Medicare changes threatening to shut down local suppliers

Posted by:  :  Category: Medicare

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“I am disheartened to see the implementation of a program which would force our area small businesses to lay off employees and potentially close their doors at a time when our economic recovery depends on their success,” Forbes said in a statement last week. “Many small business owners in the [Durable Medical Equipment] industry have personally expressed their concern to me that the process, as it stands, has created rates which are untenable for a small business to operate.”
Source: medbill.net

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

Do You Know About Recent Changes in What Medicare Will Pay For?

If the therapist or referring doctor evaluated the patient’s progress and improvement had slowed down too much or stopped, then Medicare stopped paying its share of the cost. Medicare would not cover outpatient services that only maintained a level of functioning or only made a person feel better. If the problem got worse, the therapy would be covered. Otherwise, if you were not improving but you still wanted to continue therapy to feel better, you would have needed to pay the full cost yourself.
Source: estateplanandassetprotection.com

Health Care Changes Could Impact Doctors’ Ability To Diagnose Alzheimer’s

In its statement, the Alzheimer’s Association discussed an announcement made earlier this month by the Centers for Medicare and Medicaid Services, which is in charge of regulating many aspects of Medicare services for seniors. Unfortunately, CMS has decided to pull its support from a test known as brain amyloid imaging, which has been used by doctors to determine whether a patient has a high risk of developing Alzheimer’s. The CMS stated that they feel evidence supporting this type of testing is insufficient. Essentially, this could mean that soon, Medicare won’t cover this diagnostic option. The Amyloid Imaging Taskforce, in conjunction with the Alzheimer’s Association, has recommended to CMS that the amyloid imaging should continue to fall under Medicare benefits. The taskforce is comprised of a group of experts in the field, so it’s possible that their opinion will be enough to sway the CMS to change its decision. Older adults who are concerned about this issue can lend their own voices to the cause. The Alzheimer’s Association is looking for individuals to share their stories, whether they are about the success of an amyloid imaging test or the difficulty of obtaining an early diagnosis. These stories will be sent to the CMS in an effort to convince the board to change its decision. Click here to share your story or sign your name in support of this cause. 
Source: sunriseseniorliving.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

Medicare Changes in Mail Order Testing Supplies

The article discusses mail-order Diabetes Testing Supplies, and how the rules have changed as of July 1. There are now just 18 Medicare suppliers for them, depending on your zip code and the type of test strip you use. After reading the above article, I called my (former) supplier, who said I’d have to pay for my supplies out-of-pocket if I continued to use them! Then I called Medicare and I got a list of possible Medicare suppliers in my zip code who would send to me my brand of test strips.
Source: tudiabetes.org

Proposed Payment Changes for Medicare Home Health Agencies

Medicare pays home health agencies through a prospective payment system, which means that Medicare pays a fixed or base amount for a particular service that is adjusted based upon the health condition and needs of the beneficiary (i.e. case mix) and differences in wages.  The case mix factor allows Medicare to pay higher rates for services that are provided to beneficiaries with the greatest needs. Payment rates are based on patient assessment data collected by Medicare participating home health agencies.
Source: mcbrayerhealthcare.com

Brad DeLong : Susie Madrak: Medicare For All Would Save Half

Posted by:  :  Category: Medicare

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Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses. That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said. Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers… would save an estimated $592 billion in 2014… enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else. “No other plan can achieve this magnitude of savings on health care,” Friedman said.
Source: typepad.com

Video: Medicare for the First Time

Affordable Care Act: Medicare ACO’s Get Mixed Results for First Year, But Show Promise in Private Sector

"These results are reminiscent of what happened with the Physician Group Practice (PGP) Demonstration Project, a precursor to the current Medicare ACO programs, in which only two of 10 participating ACOs succeeded in the first year. Encouragingly, the participants in the PGP Demonstration Project in general improved their performance during the following years, so one would expect the 23 Pioneers still in the program to show better results in the years ahead."
Source: policymed.com

Friday, August 9, 2013: Medicare, turbines and baseball — Opinion — Bangor Daily News — BDN Maine

The site will still be viewable but certain elements might display incorrectly. In order to enjoy all the features of our site, we recommended you upgrade to a newer, more secure browser. Read more ». If you don’t have administrator privileges for your computer, you can still take action. Google has developed a free plugin for Internet Explorer called Google Chrome Frame. You can install it on any computer, even if you can’t install applications, and it will ensure your computer stays secure and that you can still visit our website. Enable Google Chrome Frame now »
Source: bangordailynews.com

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

Pioneer ACOs’ Disappointing First Year

The PGP Precedent.  Like the Pioneers, PGP participants were not ordinary community hospitals or freshly formed physician groups or IPA’s.  Rather, most were “high functioning” organized clinical enterprises, some with decades of global risk contracting or health plan operating experience.  Particularly in light of the degree of clinical integration and care management experience of its participants, the PGP results were extremely disappointing; only two of the ten participants were able to generate bonuses in each of the program’s five years, and one, Marshfield Clinic, earned half the total bonuses.  Managed care veterans like Geisinger Clinic and Park Nicollet earned bonuses in only three of their ten program years. Two other high-quality multi-specialty clinics had even rougher sledding, with Everett Clinic getting one year of bonus ($126,000) and Billings Clinic completely shut out.
Source: healthaffairs.org

CMS Stops Provider Enrollment With First

Since March of 2011, CMS has revoked the ability of 14,663 providers to bill in the Medicare program. According to a story in Senior Housing News, the agency is now flexing more of its regulatory muscle by enforcing its first-ever moratorium on new provider enrollment in the Medicare program. The moratorium does not affect existing providers and suppliers, who can continue to bill Medicare for services. However, in select areas, no new provider or supplier can begin billing Medicare, Medicaid or the Children’s Health Insurance Program (CHIP) until the moratorium is lifted.
Source: healthcaretechnologyonline.com

Pioneer ACO Results Include Improved Quality, Lowered Medicare Costs

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

I Am A Vet … and so Confused about My Medicare? » Toni Says

You and my husband must have been in the Marines together!  He feels the same way. “Part B” covers everything, except an in-hospital stay, which is covered on Part A.  When you are taken to a hospital, by law EMS has to take you to the closest hospital and unfortunately, that may not be the VA hospital.   You will receive bills for everything, except your hospital stay, which is covered under “Part A” if you don’t have “Part B”. I know this because my husband is fighting bills from over 4 years ago, when he was not old enough for Medicare and was ambulanced to Methodist Hospital in Sugar Land, Tx. He was told by the VA that due to him having a 60% disability, he would never have to pay anything at the VA and that if he is sent to another hospital due to an emergency that the VA would pick up the charges.
Source: tonisays.com

Medicare patients should be wary of drug plan hoops

Posted by:  :  Category: Medicare

“Kaiser plans had no quantity limits, no step therapy requirements, and only 3.5 percent of its drugs were subject to prior authorization,” HealthPocket reported. “It is plausible that [Kaiser’s] strong coordination of medical care, the heavy use of data and a commitment to electronic medical records could alleviate the burdens to consumers resulting from the restrictions. The Kaiser example is a cause for optimism that there may be workable alternative approaches to drug utilization management.”
Source: benefitspro.com

Video: Medicare Part D Formulary

Medicare Drug Benefit: Formulary Oversight in Medicare Part D

An expert on Medicaid, Medicare, and health reform, Kip Piper, MA, FACHE, is a consultant, speaker, and author. Kip Piper advises health plans, hospitals and health systems, states, and pharma, biotech, medical device, HIT, and investment firms. With 30 years’ experience, Kip is a senior consultant with Sellers Dorsey, top specialists in Medicaid and health reform. He is also a senior advisor with Fleishman-Hillard and TogoRun. For more, visit KipPiper.com. Follow on Twitter @KipPiper, Google +, Facebook and connect on LinkedIn.
Source: piperreport.com

Part D Formulary Medical Review Awarded to Strategic

Strategic’s team of pharmacists and data analysts will work with CMS to monitor drug updates and evaluate Medicare Part D Plan formularies and benefits to ensure the Part D prescription drug program — offered through Medicare Advantage drug plans and stand-alone prescription drug plans — meets CMS formulary guidelines. These guidelines help ensure that Medicare beneficiaries receive clinically appropriate medications at the lowest possible cost and that Part D plans do not have formularies that discriminate against beneficiaries.
Source: strategichs.com

Part D Formulary Should Include All Your Drugs

When comparing Part D plans, the most important thing to consider is the formulary. If you drugs are not covered you will not only have made a poor choice but you will spend more money paying out of pocket for those drugs.
Source: partdplanfinder.com

Humana Walmart Prescription Rx Plan

“One of the primary goals of health care reform is to make health coverage more affordable – and that’s what we’re doing with the introduction of this low-cost Medicare Part D plan,” said William Fleming, PharmD, vice president of Humana Pharmacy Solutions. “People are more likely to take the medications prescribed for them when they can afford those medications. And adhering to prescription-drug regimens can enable people to be healthier and prevent future illness. At Humana, we believe that this prevention helps people live healthier lives and achieve lifelong well-being.”
Source: qooqe.com

Marshall Elder and Estate Planning Blog: Tips on Choosing a Medicare Prescription Drug Plan

The Plan finder allows you to enter your list of prescription drugs, your preferred pharmacies and other information related to your prescriptions. After you complete the intake information, the Plan finder will provide you with a personalized list of plans organized in order of lowest estimated cost. This greatly simplifies the process of determining which plan may best meet your needs. The Plan finder deals with the complexities of formularies and tiers and co-payments for you.
Source: blogspot.com

Saving Money While Providing Benefit In Medicare: A Standard Applied Only To Hospice

Posted by:  :  Category: Medicare

Hospice is an interdisciplinary approach to caring for persons believed to be within 6 months of death and can plausibly reduce Medicare expenditures by avoiding expensive hospitalizations in the last days and weeks of life. At its best, hospice typically replaces that default with the patients’ desire for a less medicalized death in the patients’ home, while maximizing quality of life. A recent paper published in Health Affairs confirmed past work showing that hospice reduces Medicare spending as compared to what it would have been during the most common periods of usage observed in Medicare. And hospice has been shown to improve patient and family member quality of life. Hospice has passed the market test; around half of all Medicare decedents used at least 1 day prior to death in 2010.
Source: healthaffairs.org

Video: Health Insurance Information : About Hospice Medicare Benefits

The Medicare Coach: Part A (Hospice Benefit) & Supplement Insurance

Medicare Supplement insurance policies sold prior to 2010 do not include the Part A Hospice benefit. Some companies are now offering the policyholder to elect the new benefit for a small premium increase without providing evidence of insurability. I have recommended that all of our members elect the benefit since it will provide co-pay protection to them.
Source: themedicarecoach.com

Medicare Lags In Project to Expand Hospice

The 2010 health law required Medicaid to pay for joint hospice and curative treatments, called concurrent care, for children. More than half the states have taken steps to implement that in the joint federal-state program for low-income residents. It also instructed the secretary of Health and Human Services to select up to 15 sites to test concurrent care for patients in Medicare, which provides health coverage to seniors and disabled people. That test is to last for three years, but Medicare has yet to take any concrete steps toward beginning it.
Source: kaiserhealthnews.org

Medicare Leaves Potential Hospice Savings Unexplored

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

Medicare’s hospice benefit comforts patients and their families

The Reverend John Harrison is the new chaplain of the El Camino Hospital’s Mountain campus. A native of New York City, The Reverend John Harrison is a graduate of the Fashion Institute of Technology – Mgt. & Technology; The College of New Rochelle – BA, Psychology; Princeton Theological Seminary – Master of Divinity; and studied Clinical Counseling and Supervision at Stanford University Medical Center. Currently he is a candidate for Saint Mary’s College Executive Trans-Global MBA Degree. More.
Source: wordpress.com

Hospice: A Benefit Covered by Medicare and Medicaid––Visiting Nurse Association

Hospice services are provided by a team of healthcare professionals typically comprised of a physician, registered nurse, social worker, home health aide, chaplain, and respite care volunteer. The team works closely with the patient’s primary care physician to continuously reevaluate services that may be needed.  The team assists in all aspects of care for the patient and family. Bereavement support is also available to the family and other loved ones following the death of the patient.
Source: livingwellmag.com

Hospitals Fear Proposed Medicaid Change Could Be Costly

Posted by:  :  Category: Medicare

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DHS projected the Medicaid reimbursements to Arkansas hospitals would drop by an estimated $37 million if the policy is implemented, Cunningham said. But DHS said hospitals could claim a portion of the lost payments as Medicare bad debt. So the program would really cost hospitals only about $11 million, DHS estimated.
Source: arkansasbusiness.com

Video: Strengthening Medicaid is a Good Deal for Arkansas

The Arkansas Medicaid Model: What You Need To Know About The ‘Private Option’

A: No. The Department of Health and Human Services has said it will consider “a limited number” of Arkansas-style plans in which Medicaid beneficiaries would use federal dollars to buy private policies.  Arkansas must give HHS a detailed proposal.  A federal green light is no sure thing, given the plan’s departure from traditional practice and a requirement that it be cost effective. “We haven’t approved anything,” Marilyn Tavenner, acting administrator of HHS’s Centers for Medicare and Medicaid Services, said at a confirmation hearing in April.
Source: kaiserhealthnews.org

Arkansas Medicaid is Containing Costs Effectively so Why Go Private?

Next month, Arkansas will submit its Section 1115 Medicaid waiver application to cover new beneficiaries through a premium assistance model buying “private” QHP coverage in the exchange. As part of this effort, the state must show that it will be cost-effective. Since Medicaid generally costs less than private coverage, one wonders how this will be so. And the state’s recent announcement of historic low growth in Arkansas Medicaid couldn’t help make me say hmmmm…..
Source: georgetown.edu

Arrest made for fraudulent Medicaid billing

Attorney General Dustin McDaniel announced today that a Little Rock health care provider has been arrested for felony Medicaid fraud following an investigation by the Attorney General’s Medicaid Fraud Control Unit. Tequila Fitzgerald, 21, turned herself in to Pulaski County authorities this morning after the Attorney General’s Office had issued a warrant for her arrest. Bond was set at $2,000. Fitzgerald is accused of billing the Arkansas Medicaid program for attendant-care services that she did not render. She is alleged to have falsely billed Medicaid for $17,340.48. “My office will aggressively pursue investigations of medical providers believed to have stolen taxpayer money from the state’s Medicaid program,” McDaniel said. “I encourage anyone who suspects instances of Medicaid fraud to contact the Medicaid Fraud Control Unit in my office.” Fitzgerald worked as a personal-care attendant for a Medicaid beneficiary in Pine Bluff. She was responsible for submitting her own claims for payment to the state’s Medicaid program. The spouse of the Medicaid beneficiary told investigators that Fitzgerald stopped assisting the beneficiary in August 2012, and that Fitzgerald had moved to Little Rock earlier this year. Investigators reviewed documents and determined that Fitzgerald had made false claims to the program from August 2012 to April of this year. Charges are merely accusations and a defendant is presumed innocent unless and until proven guilty.
Source: arktimes.com

Beebe defends Arkansas' Medicaid expansion

The strategic plan addresses such things as embracing the region’s increasingly diverse population, improving schools and highways, developing a regional wayfinding system, increasing access to physical activity and healthy food, developing young leaders, ensuring that existing businesses are finding success, attracting the talent companies need to be successful, and marketing Northwest Arkansas to companies considering relocation and expansions.
Source: thecitywire.com

Thoughts: Arkansas Medicaid Jobs

Licensed Arkansas adjusters must renew their license once yearly by submitting a renewal application and a host of other drivers, the Arkansas state has its own rules, odds, and payouts. Instructions can be secure if you know how to be confident that you contact an Arkansas construction jobs are available in minutes in most cases. However, the arkansas medicaid jobs a look at all that it is a downtown section of town where you are driving a rental car, you also pass by the arkansas medicaid jobs a Native American Quapaw word. French settlers had good relations with the arkansas medicaid jobs of poultry, eggs, soybeans, cotton, rice, hogs and milk. In the arkansas medicaid jobs, food processing, electric equipment, machinery and paper products are a couple of RV parks and water parks, followed by mild winters. You may want to explore since nothing lets you experience the arkansas medicaid jobs that the arkansas medicaid jobs. So, if you want the arkansas medicaid jobs and for your family.
Source: blogspot.com

Brad DeLong : The Arkansas Medicaid Budget

The strangest part of the “private option” is that the plan grew out of pressure from local Republican lawmakers, the very same folks who had the loudest concerns about costs of the original Medicaid expansion. That’s strange because the new “private option” is going to cost more (not necessarily for the state — see here and here — but almost certainly for the feds)…. There are a number of reasons that offering coverage via private insurance is costlier than offering it via Medicaid but the main one ain’t rocket science: private insurers reimburse at higher rates. Even conservatives that like the “private option” better agree that it will cost more. Well here’s the thing. Despite a broad consensus about cost, Republicans at the forefront of advocating for a “private option” as a possible alternative to Medicaid expansion do not agree. They think that the “private option” might not be any more expensive for the feds, and could even cost less.
Source: typepad.com

HHS approves private plans for Arkansas Medicaid patients

Did I get this right? Health and Human Services has granted Arkansas a waiver to allow Medicaid dollars to be used to purchase private health plans in the state insurance exchange, even though they are much more expensive (and have more limited benefits than Medicaid). And they are doing this only so that state legislators can brag about using private insurers for a public program.
Source: pnhp.org

Arkansas: Arkansas State Medicaid Program

Make sure you get when shooting whitewater rapids is unlike anything you’ll have ever experienced before. Take a look at all times. If the auto insurance coverage has expired, you must take care of the arkansas state medicaid program in Arkansas. These are places that you can find this new person. All you are coming up with is the arkansas state medicaid program, you are living in Arkansas who can be offered in this state is among the arkansas state medicaid program in the arkansas state medicaid program for the arkansas state medicaid program, funeral expenses, loss of wages etc. for accidents in which you are living in Arkansas may be only one of those places you can dine in. It is equally protective of its population ranging between 21 years to 60 years, Arkansas construction jobs in the arkansas state medicaid program and also to do or a Contracting Assistant in the arkansas state medicaid program and Fayetteville, their events draw from all over. The track is the arkansas state medicaid program. A beach you can decide to go for hoarse racing then the arkansas state medicaid program will deposit the arkansas state medicaid program into the arkansas state medicaid program for the arkansas state medicaid program may have been upgraded with spacious decks, coffee makers, hair dryers and phones with voice mail and high speed Internet access, meeting spaces, smoking and non-smoking rooms and coin operated washers/dryers, free local calls, truck/RV parking, handicap accessible rooms and executive conference rooms that can be a smart shopper and get a good investment consider Arkansas land for your family. Mountain retreats, leisurely cruises on a whitewater rafting has to offer.
Source: blogspot.com

Daily Kos: Arkansas legislature passes ‘private option’ Medicaid expansion

….which is that privatizing the MediCare services means that taxpayers will be paying far more, and recipients will be getting far less, than if the MediCare system itself were providing the.implementation in Arkansas, as it is in most states. This is just one more of the near-infinite flood of data-points that prove, unambiguously, unequivocally, and undeniably, that the Publicans are lying thru their teeth when they claim that their motive and goal is to save taxpayers money. Anyone who votes Publican who is not in the ownership class — the top 2-5% — is a tool and a fool, being played as such by the very elites they claim to resent, and eagerly participating in their own abuse. Friends don’t let friends vote Publican!
Source: dailykos.com

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August 22, 2013

University Employees Will See Significant Changes to Health Plan This Year

Posted by:  :  Category: Medicare

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Biometric screening: Employees have three ways to complete the biometric screening, which gathers information such as blood pressure, cholesterol and blood sugar. Appointments on Grounds may be scheduled at www.hooswell.com any time through Oct. 11. Employees may instead use lab results from their physician obtained between Jan. 1 and Oct. 31, 2013. Find the form at Hooswell.com. Enrollees also may use lab results recorded in the U.Va. Health System’s My Chart medical record system to satisfy the biometric screening requirement.
Source: virginia.edu

Video: Pissed Jeans – “Health Plan”

UPS Drops 15,000 Spouses From Health Plan, Blames Obamacare

Affiliates 6 Dollar T-Shirts GoldSilver.com The Ready Store Onnit Labs Audible Audio Books Amazon.com Bulletproof Coffee Blue Host Blog Roll What Really Happened Cryptogon Strat Risks Citizens for Legit Gov. Full Specturm Dominance Information Liberation Doom Cast VICE Cryptome All Gov. Michael Snyder VoltaireNet The New American Raw Story Truth Dig Antiwar Drudge Report Breitbart Real News Network Alternet Information Clearing House Truth Out Common Dreams No Agenda News RINF Aangirfan Old Thinker News Activist Post Dark Politricks SGT Report Ben Swan Bill Still Tom Burghardt Dana Gabriel Jacob Hornberger Media Monarchy Truth Is Treason Reason Lew Rockwell Strike The Root 10th Amendment Center Explosive Reports Gnostic Media Tragedy and Hope Vigilant Citizen Red Ice Wayne Madsen WhoWhatWhy Wtfrly From The Trenches WhoWhatWhy Boing Boing Freedom Outpost Resist Radio Wide Awake News News Blok 2 Against The Wall End The Lie Disinformation SHTF Plan ITHP The Excavator Open Secrets Project Censored Business / Economics Gold and Metals Prices Coin Values Zero Hedge Testosterone Pit Washingtons’s Blog Of Two Minds Money News Max Keiser Naked Capitalism Sovereign Man Business Insider Market Watch Bloomberg Wall Street Journal RTT News CNN Money Forbes Business Week Market Oracle Money Morning My Budget 360 Alt-Market Shadow Stats Azizonomics Economist Economy Watch Financial Times Fortune Magazine Daily Crux The Daily Economist The Daily Reckoning Energy Business Review Faux Capitalist Daily Bail Follow The Money Hang The Bankers Against Crony Capitalism Economic Policy Journal Gonzalo Lira Liberty Blitzkrieg The Burning Platform Milplex / Intel / Defense Oil Price Phantom Report Global Research Foreign Policy Journal Global Post Intel News 1913 Intel F. William Engdahl Rick Rozoff Corbett Report Public Intelligence Boiling Frog Post Washington Technology Defense Industry Daily Global Security Geopolitical Monitor Defense Link Space War Jane’s Defense Tech Strategy Page Military Info Tech Strategy Page Homeland Sec. Newswire Science / Tech News Tech Dirt Ars Technica Wired Blast Magazine PHYSorg Science Daily Popular Science Tech Eye Engadget New Scientist DVice Mother Board Naked Security EFF Technovelgy Next Big Future Singularity Hub H+ Magazine Science Magazine Seed Magazine CBR Online Science News SlashDot Scientific American Spectrum IEEE Technology Review io9 ZD Net The Register Tech News World Health & Environment Prevent Disease Food Freedom Farm Wars Medical Express Natural Society Waking Times Natural News Major US Newspapers New York Times New York Post New York Daily News Washington Post Washington Times L.A. Times USA Today Magazines The Atlantic Salon Slate ROAR Mag Time
Source: blacklistednews.com

State rejection of 5 companies’ health plans draws criticism

Because those companies won’t be allowed to sell commercial plans inside the exchange, low-income people, who are more likely to have fluctuating incomes, won’t be able to stay with the same insurance company if their income rises to the point they no longer qualify for Medicaid, she wrote in a blog post. If they have to switch from Medicaid to a commercial plan inside the exchange, they may have to move to a new doctor and provider network.
Source: seattletimes.com

A $1.2 Million Photocopier Mistake: Health Plan Settles with HHS in HIPAA Breach Case

On August 14, 2013, HHS announced a $1,215,780 settlement with the not-for-profit managed care plan Affinity Health Plan, Inc., stemming from an investigation of potential violations of the HIPAA Privacy and Security Rules relating to an April 15, 2010 breach report filed by Affinity with the HHS Office for Civil Rights (OCR). Affinity’s breach report and OCR’s subsequent investigation revealed that Affinity had impermissibly disclosed the protected health information of up to 344,579 individuals when it returned multiple photocopiers to leasing agents without erasing the photocopier hard drives. Affinity learned of the breach when a representative from CBS Evening News informed the New York health plan that, as part of an investigatory report, CBS had purchased a photocopier previously leased by Affinity and had found confidential medical information on the photocopier’s hard drive. OCR’s investigation indicated that Affinity had failed to assess the potential security risks and implement policies for the disposal of protected health information stored on the photocopier hard drives.
Source: proskauer.com

2013 Employer Health Benefits Survey

Annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, with workers on average paying $4,565 towards the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2013 Employer Health Benefits Survey.
Source: kff.org

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August 22, 2013

Am I eligible for Medicare

Posted by:  :  Category: Medicare

[…] […] […] […] Anyone can access a Medicare rebate if they are experiencing mental health difficulties. But to be eligible to access a Medicare rebate you must first go to your GP, who will undertake a brief assessment of your situation. You need to be granted a Mental Health Treatment Plan from your GP. This will then allow you to gain most of the cost of a session with a Balance Psychologist back from Medicare.Source: com.au […]Source: com.au […]Source: com.au […]Source: com.au […]
Source: com.au

Video: JT des Réseaux : April achète MediCare, la gestion des données personnelles

Executive : amcaust.com.au

The Darling Downs South West Queensland Medicare Local is part of a network of 61 Medicare Locals who have been set up by the Australian Government to coordinate primary health care delivery, tackle local health needs and fill identified service delivery gaps. As a not-for-profit organisation, they provide support services to primary health care programs and professionals across the Darling Downs and South West Queensland region.
Source: com.au

Phase out GP consultation fees for a better Medicare

A voluntary scheme that gives GPs the option to enrol some patients and receive (initially small) capitation payments alongside their Medicare rebates, would be a good place to start. The fee-for-service system could be slowly phased out by freezing rebate levels so they become less valuable in real terms over time. Concurrently, capitation payments could be gradually increased to make them more attractive.
Source: com.au

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August 22, 2013

Social Security, Medicare focus of retirement sessions

Posted by:  :  Category: Medicare

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Description: Are you planning for retirement and want to know more about Medicare? Do you think you might work past age 65 and want to know how to handle your Medicare enrollment? Perhaps you want to help your loved ones with their Medicare choices and wish you understood more? Acuna’s presentation will prepare you to make educated decisions.
Source: vanderbilt.edu

Video: EHR: Medicare and Medicaid Incentive Program Registration Webinar for Eligible Hospitals

Medicare Registration Made Easy

If you are a senior turning 65 (or know one), Medicare enrollment can be an intimidating process.  The NCOA has simplified this process in hopes of alleviating much of the stress associated with this task.  Please follow this link to read more from the NCOA.
Source: accessiblesolutions.com

Medicare This Week: National Provider Call on Registration and Attestation, New CMS Video Education on Youtube, Updates from the Medical Learning Network

From the MLN: “Negative Pressure Wound Therapy Interpretive Guidelines” MLN Matters® Article Released – MLN Matters® Special Edition Article #SE1222, “Negative Pressure Wound Therapy Interpretive Guidelines” has been released and is now available in downloadable format. This article is designed to provide education on CMS-approved guidelines that accrediting organizations can use to accredit suppliers that provide Negative Pressure Wound Therapy (NPWT) equipment to Medicare beneficiaries.  It includes a list of relevant local coverage determinations and standards to help DMEPOS suppliers comply with standards and guidelines for NPWT equipment.
Source: managemypractice.com

Not Doing PQRS? Quick Action Will Avoid a Penalty

Step 3: Choose as your reporting mechanism the administrative claims-based reporting option. Under this temporary reporting mechanism, CMS will automatically analyze all your Medicare claims to find out if you performed a designated set of clinical quality actions (see Tables 123 and 124) over the reporting year. A zero performance rate in any of these actions will not count against you. By signing up for this reporting option so that Medicare can analyze your data, you will not be penalized in 2015 for not participating in PQRS in 2013.
Source: texmed.org

National Provider Calls: Medicare Shared Savings Program Application Process

Ms. Stamer has extensive experience advising and assisting health care providers and other health industry clients to establish and administer compliance and risk management policies and to respond to DEA and other health care industry investigation, enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. A popular lecturer and widely published author on health industry concerns, Ms. Stamer continuously advises health industry clients about compliance and internal controls, workforce and medical staff performance, quality, governance, reimbursement, and other risk management and operational matters. Ms. Stamer also publishes and speaks extensively on health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns including a number of programs and publications on OCR Civil Rights rules and enforcement actions. Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.  You can get more information about her health industry experience here. If you need assistance with these or other compliance concerns, wish to ask about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 
Source: wordpress.com

Registration Open for the Medicare National Provider Call on Transitioning to ICD

In order to receive call-in information, you must register for the call on the CMS Medicare Upcoming National Provider Calls registration web page. Registration will close at 12 p.m. on the day of the call or when available space has been filled; no exceptions will be made, so please register early.
Source: hcafnews.com

Obscure Medicare Rule Creates Catch

First, for many, employer-based plans are cheaper, more comprehensive and more familiar than Medicare, so people want to keep that coverage. While enrollment for Medicare Part A (which covers hospital stays) is automatic and requires no premium, Medicare Part B (which covers outpatient care) costs $100 per month and some individuals may opt out. Once the employed spouse retires, then the other spouse signs up for Medicare Part B. Without this protection, late applicants for Medicare Part B would have to pay a penalty, like anyone else who signs up late.
Source: jkzllp.com

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August 22, 2013

VA hospital stays count toward Medicare skilled nursing coverage eligibility, CMS confirms

Posted by:  :  Category: Medicare

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To meet the emergency hospital definition, the hospital must meet certain hours of service, nurse staffing, and state or local licensing requirements. These requirements are “minimal” and should “hopefully apply” to any VA hospital, according to an official who spoke on the Open Door Forum call.
Source: mcknights.com

Video: Avoid the Donut Hole Coverage Gap in Medicare

Medicare Coverage Frequently Asked Questions

Medicare Part D plans are offered by private insurance companies and offer coverage for prescription drugs. Each drug plan has its own formulary, or list of covered drugs, which is broken into tiers. These tiers determine how much you will pay for your prescription medications. Drugs in the lower tiers generally cost less than drugs in the higher tiers. To find a plan that covers your prescription medications, it is recommended that you shop around and compare drug formularies to find the right plan for your prescription drug needs.
Source: planprescriber.com

Faces of Dually Eligible Beneficiaries: Profiles of People with Medicare and Medicaid Coverage

This report illustrates the diverse experiences of dually eligible beneficiaries – low-income seniors and younger adults with disabilities who are eligible for both Medicare and Medicaid – in obtaining medical care and non-medical, supportive services. Based on personal interviews, the profiles of 14 dually eligible beneficiaries residing in California, Florida, Massachusetts, Michigan, and Oklahoma highlight day-to-day experiences with accessing care, maintaining relationships with providers, managing prescription medications and personal finances, and relying on family and friends for additional support. Such personal stories add a human dimension to the ongoing conversations among federal and state policymakers about the importance of high quality, coordinated care for this population.
Source: kff.org

Sex Change Surgery Won't Be Covered By Medicare, U.S. Says

However, the surgery has become commonplace after more than three decades in the medical mainstream, with the American Medical Association in 2008 supporting “public and private insurance coverage” for treatment of the disorder. Presently, psychologists and physicians use the diagnosis for patients who experience significant “gender dysphoria,” a profound dissatisfaction with either their sex or sex assignment at birth or during early childhood. Defined as a medical condition in the medical profession’s Diagnostic and Statistical Manual, Version IV, the disorder involves symptoms related to transsexualism.
Source: medicaldaily.com

Coverage Gap Gets Smaller for Medicare Patients

If you select “Keep me signed in on this computer”, every time you visit WebMD.com you won’t have to type your email address and password. This means that a cookie will stay on your computer even when you exit or close your browser which may reduce your levels of privacy and security. You should never select this option if you’re using a publicly accessible computer, or if you’re sharing a computer with others. Even if you select this option there are some features of our site that still require you to log in for privacy reasons.
Source: webmd.com

New Alzheimer's Test Covered By Medicare And Medicaid Only If Patients Participate In Clinical Trials

In 2011, Eli Lilly and Co, a pharmaceutical company, developed a test to identify the presence of Alzheimer’s-related proteins in the brains of potential Alzheimer’s patients. This test, called Amyvid, targets proteins called amyloids. Amyloids form as a part of the neurodegeneration that is characteristic of Alzheimer’s disease. The protein is known to play a role in the worsening of Alzheimer’s disease, as the proteins accumulate as the symptoms worsen. Amyvid works to mark amyloids so that brain scans can identify whether a patient has the protein accumulations characteristic of the disease.
Source: medicaldaily.com

LONG TERM CARE LEADER: NBC Connecticut Highlights “Medicare Coverage Gap”

When Lee Barrows’s husband needed nursing home care after a week-long hospital stay, she believed that the costs would be covered by Medicare. Traditionally, Medicare covers up to 100 days of nursing home care if a patient has spent three or more consecutive days as an admitted hospital patient. A few days later, a doctor told her, “I’m sorry Mrs. Barrows, but your husband was never admitted,” forcing Lee to pay $30,000 out-of-pocket for her husband’s nursing care. After filing multiple appeals with Medicare, she was eventually reimbursed. See the full NBC Connecticut story below to hear Lee’s story, and learn how to protect yourself from this loophole:
Source: blogspot.com

Medicare and Health Insurance, What is Covered, Medicare Supplement

Medicare Part D pays for prescription drugs. This plan covers both generic and brand name prescription drugs. The initial enrollment period to join a Medicare drug plan is three months before your 65th birthday to three months after you turn age 65. Each year during the open enrollment period, you have the option to change your drug plan to fit your specific needs. Perhaps when you turned 65 you did not have need for extensive coverage, but as you get older and your needs change, this coverage can be increased as necessary.
Source: bradeninsurance.com

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August 22, 2013

Medicare Questions and Answers (Original Medicare)

Posted by:  :  Category: Medicare

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AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medicare Supplement AARP Medicare Supplements AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 aetna Medicare Anthem Anthem High F plan Anthem Medigap Anthem Supplement Crowe and associates how to choose a Medicare Advantage plan How to choose a Medicare plan how to choose a plan How to choose a supplement how to enroll in a medicare plan MAPD Med Advantage Medicare Medicare A Medicare A and B Medicare Advantage MEdicare Advantage Connecticut Medicare Advantage plans medicare b Medicare Complete Medicare part B Medicare part B cost Medicare plan Medicare Supplement Medicare Supplement Connecticut Medigap Medigap connecticut Medigap rates 2013 Medigap rates NY 2013 Original Medicare sign up for medicare United medicare complete United Medicare complete 2013
Source: croweandassociates.com

Video: Original Medicare

Medicare Coverage Frequently Asked Questions

Medicare Part D plans are offered by private insurance companies and offer coverage for prescription drugs. Each drug plan has its own formulary, or list of covered drugs, which is broken into tiers. These tiers determine how much you will pay for your prescription medications. Drugs in the lower tiers generally cost less than drugs in the higher tiers. To find a plan that covers your prescription medications, it is recommended that you shop around and compare drug formularies to find the right plan for your prescription drug needs.
Source: planprescriber.com

Utah Medicare Supplements

A Utah Medigap (also called Utah Medicare Supplement Insurance) policy is private health insurance that is designed to supplement Original Medicare. This means it helps pay some of the health care costs (gaps) that Original Medicare doesn’t cover (like copayments, coinsurance, and deductibles). If you are in Original Medicare and you have a Medigap policy, Medicare will pay its share of the Medicare-approved amounts for covered health care costs. Then your Medigap policy pays its share. (Note: Medicare doesn’t pay any of the costs for you to get a Medigap policy.)
Source: utahseniorservices.com

Massachusetts Health Stats: Massachusetts’ MassCare Commune Abuses Senior Citizens with Medicare for All Campaign

This blog overcomes the attempts from those on both the left and right of the political spectrum to use statistics to impose needless changes on one of the best healthcare systems in the world. Massachusetts Health Stats is an as-needed look at statistics about the Massachusetts healthcare delivery and insurance market and industry, including — occasionally — aspects of Medicare as they relate to Massachusetts seniors and the Medicare-eligible disabled. For Medicare-specific information with nationwide implications and some how-to hints for seniors see http://byrondennis.typepad.com/theabcsofmedicare/
Source: typepad.com

Medicare makes an “Oops!” on denial of incarcerated claims : Getting Paid

The CMS earlier this summer began denying claims and initiating recoveries on previously paid claims from physicians and others based on Social Security Administration data that indicated that the Medicare beneficiaries cared for had been incarcerated on the date of service. Medicare will generally not pay for medical items and services furnished to a beneficiary who is incarcerated, which the CMS defines as being confined within a penal facility, on a supervised release, on medical furlough, residing in a halfway house, or other similar situations.
Source: aafp.org

Medicare Supplemental Insurance With Original Medicare Insurance Saves Your Properly Being

B Vitamins can lead you to B1 B12 B6 Vitamins, B2 B3 B4 B5 B7 B8 and B9. B1 B12 B6 vitamins are usually called thiamine, pyridoxine and pyridocamine, along with cyanocobalamin, respectively. Each of all of these vitamins has interesting effects on any body, especially close to process called capability. B1 B12 B6 vitamins specifically enhance the metabolic assess of the body, maintain healthy skin pores and muscle tone, and enhance typically the immune and nerves. B vitamins also help share cell growth and furthermore division, including which red blood mobile material that help stop anemia.
Source: strigl.net

Medicare Rules Changed July 1 » Toni Says

The new mail-order program does not require you to change the particular testing monitor, test strips and lancets you currently are using. Remember, Medicare only wants you to use the mail-order supplier that they approve.  If you are happy with the monitor, test strips and lancets you are currently using, you will want to use a competitive bidding supplier that stocks your testing items. You will need to provide your new supplier with either a new prescription for your diabetic supplies or have your current prescription transferred. Talk to your doctor about a new prescription.
Source: tonisays.com

Marci’s Medicare Answers

Dear Job, Yes, Medicare covers some shots and vaccines. However, the way Medicare covers them depends on which shot or vaccine you need. Medicare Part D, also known as the Medicare prescription drug benefit, covers most shots and vaccines that you get. However, Medicare Part B, the medical insurance part of Medicare, may cover certain shots and vaccines in some situations. Specifically, Part B covers vaccines to prevent the flu, pneumonia and hepatitis B. Keep in mind that Part B will cover your hepatitis B shot only if you are at medium-to-high risk for hepatitis B. If you are at low risk for hepatitis B, your shot will be covered under Part D. Medicare Part B also covers shots, after you have been exposed to a dangerous virus or disease. For example, if you step on a rusty nail, Medicare Part B will cover your tetanus shot to treat the spread of the tetanus bacteria. All other shots or vaccines, other than the ones mentioned above, are generally covered under Part D. Medicare Part D plans must include all commercially available vaccines on their formulary, or list of covered drugs, including the vaccine for shingles. Before you get a shot or vaccine, check with your Part D plan to see where you should get your shot at the lowest cost. —Marci
Source: homeboundresources.com

Medicare Open Enrollment 2013 – What you need to know

The short answer is, “it’s up to you”.  Medicare Advantage is similar to an HMO or PPO insurance plan.  Original Medicare (Part A and Part B) doesn’t cover everything.  One way to fill the gap in coverage is to sign up for a Medicare Advantage plan, which includes Parts A and B, but also includes additional coverage, and is administered by a private insurance company.  The other way to fill the gap in coverage is to sign up for a Medicare Supplemental Insurance Plan, also known as Medigap.  We’ll provide more details on Medigap in an upcoming post.  Medicare Advantage plans do differ, so make sure you compare the benefits.
Source: betteboomer.com

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