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

Posted by:  :  Category: Medicare

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

Video: (Part 1) Using TRICARE and Medicare

ISTA Pharma Barred From Medicare, Medicaid, TRICARE Reimbursement

The pharmaceutical company had created reference sheets for physicians about the use of Xibrom for other-than-approved usage, evidence of violating the prohibition against off-label marketing. The company also encouraged its sales professionals not to leave these materials in doctors’ offices and not to document discussions with physicians related to unapproved uses of the cataract drug.
Source: federalwhistleblowerlawyers.com

Here We Go Again! Cuts to Medicare/TRICARE Physician Payments Begin January 1 Unless Congress Acts

Getting a so-called “Doc Fix,” which would end scheduled cuts in Medicare reimbursement rates, is a recurring issue. Congress temporarily stopped the scheduled payment cuts in February 2012 as part of the Middle Class Tax Relief and Job Creation Act of 2012  (P.L. 112-96). Unfortunately, that fix is due to expire on January 1, 2013, which means that without further Congressional action the 26.5% physician payment cut will go into effect. The timing of the expiration also means the issue has been caught up in the negotiations over the pending fiscal cliff. This makes fixing it that more difficult.
Source: militaryfamily.org

Permanent Medicare/TRICARE Fix?

Every year for a decade, Medicare and TRICARE have used short-term patches to put off serious cuts in physician payments that would devastate access to care. Could a permanent solution finally be on the way?  Read more: 
Source: wordpress.com

Tricare and Medicare Patch

I know I have quite a few readers who have tricare or medicare so if you are a military family, senior, disabled, or you just want to help then here is an easy one-click way to contact your congress to ask them to permanently fix the payment cut for Medicare/Tricare. The fix they have in place right now will expire in December.
Source: littlepeoplewealth.com

Medicare Supplement Plans

Medicare is the federal health insurance plan through Medicare and Medicaid Services center management. Health insurance is to provide 65 years of age or older. If you meet certain conditions, Medicare A part, also known as traditional Medicare or Original Medicare is free. Medicare Part B provides additional services, but users must pay a monthly premium. Medicare A and Part B are obtained through government include only certain services, so many older people can also buy supplemental health care benefits. Other people are reading I can get supplementary medical insurance if I lose group health insurance? Comparison of supplementary medical insurance program Medicare Advantage medical advantages, also known as Medicare C section, combined with Medicare Part A and Part B plans to provide additional services. Medicare Advantage plans to provide private health insurance companies such as Humana and Aetna, premiums, regulations, services and policies, depending on the company and the country where you live. Under normal circumstances, you must take two kinds of Medicare Part A and Part B to get the Medicare Advantage. Medicare Advantage, may have prescription drug coverage, vision and dental services, such as. Provide Medicare Advantage is often different forms, such as health management organization plans, preferred provider organization plans, health savings account plans, special needs and private paid service plans
Source: howfoodarticles.com

Medicare Part D is prescription drug coverage insurance that is provided by private companies approved by Medicare.

Example: Mrs. Smith didn’t join when she was first eligible-by June 15, 2009. She doesn’t have prescription drug coverage from any other source. She joined a Medicare drug plan with an effective date of January 1, 2012. Her drug coverage was effective January 1, 2010. Since Mrs. Smith was without creditable prescription drug coverage from July 2009-December 2011, her penalty in 2011 was 30% (1% for each of the 32 months) of $31.08 (the national base beneficiary premium for 2012), which is $9.32. The monthly penalty is rounded to the nearest $.10. She pays this late enrollment penalty of $9.30 monthly in addition to her plan’s monthly premium. Here’s the math: .30 (30% penalty) x $31.08 (2012 base beneficiary premium) = $9.32 $9.32 (rounded to the nearest $0.10) = $9.30 $9.30 = Mrs. Smith’s monthly late enrollment penalty
Source: medicare.gov

How Tricare, Medicare work in retirement

Yes it’s gen­er­ally a good deal in the states but not so good over­seas where one gets to pay for medicare but gets none of the ben­e­fits. In addi­tion if one lives in the Philip­pines they will find the Tri­care Stan­dard has been reduced to a sec­ond class ben­e­fit with lim­ited access to providers. Very often retirees find they get to pay 100% of the cost of their care. On aver­age for inpa­tient care they can look for­ward to pay­ing 50% or more of the pro­fes­sional fees and even then they have to learn med­ical cod­ing and pro­ce­dures to con­vert local global bills into a form accept­able to TMA. Any­where else in the world they accept the local global bill and pay the full 75% they should. Local providers and hos­pi­tals tend to avoid Tri­care because of its bad rep­u­ta­tion and past actions. So also expect to keep $10,000 plus lay­ing around to pay for your hos­pi­tal­iza­tion up front and then hope to get 50% back.
Source: military.com

TRICARE Moving to Medicare Type Methodology for SCHs

Medicare reimburses SCHs for inpatient care at the greater of the Medicare DRG for all Medicare discharges, or the amount the SCH would have been paid if it were paid the average cost per discharge at that SCH in fiscal years 1982, 1987, 1992, 1996 or 2006, updated to the current year, for all Medicare discharges. DOD noted, however, that establishing a methodology exactly like Medicare is not practical. While the aggregate DRG reimbursement for all TRICARE discharges can be calculated, using the Medicare cost per discharge would not be appropriate for TRICARE because of differences in the TRICARE and Medicare beneficiary case mix. Also, applying an annual update to a TRICARE base-year average doesn’t make sense because of the relatively low number of TRICARE discharges in any given year—fewer than 20 at nearly half of SCHs. The average cost per discharge in any one year may not be a good measure of the average cost in future years.
Source: healthcarereforminsights.com

5 Services Medicare Won’t Pay For

Posted by:  :  Category: Medicare

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The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Source: webmd.com

Video: Does Medicare Cover Dental Services?

Best Dental Insurance: Does Medicare Cover Dental Health

Medicare is a federal government program that provides health insurance for people age 65 and older, people under age 65 with certain disabilities, and people with permanent kidney failure requiring dialysis or a kidney transplant. Medicaid is a joint program of the federal and state governments
Source: blogspot.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

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

Dental and Vision Coverage for Medicare Recipients

Are you an Insurance Forums member yet ? To sign up for your FREE INSTANT account, please fill out the form below ! Username:     Password:   Confirm Password:     E-Mail:   Confirm E-Mail:          Question of the day:   How many stars are in USA flag? I agree to forum rules 
Source: insurance-forums.net

Benefits Of Medicare Dental Plans ~ Article Zone

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

How to pick a Medicare plan

The Kaiser Family Foundation estimates that monthly premiums for Part D stand-alone prescription drug plans will rise by 10%, on average, to $40.72 in 2011. This assumes beneficiaries stay with their 2010 plans. Many experts advise consumers to shop around. For Medicare Advantage policies, Kaiser projects relatively modest price increases, with premiums rising about $2 a month to an average of $43. This is what’s called an enrollment-weighted premium, meaning that Kaiser has looked not only at insurance plan rates but also at the numbers of people in the plans. Plans with larger enrollments have more weight when projecting average premiums. All insurers offering Medigap plans must charge the same rate for comparable coverage. Medicare has an online tool that will allow access to local Medigap policies and rates by ZIP code.
Source: msn.com

What’s the Difference Between Medicare and Medicaid? Do They Include Dental Coverage?

Certain people including pregnant women, low-income children under 21 years of age, non-Medicare eligible elderly, and low-income individuals with disabilities are automatically eligible for this program. Because Medicaid is a partnership between the federal government and participating states, levels of coverage and restrictions can vary widely depending on where you live root canal treatment instrument. For those over 21, what the program will and will not cover varies widely according to the state in which the recipient lives. For the majority of American adult members, comprehensive dental care is not provided.
Source: wordpress.com

In Minnesota Medicare Advantage plans

Minnesota seniors can choose from four Medicare Advantage, or MA (C section) plans, Medicare-approved health insurance plan provided by a private company. Each MA plan includes (Hospital) and Part B (medical) coverage, emergency and emergency medical services, and provide Part D (prescription drug) coverage. Some plans also offer dental, vision and hearing aid coverage, health and wellness programs. Other people are reading than Medicare Advantage. Medicare Supplement Plans Medicare Supplement Health Plan in Minnesota Blue Cross Blue Shield (BCBS) of its Medicare Advantage plans related to the Basel Committee on Banking Supervision provides three programs, plus a separate prescription drug plan and two supplementary program. As of May 2010, premiums range from $ 29 to $ 261 per month. The MedicareBlue PPO plans include co-payments for doctor visits and emergency care, the highest annual pocket costs and prescription drug coverage. Right MedicareBlue RX prescription drug plan, either blue or platinum plan senior gold, there is no drug coverage full coverage. Superior Gold has the highest monthly premium, but there is no co-pays, and pays no annual fee. A supplementary scheme extending basic welfare benefits could reach the highest level. Second supplemental cost-sharing scheme is to protect the gap.
Source: howfoodarticles.com

The Medicare Prescription Drug Benefit Fact Sheet

Posted by:  :  Category: Medicare

CBO estimates that Part D spending will total $60 billion in 2013 (net of premiums and state transfers).  The average annual Part D per capita growth rate was 3.7% between 2006 and 2011, but is projected to rise at a more rapid rate (5.6%) between 2011 and 2021 (2012 Medicare Trustees), in part due to slowing of trend toward greater generic drug use. Total spending depends on several factors: the number of Part D enrollees, their health status and drug use, the number of low-income subsidy recipients, and plans’ ability to negotiate discounts and rebates with drug companies and manage use (e.g. promoting use of generic drugs, prior authorization, step therapy, quantity limits, and mail order).  The MMA prohibits Medicare from negotiating drug prices directly.
Source: kff.org

Video: Medicare Part D – 5 Things To Know Before You Enroll in a Part D Plan

Medicare Part D, Prescription Drug Plan Coverage, PDP

It is best to sign up for a Part D plan as soon as you become eligible. In some circumstances, members may be charged a penalty or face higher premiums if they sign up after their initial eligibility. If necessary, you can make changes to your plan in the fall when providers announce upcoming changes during the Annual Election Period (AEP). Few exceptions allow enrollments outside of an enrollment period, but it is important to enroll as soon as possible to avoid potential penalty fees.
Source: bradeninsurance.com

A Medicare Part D Cost Saving Success Story

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Source: thrivinginthemiddle.com

Medicare Supplement & Medicare Part D: Medigap Drug Coverage

In most cases, since Medicare Supplement plans cannot work with MA plans, beneficiaries enrolled in Medigap policies who do not have other drug coverage opt to enroll in a stand-alone Part D plan for creditable prescription drug coverage. The best time for Medigap policyholders to enroll in a PDP is when they are first eligible to enroll in a Part D plan to avoid potentially paying more to join a drug plan later. Beneficiaries can enroll during their Initial Enrollment Period, during Special Enrollment Periods, during the Annual Enrollment Period (October 15th to December 7th), or anytime if they qualify for the Extra Help program.
Source: planprescriber.com

Medicare Part D: Coverage, Costs, Eligibility

Ross Blair has applied more than 26 years of technology experience to develop PlanPrescriber.com, a website that makes it easier for seniors and their caregivers to select and enroll in the best Medicare products for their specific needs. In his role as CEO, he has worked closely with pharmacists, insurers, physicians, caregivers and seniors to identify the most critical and complex aspects of Medicare and create a system that delivers this information to consumers in a format that is easy to use and understand. Google+
Source: ehealthmedicare.com

South Carolina Medigap & Medicare Rates and Insurance Plans 2014

The only way to get a 100% accurate rate quote in the state of South Carolina is to contact some of the providers or to use Medicare.gov. With Medigap and Medicare rates in 2014 you will not know the price points that are available until open enrollment which starts October 15th, 2013. If you have any questions before then, please feel free to comment below and I will be more than happy to put you in contact with the right resources that can be of great assistance. I also have a resource on South Carolina Medicaid applications for those that have the desire to apply for government financial aid.
Source: wojdylofinance.com

VIRGINIA MEDICARE COVERAGE OPTIONS

Medicare Advantage Plans availability is based on County. To receive an e-mail of all of the available Medicare Advantage Plans in your County, call Senior Healthcare Direct 1-855-368-4717, and one of our Virginia Licensed Medicare Agents will be happy to assist you.
Source: srhealthcaredirect.com

Medicare Part D Prescription Drug Enrollment Trends in 2013

According to research from Avalere, Medicare beneficiaries are overwhelmingly choosing low-cost Part D prescription drug plans . In 2013, more than 500,000 beneficiaries enrolled in the brand new AARP Saver Plus plan—catapulting it to a position in the top 10 list of plans in its first year. With the addition of Humana/Walmart and First Health Part D Value Plus, nearly 3 million beneficiaries are choosing low-premium plans with preferred pharmacy networks.  Between 2012 and 2013, premiums have been fairly stable with an average annual increase of only 2%.
Source: healthcare-economist.com

MedicareIsSimple: 2014 Medicare Advantage and Part D Maximum Commissions

At Medicare is Simple, we look to educate and enable you to choose among Medicare plans to find the policy that fits your needs. Get free quotes instantly using our advanced quoting technology. HealthCare Reform is a topic of interest to people of all ages, so we look to keep you updated on the issues that are part of that sensitive topic. Medicare Is Simple 233 W Main St Lewisville, TX 75057 800-442-4915 inf@medicareissimple.com
Source: blogspot.com

Chances For Deficit Deal Diminish As Medicare’s Outlook Improves

Posted by:  :  Category: Medicare

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The Associated Press: A Respite For Medicare; Social Security No Worse Medicare’s long-term health is starting to look a little better, the government said Friday, but both Social Security and Medicare are still wobbling toward insolvency within two decades if Congress and the president don’t find a way to shore up the trust funds established to take care of older Americans. Medicare’s giant fund for inpatient care will be exhausted in 2026, two years later than estimated last year, while Social Security’s projected insolvency in 2033 remains unchanged, the government reported (Alonso-Zaldivar, 5/31).
Source: kaiserhealthnews.org

Video: Medicaid spend down

As boomers ease into Medicare, battle rages over health

For Truman it was a moment of political triumph. As president, in 1945, he had proposed a national health care system – for all ages. The American Medical Association, representing the nation’s doctors, called it “socialism” and fought him off. President John F. Kennedy revived the idea, but focused it on the elderly. The medical establishment fought that proposal too, with help from an up-and-coming conservative named Ronald Reagan. Southern whites opposed Medicare, as well, enraged that it would end the racial segregation of hospitals.
Source: spokesman.com

Mo. To Change Medicare 'Spend Down' Rules

Alyson Campbell, the director of the Department of Social Services’ Family Services Division, told lawmakers that, in some cases, department staff had been incorrectly giving credit for the full amount of a person’s medical bill – even if parts of it were paid for by Medicare or private insurance or were written off altogether by the person’s medical provider. That means some people in the program might have received Medicaid coverage for which they were not truly eligible.
Source: kmbc.com

Daily Kos: Projected Medicare spending falls dramatically

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Source: dailykos.com

Common Questions about Asset Protection from Nursing home Medicaid spend down

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Source: wordpress.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

Maricopa County Arizona Medicare Supplement Quotes June 2013

Posted by:  :  Category: Medicare

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Robert Bache aka MedicareBob owns and operates Senior Healthcare Direct. Senior Healthcare Direct is a National Telephonic Insurance Agency that represents over 26 Medicare Insurance Companies. It is our job to make sure that you always have the best price for your Medicare Supplement Plan.
Source: srhealthcaredirect.com

Video: Medicare in Arizona- 1.800.643.7544

Arizona Medicare Supplement Policy

I am going to focus on P and G standard policies because considerable among the most desirable Medicare Supplement (often called a medsupp) policy. Also, these two suggestions are virtually identical, with F paying off the Medicare Part K deductible and V not paying that will hole. 2 plans are essentially the most comprehensive medsupp plans, plugging virtually all of holes left as a result of Medicare alone. Although they can protect you for emergency health outside the area not covered courtesy of Medicare, neither F, G, or additional medsupp will write about nursing home think about when it is literally custodial in mother nature herself.
Source: hiphopliveshere.com

Arizona Medicare SupplementCanadian English

Nattokinase is an chemical found in another cheese like food, natto, made within fermented soybeans. There are hardy claims made for properties. Personal it quickly decreases blood pressure, regulates cholesterol levels, furthermore prevents and sometimes breaks up thrombus. The heart is a six chambered, hollow muscle mass mass and double actress pump that can be found in the chest regarding the lungs. Midst diseases caused through process of high blood force contributes to solidifying of the arteries and. Complementary and alternative medicine includes a number of different medical systems. Eastern cultures buy traditional Chinese medicine, Ayurveda, and chinese medicine for centuries.
Source: canadaenglishcenter.com

Pima Community Access Program is excited to partner with CMS for the Connecting Kids to Coverage Outreach and Enrollment Grant

We know from experience that application assistance delivered by trusted members of the community is essential.  Working with the Arizona Medicaid agency, we operated a special hotline to help enroll children into Arizona’s Children’s Health Insurance Program (CHIP). Through that collaboration, we were able to access key data systems so we could answer questions, troubleshoot and expedite difficult cases.
Source: cms.gov

MedicareBob’s Blog: Maricopa County Arizona Medicare Supplement Quotes Provided by Robert
Bache

Robert Bache aka MedicareBob owns and operates Senior Healthcare Direct. Senior Healthcare Direct is a National Telephonic Insurance Agency that represents over 26 Medicare Insurance Companies. It is our job to make sure that you always have the best price for your Medicare Supplement Plan.
Source: blogspot.com

Arizona, North Carolina: A study in contrasts

The other consideration is the lobbyist groups who support Obrewercare are ready, willing and able to spend whatever it takes to make the sheeple think this federal overreach is a good thing. IF it gets to the ballot, that does NOT insure a victory for restraint. We have generations of people who believe in government nannism and think others “owe” them their basic needs. Self reliance has gone the way of the buggy whip. Obama has successfully driven a wedge between social demographics. Where the struggling previously worked towards bettering their situations through education and hard work, today their counterparts don’t aspire to achieving more. Instead, they demonize the successful, who are the risk takers and job providers. Obama told the sheeple, those businessmen and women who provided their jobs “didn’t build that, somebody else made that happen,“ and the sheeple cheered! This is what Jan Brewer plays into.
Source: wordpress.com

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July 06, 2013

CMS Releases Select Hospital Outpatient Data

Posted by:  :  Category: Medicare

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While last month’s data release centered on average charges for the 100 most common inpatient procedures, Health and Human Services (HHS) Secretary Kathleen Sebelius announced the second wave of data will include estimates for 30 types of hospital outpatient procedures including clinic visits, echocardiograms, and endoscopies, among others. The information release, which Sebelius announced in early June at the Health Datapalooza IV health-data transparency conference in Washington, DC also includes data on the adoption of specific electronic health record systems used by physicians; CMS documented these by state, specialty, and each physician’s stage in meaningful use attestation.
Source: ahima.org

Video: Medicare Supplement Select Plans

HRSA Announces PCMH Grant Funds, CMS to Select 500 sites for Medicare Demo

Last week HHS announced the Quality Improvement and Patient-Centered Medical Home (PCMH) Development grants, funds for health centers to move toward recognition as a patient centered medical home, improving the quality and coordination of care for health center patients.  These grants, totaling over $34 million, were awarded to over 900 community health centers nationwide, and will be instrumental in health centers achieving PCMH accreditation.   In the announcement, Secretary Sebelius said “[t]hese programs play a crucial role in the national effort to build high quality, comprehensive health care for those who need it most.  With these investments, health centers and other community-based organizations can expand on their efforts to ensure they are able to serve patients in their communities.”
Source: nachc.com

EUROPE TRADE: Emmerson leads select committee hearing

Sacramento bureau reporter Jim Miller contributes to the Political Empire blog. Miller covers the state Capitol with a focus on what it all means for Riverside and San Bernardino counties. When he’s not trying to understand Prop. 98, he enjoys books, baseball and banjo.
Source: pe.com

Who Can Issue Medicare Select Coverage?

Medicare Select is a managed health care system. If you have purchased a Medicare Select supplemental insurance policy, you have to use a hospital that is approved and on their list of approved health car providers. You can still use your own doctor but you have to use a hospital that is an approved provider of the Medicare Select program. The approved hospitals are local hospitals who have agreed to charge a designated sum as approved by the private insurance companies that underwrite private supplemental insurance to bridge the gap between Medicare and meeting qualifying deductibles, which means how much you have to pay before Medicare covers your health care.
Source: seniorcorps.org

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July 06, 2013

Comparison of Medicare Premium Support Proposals

Posted by:  :  Category: Medicare

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The brief compares the premium support provisions of these proposals, including how the level of premium support for beneficiaries would be determined; whether traditional Medicare would remain an option; what protections would be provided for low-income beneficiaries; and whether and how the proposals would cap federal spending on Medicare. These differences have important implications for Medicare beneficiaries, the federal budget, health care providers, and private health plans.
Source: kff.org

Video: Medicare Supplemental Insurance Comparison

Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

Many of the budget proposals and debt-reduction plans being considered by Congress and the Administration include proposals that would achieve substantial savings from the Medicare program over time. This brief features a side-by-side comparison of the key Medicare provisions in three major budget and debt-reduction plans:
Source: kff.org

Medicare Benefits and Cost

This fact sheet discusses Medicare cost-sharing requirements. Traditional fee-for-service Medicare imposes deductibles, coinsurance, and copays for Medicare services.  In addition, beneficiaries must pay premiums for receiving Part B (physician) and Part D (prescription drugs) coverage. Medicare does not cover certain essential services, such as vision, dental, and long-term care expenses, and beneficiaries must pay out-of-pocket for these services.  
Source: aarp.org

Retiree with No Technology Background Launches Medicare Supplemental Insurance Comparison Site

Here’s how plans for retirement used to go for most – work at the same job for several decades, build up social security and pension income, retire at 65 and dedicate time to improving canasta or golf skills. Maybe some people had other ideas, but suffice it to say, people view retirement much differently today than they did 20 years ago. Retired firefighter, Steven Pewter is a perfect example of this. At age 74, with absolutely no technology background, Pewter used a laptop computer he got as a birthday present to build a website for seniors to compare Medicare supplemental insurance plans, MedicareSupplementalInsuranceComparison.net. Pewter’s story supports the findings of a new survey from Del Webb – a leading builder of active-adult communities. It showed that almost 80 percent of boomers expect to work in some capacity, even after they retire, and not just for money. In fact, the majority, fifty-one percent, plan to work to avoid boredom and maintain a sense of purpose. “I come from working stock,” commented Pewter when asked about his motivation. “I certainly wasn’t going to just sit around and slowly fade to dust after retirement.” Pewter was driven to create the Medicare supplemental insurance comparison site after a frustrating personal experience shopping for supplemental coverage online. Hours and hours of research turned up only sites that required significant personal information before returning any valuable information on plans or rates. So, he decided to use his new computer skills to create a site that would give people detailed supplemental insurance coverage and rate information after entering just their zip code. The site gained almost instant popularity with 10,000 visits in the first week. By the end of the first month, 30,000 people had used the site to research Medicare supplemental insurance. And now nearly seven months later, the site continues to attract seniors, not just with its rate and plan comparison info, but with the dozens of articles, tutorials and how-to pieces it features that are updated regularly. Pewter’s family members comment that he has approached his new Internet endeavor with the gusto and enthusiasm of a man a third his age. “Well, it’s my kids and grandkids that keep me young,” Pewter said. “Knowing they’re so proud of what I accomplished with the site pushes me to keep at it.” About MedicareSupplementalInsuranceComparison.net MedicareSupplementalInsuranceComparison.net is a site for seniors to compare rate plan and coverage information for Medicare supplemental insurance. By entering just a zip code, visitors can retrieve detailed results from leading insurance providers in their area. And, the site is constantly updated with helpful articles and tutorials to guide people through the sometimes confusing world of Medicare. For more information, visit: http://www.medicaresupplementalinsurancecomparison.net
Source: sbwire.com

Comparison of Medicare Supplements and Private Medical Insurance

These figures show that individuals with private medical insurance actually are paying more money in total premiums than what an individual with Medicare actually pays. So, an individual is going to pay more for private coverage than what they would with Medicare. This is something important to consider when it comes down to standard coverage. Of course, Medicare does not cover everything and does not provide the same in-depth coverage insurance companies. Essentially, Medicare covers inpatient hospital care, nursing facilities, hospice care and other general requirements (in addition to some medication, if the individual is enrolled in the Medicare D plan). However, there are other services Medicare does not cover that health insurance does. This includes
Source: mizozo.com

Research Roundup: Comparing Medicare Budget Plans

JAMA Pediatrics: Nurse Staffing And NICU Infection Rates –Neonatal intensive care units (NICU) – which provide care for infants who are critically ill – are costly and require a significant amount of nursing services. Little is known, however, about the adequacy of nurse staffing at these units. Using data from 2008 and 2009, researchers analyzed the relationship between adherence to national staffing guidelines and hospitals-associated infections among very low birth-weight (VLBW) infants. “Our results document widespread understaffing relative to guidelines: one-third of NICU infants were understaffed… ,” the authors write. “In VLBW infants, NICU nurse understaffing relative to guidelines was associated with a sizable increase in infection risk.” They conclude that their findings “suggest that the most vulnerable hospitalized patients, unstable newborns require complex critical care, do not received recommended levels of nursing care. Even in some of the nation’s best NICUs, nurse staffing does not match guidelines” (Rogowski et al., 3/18).
Source: kaiserhealthnews.org

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

Retiree with No Technology Background Launches Medicare Supplemental Insurance Comparison Site

Africa Analysis awards Banking and Insurance business Commodities and Futures Corporate Social Responsibility CSI Dividends Earnings Economic News economy emerging markets entrepreneur facebook Finances Foreign exchange market forex Forex Education Trading Strategies forex trading Funds Google Health Insurance Investing Johannesburg Legal Issues meditation New Products & Services Newsletters Not For Profit PersonalFinance Personnel Announcements Polls and Research Public Safety Reuters Senior Citizens Socially Responsible Investing South Africa Surveys Trade Show travel Trends Uncategorized United States
Source: harounkola.com

Uwe E. Reinhardt: Comparing the Quality of Care in Medicare Options

Both traditional Medicare and Medicare Advantage plans are monitored annually through surveys of patients, using the Consumer Assessment of Health Care Providers and Systems, known in the trade as Cahps. The findings from this survey make it possible to compare traditional Medicare with Medicare Advantage plans on quality. As Medpac reports in Table 12-8 of Chapter 12 of the March 2012 report, the commission found little difference in the relatively few quality-performance scores of the traditional Medicare and Medicare Advantage plans.
Source: nytimes.com

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July 06, 2013

Augusta needs Medicaid expansion, and so does Georgia

Posted by:  :  Category: Medicare

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This idea that a 2% increase in our budget…and consequently an increase in OUR taxes…..is okay is the kind of thinking that is killing those of us who PAY the taxes. “Oh, it will create jobs” is always the answer but somehow it never does, and the welfare, SSI, food stamp, and Medicaid rolls keep growing because we keep offering them a better deal. Meanwhile the taxPAYERS are stuck with the 2% increase for this, and a 4.9% increase for that, and a sales tax increase for the roads, and, if you actually PAY you medical bills a 3% increase on your medical devices. This line of thinking that federal or state budget increases, more taxes, and more spending on give away programs are somehow good for the economy….good for the taxpayer…..is simply crap. Everyone, even the Democrats and the CBO, are already admitting that Obamacare is a BUST at controlling or lowering the cost of medical care. They already know that the federal government is not going to be able to afford even the 90% that they promised and many of the states know that they cannot afford the 10% and that the feds will most likely figure out how to get out of paying their 90%.
Source: augusta.com

Video: How to Apply for Georgia Medicaid and What Health Plans Are Available

Georgia's Medicare patient care stalls

The answer is obvious: the Medicare and Medicaid patients that no one else will see are already flooding into MCG, because MCG will not refuse to see them. Medicare payments were cut by 21% effective March 1, so MCG will be sucking up a 21% cut on every Medicare patient they see, and they will not be allowed to refuse care to anyone. Combined with the call for budget cuts from the Board of Regents, times do not bode well for MCG.
Source: augusta.com

Georgia offering Medicare info

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Source: augusta.com

Georgia’s New “Limited Medical” Law Shifts Costs to Medicare

After July 1, 2013, the amended Georgia Workers’ Compensation Act reducing the Employer/Insurer’s overall medical exposure insidiously shifts the responsibility (after 400 weeks) to Medicare in certain cases.   Prior to July 1, 2013, the WCMSA would be forced to contemplate future medical expenses for the life of the injured workers.  Now, the WCMSA analysis simply stops after 7.5 years of treatment from the date of accident in non-catastrophically designated claims.  Consequently, if the injured worker is a Medicare beneficiary, or there is a reasonable expectation he or she will be within 30 months, Medicare will likely bear the cost of the bulk of the injured workers’ future medical treatment.  For example, if an injured worker required a replacement of an artificial knee, this cost would likely be thrust upon Medicare.  This would also include diagnostic scans, films, and medication related to the Georgia work injury.
Source: ramoslawblog.com

Deal again says Georgia can’t afford Medicaid expansion

Members of the Georgia Chamber, Lieutenant Governor Cagle, Speaker Ralston, state legislators, elected officials, judges, justices, ladies and gentlemen: Let me begin by congratulating you. We have had one of the best years of economic development in quite some time. A few notable companies that have chosen Georgia include Baxter, General Motors, and Caterpillar, along with numerous others. We did this with your help, with both the private and the public sector doing their parts! Several weeks ago, the lieutenant governor, along with Sandra and I hosted a reception at the Governor’s Mansion to honor Georgia’s Olympic and Paralympic athletes who competed at the London Olympic Games. This was an outstanding group of young people of whom we are extremely proud. One of the men in the group was Aries Merritt, a native of Atlanta and a graduate of Wheeler High School in Marietta. Aries won an Olympic Gold Medal in the 110 meter hurdles. Unlike sprinters who travel in a straight line with no obstacles other than the lane markers assigned to them, hurdlers, as the name implies, must jump over obstacles that are placed in their path. Making analogies between sports and government is always risky, but I want to suggest to you that the business of governing our state is somewhat similar to running the hurdles. As governor, my goal is to see Georgia become the No. 1 state in the nation in which to do business. I have made that clear from the beginning, because I believe that is the best path to economic growth and the quickest way to get Georgians into jobs. And we are not all that far off from reaching our target: For two years in a row, we have ranked in the top five for business climate by Site Selection Magazine, and we ranked No. 3 for doing business in 2012 by Area Development Magazine. But we certainly still have some hurdles that we must overcome before we get there. This morning I will focus my remarks on one of the highest hurdles facing state government, that of healthcare. In Georgia, we have had many successes in the realm of healthcare. With rising healthcare costs, we have worked to keep Georgians healthy so that they can avoid some of these expenses rather than react to them when they become ill. We have launched the Georgia SHAPE program as a way to combat childhood obesity, a growing problem in our state. I proclaimed this past September “Georgia SHAPE Month,” during which we emphasized physical activity and proper nutrition for our state’s children. In its inaugural year, the Governor’s SHAPE Honor Roll had 39 schools achieve Gold Medal status for their dedicated work in making our state’s youth healthier. These healthier young people generally perform better in the classroom, and many will continue their healthy lifestyles into later years, making these programs an investment in the economic and cultural well being of our state. The State Health Benefit Plan just finished the first year of its Wellness Program – the largest such program in the country, with more than 245,000 enrollees. We would like to take the next step by growing and developing it; we want to see employees taking responsibility for their own health through preventative action … and receiving lower premiums as a reward. Even with all of these cost-saving approaches, it still costs approximately $10 million per day in claims to provide health benefits to active and retired employees and teachers. Those costs have and will increase because of Obamacare’s mandated benefits; in FY2014, the State Health Benefit Plan is projected to incur $106M of additional costs due to Obamacare. And because our State Health Benefit Plan is classified as a Self-Insured Plan, it is subject to the three-year Obamacare reinsurance tax. This means we would pay an additional $35M in 2015. Of course, even among the healthy, not all illness can be prevented; so last year, we grew graduate medical education by adding funding in the budget for the development of 400 new residency slots in hospitals throughout the state, helping keep Georgia’s doctors in Georgia. These are just a few of the great things we have going for us in healthcare. But we also face hurdles that we must overcome, like how to fund the state’s responsibility for Medicaid. Right now, the federal government pays a little under 66 cents for every dollar of Medicaid expenditure, leaving the state with the remaining 34 cents per dollar, which in 2012 amounted to $2.5B as the state share. For the past three years, hospitals have been contributing their part to help generate funds to pay for medical costs of the Medicaid program. Every dollar they have given has essentially resulted in two additional dollars from the federal government that in part can be used to increase Medicaid payments to the hospitals. But the time has come to determine whether they will continue their contribution through the provider fee. I have been informed that 10 to 14 hospitals will be faced with possible closure if the provider fee does not continue. These are hospitals that serve a large number of Medicaid patients. I propose giving the Department of Community Health board authority over the hospital provider fee, with the stipulation that reauthorization be required every four years by legislation. They have experience in this area, having had authority over a similar fee for the nursing home industry since around 2004. Of course, these fees are not new. In fact, we are one of 47 states that have either a nursing home or hospital provider fee – or both. It makes sense to me that, in Georgia, given the similarity of these two fees, we should house the authority and management of both of them under one roof for maximum efficiency and effectiveness. Sometimes it feels like when we have nearly conquered all of our hurdles, the federal government begins to place even more hurdles in our path. I am, of course, referring to the various mandates of Obamacare that put a strain on our state, its businesses and its citizens. As most of you are well aware, the United States Supreme Court upheld the individual mandate as a tax. Therefore, most Georgians, beginning in 2014, will be forced to get insurance coverage or else pay a minimum of $95 (and potentially far more) in penalties. So what does this mean for us? It means that Georgians must pay out dollars to either an insurance company or the federal government – whether they want to or not. But ultimately there still is a choice, albeit a rock-and-a-hard-place kind of choice. As more individuals enter the marketplace, younger, healthier Georgians might begin deciding they would rather pay the penalty than deal with the potentially much higher cost of coverage, causing the price of insurance for everyone to climb; this increase will drive even more healthy individuals out of the market, further swelling the cost. This potential cycle is one of the inherent flaws in the federal law. The employer mandate means that businesses with 50 or more employees must provide affordable health insurance to their workers or else pay the rather large penalties. Costs can increase here, as well, as the pool of insured becomes less healthy. These costs stand to hurt our state’s private sector. Because as all businessmen and women know, the higher your input costs, the lower your profits; the lower your profits, the less you operate, expand or employ. But whether it’s through fewer employees and less equipment purchases or higher costs, this mandate will negatively impact many of our state’s businesses and, of course, the would-be employees themselves. Georgians who have already received a paycheck this January have no doubt noticed that their payroll taxes went up and their take-home salary went down. This is the cost of entitlements. If you think your taxes went up a lot this month, just wait till we have to pay for “free health care.” Free never cost so much. The individual mandate has a second tier of impact involving Medicaid and its cost to the state. I have said clearly that Georgia will not expand Medicaid under the federal government’s guidelines. Even so, in Fiscal Years 2013 and 2014, Medicaid and SCHIP funding will be the second largest portion of the state funds budget with more than 13 cents of every dollar going straight to one of these programs. And with just the portions that our state must do, Obamacare is expected to add more than 100,000 new individuals to our Medicaid rolls and mandate other requirements, costing our state nearly $1.7B over the course of 10 years – and that’s on top of the $2.5 B we already pay annually. The reason: These Georgians qualify for Medicaid under the current system but have yet to enroll in it. With the individual mandate requiring either insurance or a hefty fee, they will likely think that Medicaid looks like a pretty good option. And since they fall under the current system, the state of Georgia and its taxpayers must pay the current rate of 34% and not the 0 to 10% rate proposed for the expanded population group. We constitutionally must balance our state budget – a wise requirement instituted by those who have come before us. This increase in costs to the state means we have to find that money somewhere in our already tight budget; we cannot simply create more. As such, I have instructed the Department of Community Health to reduce its budget by at least three percent in Amended Fiscal Year 2013 and by five percent in Fiscal Year 2014 – a difficult but necessary task. They have already identified $109M in cost-saving measures between the two years. But this hardly covers the additional nearly $500M in needed funds caused by growth in Medicaid expenses during the same time frame. That means we must make necessary cuts in other agencies and core functions of government since raising taxes is not an option I will accept! As I have indicated, I have rejected the Medicaid expansion in Georgia already, but let me emphasize that the expansion would have put our additional costs over 10 years closer to $4.5B – and that’s operating under the dubious assumption that the federal government, with its ever-growing national debt, would have fulfilled their promised share. The 620,000 new enrollees would have stretched our resources and our state to the limit. But whether the cost to our state would have been $2B, $4B or $6B, it does not make much sense to ask for more hurdles when you are already utilizing every muscle in your state’s body to overcome the ones you currently have before you and that you must face. So unless the federal government changes it to a block-grant program and allows Georgia to design the benefit plan, I cannot justify expanding Medicaid. The irony to me is that there are those in the medical community who are urging the expansion of the Medicaid program while at the same time, we are seeing more and more medical providers refusing to accept Medicaid patients. Their reason for doing so is that they claim the reimbursements for their services are below their costs. It is for that reason that the previously discussed provider fee is so important since that revenue is used to pay providers. If providers are already having difficulty covering their costs for care to Medicaid patients, how will they accommodate 34% more people on the Medicaid rolls? If you are losing money now, how do you reconcile the number of patients on whom you will lose even more money? Add to that the fact that the new enrollees would be higher on the economic scale, and some will be leaving their higher-paying, employer-provided health insurance plans to enter the taxpayer-funded Medicaid program with its lower reimbursements for the providers. If we have to depend on provider fees now to keep our reimbursements to Medicaid providers at a “tolerable” level, just imagine the pressure that will come when hospitals and doctors are losing more money on a larger portion of their patient base. Expansion of the Medicaid rolls does not solve the problem, it only exacerbates the one we already have. As many of you know, I also turned down the federal government’s offer to let us put our name on their insurance exchange program. I have no interest in seeing our state’s name, or its taxpayer dollars, used on something that we would have very little input in designing. If the purpose is to let those closest to and most knowledgeable about the population design the program, then we should be allowed to do so. It does not appear that is the pattern for the exchanges. I see no benefit to our citizens to have a program bearing the name of the State of Georgia over which our elected or appointed officials have little if any say so. While many federal programs come with strings attached, these strings turn states into marionettes to be manipulated by federal bureaucrats. If there is one thing we don’t need, it is another puppet show directed from Washington, D.C.! We cannot always determine what obstacles will be laid in front of us, but we can decide how we deal with them, and whether we approach them with anger, indifference or decisive action. The first two provide very little in productivity, but the latter offers opportunity to grow our state (and our businesses) in spite of newfound hurdles. Therefore, we must choose to work diligently. We must choose discernment over acquiescence, which is what I have aimed to do in my decision-making. And we must choose to confront these hurdles together, because discussion and determination, without bitterness, lead to the greatest forward progress. Despite all that is in front of us, we will still make Georgia the No. 1 state in which to do business. One last note: For those of you not attending in person, tune in tomorrow at 11 a.m. as I outline the rest of my plan for Georgia in this year’s State of the State Address, or go to my Twitter account, where my staff will be live Tweeting my remarks or at least the good parts.
Source: clatl.com

Georgia expected to spar over Medicaid expansion in election aftermath

The Centers for Medicare and Medicaid Services have told states that the first three years of expansion would be fully funded beginning in 2014, with the rate dropping to 90 percent by 2020. Robinson said that Geor­gia’s share, however, would be $4.5 billion over the next 10 years and that the state doesn’t have the money, nor does the federal government have the other $40 billion it would spend on expanding Georgia Medicaid.
Source: augusta.com

Georgia Printable Medicaid Application Forms 2013

Popular banks in the state of Georgia include PNC, SunTrust, Bank of America, Chase, Citi, Wells Fargo, First Citizens and others.  If you are truly struggling to find a bank in your local area please feel free to contact me.  Also, use Google Maps and the FDIC search tool as a way to find unique borrowing opportunities.  Google Maps has incorporated Google+ local reviews so potential borrowers will be able to see how other customers rate that particular financial institution.  This can be very important for anyone who has had to deal with bad customer service when it comes to money or finances.  Also recognize that banks are more than willing to reach out to new customers if you have done a good job of paying all your bills on time in the last several months and years.  If your credit score has increased you will likely find that borrowing money through a bank is not that difficult.
Source: wojdylofinance.com

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July 06, 2013

Medicare Advantage 2011 Data Spotlight: Plan Availability and Premiums

Posted by:  :  Category: Medicare

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This Medicare Advantage Data Spotlight provides an overview of recent changes made to the Medicare Advantage program and examines trends in plan participation, premiums and certain benefits. About 12 million people, or nearly a quarter of the Medicare population, are enrolled in Medicare Advantage, the privately administered plans that are an alternative to the traditional fee-for-service Medicare program.
Source: kff.org

Video: Improving Medicare in 2011

Medicare recipients in ‘donut hole’ to get price break on some drugs in 2011

“Regardless of what happens to the donut hole, the influx of the first wave of baby boomers will increase the demand for drugs and other medical services,” Moffit says. “All things being equal, that will mean increased costs for seniors and taxpayers alike.” According to the federal Centers for Medicare & Medicaid Services, your actual drug plan varies depending on what kind of prescriptions you buy, which plan you choose, whether you go to a pharmacy in your plan’s network, whether your drugs are on your plan’s formulary (list of approved drugs) and whether you belong to the Extra Help program. Extra Help is a Medicare program to help low-income people; it pays for Medicare prescription drug program costs, such as premiums, deductibles and coinsurance.
Source: insurancequotes.com

Year 2011 Medicare Supplemental Insurance Policy Coverage Changes

Should be it possible for the full coverage regulations to be good value? Take into mental this example even there is the particular family of give consideration to that engages about a travel present for a at least two week trip and so they end set up taking a scheme amounting to the particular hundred and 26 four thousand $ $ $ $ on a detailed travel insurance insurance option with provisions designed for accidental death then dismemberment, emergencies medical expenses, travel delays and cancellations, and lost collectibles. The normal top quality price range about such an an insurance policy policy will oven from two one hundred to two 100 and fifteen us for the person.
Source: flloecdelft.org

An Exhaustive (and Exhausting) Medicare Roundup for November 18, 2011 Including the Revalidation Call Transcript, 5010 Enforcement Delay, Medicare Sends Less Collection Letters and ICD

Today the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS) announced that it would not initiate enforcement action until March 31, 2012, with respect to any HIPAA covered entity that is not in compliance with the ASC X12 Version 5010 (Version 5010), NCPDP Telecom D.0 (NCPDP D.0) and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards. Notwithstanding OESS’ discretionary application of its enforcement authority, the compliance date for use of these new standards remains January 1, 2012 (small health plans have until January 1, 2013 to comply with NCPDP 3.0).
Source: managemypractice.com

16 Hospitals the OIG Has Tagged for Medicare Overpayments So Far in 2013

Note: The following information is based on the OIG’s hospital-specific Medicare compliance reviews from Jan. 1 through June 30, published on its website, and does not include other self-reported audits. The list only includes hospitals based in the United States. The list starts with hospitals most recently reviewed by the OIG.
Source: beckershospitalreview.com

2011 Medicare Trustees Report 

The HI Trust Fund is a victim of the economy.  Healthcare costs typically rise at a much faster rate than general inflation.  In 2010, healthcare costs rose almost four times faster than the consumer inflation rate.[3] In addition, the high unemployment rate means that fewer people are working and contributing payroll taxes into the Trust Fund.  Payroll tax contributions were also lower than anticipated because wages are not increasing. As a result, the Trustees had to change some of the assumptions they use about economic growth in projecting the solvency of the Trust Fund.   Note that the longest projected solvency period, 28 years, occurred in years in which the country experienced high economic growth and budget surpluses.
Source: medicareadvocacy.org

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July 06, 2013

Photo Scanner: VNS Choice

Posted by:  :  Category: Medicare

VNSNY CHOICE Medicare Enhanced (HMO) covers all of the services you receive under Original Medicare, plus your Medicare prescription drug coverage. VNSNY CHOICE also provides several terrific benefits, including a Care Manager who will assist you with all of the medical care you need and help you obtain other benefits and services for which you may be eligible. 
Source: blogspot.com

Video: VNSExtras.flv

 Health Care Insights

AARP * Aetna Inc * Alabama Insurance Department * American Specialty Health * Amerigroup Corporation * Ameri-Plus Select Services * Arcadian Health Plan & Management Services * Arnold & Porter * Balboa Nephrology Medical Group * Barclays Capital * BCBS of Minnesota * Blue Cross Blue Shield of Tennessee * Boehringer Ingelheim * California Association of Physicians Group * Capital District Physicians Health Plan * Care 1st Health Plan * Care N Care Health Plan * Caremore * Clarian Health Plans * DCA Solutions * DCIPA * Deft Research * Dendreon Corporation * Dial America * DMW Direct * Dynamic Healthcare Systems * Endo Pharmaceuticals * Essence Health Care * Essex Woodland * Express Scripts Inc * Family Health Plans * Firstsource * Forest Laboratories Inc * Fresenius Medical Care * Geisinger Health Systems * GemCare Health Plan * Gorman Health Group * Group Health Cooperative * Health Alliance Medical Plans * Health Data Essentials * Healthcare Partners * HealthMetrix Research Inc * HealthNet Government Programs * HealthPlan CRM * HealthSpring * Healthways Inc * Henry Ford Health System * HMS Permedion * Humana * Independence Blue Cross * Inspiris * Inter Valley Health Plan * Kaiser Foundation Health Plan of Colorado * Kaiser Permanente * Leprechaun * Marketing Direct Inc * Matrix Medical Network * Medagate Corporation * MedAssurant * MVP Health Care * North Texas Specialty Physicians * Old Surety Life Insurance Company * Oliver Wyman Actuarial Consulting * Peak Health Solutions * PopHealthMan * Preferred Care Partners * Quest Diagnostics * SCAN Health Plan Arizona * Sharp Health Plan * Silverlink Communications * South Shore * Sterling Life Insurance Company * Texas HealthSpring * The Bright Sight Group * The Harry Walker Agency * The Kaiser Family Foundation * The National Advisory Board on Improving Health Care Services for Seniors and People with Sisabilities* The Permanente Federation * Thoroughbred Research Group * TMG Health * TriZetto Group * Tucson Medical Centre * UMWA Health & Retirement Funds * United American * United Community Health Plans * United Health Care * Univita Health * UPMC Health Plan Inc * Varis * Visiting Nurse Service of New York * VNS Choice Medicare * Wilen Direct
Source: blogspot.com

Medical Assistant Sentenced to 36 Months in Prison for His Role in a Fraudulent Home Health Scheme : FERS

Ross, 51, pleaded guilty in July 2010 to one count of conspiracy to commit health care fraud.  According to court documents, Ross received kickbacks from the owners and/or operators of two Detroit-area home health agencies, Patient Choice Home Healthcare Inc. and All American Home Care Inc., in exchange for referring home health patients to those entities.   Ross admitted to receiving $500 per patient, paid either by check or in cash, in exchange for providing co-conspirator Mohammed Shahab with Medicare beneficiary information for various patients he recruited.    After paying the kickbacks to Ross, Shahab, an owner of Patient Choice and All-American, billed Medicare for home health visits purportedly made to the beneficiaries recruited by Ross.   Ross referred 21 patients to Patient Choice and All American.   During the time Ross participated in the scheme, Patient Choice and All American submitted claims for $172,573 in improper benefits.  Shahab pleaded guilty in February 2010 to health care fraud charges in connection with this case.
Source: dehaanbusse.com

Occupational Therapist Full time at Visiting Nurse Service of New York (Manhattan, NY) Job

Manhattan, NY Job ID: 23726 Company Description Visiting Nurse Service of New York (VNSNY) is the nations largest not-for-profit community-based health system. VNSNY provides a comprehensive array of home- and community-based programs,… View Full Job Description
Source: healthjobsnow.com

Clinical Evaluation Manager

We deliver professional and paraprofessional services throughout all five boroughs of New York City and Nassau and Westchester counties.The VNS CHOICE Medicare program provides full coverage to individuals with Medicare and Medicaid for hospital stays, physicians, ancillary services and care coordination – enabling access to high-quality, cost-effective medical care for New York City’s residents.
Source: findmeajobx.com

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