Come Talk With Congresswoman Shea

Posted by:  :  Category: Medicare

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WHY: Today we are faced with one of most serious assaults on Medicare and Social Security since the program began. Together Granite Staters can ensure these programs are around today and for future generations. During the forum members of the National Committee to Preserve Social Security and Medicare will present the Congresswoman with over 400 petition signatures calling on her to protect benefits Granite Staters have worked for, paid for and earned; the petition also calls on Congress to oppose privatization and other proposals that threaten retirement and health security.
Source: nhlabornews.com

Video: Romney, Ryan defend Medicare plan with NH voters

NH Hospital Keeps Medicare Funding Despite Outbreak

Thousands of patients in Arizona, Georgia, Kansas, Maryland, Michigan, New York and Pennsylvania have since been tested for hepatitis C, a blood-borne viral infection that can cause liver disease and chronic health issues. In addition to the New Hampshire patients, a handful of patients in Kansas and one in Maryland have been found to carry the strain Kwiatkowski carries.
Source: cbslocal.com

Campaigning in New Hampshire, Obama ramps up attacks over Medicare, taxes

Complicating the argument for Republicans has been the vague nature of their plans for both Medicare and taxes. Romney has endorsed Ryan’s most recent budget, for instance, but more recently has backed away from it, saying he’ll offer his own plan sometime in the future. Also, while Ryan’s budget repeals most of the Democrats’ healthcare reforms, it keeps the more than $700 billion in Medicare cuts – the same cuts the Republicans are warning will devastate the program.
Source: thehill.com

Alexander, Corker Introduce Bill To Protect Tennessee Medicare Recipients Needing Medical Equipment @ CRE Interactive Public Docket on CMS Competitive Bidding Rule

Posted by:  :  Category: Medicare

On May 21, Senators Alexander and Corker, along with Representatives Marsha Blackburn (R-Brentwood), Phil Roe (R-Johnson City), John J. Duncan, Jr. (R-Knoxville), Chuck Fleischmann (R- Ooltewah), Scott DesJarlais, (R-Jasper), Jim Cooper (D-Nashville), Diane Black (R-Gallatin), and Steve Cohen (D-Memphis) sent a letter to CMS requesting details on its policy of awarding Medicare contracts for durable medical equipment to businesses not licensed in Tennessee, a violation of the administration’s bid policy and a violation of Tennessee state law. Durable medical equipment includes products that are intended for at-home care of sick or injured individuals. The category includes wheelchairs, crutches, blood pressure monitors, and hospital beds.
Source: thecre.com

Video: 2013 Medicare Plans in Tennessee – TN Medicare Supplements and Advantage Plans

Find Pharmacist Jobs in Tennessee: Director of Quality Standards vacancy at Corporate Main Campus in Nashville

More complete informations about this vacancy opportunity kindly read the description below. To provide consultation and education to HCA facilities regarding clinical performance improvement and foundational standards of operational compliance inclu! ding the Joint Commission/AAAHC, Centers for Medicare and Medicaid Services (CMS), and other health care standard setting and enforcement entities. Manager is a role of knowledge building towards responsibility for surveys for HCA Quality Review System as a Director, Quality Standards. General Responsibilities: Travel to provide onsite expert consultation and survey for HCA Quality Review System to HCA hospital and ASC Administrator/Chief Executive Officers, Chief Nursing Officers and other hospital/ASC, Board of Trustee and medical staff leaders regarding clinical performance improvement and foundational operational standards requiring facility compliance. Role is critical to HCA strategy of Quality and Patient Safety as a differentiator of hospital and ambulatory surgery center operational performance. Role complements and provides guidance to Division Vice President, Quality or Director, Quality and Risk Management. Individual serves as the c! onsultant to hospital and ASC clinical performance improvement! . Position requires expertise to guide hospital/ASC quality and risk directors in their position requirements and to counsel CEO/Administrator, CNO, COO, medical staff and board leaders in continuous patient care improvement in a foundationally compliant manner. With increasing quality agenda, this position is critical to HCA mission and strategies. Position requires training with senior department member for training and assurance of knowledge acceptable a level of director. Incumbent travels and provides consultation but always with a Senior Director or AVP until expert knowledge is demonstrated. To design and present educational programs for HCA hospital/ASC and medical staff leaders regarding requirements of clinical performance improvement for operational compliance to public reporting including the hospital quality alliance, external quality agencies including the Joint Commission/AAAHC, CMS, State Survey agencies, etc. To conduct onsite ass! essments of focused topics within HCA hospitals/ASCs including credentialing, utilization management, peer review, medical staff and board bylaws, etc. Position demands a total command of clinical performance improvement, standards, regulations and conditions of participation. Position is critical to advancement of HCA facility delivery of safe, effective, efficient, compassionate and satisfying patient care as defined by the HCA Clinical Improvement Strategies. Qualifications 3-7 years of Hospital department manager experience and success College Degree Required Registered Nurse, Registered Pharmacist, Registered or Accredited Health information administrator Consulting and educational program delivery skills and expertise Computer knowledge and competency for presentation design and report delivery Expert speaking and presentation skills and competency Must be a team participant focused towar! d HCA clinical improvement strategies Long term position commi! tment required 80% Travel Required – . If you were eligible to this vacancy, please give us your resume, with salary requirements and a resume to Corporate Main Campus.
Source: blogspot.com

Medicare agrees to cover TMS treatment for depression in TN, GA, AL

“TMS will now be available to more patients, giving them the hope of living a life free of depression,” said Burton Hills-based Dr. Scott West, who was the first local psychiatrist to acquire the TMS machine, a space-age contraption that looks similar to a dentist’s chair. West has been using TMS to treat patients since 2010. (See our September magazine story here.)
Source: nashvillepost.com

TN Rep Roe: I'm on Medicare. Repeal Congress' Health Care and ObamaCare

It was amazing and surreal all the way around. Mark Meckler, Tea Party Whore Extraordinaire, was on claiming that the “American People” supported repeal on a 2:1 basis. Adam Green of Bold Progressives did a great job challenging Phil Roe to allow them to conduct a poll of progressive versus conservative ideas, which I think Roe agreed to. Green also corrected Meckler’s misstatement about people’s attitude toward the health care bill, pointing out that most people think it didn’t go far enough.
Source: crooksandliars.com

C peptide test and Medicare

If I recall correctly, the c-peptide reading is a one shot deal whereas the high BG can be over time. I remember submitting a history of all my BG test results over a six or twelve month period to illustrate the high BG readings and number of times a day I tested. They (CCS Medical – a Medtronics Medicare sub contractor) were looking for an average of about 5 tests per day. I submitted mine on an X-cell spread sheet – no verification was required. If this is the case, run a past history with high readings and start closely monitoring your BGs and inject as often as necessary to keep your BGs under tight control a few weeks prior to your test
Source: diabetesdaily.com

Forward Motion: The Affordable Care Act’s Big Changes to Medicare

The Part D low-income subsidy provides vital help with out-of-pocket prescription drug costs to Medicare beneficiaries with limited incomes, including full coverage of their Part D premium. However, there are several problems with the program. The plans that are available, and what they charge in premiums, vary from year to year, which makes it difficult for beneficiaries to maintain stable coverage. The changes in plans can be drastic, and new plans often have different coverage rules than the old ones. The frequent changes in coverage disrupt the continuity of care for these beneficiaries, and often those who stay in plans that no longer qualify for a full premium subsidy may incur out-of-pocket premium costs they cannot afford [6].
Source: tnjustice.org

CIGNA PFFS MEDICARE Plans ???

Posted by:  :  Category: Medicare

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CIGNA has some good plans in some counties in Upstate, NY area……..I completed the CIGNA certification,,,and would like to sell there plans however trying to get enrollment materials for 2009 is not possable…ALL log- ins do not work……..My FMO can not even get through their VERY bad customer service for agents….CIGNA does NOT have a agent service 800 number…….when you call they say call your FMO………NO BROKER service at all…Has anyone had this or any other expericense with CIGNA…any ideas on how to get enrollment materials?? or a secret phone number to call……Right now if they can not service me how are they going to service my clients????……..Any one out their deal with CIGNA MEDICARE before?? Mike King Rochester, NY
Source: insurance-forums.net

Video: Medicare Advantage Plan PFFS (Private Fee For Service)

Fewer Medicare Advantage Plans for Seniors

In the ongoing legislative tussle over how to trim the Medicare program to help pay for a health care overhaul, the Senate recently voted down an amendment by Senator Orrin G. Hatch, Republican of Utah, that would have blocked planned cuts to the subsidies that private insurers receive under the Medicare Advantage program. The extra money, 14 percent more per beneficiary on average than the government pays for seniors in traditional Medicare, has been targeted by the Democratic leadership and the White House as a giveaway to insurance companies that unfairly raises premiums for all Medicare beneficiaries.
Source: nytimes.com

Cigna Cancels Medicare PFFS plans for 2011

This may be the first of many announcements from Medicare Advantage providers that they will not renew plans for 2011. New rules requiring companies to establish a provider network will prompt plans in all but a few counties to eliminate PFFS plans in 2011. 
Source: mysenioradvisorsgroup.com

Medicare Advantage Plans and PFFS Plans

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Source: merchantcircle.com

Carriers Dumping Medicare Advantage Private Fee

Medicare Advantage plans are specific types of Medicare plans that are in place to cover the cost of healthcare related expenses for Medicare participants. These plans are similar to traditional Medicare plans in that they provide financial support for individuals seeking medical or health-related services. However, Medicare Advantage plans generally have more benefits and lower copayments than other types of Medicare plans. In order to have a Medicare Advantage plan, Medicare participants need to have Medicare Part A and Medicare Part B plans.
Source: medicaidbuyin.org

CIGNA Will Drop PFFS Plan In Arizona For 2011

The change is not entirely unexpected. On February 1, CIGNA announced that it would close its PFFS plans to prospective enrollees who are already receiving Medicare benefits under another plan during the OEP. Despite the fact that the PFFS plan provides Medicare health services to more than 100,000 enrollees and the PFFS plans have experienced significant enrollment growth in the past three years, CIGNA indicated again in May that it was considering a move away from the PFFS business.
Source: azmedicare.info

Medicare Advantage PFFS Plans Slowy Disappearing

A new MIPPA law in 2008 required PFFS plans to start having a network in most counties starting in 2011.  The few counties that were excluded were typically rural counties.  This forced the PFFS plans to either drop their plan or go out and create a network.  The result was the PFFS plans being dropped for the most part.  You will be able to find some PFFS plans still in 2011, and there will be some in 2012 as well.  As stated before though, they are few and far between now.  Some Medicare beneficiaries will see this as an improvement since they will be able to use a directory to look up a doctor.
Source: medicare-plans.net

Understanding Medicare Private Fee

1031 exchange real estate investment asset protection Asset Protection Planning assisted living facilities business tax Capital gains tax collection corporate tax durable power of attorney elder law elderlaw Elderlaw/Law For Life Estate Planning income tax internal revenue code Internal Revenue Service IRS IRS and state tax collections Jill E. Sugarman Jill Sugarman lien Long-term care long-term care insurance Massachusetts mclaughlin & quinn Medicaid Medicaid planning Moore McLaughlin nurses nursing homes Providence real estate Rhode Island Rhode Island Division of Taxation sales tax seniors Small Business Act Small Business Jobs Act Small Business Jobs Act of 2010 social security state taxes tax Tax planning Thomas P. Quinn veterans
Source: mclaughlinquinn.com

Comparison of Medicare Supplements and Private Medical Insurance

Posted by:  :  Category: Medicare

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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

Video: Medicare Supplements vs. Medicare Advantage – Understanding Medicare Supplements

Comparing Medicare Supplemental Insurance Benefits

These plans, called “Medigap” plans, each have different medical care coverage. Variable benefits of coverage to be considered are: • Coinsurance plus coverage that last 365 days after medicare benefits end (Medicare Part A) • Coinsurance/Copayment for medicare part B. • Pints of blood (transfusions, first three pints) • Hospice care copayments or coinsurance • Coinsurance for Skilled Nursing Facilities • Part A medicare deductible • Part B medicare deductible • Part B excess charges • Emergencies during foreign travel • Preventative care coinsurance, per Medicare Part B If any of these are important for you to have covered, comparing medicare supplemental plans that include benefits is the only way to ensure they are included.
Source: seniorcorps.org

How To Compare The Different Medicare Supplement Plans

1990, Medicare standardized their different plans in order to decrease the amount of confusion that consumers were experiencing as they compared different coverages offered by the different healthcare insurance providers. As a result of this standardization, it is easier for the consumer to understand the comparison of these different benefits and the associated cost comparisons between healthcare insurance providers. As a result, the terms “MediGap plans” and “Medicare supplement” basically mean the same thing and are commonly used interchangeably. As a result of having so many Medicare plans to choose from, it is important to research each one in order to decide which will be best for your personal needs and situation. One of the first things to be aware of when searching for supplement plans and comparing the ones you find is that many websites who advertise these are only there for one reason and that is to collect your personal information. In many cases, insurance providers will purchase leads or develop lead generators to accomplish this instead of actually doing what they advertise. Basically, these companies don’t know the proper ways of developing new business so they resort to these somewhat underhanded methods. Many of these companies make it appear as though they actually sell the different Medicare supplement plans but the reality is that they will collect your personal information and sell it to numerous insurance agents. Here are two ways that you can tell if they are legitimate healthcare insurance and Medicare supplement plan providers. First of all, there will be a toll-free number to call and secondly, there will be a statement promising that they will never sell your personal information to anyone else. Do price comparisons of these different Medicare plans when searching through the different companies that offer them. The better insurance brokers will be able to provide you with these comparisons from those insurance providers operating in your local area. In most cases the prices will differ despite the fact that the supplement plans they offer are identical. Remember, it is better to do plenty of research in order to make a well-informed decision when purchasing the Medicare supplement plan that is right for you.
Source: blogspot.com

Baby Boomers are Purchasing Medicare Supplement Insurance over the Phone

“It really is the best way to purchase Medicare Supplement Insurance, our agents only specialize in Medicare, our agents represent all of the top A+ rated insurance companies, and NO PAPERWORK”, Robert Bache aka “MedicareBob”.
Source: srhealthcaredirect.com

Medicare Supplemental Insurance A Quick Buyers GuidePopular Insurance Ezine

Medicare insurance Supplemental Insurance coverage is relatively clear to see in comparison to other kinds of insurance. Although it might appear overwhelming in the beginning, Medicare insurance Supplement Plans happen to be standardized through the Center for Medicare insurance Services, making the purchasing process simplified in comparison to car insurance, or individual medical health insurance. Basically Medicare insurance claims what benefits you are able to and cant buy since you must choose a pre-packed plan. Although this makes the purchasing process simpler, you will find still several things to consider including the organization that you get your plan from, just how much you have to pay, and also the method that you buy.
Source: popularinsuranceezine.com

Medicare Supplement Plan F

Medicare Supplemental Plan F is the most popular supplemental plan because it provides the most robust coverage, and the premiums are not much higher when the benefits are compared to the plans offering less coverage. A patient with Plan F can in many situations pay nothing additional out of pocket for doctor and hospital services. People eligible for a Medicare Supplemental Plan should compare the benefits and premiums of the plans and purchase the best coverage they can afford. For many patients, that is Plan F.
Source: wastedenergy.net

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July 11, 2013

Ask The Experts: Retirement

Posted by:  :  Category: Medicare

Q. My father retired from the federal government in 1976. For whatever reason, he does not have Medicare Part A. My mother recently suffered a stroke, and because my dad did not have Medicare Part A, rehab at a nursing facility will not be covered. Apparently federal workers did not pay into the Social Security system back then and therefore have had to pay separately for Part A. It took hours of calls to SSA, OPM and Medicare to unravel this bureaucratic mess! BCBS (federal) is his secondary insurance and would not pay because Medicare A is primary.
Source: federaltimes.com

Video: Excellus BCBS Medicare What does Medicare cover

Cool BCBS Medicare pictures

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Source: wwwroguevalleymedicinals.com

CareFirst BCBS’s Medicare plan gets high ranking from CMS

The ranking is for Medi-CareFirst’s BlueRx standard and enhanced prescription drug plans (Part D), and is an improvement over last year’s 4-star ranking. The CMS Medicare program each year rates all health and prescription drug plans in four categories, with ratings of up to five stars.
Source: ifawebnews.com

Blue Shield Insurance: Cost Blue Cross Blue Shield Insurance

TASC’s innovative Claim ConneX feature has expanded its reach again by adding this carrier.Madison, Wisconsin (PRWEB) November 18, 2012 TASC, a national leader in employee benefit plans administration has established a claim feed connections with Physicians Plus of Richardson, Texas. Every week more and more insurance carriers are getting on board with DirectPay’s great Claim ConneX option
Source: blogspot.com

AZ Agent to Write BCBS Medicare PPO

I have lead for an agent contracted and certified with BCBS in Arizona to write a Medicare PPO on a 55 year old new to Medicare as of 8/1. He’s contacted his doctors who all say they accept the plan but I’m not certain if they mean in or out of network. Send me an email (address below) if you’d like to help. And unlike many of the posters here, I’m not selling the lead, just want to take care of a client. Also, I have a website I don’t want to use: www.medicareplansarizona.com. Happy to sell it. Rick
Source: insurance-forums.net

Excellus BCBS holding free Medicare planning meetings for Kodak retirees

Kodak retirees who will lose their health care benefits by the end of this year can ask questions and get answers from Excellus BlueCross Blue Shield Wednesday. Excellus is offering free Medicare planning seminars. The first one is at 9:30 a.m. at the Wishing Well on Chili Avenue in Chili. Click here for dates of additional seminars.
Source: whec.com

Blue Cross Blue Shield of Texas Medicare Supplement Plan

Medicare Supplement Insurance in Texas, like all other traditional forms of coverage does have rate increases and I dislike them as much as you do. BCBS seems to have some of the most stable rates in the industry, where some carriers have pounded the rates some 10 and 12% these guys have not exhibited that type of behavior. They actually experienced a rate decrease this last October which was a pleasant surprise to most seniors. Of course there is no way of knowing what may or may not happen from one year to the next so yes, they could raise rates soon, but so far so good.
Source: medicareinsurancetexas.com

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July 11, 2013

Current Medicaid Patients Will Miss Out on Better Preventive Care In 2014

Posted by:  :  Category: Medicare

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In fact, the researchers found that many Medicaid rules contained confusing language indicating that coverage of any procedure, including preventive testing and counseling, would be denied without proof of “medical necessity.” By definition, the authors explain that preventive services cannot be described as medically necessary because they are intended for patients who are not yet showing symptoms of the diseases they are intended to detect.
Source: kaiserhealthnews.org

Video: Medicare – Part 1

Republicans doubt Palin will actually run for Senate

Republicans surveyed by TheDC about a potential Palin candidacy mentioned several other factors that would keep her out of the race, including poor poll numbers and the fact that she turned voters off by resigning as governor. Both Republican and Democratic-affiliated pollsters have indicated in polls this year that her unfavorables in the state hover at 60 percent.
Source: dailycaller.com

Medicare patients are the focus of Alaska medical clinic

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

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July 11, 2013

Georgia BCBS Medicare Supplement

Posted by:  :  Category: Medicare

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:   In which state is Miami Beach ? I agree to forum rules 
Source: insurance-forums.net

Video: Excellus BCBS Medicare plan travels with you

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

CareFirst BCBS’s Medicare plan gets high ranking from CMS

The ranking is for Medi-CareFirst’s BlueRx standard and enhanced prescription drug plans (Part D), and is an improvement over last year’s 4-star ranking. The CMS Medicare program each year rates all health and prescription drug plans in four categories, with ratings of up to five stars.
Source: ifawebnews.com

Blue Shield Insurance: Bluecross Blue Shield Insurance Plans

Anthem insurance Companies, inc. Blue Medicare access X anthem insurance • Blue Cross and Blue Shield of nebraska • BlueCross BlueShield of north 2009 Medicare Advantage Plans Offered by Blue Cross and Blue Shield Plans 2009 Standalone Prescription Drug Plans(continued) Offered by Blue Cross
Source: blogspot.com

Blue Cross Blue Shield of Michigan Offers New Medicare Plans

HMO’s (health maintenance Organizations) let you select a primary care physician from the BCBS provider network and this PCP manages your overall care. He or she will refer you to a specialist or to a selected hospital for care should you need additional services beyond his scope of practice. Referring yourself to an outside provider will cause a forfeit of benefits and out-of-pocket costs. The four BCBSM HMO products, formerly known as Options 1, 2, and 3, will now be known as BCN Advantage Elements, Classic , and Prestige. The Blues Care Network will also continue to offer the BCN Advantage Basic Plan.
Source: emaxhealth.com

Excellus BCBS holding free Medicare planning meetings for Kodak retirees

Kodak retirees who will lose their health care benefits by the end of this year can ask questions and get answers from Excellus BlueCross Blue Shield Wednesday. Excellus is offering free Medicare planning seminars. The first one is at 9:30 a.m. at the Wishing Well on Chili Avenue in Chili. Click here for dates of additional seminars.
Source: whec.com

BCBS Medicare Advantage Plans

I would just cut your losses. Sitting around waiting for med advantage commish will destroy your focus. If it comes, then it comes. I would recommend never, ever selling that junk again and moving on. Sell a real insurance policy. If you don’t cut it off in your mind it will kill your focus, your sanity, and ultimately your business. There is nothing more insane then waiting to get paid by the govt’. Fool me once…
Source: insurance-forums.net

Anthem Blue Cross Blue Shield Medicare Supplement Plans Are Affordable…

Based in beautiful Jackson Hole, Wyoming, we currently market health insurance in 18 different states from our website IndividualHealth.com. I have worked in the domestic and international markets for most of my adult life. Recently we launched a newly revamped website www.tetonmarketing.com which has a primary focus on music and Native American Flutes and hand crafted items made in Wyoming. Check it out! I want the Insurance Simplified Blog to be a place you can visit from time to time and read about real world issues that individuals and families face daily. Our parent website IndividualHealth.com we like to think of as a virtual brochure. But with the blog I want to talk about the topics behind the brochure. Also check out our blog www.JacksonHoleTim.com which is “All Things Wyoming, Everything Jackson Hole” . If you love the Yellowstone basin this is blog for you! Then when you are ready check out our new Social Network site Jacksonholetim.ning.com – this is a place you can connect with other who visit and live in Wyoming. And finally we have just launched another new blog. Jackson Hole Tim (www.jacksonholetim.com) is a new place to visit that talks about “All things Wyoming, Everything Jackson Hole”. I hope you find these blog helpful.
Source: wordpress.com

Newsroom – Blue Cross Blue Shield of Michigan broadens Medicare options with new Medicare Advantage PPO product

October 1 is the first day BCBSM and Medicare Advantage carriers across the nation can market their Medicare Advantage products for 2010. Beneficiaries in BCBSM Medicare Advantage products will receive letters in the next 10 days about the new product line-up. "Blue Cross remains fully committed to providing products to Medicare beneficiaries and will continue to have the broadest array of Medicare Advantage products in the state," said Mark Owen, BCBSM vice president for federal and individual business. "It’s important for Medicare beneficiaries to know that there is no immediate change to their coverage. They have until the end of the year to make their selection for 2010." In addition to the three BCBSM products for 2010, seniors also can select from three Medicare Advantage products offered by Blue Care Network, the BCBSM-affiliated HMO. "We will be working with insurance agents and other groups across the state to reach out to Medicare beneficiaries to help them navigate these product and premium changes," said Owen. Seniors who meet low income guidelines can receive subsidies from the state and/or federal government to pay for all or part of their premiums. Medicare Advantage premiums vary by product and region. The new PPO product is expected to provide beneficiaries with value for their premium. For example, the BCBSM Medicare Plus Blue PPO, which includes Part D prescription drug coverage, will cost between $61 and $141 a month (premiums vary by geographic region), while traditional BCBSM Medicare Supplemental (Medigap) Plan C plans cost $183 when combined with a stand-alone Part D BCBSM prescription drug program. Medicare Advantage plans offer Medicare benefits through private health insurance plans and most include Part D prescription drug coverage. When you purchase a Medicare Advantage plan, you do not need to also purchase a Medigap policy. Medicare Advantage plans are regulated solely by the federal government, while Medigap plans are regulated by the state. The announced product changes are only for Medicare beneficiaries who directly purchase their Medicare Advantage products, not for beneficiaries enrolled in a group plan. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Source: bcbsm.com

Blue Cross Blue Shield of Texas Medicare Supplement Plan

Medicare Supplement Insurance in Texas, like all other traditional forms of coverage does have rate increases and I dislike them as much as you do. BCBS seems to have some of the most stable rates in the industry, where some carriers have pounded the rates some 10 and 12% these guys have not exhibited that type of behavior. They actually experienced a rate decrease this last October which was a pleasant surprise to most seniors. Of course there is no way of knowing what may or may not happen from one year to the next so yes, they could raise rates soon, but so far so good.
Source: medicareinsurancetexas.com

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July 11, 2013

Current Medicaid Patients Will Miss Out on Better Preventive Care In 2014

Posted by:  :  Category: Medicare

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In fact, the researchers found that many Medicaid rules contained confusing language indicating that coverage of any procedure, including preventive testing and counseling, would be denied without proof of “medical necessity.” By definition, the authors explain that preventive services cannot be described as medically necessary because they are intended for patients who are not yet showing symptoms of the diseases they are intended to detect.
Source: kaiserhealthnews.org

Video: 7 Accused of Bilking $375M From Medicare

Texas Makes Changes to Medicaid Laws and Programs

Another bill, S.B. 1803, amends the Texas Government Code to meet federal requirements allowing the state to continue receiving matching funds from the federal government for the state’s Medicaid program. Among other provisions, the bill requires the Texas Medicaid program’s Office of Inspector General to conduct preliminary investigations of any complaint of Medicaid fraud or abuse, mandates referrals of fraud to the Texas Medicaid Fraud Control Unit or other law enforcement entities, and requires the Medicaid program to impose a payment hold on claims for reimbursement when credible allegations of fraud exist.
Source: jdsupra.com

Texas Steps Up Efforts to Fight Medicaid and Medicare Fraud

Broden & Mickelsen have represented numerous healthcare professionals charged with Medicare and Medicaid fraud in federal courts throughout the United States. Clint Broden recently won an appeal in a Medicare/Medicaid fraud case in the United States Court of Appeals for the Fifth Circuit and Mick Mickelsen recently persuaded prosecutors in the Southern District of Mississippi to dismiss all charges in a federal Medicare/Medicaid fraud case after taking over the case from another attorney.
Source: brodenmickelsen.com

Harris County Texas Medicare Supplement Quotes

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

Texas man sentenced for Medicare scam

Prosecutors say Kimble operated four ambulance companies in the Houston area from 2008 to 2010. He routinely billed the federal Medicare program for ambulance transports that were not provided, not needed or not ordered by a treating physician.
Source: ems1.com

MedicareBob’s Blog: Aflac is now offering Texas Medicare Supplement Insurance

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

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

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

Possible Medicare Supplement Offers In Texas

Overall, no herbs or else supplements have effortlessly been shown for better than prescribed meds in combating heart attacks. And the absolute best prevention is brought on by diet and exercise, which is doubly good as many herb or supplement, or prescription pharmaceutical for that substances. If you are suffering from stroking disturbance heart disease, you are necessary to consume largemouth bass oils. In this particular type of aerobic condition, you may go through an array related with things, such given that palpitation, flutter, so fibrillation.
Source: raisonsdagir.org

Texas governor reiterates opposition to Medicaid expansion

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

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July 11, 2013

Preserving Medicare for Future Generations: Market

Posted by:  :  Category: Medicare

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America’s fee-for-service Medicare program represents the third-largest category of federal spending and has been under scrutiny for decades for spending more on health care benefits for enrollees than taxes can generate to pay for them. The CBO estimates that over the next 10 years, the number of Medicare enrollees will increase by one-third—approaching 67 million Americans.
Source: rwjf.org

Video: Does the Original Medicare Plan Pay for Mental Health Care?

Eastern Group Publications

The Ortiz family doesn’t remember the exact date it first went up, but matriarch Hermila Esparza Ortiz recalls her son didn’t ask permission to begin an elaborate mural located on the southern wall of their factory in East Los Angeles. A few years ago, she and her late husband,… [Read more…]
Source: egpnews.com

Examples of Taxpayers Facing Medicare Tax Increase under Health Care Bill

The health care bill passed by the House of Represenatives on Sunday (Senate bill plus reconciliation) includes, among many other tax increases, two tax hikes on high-income taxpayers set to go into effect in 2013. One of the increases is a higher employee Medicare tax on wages earned above $250,000 (married; $200,000 for singles). The other tax hike is a 3.8 percent Medicare tax on investment income earned by couples earning more than $250,000 in modified adjusted gross income ($200,000 for singles). Investment income includes such sources as rental income, dividend income, interest income, income from trusts, and most capital gains.
Source: taxfoundation.org

The Cost of Privatization: Extra Payments to Medicare Advantage Plans

The Medicare Modernization Act of 2003 sharply increased payments to private Medicare Advantage plans. As a result, every plan in every county in the nation was paid more in 2005 than its enrollees would have been expected to cost if they had been enrolled in traditional fee-for-service Medicare. The authors calculate that payments to Medicare Advantage plans averaged 12.4 percent more than costs in traditional Medicare during 2005: a total of more than $5.2 billion, or $922 for each of the 5.6 million Medicare enrollees in managed care. This issue brief updates an earlier analysis of Medicare Advantage payments in 2005 previously published by The Commonwealth Fund; the updated estimates in this report are based on final 2005 enrollment figures that were not available at the time the previous estimates were developed, and they include the effect of policy decisions that were not reflected in the previous estimates.
Source: commonwealthfund.org

The Impact of Medicare Part D on Out

After adjusting for sociodemographic characteristics and health status, compared to the near-elderly group, they found that Medicare Part D beneficiaries had a $179.86 reduction in out-of-pocket costs and a 2.05 increase in the number of prescriptions between 2005 and 2006. There was no significant change in emergency department use, hospitalizations, or preference-based health utility that would suggest a cost offset.
Source: rwjf.org

Bricker & Eckler LLP, Please try again

We have recently redesigned our website! As we continue to improve the content of our site, we appreciate your patience as certain pages may be temporarily unavailable or moved. May we assist you in your search? The links below might be helpful in locating information:
Source: bricker.com

1997 Conference Publications Fuel Discussion on Medicare Reform

In 1997, the Council on the Economic Impact of Health System Change convened leading health policy academics, practitioners, and policy-makers for a conference on the future of Medicare and then published a book of papers from the conference. The conference was the fifth in a series of conferences hosted by the council.
Source: rwjf.org

Trends and Variation in End

From 2003 to 2007, among the 35 academic medical centers for which data are available, 22 had increases in the percentage of patients seeing 10 or more doctors in the last six months of life. Emory University Hospital saw the largest growth in this rate, from 40.4 percent to 63.2 percent, while the University of North Carolina Hospitals in Chapel Hill had the largest decrease, from 45.0 percent to 35.2 percent. In 2003, the likelihood that a patient at Emory University Hospital would see 10 or more doctors was similar to that for a patient at the University of North Carolina Hospitals. But over the next five years, the percentage of patients seeing 10 or more doctors increased 22.8 percentage points at Emory, while the percentage dropped 9.8 percentage points at UNC Hospitals.
Source: rwjf.org

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

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

The Final Rule for the Medicare Shared Savings Program

The Affordable Care Act authorizes the Centers for Medicare and Medicaid Services (CMS) to establish a Medicare Shared Savings Program that would create a new category of health care provider, called accountable care organizations (ACOs), in the Medicare program. On March 31, 2011, CMS released a proposed rule for implementing the new program and solicited public comment. On October 20, 2011, CMS released the final rule for implementing the new program. This paper offers a detailed summary of the final rule.
Source: commonwealthfund.org

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July 11, 2013

Medicare Expands Competitive Bidding Program for Durable Medical Equipment

Posted by:  :  Category: Medicare

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You can also get the supplies from a store or pharmacy that accepts "Medicare assignment." This means that the store will accept the Medicare-approved amount as payment in full and that you cannot be charged more than a 20 percent copay (after you meet your annual deductible). A Medicare contract supplier can’t charge you more than that for the equipment or supplies included in the competitive bidding program.
Source: aarp.org

Video: Medicare Changes in 2013 by 1-800-MEDIGAP®

Changes in Hospitals’ Treatment of Medicare Patients (Part 2)

Nevertheless, the consensus at this point seems to be that the Act will have a continued impact on readmission rates.  The theory is that hospitals and their discharge planners will work more closely with assisted living facilities, nursing homes, subacute rehabilitation facilities, home care agencies, doctors, nurses, hospice providers, pharmacists, mental health providers and others to insure better care for their patients after they leave the hospital.  If the follow up care improves, the less likely the hospital is to see the patient back in its facility any time soon.
Source: hauptmanlaw.com

Value of Outsourcing Family Practice Billing Amidst Changes to Medicare Rates

Accountable Care Organization ACO ar management Cardiology Billing Cardiology Billing Services cardiology medical billing denial management EHR EHR Adoption EHR System Electronic Health Records Electronic Medical Records EMR EMR and EHR EMR software EMR system Health insurance HIPAA HIPAA 5010 Hospital Billing icd-10 ICD -10 ICD-10 codes ICD-10 implementation ICD-10 transition ICD 10 medical billers medical billers and coders Medical Billing medical billing and coding medical billing and coding services medical billing coding medical billing companies medical billing outsourcing medical billing practices medical billing service medical billing services Medical Billing specialists medical coders medical coding medical coding services physician billing physician medical billing RCM revenue cycle management
Source: medicalbillersandcodersblog.com

Lindsey Graham advocates changes in Medicare, Medicaid

Opencurtain….Thank you for your beatifully worded response. You hit ir right..I for one can say my familiy used welfare programs as a lst resort…My father found replacement work in some cases less money but still went back to work..This happens and people need to swallow that pill. Look back in time factories changed to mechanical labor, robotics and other things…This is reality..The unions do not get this..The job is gone when smart educated people come up with smarter ways to do things. Outsorcing is well sort of an evil but if Unions had not been so greedy those jobs may not have moved overseas. Let’s face it we all need to cut back. Defense spending is a place we can chop but within reason..Eliminate duplicate programs…This is rampant in the defense industry as it is just as bad as wasteful spending in states …TSPLOST is just another example of highlighting wasteful spending..I would bet that these bridges and road could cost 40 to 50% less but too many people inflate prices for greedy purposes. Lest worry about fixing the broken stuff the budget will fix itself if fraud is fixed..medical programs need fixing…get the trial lawyers out of this stuff..just lookat a Television ad or newspaper or even magazine..People need to earn their keep instead all of these parents have made it a growing society of entitlements instead of teaching their children to stay in school, ignore economics (poor has nothing to do with reading, writing,math, and science scores), These parent should go back to disciplining when wrong, showing what is right and lead by EXAMPLE and certainly not the one we have right now.
Source: augusta.com

Medicare Proposes Deep Cuts for Dialysis

I am a dialysis nurse, and former dialysis patient / now grateful transplant recipient. Dialysis is a very difficult balancing act. At the facility I am employed at, we draw labs every two weeks and adjust medications as needed. The nurses along with the doctor, nurse practitioner, and dietician work tirelessly teaching our patients every aspect of care and how best to accomplish good outcomes. With all the teaching we do, there are some patients who are non compliant. Why are we punished for the patients non compliance? There is NEVER a mention of patient compliance! Also, there are patients who try as they might continue with less than optimal outcomes. Why should they be punished? It really disgusts me that politicians make decisions in the medical community that they have absolutely no knowledge of! With proposed cuts will come less staff / less time to accomplish tasks important to performing optimal care. I shudder at the thought of the care patients will then receive!
Source: wordpress.com

Changes in Medicare Statement to Help Combat Fraud

Medicare encourages beneficiaries and their caregivers to report potential fraud which can includes changes that you don’t recognize for services or suppliers you don’t know.  Over the last 4 years the Administration has recovered over $14.9 billion related to fraud charges and revoked the right of 14,663 providers and suppliers to bill Medicare. Medicare fraud can be reported by calling 800-447-8477 or going online to www.stopmedicarefraud.gov/. 
Source: iquote.com

July 1 Medicare and Durable Medical Equipment Changes!

July 1, 2013 is the starting date for Round 2 of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program affecting many parts of the country.   In an attempt to save money plus limit fraud and abuse for Medicare and people on Medicare, a program which competitively selects and limits the number of suppliers of Durable Medical Equipment (DME) will expand today.   To find out if your zip code is affected, check www.medicare.gov/supplier OR call 1-800-MEDICARE.
Source: retirementeducationplus.com

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