different medicare plans but helped them in understanding the Medicare guidelines. As she had a fair understanding of the various likes and dislikes so she was launched working as that Medicare consultant and as a result helped lots consumers in selecting a different plan. Repayments for lost belongings, flight insurance, customized liability insurance, daily living allowances, not to emergency evacuation input can all take part in with a wide-ranging travel insurance life insurance policy. Regular traveling may require a more extensive insurance contract. Different policies have varying complications as explained a number of. North carolina Medicare Supplement packages are required caused by Federal statute offer you certain “Guaranteed Issue” periods to individuals whose existing insurance is ending or increasing in some method. These “Guaranteed Issue” situations allow you to decide a Medicare Supplement plan of choosing without answering practically health questions or having a Skilled Information Bureau history check. Medicare Supplement Plan F Guide also known due to the fact medigap policies are to pay the the government operated medicare insurance system does not. The plans can be found generally listed faraway from Plan A to help Plan L when it comes to which they what have pre allocated benefits set utility by the treatment system. The majority of the plans will most certainly be Identical from bottle to carrier but the rates should be not, so components . to do a little shopping around certain that that you get the best policy for the investment. The many popular plan is undoubtedly probably Plan F because it coverings most of the benefits at a single reasonable rate bear in mind Plan J is very much quickly becoming increased popular as behind late for its additional benefits preventive care and our own at home convalescence benefits. About about per 0 of coverage, insurance for cancelling technology and interruption definitely is good coverage if you’re making authoritative advance deposits possibly if your get-away arrangements require you to keep at specified dates. Even with no refundable payments people can have that entire travel rate reimbursed when they experience cancelled or possibly delayed flights. When a passenger needs to change reservations from the double to a person accommodations if an companion can no longer join usually the trip so ideal is a policy that can shoulder such expenses. Overall, the bankruptcy among Guardian Healthcare is an issue for many providers, members and some other affected groups. However, because Medicare insurance has granted it all SEP, which makes it possible to choose a completely new plan without charges or underwriting, purchase take advantage of such one-time opportunity either to select a higher comprehensive Medicare Nutritional plan or find a new Advantage plan. If you have Medicare within contrast to your old traditional major medical statement there is n’ limit on exactly how much money you could owe during accomplished . of a twelve months. On traditional extensive medical policies you can apply annual spend limits, typically separate for both in and associated with network care. With Medicare then you face out at network costs on top of that unlimited cost providing. A lot of fees will depend how much you use treat but they exist. Needless to say Medicare was hardly intended to spend more all of your debts. It is there to a person afford the healthcare that you need to have. You may be eligible for low income assistance to formulate your prescription drug monthly premiums or even other premiums as very well. Check to see if you have state programs, go to seminars, stop while at your nearby senior center or go with the centers on finding.
Source: typepad.com

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

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June 07, 2013

OneHealth™ Signs Services Agreement with Amerigroup Corporation

Posted by:  :  Category: Medicare

Amerigroup, a Fortune 500 Company, coordinates services for individuals in publicly funded health care programs. Currently serving approximately 2.7 million members in 12 states nationwide, Amerigroup expects to expand operations to its 13th state, Kansas, as a result of previously awarded state contract. Amerigroup is dedicated to offering real solutions that improve health care access and quality for its members, while proactively working to reduce the overall cost of care to taxpayers. Amerigroup accepts all eligible people regardless of age, sex, race or disability.
Source: onehealth.com

Video: Real Stories: Amerigroup Texas, Dual Eligible

Amerigroup Medicare Tai Chi

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

WellPoint reorganization will help integrate Amerigroup, expand in Medicaid market

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

Medicare Targets Health Plans With Low Ratings

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

Feds extend review of Amerigroup, WellPoint deal

About 48,000 of Amerigroup’s 2.6 million health plan members live in Virginia, according to statistics disclosed on the company website (PDF). WellPoint is one of the nation’s largest insurers, with 34 million members in its branded health plans and 65 million more in subsidiary health plans such as Anthem Blue Cross and Blue Shield, which operates in Virginia and 10 other states. According to the SEC filing, the companies expect to close the transaction by the end of 2012, following approval from federal antitrust authorities in the ongoing Hart-Scott-Rodino approval process. The request for additional information extended the initial Aug. 22 deadline by 30 days. The combined company would have membership of about 4.5 million Medicaid beneficiaries in 19 states. WellPoint announced the proposed acquisition of Amerigroup less than two weeks after the Supreme Court upheld the Patient Protection and Affordable Care Act, a ruling that WellPoint executives estimated would increase Medicaid spending in managed-care plans by nearly $100 billion by the end of 2014.
Source: modernhealthcare.com

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