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

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As boomers ease into Medicare, battle rages over health

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Seniors See Value in Medicare Supplement Plan G

Posted by:  :  Category: Medicare

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Why would an insurance company charge a consumer $500 to cover a $147 expense? The better question might be; why would anyone pay it? The answer to the first question is two-fold, first of all, because they can and secondly, because of Federal laws which require Medicare supplement companies to accept without underwriting individuals losing group insurance and/or leaving a Medicare Advantage plan, companies incur greater claims losses since they can’t weed out the sick individuals. This law does not apply to Medicare Supplement Plan G. Now to answer the question, why would anyone pay so much to cover such a little difference? The answer is simply because they don’t know any better. Whose fault is it that they don’t know any better? That blames rests on the consumer themselves for not doing adequate research, the insurance agent who is not knowledgeable or unscrupulous, the insurance company which is profit driven and the Medicare system for not providing proper education.
Source: askmedicareblog.com

Video: Medicare Supplement Plan G – A Money Saving Alternative To Plan F

Medicare Insurance Part B Policy Coverage

So long as the elderly don’t understand the issues between Medicare in addition to the medicare supplement plans they does find themselves dealing with medical the bills every month later in functional life that they instead of only didn’t anticipate to have, though will have simply way to automatically be able to pay the price them. This one isn’t to claim the Medicare can flawed, but in which should be claimed that it can have limited coverage, and it’s some consumer’s responsibility to make sure you know what Treatment does provide yet what it will. Having wanted to say that, often our seniors need help thanks Medicare supplement assurance from their families, and also should have to know even they can try to find pricing for Medicare health insurance supplement coverage that experts claim suits their budget. AARP is a gigantic service organization to senior citizens, while anyone age 25 or older is able to join. Inside addition to the Medicare vitamin insurance plans, individuals offer many profits such as no cost of charge legal consults, biker education courses yet discounts on essentially everything. It also offer excellent of advice which can older Americans within their comprehensive word wide web site for the actual membership fee created by only annually. Medicare insurance Supplement Plan F ree p is the some popular plan this is because it is the mainly comprehensive plan available for sale. This plan comforters the Medicare a segment A deductible, our own Medicare Part G deductible, and a new 20% co-insurance which experts claim Medicare will never pay. Furthermore, this process plan covers Ration B excess premiums and has the particular foreign travel take advantage. Essentially, people which in turn purchase Plan W have any regarding your pocket costs aside from for their normal monthly premium. Around addition, as offering all Medicare Nutritional Plans, you can certainly visit almost each one doctor or facility as long exactly as they accept distinctive Medicare. My government is as of now attempting to limit the number involving certain medical areas in an use to control fees. Such a single move is manoeuvreing cardiologists, oncologists, or others right to choose from of medicine for the most part. These realities were confirmed using doctors themselves ultimate year when my writer spoke to a physicians’ Teas Party gathering wearing Raleigh, North Carolina. This becoming harder that will help reach the middle-class, regardless of the best education, and the most important competition is upping your. Unions want workers to enjoy a voice appearing in any changes so that you can their health cure coverage benefits preceding and after pension. The issue in Sacramento is how performed they get it’s? When you’re retiring, need to want to try to be put on your back burner when it appears to health really do care coverage changes through your former superior as you age group ranges ,. Far typically you possess a spouse or several other family who take into consideration you for underpin or to that you wish to avoid a legacy. In these patients LTCI helps make sure to can still allow for your family and/or leave behind the perfect legacy. In these instances you work along with an agent to maintain the amount amongst coverage you consider adequate to look after coverage and to make sure you don’t bankrupt salinger sued.
Source: typepad.com

Extra Benefits Of Medicare A Part A And GCUFBIH Organization International

These initial research method may result using less than fantastic niches, but the following niches should wind up being saved because that have changes in marketing, it will usually a good area to start when a niche will be saturated and you actually need to seek a new place. The idea is now to be liquids and be knowledgeable to make most of an actual profitable niche along with you can, so be ready in the market to change niches for the reason that soon as the application is apparent in which it the niche is generally no longer a niche market. It could be best to replace before the forte stops being viable not after this item has failed of bring in enough income for a very extended period with regards to time.
Source: cufbih.com

MedicareBob’s Blog: Virginia Medicare Supplement Plan G Quotes

Virginia Medicare Supplement Plan G Information Medicare Supplement Insurance (Medigap) is for a person who would prefer to pay more money towards their monthly premium to have additional coverage with original Medicare. A Medicare Supplement (Medigap) also provides more freedom when choosing your Doctors and Hospitals.
Source: blogspot.com

Deadline for Avoiding the eRx Payment Adjustment Approaching at End of the Month

The June 30, 2013 deadline to participate in the Electronic Prescribing Incentive Program (“eRx”) and avoid the 2014 eRx payment adjustment is fast approaching.  Eligible Professionals (“EP’) looking to avoid the 2% payment adjustment in 2014 (payment adjustment means that EPs will only receive 98% of his/her Medicare Part B Physician Fee Schedule amount for covered professional services),  must either participate in the eRx program, fall under the exclusion criteria, or file for a hardship exemption by June 30, 2013.  Information regarding participation in the eRx program can be found here.
Source: omwhealthlaw.com

I’m Signing up For Medicare Part G

Sheryl started off my morning with, to quote Romney, a guffaw. The joke posits a situation in which seniors get sick but have no resources, so Medicare Part G kicks. Seniors get a gun, four bullets and the addresses of lawmakers voting to cut senior medical benefits. Prison kicks in, providing meals, a bed, excellent health care and no one need worry that turning up the heat will send power bills into the stratosphere. Sure, the kids may not be thrilled about being frisked when they visit, but they never have to worry about you moving in with them, either.
Source: wordpress.com

Elements Of Medicare Extra Insurance

Ideal. Your about to proceed to on Medicare, but your mail penalty box and phone are being inundated accompanied by eager sales agents and insurers requiring you to autograph up with them. So, you want to be out smart folks and go via the internet and try to actually wade through miles of information associated with Medicare-Medigap- plans. You have decent intentions but have in and pay a visit to a website very promises multiple states from different carriers and agents. Now you feel in control and you have your market face on. You fill out the form furthermore push that beauty button. Yes, I did this situation. may have observed of as okay of the Part C Medicare Take advantage Plan, sometimes proven as Medicare Replacement Plan or Medicare health insurance Alternative Plan. Because this policy seems to mix both medicare parts, the medicare favour plan looks like a good idea. Note however the idea only a a small number of doctors and hostipal wards accept this regimen as this process is a privatized Medicare introduced of for-profit insurance businesses. In addition o that, you does indeed still pay to make the part J premiums and make ineligible to grab a medicare supplement insurance plan now that medicare supplement delivers not include filling the gaps created by part C. Overall, Medicare Supplement Program F, G, not to mention N are a few most popular intentions of the market. With the regarding the economy, most people are looking to experience good coverage cheaply. In a situation, Medicare Enhance Plan G is often recommended. Medicare complement insurance is almost certainly not some thing that should befuddle you or come up with you’re feeling overwhelmed. Just consider the a chance to learn on the subject of each with our own twelve ideas obtainable, and select make certain that functions very best for you really. Then, you are within a to visit or get in experience with private life insurance businesses to conclude which companies purchase the best expenses around the photos that you yearn for or need. Choosing a exclusive business is going to be tremendously subjective. That means that you’ll are required to store identical to and price tags the charges a person can are able to actually get, as in fact because the service that every agency offers, to get the best 1 on. Medicare originally is understood to be Part A, which can hospital insurance in addition Part B, can be medical insurance. This original an insurance plan allows for masses of but not each individual medical or health related service and provide you with. There is insurance available, called Medigap or If Only The State Could Make It This Easy To Get A Medicare Supp Plan For Working Class People that covers expenses that aren’t covered under basic Medicare Part A and Part G. This includes things regarding copayments, coinsurances, insurance deductibles and expenses when you are traveling outside of america. Believe it not really the out connected with pocket expenses will add up very easily and before are familiar with it you may well easily paid the entire monthly premium for this Medicare Supplement Plan. With general, all persons 65 years of aging or older which been legal locals of the Usa for at least 5 years are eligible for Medicare. Also, all individuals with disabilities in that this United States, as long as their condition(s) is/are congenital or dead permanent, are naturally entitled to Medicare, regardless of age. This is due for the fact that form of disabled people will also inherently entitled to successfully Social Security Afflictions Program (SSD); paid their involvement all over SSD, physically impaired people both young and old are systematically entitled to Medicare health insurance. You can get insurance to make most of the most important health expenses you might incur past purchasing Medicare Element C and Medicare health insurance Part D, their Medicare Part N plan that safeguards prescription drugs or a Medicare Dietary supplement policy and Medicare insurance Part D. Treatment is health policies for people time 65 or older, under 65 by certain disabilities on the other hand any age with End-Stage Renal (permanent kidney failure). More or less virtually every event, after you mail out in a build at one kinds insurance policy web-sites, you will possess Five and more realtors contacting your self the phone and seeking in the market to market the plan of action that creates these kinds of people the most fee. By way of example, a female, non-tobacco consumer, age sixty seven in addition to the dwelling in Macon, GA would shell out 5 per 30 days for Medigap strategy F from Violet Cross. If in case she have just lately been a very informed shopper she are able to come across not less than fifty percent 14 carriers providing the very same method for when tiny as 6 per 30 hours.
Source: typepad.com

Medicare Supplement Studies > Minnesota Medigap Companies > MedicareSupplement.com

Posted by:  :  Category: Medicare

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While most of America (47 states) must consign to the National Association of Insurance Commissioners (NAIC) standardization of Medigap policies, Minnesota does not. Minnesota is one of the three waiver states that standardized their Medicare supplement plans before NAIC’s involvement in 1990. Because of this, so long as the plans offered cover the basic requirements, Minnesota (along with Massachusetts and Wisconsin) is able to continue issuing their Medicare supplement plans.
Source: medicaresupplement.com

Video: Medicare Plan N

Inescapable fact regarding US Medicare Advantages On Filipino Land

US Medicare health insurance coverage in a international hospital is restricted, with hardly any exclusions: (1) once the insured resides within the US but the the majority of proximate hospital is really a non-US territory, or even (2) when an urgent arises while the covered by insurance is travelling without irrational delay between Alaska as well as another US state, along with a Canada-based hospital will be the closest spot to seek emergency treatment.
Source: insuranceprog.com

How Does Medicare Part D Affect Medigap Plan N?

The Medicare Part D plan usually creates more paperwork for you then you certainly find with something like Medigap Plan N situation. The Medigap Plan N tries to make sure there is very little paperwork associated with the plan in an attempt to make things less confusing and easier to understand for seniors. Medigap Plan N is typically associated with secondary care as is Medicare Part D. Many people think of their prescription drugs after the fact quite often. You have to find a way to be able to afford your prescription drugs and finding the right plan with Medicare Part D can be key to this process.
Source: seniorcorps.org

Income Thresholds For Medicare Part B And Part D Premiums

While the surtax due to higher Medicare premiums that resulted from the Roth conversion was not huge, at only 1.6%, it nonetheless represents an entirely manageable – and potentially avoidable – surtax that planners and clients should carefully consider. For instance, the client might have decided to convert only $27,000 in the prior example – rather than $39,350 – to keep from exceeding the $87,000 AGI threshold that triggers the first Medicare premium increase, allowing the conversion to have a cost of "only" the 25% marginal tax bracket, and not 26.6%. On the other hand, if the client’s income was higher, the impact would have been more severe. For instance, if AGI was already $85,000, then a $5,000 conversion would result in $1,250 of taxes (at a 25% tax) plus the same $619.20 (for additional Medicare premiums), which leads to a marginal "tax" of $1,869.20 and a marginal tax rate of 37.4%; on the other hand, if the conversion was $10,000, the marginal rate would only be 31.2% (since the additional taxes would rise to $2,500 but the Medicare premium impact would still be the same $619.20/year). The end result: the closer clients are to an income threshold, the better it is to either stay right below the line, or rise far above it until the next threshold (or a new tax bracket) approaches, because the additional Part B and Part D premiums are a flat additional amount even if clients are just $1 across the line (unlike tax brackets, which are always a percentage of additional income). And because the premium adjustments are calculated based on AGI, anything that increases AGI can impact exposure, from IRA withdrawals and Roth conversions, to capital gains, to dividends and interest and income from pass-through entities; on the other hand, any deductions that are taken above the line, such as capital losses or certain business losses, can also reduce exposure.
Source: kitces.com

MEDICARE SUPPLEMENT INSURANCE STILL IN VOGUE

When a Medicare enrollee purchases a Medicare supplement Plan N they are making a commitment to participate in their healthcare costs, while still maintaining their freedom to use the services of any physician or hospital. Plan N requires the insured to pay their annual Medicare Part B deductible, up to a $20 physician’s office co-pay, a $50 emergency room co-pay unless admitted to the hospital and any excess charges over and above the Medicare approved charge. One should note that Medicare excess charges very rarely even exist as almost all physicians and hospitals accept the Medicare approved charge as full payment. This is called Medicare assignment and the consumer can contact their physician’s insurance billing office to confirm that they accept assignment and are considered a “participating” provider. Healthy, typically younger Medicare enrollee’s see Medicare supplement Plan N is a viable alternative to a Medicare Advantage plan. Medicare supplement Plan N offers substantially reduced premiums when compared to a Medicare supplement Plan F while maintaining the “freedom of choice” not offered by a Medicare Advantage plan.
Source: askmedicareblog.com

Open Enrollment For Medicare Part C & D

Why shop around? Like any other insurance policy that renews annually, it’s important to see if your current options still best fit your needs. For example, what may have been the most efficiently priced policy last year could be significantly higher this year. Pricing for most Medicare Advantage Plans are expected to increase moderately this coming this year. However many Medicare Part D Plans are expecting double digit increases in premiums. Second, your current plans provisions and benefits may have changed and may not best fit your needs anymore. Finally, you may have had a change in your personal circumstances where another option may be more efficient. When shopping around for Medicare Advantage, just make sure that any new plan that you are considering has your primary care physician, specialists and care facilities that you are likely to use are on the plans network of providers.
Source: figuide.com

AARP Medicare Supplement Plan N

One thing is certain. Medicare Advantage plans are changing and in many instances, monthly premiums are increasing. Some Advantage plans now cost more than a Medicare supplement. An Advantage plan will certainly  require cost sharing for hospital inpatient charges. Most plans require you to pay a couple hundred dollar co-pay, for a fixed number of days, as part of your cost sharing responsibility. You may even be required to pay more than if you had only Medicare. This is not the case with AARP Medicare supplement Plan N.
Source: seniorsupplementinsurance.com

New Medicare Plan N takes off

But, unlike a Medicare Advantage Plan, Plan N has no network restrictions, doesn’t require referrals and has lower out-of-pocket cost-sharing. These features make it more appealing to those who are healthy and wouldn’t otherwise see the need for health insurance.
Source: outreachnc.com

Florida Medigap & Medicare Rates and Insurance Plans 2014

If you are struggling to figure out which plan will work best for you please feel free to comment below and I will be more than happy to assist you with the process. There are some great websites that can go over the plans. The Florida Office of Insurance Regulation will have all the numbers you need. There are some states that do not have a website this thorough. Take advantage of this resource as you live in a state that is helpful to those looking to switch MediGap or Medicare insurance companies.
Source: wojdylofinance.com

Anthem Medicare Preferred from Anthem Blue Cross has Advantages for Seniors

Posted by:  :  Category: Medicare

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One of the advantages of the Anthem Medicare Preferred is that members can see any doctor or use any hospital within the network, without needing a referral. This includes appointments with specialists, as well. Plan participants may also see doctors that are outside of the plan. However, they will have to pay higher costs for their visits. The costs of Anthem Medicare Preferred vary depending on where you live, but premiums are low and there are many other benefits to the program as well.
Source: benefitpackages.com

Video: Medicare 101 – Top Things Regarding Medicare Advantage

Should I Consider Medicare Advantage?

Another main dissimilarity is that a lot of Medicare Advantage packages have medicine coverage built in. With the Traditional Medicare, Part D medicine coverage has to be bought separately. Also, with the Traditional Medicare, you can visit any hospital or doctor that accepts Medicare. Numerous Medicare Advantage packages work with contracted providers such as hospitals and physicians with whom they have established a long-term relationship.
Source: leerogers2012.com

CMS: Health plans for dialysis patients on Medicare Advantage not impacted by sequester

The Centers for Medicare & Medicaid Services issued a memorandum last month affirming that Medicare Advantage Plans are exempt from the 2% cut. Part D plans are also exempt. Some insurance plans, including United Healthcare, Humana, and Anthem Blue Cross Blue Shield, had notified care providers that they should expect a 2% cut, according to Lexology, an industry newsletter published in cooperation with the Association of Corporate Counsel.
Source: homedialyzorsunited.org

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

The Future of Medicare Advantage: Are We on the Right Path?

Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.
Source: kff.org

Blue Care Network expands Medicare Advantage service area, Blue Cross and Blue Care Network add plan options

In addition, BCN Advantage members will now be able to “buy up” to more comprehensive dental and vision benefits for a modest additional premium. Members will receive partial coverage on restorative services such as fillings, root canals, crowns and crown repairs. They’ll also get an allowance for frames and lenses to improve their vision health.
Source: hcwreview.com

The Future of Medicare Advantage

Most of the discussion was optimistic that MA enrollment could be sustained if not increased even in the light of budget cuts.  MA plans are projecting enrollment increases of 9-10 percent for 2014. Mark Miller of MedPAC cited analysis that MA bids have come down in recent years (e.g. MA plan bids are 96 percent of FFS costs on average and HMO bids are 92 percent) suggesting that  MA plans could continue to successfully compete against Medicare FFS even in areas that will be paid at 95 percent of FFS.  Carl McDonald cited 2010 as a historical precedent when MA plans were able to manage large program cuts by lowering costs.  He also noted research shows that current Medicare enrollees are very loyal and do not leave their plans even when premiums are increased or benefits reduced.  Alissa Fox from the Blue Cross and Blue Shield Association argued that  plans will have a hard time absorbing all of the upcoming cuts and that their Association is lobbying for Congress to repeal the upcoming $100 billion tax on insurers.  George Strumpf of Emblem Health says he was pessimistic about future MA enrollment and reminded the audience of the experience in the late 1990s when budget cuts drove half of the Medicare managed care plans from the market.
Source: gormanhealthgroup.com

Inescapable fact regarding US Medicare Advantages On Filipino Land

US Medicare health insurance coverage in a international hospital is restricted, with hardly any exclusions: (1) once the insured resides within the US but the the majority of proximate hospital is really a non-US territory, or even (2) when an urgent arises while the covered by insurance is travelling without irrational delay between Alaska as well as another US state, along with a Canada-based hospital will be the closest spot to seek emergency treatment.
Source: insuranceprog.com

Get 'rock solid' with Medicare Advantage

When providers partner with Benefits365, they receive educational pieces on Medicare Advantage that they then provide to beneficiaries. One way to do that is through monthly statements. The idea: A beneficiary calls Benefits365 to switch from Medicare to Medicare Advantage, and both the beneficiary and the provider benefit from working with the latter vs. the former.
Source: hmenews.com

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July 14, 2013

Study: Star Rating System Resonating With Seniors

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Medpage Today: Seniors Favor Higher-Rated Medicare Plans First-time enrollees in Medicare Advantage plans and those switching plans were more likely to enroll in ones with a higher star rating, a study of nearly 1.3 million Medicare beneficiaries found. An increase of one star in the ratings made it 9.5 percent more likely a first-time Medicare Advantage enrollee would choose a given plan, the study published in Tuesday’s Journal of the American Medical Association found. Similarly, for those switching plans, a higher star rating was associated with a 4.4 percent greater chance of enrollment. … But awareness and use of Medicare Advantage’s star-rating system has been mixed, Jack Hoadley, PhD, of the Health Policy Institute at Georgetown University, in Washington, wrote in an accompanying editorial (Pittman, 1/15).
Source: kaiserhealthnews.org

Video: Dr. Eric Larson on Medicare 5-Star Rating System Part 1

Florida Healthcare Facility Reviews

Comparing the quality of a long term care provider based on data that facilities reported or other websites that advertise free services, only to give you limited options from paid providers, is the reason Placing Pros was created. As healthcare professionals we are able to review the facilities, have access to information only available to providers as well as understand the terminology and assist you with making the best possible placement decision. We have helped thousands of families around the United States with this very task and continue to work everyday to assist those in need of long term care placements.
Source: placingpros.com

Exceptional Living Center Earns Five Star Rating

The Center for Medicare and Medicaid Services have awarded a Valley retirement facility with a five star rating. Exceptional Living Center of Brazil earned the honor, which also puts them in the top ten percent of skilled nursing facilities in the state of Indiana. The rating is based on health inspections, quality measures, and staffing. The center’s Executive Director says their staff takes a lot of pride in an award that recognizes all their hard work. Gayle Camonte- Executive Director “The staff has really been excited about it. We are actually very excited about it because we try to offer resident care through every form of residential care that we give to residents whether it be for a short term rehabilitation residents or long term care residents.” Exceptional Living Center of Brazil offers tours of their facility seven days a week, and accept admissions 24 hours a day. To set up a visit or for more information call (812) 446-2636.
Source: mywabashvalley.com

All about CMS Star Ratings And Why It Matters

CMS is launching a 3-year demonstration with progressive bonus payments based on ratings, as well as offering bonus payments to plans with average ratings. CMS is also launching a demonstration beginning in 2012 that will last for 3 years, and will increase the size of the bonus payments to these high rated plans (4 or more stars), and will also provide bonuses to plans who have average ratings (3 to 3.5 stars). The intent of the demonstration is to encourage plans at all levels of performance to work on quality improvement, and to test the impact on scaled bonuses on expediting year-over-year improvement across plans, in comparison to the health reform law payments.
Source: 2014medicareadvantage.com

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July 14, 2013

Social Security, Medicare are going broke; so what’s new?

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If you’re at strengthensocialsecurity.org, you see only blue skies smiling at you. The website said the report shows only a growing Social Security surplus that, with a few minor tweaks, can be kept strong forever — provided the nation can keep the greedy corporations and bankers from getting hold of it. (Read the report here.)
Source: jayevensen.com

Video: Over Two Million Americans Tell Obama: No Cuts to Social Security and Medicare Benefits

Turning 65: Another milestone known as Medicare

Somehow the whole world has received notice that you are soon turning 65. Every insurance company you’ve heard of and those you haven’t will start sending you information and calling you about Medicare supplemental insurance plans. Military retirees, their spouses, and survivors shouldn’t need those policies because they qualify for Tricare for Life, which picks up the cost shares not paid by Medicare. But, remember—to be eligible for TRICARE for Life, you MUST sign up for Medicare Part B!
Source: militaryfamily.org

Your Smartphone Might Hold Key To Your Medical Records

Before a patient can download medical information to a computer or a smartphone, the files must first be stored electronically. And while electronic health record advocates note that there has been a sharp increase in the number of hospitals and doctors using EHRs, they acknowledge that a complete electronic system is a long way off. According to a 2012 CDC survey, while 72 percent of office-based physicians are using some sort of electronic system in their practice, only 40 percent of practices meet the definition of a “basic” system.
Source: kaiserhealthnews.org

New Black Panther hopes Zimmerman is killed in prison

Muhammad told the Daily Caller that he’d been invited to multiple protests by the Martin family and their family attorney Benjamin Crump. The group had associations with other civil rights leaders including Al Sharpton and his brother Kenneth Glasgow. “We came, and we supported,” said Muhammad of their visits to Sanford last year.
Source: dailycaller.com

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July 14, 2013

Rates of major CV procedures differ between Medicare Advantage and fee

Posted by:  :  Category: Medicare

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As healthcare costs in the United States grow rampant and stress the economy, investigations of causes and solutions to the system’s inefficiencies have gained much attention. Since one of the largest sectors of healthcare costs in this country is due to cardiovascular disease and its related procedures, the authors of this study sought to identify differences in rates of cardiovascular procedures performed under two different Medicare reimbursement systems: Fee-for-service (FFS) and Advantage, a capitated plan. The study found that rates of angiography and percutaneous coronary intervention (PCI) were significantly lower in the Advantage versus FFS program, even when adjusted for age, sex, race and income, though regional variations in procedure rates were equivalent in both groups. These results suggest that financial/reimbursement incentives do affect patient care delivery and overall health care costs. While these results are still important, this study did not analyze for any differences in patient outcomes between the two groups. Furthermore, conclusions are based solely on cardiovascular procedures, and thus more studies on the affect of reimbursement systems on patient outcomes are also necessary.
Source: 2minutemedicine.com

Video: Update on Medicare Reimbursement

Transparent Medicare Physician Payment Reform Process Gains Momentum

The advanced draft legislation unveiled today incorporates feedback received from a broad range of bipartisan lawmakers and over 80 stakeholder organizations, representing ideas of committee Republicans and Democrats. The policy would repeal SGR and, in return, replace it with an improved fee for service system in which providers develop quality measures that will lead to better care in a more efficient manner. Better quality care will lead to better outcomes and put a greater emphasis on efficiency which can lead to cost savings. In addition, providers will have the option of leaving the fee for service system and opt instead for new ways of delivering care that put an even greater emphasis on quality and efficient care, particularly those that can mean more time with patients and more savings to the system. 
Source: house.gov

Important Change to Medicare Reimbursement Guidelines

On July 10, 2013, an important piece of the SMART Act went into effect.  The government will now have a set period of three years to seek reimbursement for costs that another party has accepted responsibility for (per a settlement, judgment, award, or other payment).  The three-year statute of limitations is to be measured beginning on the date of reporting the case to CMS (see Section 111 of the Medicare Medicaid SCHIP Extension Act of 2007 for Mandatory Insurer Reporting Rules).  This change protects the Medicare beneficiary from being hit several years down the line for reimbursement.
Source: legalexaminer.com

CMS Proposes Permanent Medicare Payment for VisionCare&#8217

) is indicated for monocular implantation to improve vision in patients greater than or equal to 75 years of age with stable severe to profound vision impairment (best-corrected distance visual acuity 20/160 to 20/800) caused by bilateral central scotomas (blind areas) associated with end-stage AMD. This level of visual impairment constitutes statutory (legal) blindness. Smaller than a pea, the telescope is implanted in one eye in an outpatient surgical procedure. In the implanted eye, the device renders enlarged central vision images over a wide area of the retina to improve central vision, while the non-operated eye provides peripheral vision for mobility and orientation.
Source: latinbusinesstoday.com

Medicare Telehealth Reimbursement

Medicare is federal health insurance for senior citizens. The first attempt at Medicare reimbursement for telehealth was the Balanced Budget Act of 1997 (BBA), which provided partial reimbursement through telehealth demonstrations. The BBA created coverage for telehealth consultations to Medicare beneficiaries living in rural health professional shortage areas (HPSA). HPSA’s are areas in which accessibility to healthcare professionals is limited and require the patient to travel many miles to their physician’s office. In this case, telehealth overcomes this barrier and allows access to their physician from the locality of their home. A caveat should be inserted here. Not all physician visits can be accomplished via telehealth. There are times when a physical visit is required. The BBA also set forth the requirement that a Medicare practitioner must be with the patient at the time of the consultation. This pretty much negates the benefit of telehealth.
Source: healthworkscollective.com

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July 14, 2013

What Podiatry Services Are Covered By Medicare?

Posted by:  :  Category: Medicare

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.
Source: healingfeet.com

Video: Occupy activists observe 47th Anniversary of Medicare – NYC

Daily Kos: NYC Mayor: Anthony Weiner (D) Proposes Single

The coverage devised by the task force, which he called Thrive (standing for Taskforce for Healthcare Reform, Innovation and Vitality for Everyone), could eventually be offered to all New Yorkers by being listed on the state insurance exchange required by the Affordable Care Act. Such an experiment could not be tried in places like Cincinnati or St. Paul, he went on, but “New York is the health care capital of the world,” with more than 560,000 health care workers, including tens of thousands of doctors and nurses in the city’s own employ. – New York Times, 6/20/13
Source: dailykos.com

DCCC Ad Targets Buerkle’s ‘Outrageous’ Medicare Vote (Updated)

Buerkle is the one who voted twice to limit Medicare expenditures by that $716 billion, not her opponent. Ryan and Buerkle were against those Medicare limitations until they were for them. Ryan embraced that very same $716 billion in his Ryan Plan, but neither he nor Buerkle have the honesty or character to be up front about it. Now Romney has forced Ryan to flip back the other way on it. Does Buerkle stand by her votes, or does she support Romney?
Source: nystateofpolitics.com

Schneiderman catches top NYC hospital overbilling Medicare and Medicaid

According to the Complaints and Settlements filed in this case, the hospital double-dipped by billing New York and the federal government for psychiatric services provided by its physicians.  St. Luke’s-Roosevelt billed out-patient psychiatric services to Medicaid as a rate-based service, which included the care provided by the physician and all other related costs. At the same time, SLR billed the state and federal governments on a fee-for-service basis for the same care provided by the physician. Also, St. Luke’s-Roosevelt sought and received reimbursement from Medicare for non-reimbursable costs for outpatient psychiatric visits. As a result, the Hospital received Medicare and Medicaid payments that it was not entitled to receive.
Source: seniorlivingcare.com

corrupt nyc, ny: AETNA, CIGNA, HIP, OXFORD, TOUCHSTONE, UHC HMO ASK DR. FAGELMAN IS IT OKAY FOR DELITA HOOKS HIS RECEPTIONIST OFFICE MANAGER TO PUNCH A PATIENT?

Painful to see Dr Andrew Fagelman who paid Delita Hooks and did not fire her has a page with NYU Langone….. Dr Andrew Fagelman did not fire Delita Hooks and my MD that shared the office demanded she be fired.  Delita Hooks attacked me as I help my bags rather than close the door but first she verbally assaulted me telling me I have no rights for asking would you consider paper cups instead of styrofoam it is better for the environment. In my opinion corrupt NYPD detectives fixed this violent crime despite Delita Hooks threatening me with bodily harm.  She walked in the day after me and filed a false cross complaint yet another crime lying and blaming the patient that would be me. Why did the NYPD fix this? Why?  
Source: blogspot.com

Roundup: Feds Cut N.Y. Medicaid Payments $1.2B; 93,000 Fewer Kids Enroll In CHIP In Pa.

California Healthline: Changes Set Stage For ‘Shakeout’ Of Medical Suppliers, Services Shifts in contracting practices — part of the trickle-down effects of health care reform — are going to change the landscape of medical equipment and service suppliers in California, stakeholders predict. … Bob Achermann, executive director of the California Association of Medical Product Suppliers … predicted the number of California businesses providing medical supplies and services may be cut in half over the next few years. Two changes are at the heart of the “thinning of the herd,” as Achermann calls it. One is state-driven: California is shifting beneficiaries of Medi-Cal — California’s Medicaid program — from fee-for-service to managed care. The second is a federally mandated change in the way Medicare contracts with suppliers (Lauer, 4/1).
Source: kaiserhealthnews.org

What If A NYC Elderly Daycare Center Is Accused Of Medicare Fraud?

On the other hand, the services must be provided to elderly people who are actually disabled, which in this context generally means someone who needs at least 120 days a year of home care to assist with tasks of daily living, such as self-care, taking medication, walking, etc. If your day care provides services to elderly people who are not disabled, your service is not eligible for Medicaid reimbursement.
Source: jpdefense.com

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July 14, 2013

Everyone Has a Plan to Save Medicare

Posted by:  :  Category: Medicare

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Having a plan to save Medicare is somewhat like wearing a tie or cufflinks, in that it is somewhat de reigueur in some parts of society – but ultimately a cultural signal of belonging, of little value otherwise. The economic future of the US is somewhat grim; the decline of an empire is inevitable as its increasingly unaccountable elite class debauch the currency, centralize power, and regulate all aspects of a citizen’s life. They tax and waste ever more of the flow of resources whilst destroying the freedom and competition needed for the creation of those resources – in much the same way as a cancer is parasitic to its host but ultimately destroys both host and itself. This is an inexorable progression of society, built upon the foundation of human nature and the individual actions and interactions of millions of people. It has happened over and again and is just about as likely as the tide to be turned aside.
Source: fightaging.org

Video: How to Understand Medicare Plans

Medicare To Propose New Doctor Payment For Managing Multiple Chronic Conditions

Reuters: Medicare Plan On Alzheimer’s Test Dismays Advocates Alzheimer’s experts plan to protest proposed Medicare guidelines that would deny coverage of an Eli Lilly diagnostic test for the disease unless patients are taking part one of several clinical trials in which the $3,000 test is being used. Eli Lilly and Co and the Alzheimer’s Association have objected to the draft guidelines, issued last week by the U.S. Centers for Medicare & Medicaid Services, the agency that runs Medicare (Steenhuysen, 7/9).
Source: kaiserhealthnews.org

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

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

MedPAC on Medicare plan competitive bidding

Consistent with the goal of encouraging beneficiaries to make cost-conscious choices, this chapter presents an overview of a model based on government contributions toward purchasing Medicare coverage—an approach we call competitively determined plan contributions (CPCs). The Commission uses the term CPC to broadly describe a federal contribution toward coverage of the Medicare benefit based on the cost of competing options for the coverage, including those offered by private plans and the traditional FFS program. Specifically, CPC has two defining principles: First, beneficiaries receive a competitively determined federal contribution to buy Medicare coverage; second, beneficiaries’ individual premiums vary depending on the option they choose.
Source: theincidentaleconomist.com

Top Medicare Official: ‘We Can and Should Do More’ to Oversee Drug Plan

Sen. Tom Carper, D-Del., who chaired the hearing, cited two new government reports on the program, known as Part D, from the inspector general of the U.S. Department of Health and Human Services. The first, issued last week, found more than 700 general-care physicians with extremely questionable prescribing patterns, including some whose prescriptions were filled at hundreds of pharmacies across dozens of states.
Source: propublica.org

Medicare Part D: A First Look at Part D Plan Offerings in 2013

The analysis is the first in a series of planned reports examining the private plan choices available to Medicare beneficiaries for 2013. It is authored by researchers at Georgetown University, the Kaiser Family Foundation and NORC at the University of Chicago.
Source: kff.org

Is A Medicare Advantage Plan Right for Me?

When it comes to picking a Medicare plan, it can be very difficult to decide which type of policy you need. When you are evaluating whether you need to get a Medicare Advantage plan or not, focus on your health history and see what you really need the most. For example, if you have a condition that will most likely cause you to be in the hospital at some point, then you obviously need Medicare Part A. If you make frequent trips to the doctor, then getting Part B makes sense too. If you would rather not have to deal with multiple policies, and you want other health benefits as well, then Medicare Part C makes a lot of sense for most people.
Source: wastedenergy.net

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

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