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

Posted by:  :  Category: Medicare

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

Video: Medicare Part D – The Donut Hole

A Lesson in Avoiding Medicare Coverage Gaps

Furiously logging into my insurance account did not, in fact, reveal a way for me to submit a claim for reimbursement. It revealed the fine print that I’d conveniently ignored. All of my prescriptions for the rest of December cost me hundreds more than I normally paid, because I’d reached the coverage gap in my insurance. Had I paid attention to the details, I’d have planned for this expense. Instead, I was sideswiped by massive added expenses at the worst possible time of the year. Ultimately, this mistake cost me $1,362.
Source: thesimpledollar.com

Medicare Part D 2010 Data Spotlight: The Coverage Gap

In 2010, nearly all the private stand-alone drug plans have a coverage gap, though a small share do provide some help to beneficiaries in the coverage gap, usually covering only generics or a small number of brand-name drugs. One third of those plans with gap coverage charge more for generic drugs in the gap than they do for the same drugs in the initial coverage period.
Source: kff.org

What on Earth is the Donut Hole? A Brief Explanation of Medicare Part D and the “Donut Hole” » The NeedyMeds Blog

In 2013, you get out of the coverage gap when you have paid $4,750 out-of-pocket for covered drugs since the start of the year. When you reach this out-of-pocket limit, you get catastrophic coverage. The costs that help you reach catastrophic coverage include what you spent on drugs while in the donut hole and most of the discount on brand-name drugs you received in the coverage gap. If someone else pays for your drugs on your behalf, this will also count toward getting you out of the coverage gap. This includes drug costs paid for you by family members, most charities, State Pharmaceutical Assistance Programs, AIDS Drug Assistance Programs and the Indian Health Service. You continue to pay your drug plan’s monthly premium during the gap, but the premium does not count toward the $4,750 out-of-pocket limit. The amount your drug plan paid for your drugs in your initial coverage period also does not count.
Source: needymeds.org

UnitedHealth Issues Warning Over Medicare Advantage Cuts

Posted by:  :  Category: Medicare

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Kaiser Health News: Capsules: Despite Win, UnitedHealth Criticizes Medicare Rates, Eyes Pruning Business If the Obama administration expected the biggest health insurance company to give thanks for this month’s decision to reverse cuts to private Medicare plans, it was wrong. UnitedHealth Group CEO Stephen Hemsley said Thursday that Medicare Advantage rates are still far too low and that the company may shrink its business of managing care for seniors. … But in Thursday’s call to discuss the company’s quarterly profits of $2.1 billion on revenue of $30.3 billion, Hemsley said other changes — including the Affordable Care Act’s long-term reduction in Medicare Advantage payments – would still lead to a net reduction next year of more than 4 percent. That’s inadequate when medical costs are rising in the 3 percent neighborhood, he said” (Hancock, 4/19).
Source: kaiserhealthnews.org

Video: Medicare Advantage Funding Cuts

Insurers: Cuts to Medicare Advantage will hit poor, minorities

“Medicare Advantage is a lifeline for millions of low-income and minority Medicare beneficiaries who rely on the high-quality coverage and innovative programs and services these plans provide,” AHIP President and CEO Karen Ignagni said in a statement.
Source: thehill.com

Seniors Speak Out Against Medicare Advantage Cuts in AHIP’s New TV Ad

Current discussions about the impact on seniors of the ACA’s $200 billion in cuts to Medicare Advantage have largely ignored the fact that only four percent of those cuts have gone into effect through the end of 2012. The Congressional Budget Office (CBO) projects that, when fully phased in, these cuts alone will result in three million fewer people enrolled in the program. In addition, Medicare Advantage enrollees also will be impacted by the new health insurance tax established by the ACA that starts in 2014. Oliver Wyman previously estimated that this tax alone will result in seniors facing $220 in higher out-of-pocket costs and reduced benefits next year and $3,500 in additional costs over the next ten years.
Source: ahipcoverage.com

Seniors speak out against Medicare Advantage cuts

“Living on a small restricted limited income in a world where the cost of living goes up regularly, my Medicare Advantage plan has consistently provided me with coverage that has allowed me to get the medications I need, see the doctors who treat me best, and have dental care for the past four years,” said Marietta Hanley of Auburn, N.Y. “A cut to this program would be devastating to me.”
Source: benefitspro.com

Pitts Statement on CMS’ Decision to Reverse Some Cuts to Medicare Advantage

“I am pleased that CMS seems to be listening to concerns voiced by Medicare beneficiaries and members of Congress by appropriately rolling back some of the proposed cuts to the Medicare Advantage program,” said Chairman Pitts. “While the decision is welcome news, we must not forget the program still faces significant hurdles. In order to fund new entitlement programs, the health care law raided more than $716 billion from Medicare, $308 billion coming from Medicare Advantage. These cuts, which could disrupt coverage for over 14 million Americans, represent another one of the president’s broken promises that if you like your current health care plan you can keep it.”
Source: house.gov

CMS backs off Medicare Advantage cuts that were to help pay for Obamacare

On Monday, the Centers for Medicare and Medicaid Services announced that instead of reducing payments to health insurers who provide seniors insurance through Medicare Advantage by 2.3 percent in 2014, the federal government will increase payments by 3.3 percent. Ever since Obamacare was being debated, skeptics questioned whether the administration and lawmakers would actually follow through on Medicare cuts. Historically, when Congress has passed such cuts, they’ve been rescinded once it comes time to implement them. According to the CBO, $156 billion of the more than $700 billion in Medicare cuts under Obamacare were supposed to come through reducing payments to private companies within the Medicare Advantage program.
Source: washingtonexaminer.com

Moneycation: Medicare Advantage: Will it survive Obamacare?

The age-old adage that knowledge is power certainly applies in this case. If you are a current Medicare Advantage plan member, you can start now by keeping an eye out for communications from your insurance carrier that foretell some of the possible changes coming. Check with your physicians to find out which plans they are contracted with so that you can get an idea about your other options if your current carrier has benefit changes that are more than you can handle. It would be a good idea to also check on Medicare supplement rates in your area. If your plan has a significant rate increase, you will likely want to compare your plan against what the more comprehensive Medigap plans would cost you.
Source: moneycation.com

InsureBlog: Medicare Advantage Cuts

For just a few dollars more than most pay for a Medicare Advantage plan you could own a Medicare supplement insurance plan N and have much less out of pocket exposure than you will have under a Medicare Advantage plan.
Source: blogspot.com

Obama Admin. to Cut Medicare Advantage Reimbursements

The Obama administration is planning new cuts to Medicare, a federal regulatory filing reveals, cuts that could mean higher premiums or seniors losing their coverage altogether. The new cuts come in the form of a planned reduction in the reimbursement rates the government pays to insurance companies that operate Medicare Advantage plans, which are services administered by private for-profit or non-profit providers that offer additional services than can be found in traditional Medicare. In a Feb. 15 regulatory filing, the Centers for Medicare and Medicaid Services (CMS) announced the surprise rate cuts of 2.3 percent – meaning it would pay health care providers 2.3 percent less for providing services to patients. CMS said it was cutting payments because it foresaw the overall costs of the Medicare Advantage program shrinking by 3.2 percent, despite the fact that healthcare costs – the driver of all federal health care program costs – are only rising. Medicare Advantage is like traditional Medicare except that its plans are administered by insurance companies, who are paid a per-enrollee reimbursement fee by the government. If insurance companies can provide care to seniors at less than what the government pays them for it, they make a profit. Medicare Advantage provides coverage for approximately 28 percent of all Medicare beneficiaries, offering them higher-quality services and additional benefits, such as vision and dental care, than the traditional government program at slightly higher cost. The Obama administration already plans to cut the Medicare Advantage program by $200 billion as part of Obamacare. However, the proposed reductions it announced in February are new, and will cut the program in addition to the planned $200 billion in Obamacare cuts, most of which are delayed in 2014. The new cuts are also scheduled to go into effect in 2014, but as a function of the normal rate-setting process for that year, not a political effort to delay financial pain for seniors past an important election, as apparently was the case with the original Medicare cuts that Obama signed. In its regulatory announcement, the CMS said it was assuming that reimbursement payments in traditional, government-run Medicare will be cut, and cited that as justification for cutting Medicare Advantage. However, while those cuts to traditional Medicare have been set into law for more than a decade, Congress has never allowed them to happen, instituting what is known as the Doc Fix every year, to keep reimbursement payments the same. Senator Marco Rubio (R-FL) wrote to the CMS urging them to consider political reality and reverse their planned Medicare Advantage cuts. “This assumption is highly problematic because – even though it almost certainly will turn out to be wrong – it translates into lower funding to support the health benefits of the 14 million Medicare beneficiaries who are currently enrolled in MA [Medicare Advantage] plans,” Rubio wrote on March 8. In other words, if the Obama administration continues with its proposed new Medicare cuts, some or all of the 14 million seniors who get health care through the MA program could be negatively affected, that is, paying higher premiums or possibly losing coverage. READ FULL SOURCE ARTICLE: 03/14/2013
Source: newmediajournal.us

Health Insurers Fall On Medicare Advantage Cuts Under ObamaCare

Advantage plans are popular, however, with more than 14 million seniors expected to enroll. (Humana alone has two million Advantage members.) Whatever the reason, the Obama administration largely delayed initial cuts. One method was via a historically expensive “demonstration project” that critics said was a transparent attempt to avoid politically painful steps through through the election season. But the election is over now.
Source: investors.com

CMS Drops the Ball on Medicare Advantage Cuts

So we have politicians that are already wary of messing with Medicare, and then we have a lot of money on the line for some powerful lobbying groups. It’s the perfect recipe for disaster. What makes people think that the rest of the Medicare cuts will go through? There are supposed to be $700 billion in Medicare cuts. If they’re not made,
Source: unitedliberty.org

CMS Plans to Cut Medicare Advantage Reimbursements

“There are going to be some markets that at these rates, if they go the way they’re going, it’s going to be very hard for Medicare Advantage to survive,” Universal American Corp CEO Richard Barasch said in a February 19 conference call with shareholders, the industry publication Health Plan Week reported.
Source: medbill.net

Proposed 2014 Medicare Advantage rates cut insurer payments

Should the rules become final, Skolnick said she would expect UnitedHealth to exit many Medicare Advantage markets and experience a significant or severe contraction in that business. But she said that as with past rule changes, expected lobbying over the next few weeks by insurers may affect the final rule.
Source: medcitynews.com

Insurer Stocks Slip Over Possible Medicare Advantage Cuts

What: Health insurance stocks wobbled Tuesday after data released by the federal government pointed to possible steep Medicare Advantage payment cuts in 2014, which could lead to reduced coverage or fewer options for people buying the plans. The Centers for Medicare and Medicaid Services said Friday after markets closed that it expects costs per person for Medicare Advantage plans to fall more than 2 percent in 2014, a bigger drop than many analysts who cover the industry anticipated.
Source: medicalpracticetrends.com

marketing management by philip kotler 13th edition.ppt free download

Posted by:  :  Category: Medicare

Philip kotler marketing management 13th edition download on GoBookee.com free books and manuals search – Marketing Management, Millenium Edition – Tài Nguyên Số Marketing Management (13th Edition) ,pdf. Marketing Management by Philip Kotler. Die besten Bücher bei Amazon.de. Jetzt versandkostenfrei bestellen!                      Philip Kotler Marketing Marketing Management (13th Edition) [Phil Kotler, Kevin Keller] on Amazon.com. *FREE* super saver shipping on qualifying offers. Kotler
Source: rediff.com

Video: Compare Plans with Viva Medicare Plus

Higher copays seen for Medicare brand

[…] […] AARP Al Norman Angela Rocheleau attorney baby boomers Block Boston budget Cammuso caregiving Congress decorating Dementia Dodge Park Rest Home elderly Estate Preservation Law Offices exercise eye care Finance Goslow Goslow Health Health Care Reform home Home Care Home Improvement Home Staff LLC Just My Opinion law Legal Mario Hearing Mass Home Care Medicaid Medicare Obama retirement Saint Vincent Hospital Shalev Shapiro Social Security Sondra Shapiro study Tracey Ingle Travel VeteransSource: fiftyplusadvocate.com […]Source: fiftyplusadvocate.com […]
Source: fiftyplusadvocate.com

Do.You.Think Medicare Member Benefits? Medicare Member Benefits

aarp offers members exclusive discounts brand-name providers retail travel health fitness home questions answers prescription drug transitions exceptions coventry health care s advantra productsimportant information regarding prescription drug benefits medicare member commercial member looking learn viva medicare plus antenna care management innovative high-touch care older adults severe disabling chronic conditions partnership member benefits member explore medicare i m member member home plans &amp benefits pharmacy contracts federal government provide medicare services heather benefits member liability blue medicare ppo greater services received summary benefits blue medicare hmo blue medicare ppo plans set maintain secure connect devices home network plus tips wired wireless networking choosing firewall setting ultimate amazon com smc barricade g wireless broadband router smcwbr14-g electronics big deal home applications just hook printer pc slave amazon com smc barricade g wireless broadband router smcwbr14-g electronics va big deal home applications just hook printer pc slave
Source: gdf-jorge-antunes.com

Member Directory | Chilton County Chamber of Commerce

Allstate Insurance (South) Jason Calhoun 122 Chilton Place Clanton, AL 35045 205-755-8181 jasoncalhoun@allstate.com Always Money Money Service Business Jaime Smitherman 513 7th Street South Clanton, AL 35045 205-755-6661 clanton@alwaysmoney.com
Source: chiltonchamberonline.com

VIVA MEDICARE Plus Earns Highest Quality Rating Score in Alabama for Second Year in a Row

VIVA MEDICARE Plus has earned the highest overall star rating in the state for the second year in a row, company officials announced today. Alabamas highest ranked Medicare Advantage plan also has experienced the largest membership growth in its service area, according to Medicares enrollment numbers from October 2010 to October 2011, available on http://www.cms.gov.
Source: jobsdomain.us

Medicare Member Services Representative

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Source: alabamajobdaddy.com

Assurant Renters Insurance: Viva uab insurance

UAB – Postdoctoral Training – Benefits and Leave UAB Paid Viva Health Insurance. Dental Insurance: Vision Service Plan : Postdoctoral ScholarTrainee: 20: No: Yes: Yes* Yes* Postdoctoral ScholarEmployee: 21: Yes (matched up to 5%) UAB – Student Health Services – Mandatory Insurance/Waivers All mandatory students are required to have major medical insurance. These students will automatically be billed for VIVA Student Health Insurance via their …
Source: blogspot.com

Top Medicare Part D Plan Costs Spike in 2013

Posted by:  :  Category: Medicare

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

Video: My New Drug Coverage – 2/21/2013

Medicare Part D Prescription Drug Enrollment Trends in 2013

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

Medicare Part D Data Spotlight: A First Look at Part D Plan Offerings in 2012

This data spotlight examines the stand-alone Part D drug plan options available to Medicare beneficiaries in 2012. Medicare beneficiaries will, on average, be able to choose from 31 stand-alone Medicare Part D prescription drug plans to choose from, a new Kaiser analysis finds. Average premiums would increase by 4 percent from 2011 to 2012 if beneficiaries remain with their current plans during the open enrollment period, which begins October 15 and December 31. That represents the lowest projected increase since the program began in 2006.
Source: kff.org

Part D Savings Continues, Especially For Cost

The donut hole is the gap in prescription drug coverage offer by a PDP that was part of he original Part D program, put in place to reduce the cost of the legislation that was enacted in 2003 that included Part D. Under the original benefit, as Part D beneficiaries accrued drug expenses, they first had to satisfy a deductible, then 75 percent of their drug costs were covered up to a certain dollar amount. Then, the donut hole kicked in, a coverage gap where the beneficiary was responsible for 100 percent of drug costs. When total out-of-pocket spending reached a specific maximum, the PDP then provided 100 percent coverage for any additional drug costs.
Source: wolterskluwerlb.com

Medicare 101: A Free Informational Webinar

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2012 employment laws ACA ADA avoiding lawsuits California employment laws California Labor Laws California Workers’ Comp cheap health insurance employee administration Employee Benefits employee documentation employee lawsuits employee management employment compliance Employment Laws Employment Practices FLSA Health Care Reform Health Care Reform Act HR compliance HR Consulting HR Laws HR Management HRO HR Outsourcing Human Resources human resources outsourcing labor laws in California layoffs management training motivating employees Obamacare outsource HR payroll tax PEO Professional Employer Organization Professional Employer Organizations recordkeeping reduce workers’ compensation sexual harassment small business medical insurance Value of HR in a weak economy Wage and Hour Workers’ Compensation Workplace Safety
Source: cpehr.com

Video: The ABCs of Medicare: Medicare Basics

Optimum HealthCare Medicare Advantage

Optimum Healthcare is one of the nations most popular providers of Medicare health plans. The health maintenance organization (HMO) is based in Tampa, and was established in 2004.  It’s operated by a group of physicians and offers policies to the residents of more than two dozen Florida counties. They offer four different Medicare health plans depending on where you live. There’s also a company office located in Spring Hill. Optimum Health Care Medicare Advantage plans offer more benefits than the original Medicare and include those with Part B premium reductions, prescription drug plans, and special needs plans (SNP), which are designed for those with chronic conditions. All of the plans come with zero deductibles and offer benefits such as dental, vision, and hearing coverage as well as fitness programs.
Source: qooqe.com

Sightings Over Sixty: I Apply for Medicare, Part I

     My ex-wife is a year older than I am. Last year she turned 65 and applied for Medicare. I remember at one point asking her about the whole process of signing up for Medicare. How do you apply? Is it complicated? How do you know what coverage you’re getting?      She told me not to worry. A few months before you turn 65 you start receiving all kinds of information in the mail. She’d looked over the basics. “Then I was able to sit down with an insurance agent who specializes in Medicare,” she told me, “and he explained the whole system to me. He said he gets paid by the insurance companies, so it didn’t cost me a thing.”      So I didn’t worry. And now this year, in advance of my own 65th birthday, I expected to start receiving lots of literature in the mail, inviting me to join Medicare, showing me how to do it, and explaining all the benefits. I didn’t know who it would come from. The government? My insurance company? It wouldn’t be from my employer. I no longer have an employer. My company started shedding employees in the 1990s, and got around to shedding me in 2002, so I’ve been on my own for the last decade.      The calendar turned over, and the months came and went, but I heard not a word from anybody. Maybe my ex-wife was wrong, I thought. Maybe she got information in the mail, because of where she lives, or because of her insurance company, or because she’s a woman. But that doesn’t necessarily mean everyone gets information in the mail.      I started worrying. Maybe, somehow, I’ve dropped off the the Medicare “membership” list. Maybe my name got lost in the computer. Maybe they forgot about me!?!      So I finally decided I’d better find out. I realize that for many of you this is “old hat.” You’ve been through all this already. But anyway, like the modern tech-savvy person I am, I typed “How to apply for Medicare” into google. I found lots of general information. There’s Part A which is free, and it “helps pay” for inpatient care in a hospital. There’s Part B which you pay for, and that “helps pay” for doctor services.      Well, that’s pretty good, I thought, but also pretty vague. I found a link for Medicare Premiums and found out my premium for Part B would be $104.90 a month, as long as my MAGI is $85,000 or less. I know what MAGI means (Modified Adjusted Gross Income), although I’m not sure how to calculate it. But I’m pretty sure my MAGI is less than $85,000 so I’m not going to worry about it.      This is getting awfully complicated, I realized. And since I really couldn’t find out any specifics, I decided to call the Medicare 800 number, which is 1-800-772-1213. I understood what Parts A and B are, at least in theory. They pay for the majority of your doctor and hospital bills. But I wanted to know some of the particulars. Would they pay for my next colonoscopy? What if I needed surgery on my bad knee? Would it make a difference if I went to the hospital, or had it done in the doctor’s office? Could I go to a specialist if the specialist wasn’t in my medical group?      Plus, what about Parts C and D? What’s the difference between the various Medicare Advantage programs, and the Medigap program?      I negotiated the Medicare phone tree. I finally got to the option to talk with a real person. Then an automated voice announced the wait would be 10 minutes. Arghh! I must admit, I was too impatient. I didn’t want to wait and so I hung up.      I called my own current medical insurance company. Maybe they could help.      I negotiated the phone tree and eventually got a very nice lady on the phone. She spoke with a fairly heavy accent, but I understood most of what she was saying. Yes, my insurance company could provide me with a backup plan. There’s a PPO plan and an HMO plan. Actually, there are four different PPO plans, and a couple of HMO plans. “What”s your i.d. number?” she began.      The woman stayed on the phone with me for a good 15 or 20 minutes, trying to explain the basics of the different plans. But I had plenty of questions. How do I find out if my doctor is in the HMO network? She gave me a link on the website. How much would it cost? It depends what plan I picked, and what county I live in. Does the plan cover drugs? One of the plans does; another doesn’t. She wasn’t sure about the others. Are there any dental benefits? Again, it depends on the plan.      What if I moved? Like many retirees and pre-retirees, B and I are thinking of moving in a few years, probably to a different state. She told me that their plan was only good in my state. If I moved I’d have to switch plans.      I confess, I got tired of the conversation before the woman did. She must be used to people asking dumb questions. She finally offered to send me some published materials that would provide me with all the details. It would take about ten days or two weeks to get to me.      The woman did tell me one concrete and crucial thing. Regardless of what else I did, I should apply for Medicare Plans A and B. And I should do it right away, because if I waited and missed the deadlines, then there are restrictions about when you can apply, and I may be subject to higher rates … for the rest of my life.      You can apply by telephone (at the above 800 number), or in person. But I went back on the website where you apply for Medicare. I found the application. I filled it out. It was pretty easy.      And so as of right now, I await confirmation that I’m accepted into Medicare. And I await some materials in the mail which will presumably inform me what else I need to do to get more than the basic Medicare Parts A and B coverage.      I’d worried that I’d somehow fallen out of the system, or that it might be hard to sign up for Medicare. Bottom line:  Don’t worry, it’s easy to sign up. But it is hard to find out exactly what you’re signing up for, and to figure out what kind of backup medical insurance you should get.      More on that in Part II, after I’ve had a chance to look over those materials.        
Source: blogspot.com

Medicare’s Role for Dual Eligible Beneficiaries

This brief examines overall and per capita Medicare spending for these beneficiaries, including variations reflecting their diverse circumstances. It describes the characteristics of those with the relatively high and low Medicare costs and includes state-specific data on the share of Medicare beneficiaries who are also Medicaid-eligible.
Source: kff.org

I Am Under 65 Disabled and Just Became Eligible for Medicare. What Are My Choices?

Like any other Medicare beneficiary who turns 65 and is newly eligible to Medicare Part A and B, you have choices:  (1) you can select a Medicare defined supplement/medigap policy and a stand-alone drug plan; (2) you can select a Medicare Advantage/HMO plan with drug coverage; or (3) you may be eligible for a retiree plan that either includes Medicare comparable drug benefits or you will add a stand-alone drug plan.
Source: personalmedicareadvisor.com

North Carolina Medigap & Medicare Rates and Insurance Plans 2014

Medicare-Aid is a free Medicaid program for people who have Medicare and also have limited income and resources. The program can help pay your Medicare premiums, co-payments and deductibles. It is also known as Medicare Savings Program. There are three different levels of Medicare-Aid. All are based on an individual’s countable income. Comprehensive Medicare-Aid (MQB-Q) covers: Medicare Part B premium Medicare Part A premiums (when applicable) Medicare hospital deductible Medicare annual deductible 20% Medicare co-payment If you go into a nursing home, Medicare-Aid only covers the first 20 days. For more information, see Medicaid for long term care. Limited Medicare-Aid (MQB-B) covers the Medicare Part B premium Limited Medicare-Aid Capped Enrollment (MQB-E) also covers the Medicare Part B premium. Funds for this program may be limited.
Source: wojdylofinance.com

Understanding Medicare for Working Individuals

However, if you choose to delay enrollment as a result of existing health coverage based on current employment, which does not include COBRA or retiree health coverage, you can enroll in Part A and/or Part B at any time without penalty. When your employment ends, you then have an 8-month Special Enrollment Period (SEP) to sign up for Part A and/or Part B coverage without penalty. After that, you would be subject to late enrollment penalties.
Source: ehealthmedicare.com

Extending Social Security and Medicare Eligibility Ages

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

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July 20, 2013

How to Get Affordable Senior Medicare Supplemental Health Insurance

Posted by:  :  Category: Medicare

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Another option for seniors is a managed care plan. This means that a group of doctors and hospitals have agreed to provide medical care to senior citizens in exchange for payment from Medicare. These plans require you to only use certain hospitals and doctors who are participants in the managed care plan. This is often a good choice if your preferred hospital and doctor are participants. If they are not, you may want to go with a different form of supplemental insurance.
Source: goldenautosinsurance.info

Video: Introduction into Medicare Supplements (Medicare Supplement Insurance Series)

Get The Facts First Medicare Supplement Insurance Medigap

Since Medicare supplement insurance is meant to help Medicare recipients, it should come as no surprise to learn that these insurance policies are restricted to people who meet their requirements. First and foremost, eligible Medicare recipients must be signed up for Parts A and B of Medicare. Each eligible Medicare recipient has an open enrollment period that lasts for six months. The period begins as soon as the eligible Medicare recipient reaches 65 and enrolls in Plan B of Medicare. During the open enrollment period, eligible Medicare recipients can enroll in a supplement without undergoing medical screening. It is important to remember that private insurance companies are not required to sell these insurance policies to Medicare recipients under 65, though the exact rules are not the same from state to state. For example, 25 states require private insurance companies to sell such insurance policies to all Medicare recipients, while other states might demand the same for smaller subsets of Medicare recipients. In most cases if you are under 65 and have Medicare A and B, the Medicare supplement would be a very expensive option as most carriers charge a great deal to get the coverage if you are under 65. However, Medicare Advantage plans could be available for such people.
Source: easytoinsureme.com

The Ins and Outs of Medicare Supplemental Insurance

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

Medicare Supplemental Health Insurance Benefits And They Can Help Anyone Out

Unsure whether to subscribe to a Medicare Advantages plan or the new Medicare supplement this is because Medicare-eligible? I would say the Medicare Advantage structure often has certainly no premiums to pay, and it at all times includes prescription-drug delivers. A Medicare supplement, on the a variety of other hand, requires the latest releatively high fee. Your total out-of-pocket costs, though, fluctuate aaccording to an extent that you utilize hospitals, physicians, various other health-care providers. The deductibles to coinsurance could represent more within a definite Medicare Advantage package than you probably would pay in monthly premiums for a Medicare health insurance supplement, which repeatedly pays what Treatment does not.
Source: uydo.org

medicare health insurance supplement

Who should I buy Medicare supplement insurance from? The excellent aspect of Medicare Supplement Insurance is that they are standardized. So, once you identify which strategy is best for you you can go shopping the marketplace to see who can offer the very best rates. You can virtually feel comfortable choosing whoever is providing the very best rate for the strategy you feel most comfy with. You might use the services of a Medicare supplement insurance firm to determine the rates from numerous companies and possibly get some skilled information on which companies might be better for the long term medicare health insurance supplement.
Source: wordpress.com

Florida health insurance broker: excellent services and special attention.

Florida Health Insurance Broker can help you find the best life insurance policy for you or your business. If you are looking for a life insurance quote or you are ready to buy life insurance, give Neil a call today. Neil can help you with a variety of different plans including group life insurance, whole life insurance and term life insurance.
Source: blogspot.com

FAQ: Seniors May See Changes in Medigap Policies

Advocacy groups like the Medicare Rights Center oppose restricting Medigap plans, saying it would simply shift more costs from the government to elderly and low-income people who can least afford it. “Some in government feel people in Medicare don’t have enough ‘skin in the game,’” says Ilene Stein, federal policy director for the center. In fact, she says, people on Medicare already pay 15 percent of their incomes for health care, well above the level paid by non-Medicare households. While the proposals would cap maximum annual spending per enrollee to $5,500 or $7,500, “that’s a lot of money for someone making $22,000,” the median household income for those on Medicare, she says. 
Source: kaiserhealthnews.org

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July 20, 2013

Pioneer ACO Results Include Improved Quality, Lowered Medicare Costs

Posted by:  :  Category: Medicare

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Detroit Free Press: U-M System Pulls Out of ACO Health Care Program Patient health may have improved within the nation’s 32 Pioneer Accountable Care Organization (ACO) programs, but the results were mixed after the first full year, the U.S. Centers for Medicare & Medicaid Services (CMS) said Tuesday. And one of the three Pioneer ACOs in Michigan — the University of Michigan Health System — is withdrawing from the program designed to test a tenet of federal health care reform: that coordinated care keeps chronic conditions under control and drives down costly trips to the hospital (Erb, 7/16).
Source: kaiserhealthnews.org

Video: Fox News Sad Medicare Is Safe

CMS identifies ‘large number of overpayments’ for incarcerated Medicare beneficiaries

If a beneficiary did not inform the SSA of his or her release from custody, this may result in his or her record being incorrect. If a provider believes this is the case, the provider may wish to encourage the beneficiary to contact his or her local SSA office to have his or her records updated. It can take up to one month for the beneficiary’s Medicare eligibility file to be updated with the revised SSA information. If the beneficiary tells the provider that SSA is updating his or her records, we suggest the provider contact the Medicare Administrative Contractor using the contact information on the overpayment demand letter.
Source: hmenews.com

Taking care of Medicare and Medicaid’s dual

This all sounds good, but if you’ve been keeping track of the dual-eligible demonstration program (official title: the Financial Alignment Initiative), you may be raising a skeptical eyebrow rather than applauding. The initiative has been criticized repeatedly since it was launched in two years ago this month. Many of the 26 participating states are now moving back start dates or are shying away from their original proposals, which prompted the director of the Medicare-Medicaid Coordination Office at CMS, Melanie Bella, to defend the program in May.
Source: mcknights.com

Poll: Seniors Overwhelmingly Oppose Medicare Copays

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

Managing Diabetes Effectively And Affordably On Medicare ….. : Foster Folly News, Chipley, Florida

(NAPSI)—While diabetes continues to be on the rise in America, there are ways you can deal with it. It may help to know that an American is diagnosed every 17 seconds, and the Centers for Disease Control estimates that by 2050, as many as a third of the U.S. population will have diabetes. Not only is it a common disease but it is a costly one; people living with diabetes spend 2½ times more on health care than the average consumer and approximately $350 annually on over-the-counter health products, including critical diabetes testing supplies. In fact, many Medicare patients rely on Part B coverage to secure their diabetes testing supplies.
Source: fosterfollynews.com

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July 20, 2013

The Medicare Prescription Drug Benefit Fact Sheet

Posted by:  :  Category: Medicare

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

Video: Medicare Part D for Producers

Can Medicare Save Money? How The Part D Program Can Be More Cost

Many seniors may not be aware that the infamous “doughnut hole,” or gap in coverage, is closing thanks to the Affordable Care Act. Before the health care law was passed, if beneficiaries reached the initial limit on total drug expenses ($2,970 in 2013), they had no prescription drug coverage until they spent an added $3,700 out of their own pockets. But in 2013, people in the doughnut hole are receiving discounts of 52.5 percent on name-brand drugs and 21 percent on generics. These discounts will result in significant savings for about 4 million Medicare beneficiaries in 2013. More importantly, the discounts will continue every year until 2020, when the doughnut hole will be completely eliminated.
Source: smmirror.com

Understand how Medicare Part D works

An example of this would be if Jane turned 65 and in October declined to purchase a part D drug card then one year later decided she needed to have a prescription drug card dealt with the rising cost of for medications she would be responsible for a 1% penalty for every month since her open enrollment ended. Since you’re open enrollment is a total of seven months that’s three months before your birthday the month of your birthday and three months afterwards her penalty would start on month of February. So she would have a 9% penalty, at her drug plan of choice is $30 a month then she would paying after $2.70 after penalty.
Source: qooqe.com

Moneycation: Medicare Part D: Plans and price comparison

You are likely to find several plans offered to you from several private insurance companies that seem to meet your needs. By using Medicare.gov’s Medicare Plan Finder before you make a change, you will be able to see which plans provide coverage for your state and town. You will see which are likely to have a low cost when the monthly premium, deductible and copayments are all considered. By contacting the various company’s websites or agents you can learn what is required of you in regards to using their network. Following these steps should make it easier for you to select the right prescription drug plan for you needs.
Source: moneycation.com

How Do You Get Medicare Part D?

As the nation’s largest drugstore chain with fiscal 2012 sales of $72 billion, Walgreens (www.walgreens.com) vision is to become America’s first choice for health and daily living. Each day, Walgreens provides more than 6 million customers the most convenient, multichannel access to consumer goods and services and trusted, cost-effective pharmacy, health and wellness services and advice in communities across America. Walgreens scope of pharmacy services includes retail, specialty, infusion, medical facility and mail service, along with respiratory services. These services improve health outcomes and lower costs for payers including employers, managed care organizations, health systems, pharmacy benefit managers and the public sector. The company operates 8,077 drugstores in all 50 states, the District of Columbia and Puerto Rico. Take Care Health Systems is a Walgreens subsidiary that is the largest and most comprehensive manager of worksite health and wellness centers and in-store convenient care clinics, with more than 700 locations throughout the country.
Source: womanaroundtown.com

Top Medicare Part D Plan Costs Spike in 2013

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

A Medicare Part D Cost Saving Success Story

agencies on aging aging issues aging parent aging parents Alzheimer’s disease care chair caregiver care caregiver help caregiving Certified Senior Advisor change chaos companion care Dream elder care exercise family finances fitness friendship geriatric care managers Goal Goal setting grief healthy body healthy mind healthy spirit home health aides investment Kathleen Cleary life purpose money organization parents professional women relationships sandwich generation saving time the balancing act time management travel trends walking working moms working women
Source: thrivinginthemiddle.com

thriftymommastips: You Might Be A Caregiver If: Medicare Part D Costs #Walgreens #ad

Caregiving is hard work. That’s reality. No way around it. It can be draining – emotionally, psychologically and physically. Walgreens Medicare Part D cost means it doesn’t have to be draining financially also. Which is good because this is what my prescription story looks like many weeks. I work 24/7 almost every day of the week. It’s exhausting and then some. Up until very recently I was caring for my Mom, caring for my kids, my family and myself. One of my children has special needs and that makes life challenging also. I have my own disability to contend with. Crohn’s Disease is a digestive disorder that rears its nasty head when least expected and leaves you with chronic pain in the abdomen and joints. Frazzled? Why yes, I am. Organized? Well, yes one day I will get around to straightening out my planner and setting up reminders for all those appointments and papers and forms and – well, who am I kidding? 
Source: thriftymommastips.com

Medicare physicians exposed for abusing prescription drugs

• Beneficiaries with Part D claims: 28 million. • Average prescriptions per beneficiary: 40. • Average prescriptions per patient, per provider: 11. • Nearly three-fourths went to patients 65 and older; the rest were for disabled patients. • Prescriptions (including refills): 1.1 billion. • Number of prescribers: 1.7 million. • Of these providers, 350,000 wrote 50 or more prescriptions for at least one drug. • Portion of prescribers responsible for writing half of all prescriptions: 3 percent. • Retail price of all prescriptions: $78 billion. • Average retail price of a prescription: $70. • The state with the highest prescription costs: California ($7.1 billion). • State with the lowest prescription costs: Alaska ($55 million).
Source: naturalhealth365.com

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July 20, 2013

IRS mistakenly posted thousands of Social Security numbers on website

Posted by:  :  Category: Medicare

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The IRS mistakenly posted the Social Security numbers of tens of thousands of Americans on a government website, the agency confirmed Monday night. One estimate put the figure as high as 100,000 names. Read more: 
Source: theteapartynetwork.org

Video: Patty Duke Applies Online for Social Security Retirement Benefits . . . In Her Pajamas!

L.I. Town Accidentally Posts Workers’ Social Security Numbers On Its Website

(TM and © Copyright 2013 CBS Radio Inc. and its relevant subsidiaries. CBS RADIO and EYE Logo TM and Copyright 2013 CBS Broadcasting Inc. Used under license. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.)
Source: cbslocal.com

Social Security Announces New Mobile Site for Smartphone Users

Carolyn W. Colvin, Acting Commissioner of Social Security, has announced that the Social Security Administration is offering a new mobile optimized website, specifically aimed at smartphone users across the country. People visiting the agency’s website, www.socialsecurity.gov, via smartphone (Android, Blackberry, iPhone, and Windows devices) will be redirected to the agency’s new mobile-friendly site. Once there, visitors can access a mobile version of Social Security’s Frequently Asked Questions, an interactive Social Security number (SSN) decision tree to help people identify documents needed for a new/replacement SSN card, and mobile publications which they can listen to in both English and Spanish right on their phone.
Source: sheriabrams.com

Social Security survivor benefits will result in reduced income

USAA Financial Planning Services® refers financial planning services and financial advice provided by USAA Financial Planning Services Insurance Agency, Inc. USAA Financial Planning Services Insurance Agency, Inc. (known as USAA Financial Insurance Company in California, Lic. #0E36312), a registered investment adviser and insurance agency and its wholly owned subsidiary, USAA Financial Advisors, Inc., a registered broker dealer. (known as USAA Financial Insurance Agency in California), a registered investment adviser and insurance agency and its wholly owned subsidiary, USAA Financial Advisors, Inc., a registered broker dealer.
Source: military.com

Agency's website offers tools to help decide when to retire

Everyone’s situation is different. Find out about your situation by using Social Security’s online Retirement Estimator. It can provide immediate and accurate retirement benefit estimates to help you plan for your retirement. The online calculator is a convenient, secure and quick financial planning tool that uses your own earnings record information, thereby eliminating any need to manually key in years of earnings information. It also will let you create “what if” scenarios. For example, you can change your expected future earnings to create and compare different retirement options.
Source: mysanantonio.com

Social Security Optimization: Special Supplement Sponsored by Forethought

If more money is needed right now, this strategy is not appropriate.This strategy focuses on a way for a couple to receive the maximum benefit over a lifetime. It makes a lot of sense for couples in which one spouse has earned substantially more. The process is for the higher wage earner to claim and immediately suspend benefits and wait to start higher benefits later. At the same time, the other spouse can begin claiming spousal benefits and not claim his or her own benefits until later. Whomever files and suspends has the ability to continue to work and avoids the potential of withheld benefits if earnings are above a certain amount. An added consideration in suspending until age 70 is to determine if doing so will provide the other spouse with a higher benefit when the filing and suspending spouse passes away.A variation of this strategy is Claim Now – Claim Later. The lower earning spouse, when eligible, can claim their benefits, which allows the higher wage earner to claim spousal benefits at full retirement age and delay claiming full benefits until later.
Source: annuityoutlookmagazine.com

Washington State Court Website breached; 60,000 Social Security numbers and 1 million driver’s license accessed

When court officials were first alerted to the breach, they believed all of the information accessed was public record, and didn’t think confidential information was taken, but after an investigation by the Multi-State Information Sharing and Analysis Center, the broader breach was confirmed last month, said courts spokeswoman Wendy Ferrell. Court officials said a law-enforcement agency also investigated the case but they declined to say which one. They said the investigation was concluded and there was no information on who might be to blame.
Source: hackersnewsbulletin.com

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July 20, 2013

Hospitals, Doctors Consider Changes Amid Medicare Hospital Readmissions Scrutiny

Posted by:  :  Category: Medicare

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Medpage Today: Hospitals Already Feeling ACA Pinch Putting the Affordable Care Act (ACA) into practice has left some hospital-based physicians feeling trapped between two worlds. Although most care is still delivered in the fee-for-service realm, many have started to think in terms of a pay-for-performance model, with a focus on improving outcomes while simultaneously trying to make care cheaper. … A triumvirate of ACA reforms is driving most of the changes that serve an ultimate goal of improving outcomes in order to lower costs. These are reducing readmissions, diminishing hospital-acquired infections, and getting paid based on the value of service provided (Fiore, 6/28).
Source: kaiserhealthnews.org

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

Medicare Expands Competitive Bidding Program for Durable Medical Equipment

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

Changes in Medicare for Diabetic Supplies, Wheelchairs and Other Medical Equipment

If a beneficiary lives in a contracted area such as Denver and travel outside of the area, they must use a contracted supplier that serves that area to avoid being charged for the medical equipment.  Also if beneficiaries live outside of a contracted area, special rules may apply. This is especially important for individuals who might live on the Western Slope and come to Denver for treatment.  Individuals who live on the Western Slope are outside of a contracted area; for them the Denver supplier will be paid differently, than if the beneficiary were purchasing the equipment from a supplier on the Western Slope. Most individuals who use multiple types of medical equipment will find themselves working with more than one supplier for equipment, as none of the national suppliers provide all types of medical equipment.
Source: myprimetimenews.com

Summary of Key Changes to Medicare in 2010 Health Reform Law   

This brief provides a detailed look at the improvements in Medicare benefits, changes to payments for providers and Medicare Advantage plans, various demonstration projects and other Medicare provisions in the law. It includes a timeline of key dates for implementing the Medicare-related provisions in the law.
Source: kff.org

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

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

Medicare Considers Ending Bariatric Surgery Center Accreditation

More Articles on Accreditation: AAAHC, Basha & PowerDMS Partner to Offer Software Tools for Accreditation American College of Radiation Accredits Windham Hospital Center ACHC, DNV Healthcare Announce Partnership
Source: beckersasc.com

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