Group & Benefit Consultants

Posted by:  :  Category: Medicare

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Source: gandbc.com

Video: Savvy Medicare Planning by Beacon Wealth Consultants

Slalom Tableau Showdown delivers key Medicare insights to Provider CIOs

From John Mathis, first-place winner: Visualizing Medicare data revealed several interesting financial aspects of our healthcare system. By viewing the state and classification heat map, it is apparent that California, Nevada, and New Jersey have the highest average costs. It is especially odd for New Jersey given its proximity to Maryland, which has the lowest state costs. Also interesting is the scatter plot of Diagnosis Related Group (DRG) codes, which reveals several outliers in terms of cost and patient volume. Public health administrators looking to bring down costs could use this visualization to identify procedures with the highest costs and frequency that would most benefit from efficiency improvements.
Source: slalom.com

The “Yes, But” That Saves You From Surveyors

The Medicare cost report is to be filed using the accrual basis of accounting. Yes, but Medicare does not require that your internal financial records be on the accrual basis. Many organizations prefer cash basis accounting for its simplicity and for their tax returns. You may choose to have your internal financial statements on the accrual basis but that is your decision and not a Medicare requirement. However, you do obtain better and more accurate information on the accrual basis of accounting. Providers who file cost reports need to convert their year-end financials from cash to accrual for the Medicare cost report.
Source: kenyonhcc.com

How Medical Billing Consultants are Crucial to Credentialing with Medicare & Medicaid?

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

Innovative Healthcare Consultants

Earlier this summer, the federal government approved an 11.1% cut in Medicare rates effective on October 1, 2011. As that date nears, seniors and elder care professionals are now bracing for the impact of those cuts – and desperately seeking ways to slash expenses in preparation for significantly reduced reimbursements. Meanwhile, government officials and elected representatives continue to grapple with further deficit cuts to balance the national budget; and according to Bloomberg Business Week, gridlock may be the industry’s only protection against further cuts to Medicare, Medicaid, and other benefit programs – all of which would have a profound effect on health care employees, aging seniors and low-income individuals.
Source: delmartimes.net

Massachusetts Health Stats: Massachusetts Hires Consultant to Hire Consultants to Consult with You on How to Drop RomneyCare

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

The Motley Fool on Medicare for All

The spending difference is very real, but it is not clear how much of the administrative excesses would be recoverable under a single payer system. However, there are other savings in the PNHP model of single payer that are not due to recovery of administrative waste. There would be improved pricing such as negotiation of rates with health professionals, bulk purchasing of pharmaceuticals and medical equipment, and global budgeting of hospitals. There would also be separate planning and budgeting of capital improvements, avoiding excess capacity that results in over-utilization (while ensuring adequate capacity in underserved regions). Also there would be greater efforts to identify and apply clinical guidelines as with the British NICE system (not paying for worthless or harmful health care is not rationing, it is merely reducing waste).
Source: pnhp.org

IOM says Rochester has lowest Medicare spending rate in nation

For example, if an orthopedic practice wanted to buy its own MRI machine and the hospital two blocks away had one that could accommodate those patients, the committee would recommend against it. Insurers can use its recommendations to set reimbursement policies. Experts say the approach tackles the two biggest drivers of rising medical expenses: new technology and salaries. The idea is that those expensive items have to be paid for somehow and they create a need for health care providers to order up more tests and treatments, the cost of which are ultimately passed on to patients and insurers. “Supply-driven use of services is one of the major drivers of unwarranted, wasteful health care expenses,” said Dr. Martin Lustick, chief corporate medical director for Rochester-based nonprofit insurer Excellus BlueCross BlueShield. State Health Commissioner Dr. Nirav Shah called Rochester’s “a phenomenal model.” “The governor’s plan is to do regional planning across New York using Rochester as the example,” Shah said. “It’s about bringing rationality to the system. It’s about adult supervision and not a Wild West. Right now, supply drives demand.” Institute researchers say U.S. health care cost $2.7 trillion in 2011, almost 18 percent of the gross domestic product and higher than other developed countries. The institute, a nonprofit arm of the National Academy of Sciences, advocates payment reform to push competition toward value rather than toward volume of services, including the Medicare system that covers 39 million people age 65 and older and 8 million with disabilities. “The chaotic free market health care system costs Americans a bundle,” said Blair Horner, legislative director of the New York Public Interest Research Group, adding there would probably be pushback from providers against regional committees limiting their expansion plans. “Rochester offers a way to do it better.”
Source: modernhealthcare.com

Is it too late to change my Medigap/Medicare Supplement for 2013?

If you are 65 or older and have been on Medicare Part B for longer than 6 months, you will most likely have to answer some health questions as part of the application process for a new Medicare Supplement/Medigap policy.  The majority of people have no trouble qualifying for a new policy, and usually an agent or broker can tell in the first conversation whether or not you will qualify.  Illinois also has a few companies that have guaranteed issue Medicare Supplements.  These companies never ask health questions of any applicants and will issue a policy to everyone who applies.
Source: bcmil.com

Medicare and Employment Based Health Insurance for Workers Over Age 65 : Pennsylvania Law Monitor

Posted by:  :  Category: Medicare

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These days, many people are still working past age 65, the age at which you can start receiving health insurance coverage through Medicare.  If you are one of these people, and are covered by your employer’s health insurance plan, you may think there is no need for you to sign up for Medicare. You would be wrong.  Provided that you have had Social Security and Medicare taxes deducted from your wages, Medicare hospitalization insurance, known as “Part A”, is free.  If you work for a company that has more than 20 employees, your hospital bills first go to your company-provided health insurer for payment.  If some amount of the bill is not covered by this private insurer, the bill goes to Medicare as a secondary payer.  If you work for a small company that has less than 20 employees, your hospital bills first go to Medicare, then to the private insurer as a secondary payer.    However, if you don’t sign up for Medicare, Part A, you may have to pay the Medicare portion of your hospital bill.  Medicare, Part B, however, which covers doctor fees, outpatient care, physical therapy and some home health care, is not free.  If you are covered by your employer’s insurance plan, you don’t want to start Part B while you are still covered by the private insurer – that is you don’t want to sign up for Part B until you retire.  You need to sign up for Part B within eight months of the date you retire or your Part B premium will cost you 10% over what it would have been had you signed up in that eight month retirement window.  
Source: stark-stark.com

Video: The Employment Law Group®’s David Scher on What Whistleblowers Can Do About Medicare Fraud

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

IRS issues proposed reliance regs on new 0.9 percent Additional Medicare Tax

Medicare is funded through payroll taxes.  Employees and employers (and self-employed individuals) all pay into Medicare.  Employees and employers each pay Medicare tax at a rate of 1.45 percent (self-employed individuals pay at a combined rate but are allowed to deduct half of the Medicare tax as an adjustment to income). The Additional Medicare Tax is a new tax that may apply to certain taxpayers in addition to regular Medicare tax.  The new tax was part of the Patient Protection and Affordable Care Act (Affordable Care Act), which was passed by Congress in 2010.  However, Congress delayed the start date of the new tax until 2013. 
Source: pntax.com

UnitedHealthcare employee stole personal and Medicare information

“On Jan. 30, 2012, the company discovered that a former employee, during the course of his employment, may have accessed information in a database in a way that was inconsistent with his job duties,” the company said Friday.
Source: phiprivacy.net

Ambulatory Care Services Drives August Healthcare Jobs Growth, Adding 26,000 Jobs

In August, ambulatory services accounted for 45 percent of healthcare employment, compared to 33 percent from hospitals, according to a report from Altarum Institute. Over the past 12 months, the total private sector healthcare employment grew 2 percent while non-health payroll employment grew 1.6 percent. The healthcare sector has added 1.5 million jobs, a growth of 11.5 percent, since the recession began in 2007 while the non-health employment experienced a 2.7 percent decline. Last month, ambulatory care services jobs grew by above-average 26,600 jobs, according to the report. High jobs numbers were driven by ambulatory care while hospital jobs remained flat. Outpatient care centers added 2,500 jobs while physician offices gained 6,000 jobs in August. Outpatient care centers grew by 6 percent, or 39,600 jobs, over the past 12 months. At the same time, hospital jobs grew just 0.7 percent, adding 35,800 jobs. More Articles on Ambulatory Surgery Centers: 22 Observations on ASCs for 2014 http://www.beckersasc.com/lists/23-observations-on-surgery-centers-for-2014.html Ambulatory Surgery Centers Projected to Save Medicare $57.6B Over Next 10 Years http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/ambulatory-surgery-centers-to-save-medicare-57-6b-over-next-10-years.html 6 Golden Rules of Surgery Center Staff Engagement From Administrator Lori Martin http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/6-golden-rules-of-surgery-center-staff-engagement-from-administrator-lori-martin.html
Source: beckersasc.com

New Rule Ups the Ante for Medicare Fraud Whistleblowers

Blowing the whistle on Medicare fraud may become dramatically more lucrative. On April 29, 2013, the Department of Health and Human Services (HHS) announced its intention to elevate the maximum payout for whistleblowers by a multiple of nearly one million. Specifically, the HHS’s Centers for Medicare and Medicaid Services (CMS) announced it would raise the ceiling for whistleblower payouts to nearly $10 million from the current cap of $1,000. By revising the Incentive Reward Program provisions in § 420.405 of the Code of Federal Regulations, the proposal would entitle any Medicare fraud whistleblower whose tip leads to a recovery to 15 percent of the overpayments recovered, with a cap of $9.9 million. The goal, according to CMS, is to “increase the incentive for individuals to report information on individuals and entities that have or are engaged in sanctionable conduct; improve our ability to detect new fraud schemes; and help us ensure that fraudulent entities and individuals do not enroll in or maintain their enrollment in the Medicare program.”
Source: healthcareemploymentcounsel.com

Medicare Open Enrollment Period Begins Oct. 15, 2013

Medicare recipients reaching the drug donut hole will benefit from lower costs. The gap in prescription drug coverage starts when someone reaches the initial coverage limit, estimated at $2,850 in 2014. It ends when they have spent $4,550, when catastrophic coverage begins. (These are reductions of $120 and $200, respectively, from 2013.) During the donut hole, all costs are covered by individuals out of their own pocket. In 2014, those who reach the donut hole can receive a 52.5 percent discount on brand-name drugs and 28 percent discount on generic drugs (an increase from 21 percent in 2013).
Source: disabled-world.com

anthem medicare preferred standard and select (ppo) @ Master chief descargar char para mugen :: 痞客邦 PIXNET ::

Posted by:  :  Category: Medicare

Anthem Freedom Blue is a Medicare Advantage Plan with the benefits of a PPO allowing you the freedom to go directly to specialists without a referral Search BlueCross BlueShield to find a Doctor or Hospital. View Doctor Index, browse by specialty, find urgent care, or locate doctors worldwide. View Anthem Medicare Preferred Standard (PPO) Medicare Part D Plan in Los Angeles, California details. Compare premiums, deductibles, coverage information, and Anthem Medicare Preferred Standard PPO is California Medicare Advantage plan from Anthem Blue Cross. Compare your Medicare Advantage options today. National Doctor and Hospital Finder
Source: pixnet.net

Video: Roswell Georgia Chiropractor, Open Weekends, Saturdays, Sundays, 6am-9pm 770 992 2002

California Medicare Insurance: Anthem Medicare Preferred PPO Replaces Freedom Blue for 2012

One of the newest Medicare Advantage plan in California for 2012 is the Anthem Medicare Preferred Standard PPO or AMP. The Anthem Medicare Preferred is the newest successor to the Freedom Blue Regional PPO plan that became very popular over the past few years. The plan offers significant freedom of choice in regards to your medical service providers. The AMP PPO plan is only available in select counties throughout California and the benefits are different from county to the next. The plans are grouped below by counties that share the same benefits:
Source: blogspot.com

Medicare Targets Health Plans With Low Ratings

Medicare officials are encouraging 525,000 beneficiaries to switch out of these 26 Medicare Advantage and drug plans that have received low ratings for three consecutive years and enroll in better plans for next year. The poor performing plans will have this warning symbol next to their names on Medicare’s plan finder website to steer shoppers to other plans.
Source: kaiserhealthnews.org

Medicare Advantage Plans From Anthem Blue Cross

An Anthem Medicare Advantage HMO offers low or no monthly premiums, so your dollars can really stretch. You’ll be using doctors and hospitals that are within the Anthem network, so you’ll find that the savings are substantial. You will also have access to hundreds of preventive and wellness programs, discounts on products and services, and tools and kits that can help educate and guide you about ways to live a healthier lifestyle. Part D Prescription Drug Coverage is included.
Source: medicareoptionsnow.com

Medicare Advantage: Anthem Medicare PPO Alternative in Las Vegas, NV

The second option is to upgrade to a Medicare Supplement.  Because your plan is not renewing, you have the guarantee issue right to a supplement.  You cannot be denied for health history.  The monthly cost will be higher than that of the PPOs, but a supplement will give you freedom to see any doctor that accepts Medicare and you will no longer have co-payments if you select a Medicare Supplemental Plan F.
Source: suncityfinancial.com

Council for Older Adults Annual Insurance Semincar

Posted by:  :  Category: Medicare

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This FREE seminar will provide attendees with the opportunity to learn about Social Security’s role in Medicare, Medicare insurance programs, prescription drug coverage, and state and community resources available to Delaware residents age 60 and older.  A complimentary continental breakfast sponsored by OhioHealth will be served from 8:30 a.m. to 9:00 a.m.
Source: growingolder.org

Video: Delaware Medicare Supplements

Delaware Receives $2.48 Million Innovation Grant from Center for Medicare and Medicaid Innovation

Delaware’s proposal entitled, “Transforming Delaware’s Health: A Model for State Health Care System Innovation,” addresses the need for a broad vision and comprehensive approach to more cost effective delivery of quality health care for all Delawareans.  Delaware plans to build a strong local foundation for innovation in order to develop a system-level transformative healthcare plan that can serve as a model for the country.  Through the collaborative planning process, Delaware will design a model to accelerate the adoption of payment and service delivery models across public and private payers; enhance health data collection and analytic capacity to support care coordination and outcomes-based payment models and integrate workforce planning, behavioral health and public health initiatives.
Source: delaware.gov

An End to the Doc Fix for Medicare and TRICARE?

Working with the House Committee on Ways and Means, leaders from the House Energy and Commerce Committee have unveiled draft legislation that would repeal the current Sustainable Growth Rate (SGR) system and replace it with a fair and stable system of physician payments in the Medicare program.  Enacted in 1997 as part of the “Balanced Budget Act,” the SGR is a continued concern for physicians who serve Medicare beneficiaries and for the beneficiaries themselves.  Because payments to doctors who treat TRICARE beneficiaries are tied to Medicare, it also affects active duty, reserve, and retired military personnel and their families.  Congress had implemented a temporary “doc fix” to prevent substantial Medicare reimbursement rate cuts, which could result in fewer physicians willing to serve Medicare/TRICARE patients.  This draft legislation would replace the current SGR with an enhanced fee-for-service.  Although the draft legislation provides a clearer picture of the proposed new payment system, it does not address how to pay for the cost of repealing the current payment system.  What’s next:  Health Subcommittee Chairman Joe Pitts, R-Penn., plans to hold a markup of the legislation next month.
Source: ausade.org

Medicare Open Enrollment Begins Monday — Seniors Have More Benefits, Better Choices, Lower Costs

During this Open Enrollment Period, Commissioner Stewart recommends that people treat their Medicare number as they do their social security number and credit card information. People with Medicare should never give their personal information to anyone arriving at their home uninvited or making unsolicited phone calls selling Medicare-related products or services. Beneficiaries who believe they are a victim of fraud or identity theft should contact Medicare (contact information above). If you suspect you are the victim of Medicare fraud, call 1-800-223-9074. More information is available at www.stopmedicarefraud.gov
Source: delaware.gov

MIAMI: Exchanges create confusion for Medicare recipients

In this image made available by AARP shows Ida Gall, right speaking to an unidentified customer at the Connecticut Women’s Expo on Saturday, Sept. 7, 2013 in Hartford, CT. AARP Connecticut volunteers Ida Gall and Sophia Forbes, seated, talked to women about the Affordable Care Act. Federal Health Officials are assuring medicare recipients that their benefits will not change when the Affordable Care Act starts. Many are confused by overlapping enrollment periods for Medicare and the Affordable Care Act.
Source: heraldonline.com

The Delaware Libertarian: The Highmark footprint in Delaware is both deeper and wider than you think …

I have, of course, been going into great detail to explain the relationship between Highmark and MedExpress, and to lay out what appears to be the Highmark plan for establishing a monopoly on health insurance and even health care in Delaware. This is apparently worrisome to some of the leaders of Highmark Delaware, who appear to have become new followers of this blog, like President/CEO Timothy Constantine and (this title is not only a mouthful but quite unintentionally revealing) Senior Vice President for Provider Strategy and Integration Paul Kaplan. Well, I always welcome new readers, even aggrieved new readers. It is important right now to step back and take an even broader look at the overall Highmark empire, to include specifically the parts of that empire that impinge on Delaware. I will warn you at the outset that this is a long, LONG post, but if you actually care about free-market competition, monopolistic business practices, or government corruption, you need to read it all. What you have to know to begin with is that Highmark (the parent company) is a not-for-profit (no, I’m not kidding) corporation that includes in its holdings a fascinating mix of both non-profit and for-profit subsidiaries.  Time to read below the fold if you truly want to be informed: For example, Highmark controls (at least) the following not-for-profit entities: Highmark Health Services Highmark Blue Cross Blue Shield (Western PA) Highmark Blue Cross Blue Shield (Central PA) Highmark Blue Cross Blue Shield (West Virginia) Highmark Blue Cross Blue Shield (Delaware) The Highmark Foundation Alleghany Health Network (a hospital chain in PA) But to those we must add this (possibly incomplete) list of Highmark’s for-profit holdings: United Concordia (dental insurance) Davis Vision (managed care vision insurance) Visionworks of America (the nation’s second-largest chain of optometry stores) Viva International Group (eyewear manufacturing) Eye Care Centers of America HM Insurance (a re-insurer for workplace, low-benefit medical, disability, and other insurance) MedExpress urgent care centers (reportedly a 10% stake) By the way, as I was doing the final editing on this piece I discovered that I was wrong.  Highmark actually owns AT LEAST 35 subsidiary (and mostly for-profit) companies. Within Delaware, then, we need to note that Highmark controls the following: Highmark Blue Cross Blue Shield (Delaware) [the state’s largest insurer] MedExpress (five current centers; at least three more to come) Visionworks (one store in Wilmington) United Concordia Dental Insurance If you want to get a real glimpse of how Highmark reports its own strategy, you really have to look now further than Visionworks, which is now the largest American-owned chain of optometry stores, and second in size only to foreign-owned Lens Crafters. First, here’s the story of the great Visionworks consolidation: Visionworks is the name that eventually will be taken by all 600 or so of the retail vision outlets that Highmark operates across the 
Source: blogspot.com

Commissioner Stewart Reminds Delaware’s Seniors that the Insurance Department Offers Assistance During Medicare Open Enrollment

During this enrollment period, Medicare beneficiaries will select their health plan and possibly their prescription drug plan. They will decide whether their 2011 Medicare health plan will be Original Medicare or Medicare Advantage. Those choosing Original Medicare will also choose a Medicare Prescription Drug Plan (Part D). Additionally, Original Medicare beneficiaries may choose a Medigap policy (Medicare Supplement coverage) that will cover medical co-pays, deductibles, and in-patient hospital fees. The Medicare Advantage plan, an all-inclusive plan that usually includes prescription drug coverage, is an alternate health plan choice to Original Medicare. Commissioner Stewart urged citizens to review Medicare Advantage plans closely, since occasionally these plans may not include prescription drug coverage. In that case, a Medicare Prescription Drug Plan should be chosen, along with the Medicare Advantage Plan.
Source: delaware.gov

Office of Statewide Benefits provides information on Medicare Parts A, B enrollment

Failure to enroll and maintain enrollment in Medicare Parts A and B upon eligibility may result in the subscriber being held financially responsible for the cost of all claims incurred, including prescription costs. Retirees and spouses enrolled in Medicare Parts A and B must provide a copy of their Medicare Identification Card to be enrolled in the state of Delaware Special Medicfill plan.
Source: udel.edu

Medicare Now Covering Gastric Sleeve in Our Region

What is Gastric Sleeve? The gastric sleeve procedure is an innovative way to reduce weight, lower obesity related illnesses, and improve the quality of your life. During gastric sleeve surgery at CHRIAS, one of our three board-certified surgeons will create a smaller, sleeve shaped stomach from your stomach pouch. No re-routing of the intestines (like with gastric bypass) is necessary. For this reason, patients experience fewer complications while still enjoying weight loss and improved health benefits. Typically, after having gastric sleeve, patients will feel satisfied eating smaller 3-4 ounce portions.
Source: chrias.com

Cigna Acquires Home Care Company Specializing In Elderly, Chronically Ill

In October 2011, Cigna announced plans to buy HealthSpring of Nashville, Tenn., for $3.8 billion. HealthSpring is a health plan with more than 1 million Medicare and Medicaid customers in Alabama, Arizona, Arkansas, Delaware, Florida, Georgia, Illinois, Maryland, Mississippi, New Jersey, Oklahoma, Pennsylvania, Tennessee, Texas, West Virginia and Washington, D.C.
Source: courantblogs.com

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September 13, 2013

Medicare allows for replacement of oxygen equipment if supplier leaves

Posted by:  :  Category: Medicare

Source: alpha-1foundation.org

Video: Medicare Supplement vs. Medicare Advantage Plans – A Doctor’s Perspective

Medicare Advantage Fact Sheet

Since 2006, Medicare has paid plans under a bidding process.  Plans submit “bids” based on estimated costs per enrollee for services covered under Medicare Parts A and B; all bids that meet the necessary requirements are accepted.  The bids are compared to benchmark amounts that are set by a formula established in statute and vary by county (or region in the case of regional PPOs).  The benchmarks are the maximum amount Medicare will pay a plan in a given area. If a plan’s bid is higher than the benchmark, enrollees pay the difference between the benchmark and the bid in the form of a monthly premium, in addition to the Medicare Part B premium.  If the bid is lower than the benchmark, the plan and Medicare split the difference between the bid and the benchmark; the plan’s share is known as a “rebate,” which must be used to provide supplemental benefits to enrollees.  Medicare payments to plans are then adjusted based on enrollees’ risk profiles.
Source: kff.org

GOP Eyes Medicare ‘Doc Fix’ Bill For Summer, Obamacare Replacement

CQ HealthBeat: House Medicare Payment Bill Could Be Ready This Summer House Republicans said they are continuing to move ahead with legislation to replace Medicare’s physician payment system but will wait to negotiate some of the more contentious issues. Rep. Joe Pitts, chairman of the House Energy and Commerce Health Subcommittee, said the panel remains “on track” and continues to work with Democrats and members of the Ways and Means Committee on a replacement measure (Ethridge, 6/5).
Source: kaiserhealthnews.org

Important Notice to Medicare Beneficiaries Regarding Hip and Knee Replacement Surgery

Last week I was involved in a conference with hospital administrators regarding hip and knee replacement surgery. The Medicare program has designated these procedures as “high cost” and is targeting these operations for review. Please see the document I put together that explains the review and what we need to do going forward.
Source: doctorgordon.org

For coverage of hormone replacement therapy and alternative treatments for hormone replacement therapy (HRT) in Medicare and offer … and individual health insurance.

BiblioGov project is an effort to expand awareness of the public documents and records of the U.S. Government via print publications. In expanding the understanding of society and government for their work can grow and develop an enlightened democracy. Ranging from historic Congressional Bills last budget of the United States Government, the project BiblioGov covers wealth of government information. These works are now made available through an environmentally friendly, print-on
Source: healthliving.tk

Indiana Health Care Association: Indiana Health Coverage Program Change in Medicare Replacement Claim Processing

The Office of Medicaid Policy and Planning (OMPP) published notice on May 31, 2013 that a change will be made on Medicare replacement claim processing.  For claims received on or after June 27, 2013, the Indiana Health Coverage Programs (IHCP) will require a claim filing indicator of “16” when providers file Medicare replacement plan claims through an 837 electronic data interchange (EDI) transaction and Web interChange. Previously, providers were instructed to use a claim filing indicator of “MA” or “MB” when filing Medicare replacement claims. The IHCP will begin to validate Medicare replacement plan payer IDs based on the contract number published by the Centers for Medicare & Medicaid Services (CMS).  To view the posting, see http://provider.indianamedicaid.com/news,-bulletins,-and-banners/news-summary/the-ihcp-to-implement-change-in-medicare-replacement-claim-processing-.aspx.
Source: ihca.org

Joint Replacement Surgery More Accepted by Rural Medicare Beneficiaries

The investigate team, led by Mark L. Francis, M.D., used a 2005 Medicare Provider Analysis and Review File from a Centers for Medicare and Medicaid Services along with a whole 2005 Medicare denominator record to settle a investigate group. This conspirator was comprised of tighten to 6 million farming Medicare beneficiaries and scarcely 38 million civic recipients. Both organisation and women were represented in a study, with a meant age of 70 for farming and 71 for civic participants. Racial illustration in a farming contra civic areas enclosed white (90.8% vs. 83.2%), African American (6.4% vs. 10.5%), Hispanic (0.6% vs. 2.3%), Asian (0.2% vs. 1.9%), Native American (1.3% vs. 0.3%), and other (0.5% vs. 1.7%).
Source: dociris.com

MedicareIsSimple: 2014 Medicare Advantage and Part D Maximum Commissions

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

Hip Replacement Surgery In India

took place when MIS or minimally invasive surgery was brought in by the surgeons of US around 6-7 years ago. In this technique, only a small incision of 10 cm is made on the skin and even muscles and soft tissues are not exposed unlike the previous conventional method. Apart from the cosmetic advantage, less pain, decreased days of hospital admission, early recovery with better mobility are some of the advantages. This technique of hip replacement surgery is also practiced in India as well. A lot of development work went into this method of implanting artificial hips. A coin has two sides, showed its face over here too. Smaller incision on the skin made the job of the surgeon difficult since the visibility became poor. But the technology’s advancement removed off this difficulty too. Light conducting fiber-optic cables were developed henceforth to aid the clear visualization of the surgery area.
Source: maitrimedicare.com

Medicare Replacement Plans

The problem of referring to a Medicare Advantage plan as a Medicare replacement plans becomes evident when people mistakenly believe that they have left the Medicare program. Once you become eligible for Medicare, you remain eligible for Medicare, as evidenced by the fact that you can choose to receive your benefits from original Medicare by not renewing your Advantage plan for the following calendar year.
Source: affordablemedicareplan.com

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September 13, 2013

AMA Criticizes Proposed 2014 Medicare Fee Schedule

Posted by:  :  Category: Medicare

Source: kaiserhealthnews.org

Video: 2013 Medicare Physcian Fee Schedule webinar part II

MGMA Analysis of 2014 Proposed Medicare Physician Fee Schedule

Diamond Level Platinum Level Gold Level Biz Technology Solutions, Inc. First Citizens Bank rmsource, Inc. Wells Fargo Insurance Services Silver Level Ball Dermpath McGladrey Medical Protective SunTrust Bank United HealthCare Group Bronze Level Allegacy Business Solutions – JBA Benefits & Cooperative Payroll Allscripts Apex Technology Assured Waste Solutions, LLC Bactes Imaging Solution Bernard Robinson & Company, LLP Call-A-Nurse Capario ChoiceHealth, Inc. Coverys, Inc. DataMax Corp / Interstate Credit Collections The Doctors Company Eastman Kodak Company Fifth Third Bank Ford & Harrison GMK Associates, Inc. Gordon Asset Management, LLC Greenway Medical Henry Schein Medical Humana Konica Minolta LabCorp Marketing Works McNeary, Inc. Medicus Insurance Company Medstaff National Medical Staffing mindShift Technologies, Inc. MSOC Health NCHA Strategic Partners NextGen Healthcare ONLINE Information Services Physician Discoveries Physicians’ Alliance of America Prince Parker & Associates Professional Recovery Consultants SCA Collections, Inc. Solstas Lab Partners SouthData Stanley Benefits Stern & Associates, P.A. Attorney at Law Total Merchant Services Transworld Systems, Inc. TriMed Technologies Corp TriZetto Provider Solution – Gateway EDI
Source: wordpress.com

Replacing Medicare’s Ridiculous Fee Schedule

1. John C. Goodman, “Markets and Medicare,” Wall Street Journal, February 23, 2008, http://online.wsj.com/article/SB120373015283387491.html; John C. Goodman, “A Framework for Medicare Reform,” National Center for Policy Analysis, Policy Report No. 315, September 2008, http://www.ncpa.org/pdfs/st315.pdf; John C. Goodman, “Reforming Medicare the Right Way,” John­ Goodman’s­ Health ­Policy­ Blog, June 13, 2011, http://healthblog.ncpa.org/the-only-way/.
Source: independent.org

Mick Raich of Vachette Pathology: Thoughts on the proposed Medicare fee schedule

When will the hospitals decide to leave the histology business and outsource this work? Who will take up this volume? What happens if Medicare cuts the (APC) rate for an 88305 also?  How will the 88342 TC cut affect non-pathology practices such as Urology?  Where is the tipping point that forces this work back to community pathologists?  Many of these labs are down to paying their pathologists $15.00 per case.  Are we poised on the cusp of an $8.00 pathology case?  Does this eliminate the non-pathology lab margin?  What will the national labs do when their shareholders find that anatomic pathology is no longer profitable?  Could the big three be looking to divest themselves of this loss leader? The payers are lowering their rates at a very quick rate, when do pathologists start saying no to this pay cut?  When are hospital based groups going to gain leverage to remove themselves from low paying contracts?
Source: pathologyblawg.com

CMS Proposes Updates to Medicare Physician Fee Schedule, Other Part B Policies for CY 2014 : Health Industry Washington Watch

Under its potentially misvalued code initiative, CMS is proposing to reduce PFS rates for more than 200 codes if Medicare physician office payment exceeds the payment in the outpatient hospital department or ambulatory surgical center (ASC) setting. CMS proposes limiting PFS payment in such cases to the total payment that Medicare would make to the practitioner and the facility when the service is furnished in a hospital outpatient department or ASC. Certain services would be exempt from this provision, including services without separate hospital outpatient prospective payment system (OPPS) payment rates and codes already subject to cuts pursuant to the Deficit Reduction Act imaging cap, among others). CMS estimates that this policy would have the biggest negative impact on allowed charges for independent laboratory PFS payments, radiation therapy center services, and pathology services. CMS also proposes to examine other specific codes as part of the agency’s ongoing review of misvalued codes.
Source: healthindustrywashingtonwatch.com

CMS Changes to the Clinical Laboratory Fee Schedule : Health Care Reform Blog

The third proposal would limit Medicare payments for non-facility based services paid under the Physician Fee Schedule (PFS) to the amount paid when the service is performed in the facility setting. CMS believes that anomalies in data used to set rates under the PFS and the way that data are used in the PFS’s resource-based Practice Expense (PE) methodology leads to inaccurate payments for certain services. CMS believes that PE input data voluntarily submitted to the Relative Value Scale Update Committee (RUC) may be inaccurate, incomplete or biased. Further, the lack of a comprehensive review and evaluation of PE inputs is believed to contribute to these discrepancies. For most services, this proposed policy change will have a small impact (-2 percent to +1 percent); however, for clinical laboratories in particular, CMS estimates that this proposal will reduce payments by 25 percent.
Source: healthcarelawreform.com

Understanding Medicare Billing and Reimbursement Coding

Medicare pays for physician services under Part B according to the Medicare Fee Schedule (MFS).  Medicare reimburses other healthcare providers, such as acute inpatient hospitals, home health agencies, hospice, outpatient hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities, through mechanisms known as Prospective Payment Systems (PPS). PPS reimbursements are made based on a predetermined, fixed amount.  The payment amount for a service is determined based on the classification system of that service.  For example, inpatient hospital services are reimbursed on the basis of diagnosis-related groups (DRGs), and outpatient hospital services are reimbursed on the basis of Ambulatory Payment Classifications (APCs).
Source: jameshoyer.com

ISASS Responds to Proposed CMS Changes to Physician Fee Schedule

•    82 percent of the codes have direct expenses that exceed the proposed payment rate. •    Proposed reductions could reduce payment for some services by more than 50 percent, driving the services completely out of the physician office setting. •    At OPPS rates, 78 of the 211 services proposed for reduced payment will actually cost Medicare and patients more than the current MPFS rates. •    CMS automatically assumes OPPS rates are accurate, rather than implementing a data-driven process to determine payment caps. •    Physician reimbursement for kyphoplasty and vertebroplasty subject to the OPPS/ASC payment caps would experience 27 to 54 percent cuts. •    Such dramatic payments cuts would severely limit patient access to spine care.
Source: beckersspine.com

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September 13, 2013

MIAMI: Exchanges create confusion for Medicare recipients

Posted by:  :  Category: Medicare

Source: bradenton.com

Video: Connecticut Medicare Advantage Plans – Supplement Insurance

Medicare Advantage Plans Connecticut 2014

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 Medicare Anthem Medigap 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 Wellcare medicare
Source: croweandassociates.com

Medicare To Punish 24 State Hospitals For High Readmissions

Facing fines higher than the national average are: Bristol Hospital (.85 percent); Greenwich Hospital (.41 percent); Griffin Hospital in Derby (.97 percent); MidState Medical Center in Meriden (.78 percent); Milford Hospital (.76 percent); and St. Francis Hospital & Medical Center in Hartford (.39 percent). The other state hospitals will face lower penalties, including Lawrence & Memorial in New London, which will lose .13 percent of every Medicare payment for a patient stay; Bridgeport Hospital (.2 percent); Hartford Hospital (.1 percent); and Charlotte Hungerford in Torrington (.04 percent).
Source: courant.com

Medicare Will Punish 24 Connecticut Hospitals

Facing fines higher than the national average are: Bristol Hospital (.85 percent); Greenwich Hospital (.41 percent); Griffin Hospital in Derby (.97 percent); MidState Medical Center in Meriden (.78 percent); Milford Hospital (.76 percent); and St. Francis Hospital & Medical Center in Hartford (.39 percent). The other state hospitals will face lower penalties, including Lawrence & Memorial in New London, which will lose .13 percent of every Medicare payment for a patient stay; Bridgeport Hospital (.2 percent);Hartford Hospital (.1 percent); and Charlotte Hungerford in Torrington (.04 percent).
Source: cttalking.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

New Report Highlights Problems Of Hospital ‘Observation’ Stays

The OIG report indicates that the designation options used by hospitals have significant cost consequences for patients. For more than 2,000 outpatient and observation stays last year, patients were liable for $22 million in follow-up nursing home charges that Medicare would not cover, the report says. At the same time, Medicare improperly paid out $255 million for nursing home care for patients who should not have been eligible for such coverage, the OIG said.
Source: ctwatchdog.com

TRAFFIC ALERT: Portion of Silver Creek Road AND Connecticut Aven

Michael Stokes, also known as “The Rodent,” 65, of Lebanon, Mo., and James Noel, 47, of Springfield, Mo., were each sentenced to five years in federal prison without parole in separate hearings before U.S. District Judge Dean Whipple. Marilyn Bagley, 48, of Lebanon, was sentenced to five years of probation.
Source: koamtv.com

CONNECTICUT STATE COURT FINDS MSA NOT NECESSARY WHERE BENEFICIARY WOULD INCUR FUTURE MEDICAL BILLS

The court concluded that the settlement agreement did not reflect compensation for future medical costs that might be covered by Medicare.  Rather, the settlement amount represented payments for noneconomic damages, with a small portion to be used for non-Medicare economic damages. While there were conditional Medicare payments made to the plaintiff, the court held that the sum would be reimbursed to Medicare after the settlement amount was conveyed to plaintiff’s counsel. As such, the court found that the defendants in the underlying personal injury suit, along with their carriers, lacked liability for the payment of plaintiff’s future medical expenses. Typically, courts will only determine whether a settlement requires an Medicare Set Aside (“MSA”) in the following two situations: (1) where the parties agree that an MSA is required, but cannot obtain the approval of CMS for the MSA arrangement; and (2)  where the parties have a settlement agreement but disagree as to whether the settlement agreement’s terms included the creation of an MSA.  The decision in Sterret is unique in that the court appears to provide an advisory opinion with respect to whether a MSA was required as part of the settlement in a personal injury case.  Click here for a discussion of Early v. Carnival Corp., No. 12-20478, 2013 U.S. Dist. LEXIS 16711 (S.D. Fla. Feb. 7, 2013).
Source: themedicarespa.com

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September 13, 2013

BCBS Medicare Advantage Plans

Posted by:  :  Category: Medicare

Source: insurance-forums.net

Video: Blue Cross Medicare Advantage – Popular Plan Options

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

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

Blue Cross Blue Shield of Michigan Offers New Medicare Plans

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

Oregon Chiropractic Association

Regence is building on our existing utilization management program efforts for our group and Individual products, including Medicare Advantage plans. We have selected an experienced third-party vendor, CareCore National, LLC (CCN), to administer a new physical medicine program component of our overall utilization management program.
Source: oregonchiroassoc.com

Medicare Supplements (Medigap) For Dummies

[…] 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 Medicare 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 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 2013Source: croweandassociates.com […]
Source: croweandassociates.com

Blue Cross Medicare Plans

If you have decided on Blue Cross you will want to compare the plans available. Medicare supplement Plan F has been the most popular choice for people looking for the most comprehensive coverage. In June 2010, new Modernized Medicare supplement plans were introduced. Medicare supplement plan N has proven to be very popular due to the lower monthly premium. This is accomplished by shifting some cost sharing to the policy holder.
Source: affordablemedicareplan.com

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September 13, 2013

No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces

Posted by:  :  Category: Medicare

Source: kaiserhealthnews.org

Video: What is a Medicare health insurance exchange?

No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces

Enrollment in health plans offered on the marketplaces, also called exchanges, begins Oct. 1 and runs for six months. Meanwhile, the two-month sign-up period for private health plans for millions of Medicare beneficiaries begins Oct. 15. In that time, seniors can shop for a private health plan known as Medicare Advantage, pick a drug insurance policy or buy a supplemental Medigap plan. And in nearly two dozen states, some Medicare beneficiaries who also qualify for Medicaid may be choosing private managed care plans. None of these four kinds of coverage will be offered in the health law’s marketplaces.
Source: webmd.com

Health insurance on the way

The prices aren’t cheap, but you can earn quite a bit of money and still get some government help to pay for the insurance. A family of four can earn as much as $94,000 and still be eligible for assistance. If you earn less than 250 percent of the federal poverty level — $2,394 per month as a single person or $3,231 per month as a couple — you qualify for significant help, including subsidies to pay such out-of-pocket health care costs as deductibles and copays. The Kaiser Family Foundation offers this example: A single 60-year-old living in Indianapolis will be able to buy a standard “silver” plan without subsidies for $626 a month. That price drops to $193 after subsidies. A more modest “bronze” plan will be $531 a month without a subsidy, but only $97 a month after subsidies.
Source: bankrate.com

Affordable Care Act’s 10 Essential Health Benefits

As of Oct. 1, every state will have a health insurance marketplace, where consumers can shop for coverage. In addition to mandating that insurers in those marketplaces offer the 10 essential health benefits, the health care law also sets certain standards that all insurers must meet, whether they’re providing health insurance through an employer or directly to individuals and small groups. The law:
Source: aarp.org

Time Warner to drop Medicare supplement and move retirees to healthcare exchanges

According to an August memo obtained by Reuters, the media company will make allocations to a Health Reimbursement Arrangement account for retirees to use towards the purchase of coverage on an exchange. Previously, Time Warner provided an indirect subsidy through a supplementary Medicare program.
Source: medcitynews.com

Shazam! Burgess has a smart — and bipartisan — plan for paying Medicare doctors

After a five-year transition period, doctors would be reimbursed based upon their ability to meet certain quality measures. When he came by to visit with our editorial board over the August recess, Burgess said that American medical societies will help determine the metrics. The Health and Human Services secretary would finalize the measures each year.
Source: dallasnews.com

ibm medicare options: IBM Medicare Extend Health Does NOT Negotiate Insurance Premiums

It has been confirmed a couple of times that the Extend Health Medicare insurance products we will be offered are a subset of the SAME products in the general marketplace and will be the SAME price. One would think Extend Health would have more leverage with insurance companies.  Here’s an even bigger irritant.  EH will probably not offer the cheapest Medicare insurance products in your zip code.  They offer insurance products where they are paid a commission from the insurance company to sell those products.  I continue to urge you to decide what kind of products you want to get BEFORE you talk to an Extend Health advisor.  By way of example, I will tell you what I am doing.  I looked on Extend Health’s website to see what was offered to employees of other companies.  I did that by looking at www.extendhealth.com/dupont and www.extendhealth.com/gm  (isn’t it interesting that anyone can go to www.extendhealth.com/ibm which is the site we are using to enter our profile information) and I saw the products offered by EH in my zip code in 2013. I am reasonably sure it will be the same stuff offered to us.  I am specifically interested in a medigap plan called F high deductible (F+).  Unfortunately, the F+ plan offered by Extend Health is not the cheapest plan in my zip code.  That’s really irritating as there is no difference in the content of a medigap plan from one company to another.  By law, all F+ plans must offer the same coverage.  However, I have to use the one offered by EH to get the HRA subsidy.  Here’s my decision on what kind of products I want to buy:
Source: blogspot.com

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September 13, 2013

New Hampshire: Brand New Medicare Supplement Plan

Posted by:  :  Category: Medicare

About GarityAdvantage Agencies We are specialists in the Senior Market with over 75 years combined experience helping independent brokers grow their business and client base. As a national field marketing organization (FMO) specializing in the Medicare/Senior Market, we offer independant insurance agents outstanding service, competitive products and top commissions across a wide range of senior products including Medicare Advantage, Medicare Supplement, Final Expense, Funeral Trust, Hospital Indemnity and more.
Source: wordpress.com

Video: New Hampshire Medicare Advantage Plans

Catch Up On All The News About Medicaid Expansion In NH

This week the decision wether or not to take part in the Medicaid expansion is absolutely dominating the news media. There have been many storys both pro and con about the expansion. In this post I will highlight some of the stories about the Medicaid Expansion. I also want to say that I am very much for the expansion and believe that helping tens of thousands of low and middle class families is the best thing the state can do. Not all these stories do not push for the expansion but we need to know why people are opposing it. The first one that came out was Just call us ‘The Donor State’ “Senate President Peter Bragdon and his fellow Republicans on the Senate Finance Committee, Sens. Bob Odell of Lempster, Jeanie Forrester of Meredith and Chuck Morse of Salem, want to make New Hampshire “The Donor State.” The full Senate should tell them no thanks.” “Accepting these federal resources will provide health insurance to tens of thousands of low-income New Jerseyans, help keep our hospitals financially healthy and actually save money for New Jersey taxpayers. Expanding Medicaid is the smart thing to do for our fiscal and public health,” Christie said at a press conference in February. New Jersey expects to save $227 million by expanding Medicaid access.” The second comes from the Nashua Telegraph’s Kevin Landrigan. Health care providers kick off campaign to support Medicaid expansion in NH. “Health care providers kicked off a monthlong blitz in favor of expanding Medicaid on Thursday, hoping to overcome Senate Republican leaders who propose to short-circuit it in a state budget. The campaign ramps up Tuesday, when Gov. Maggie Hassan will join a Voices for New Hampshire Health press conference featuring three low-income adults who would get coverage if lawmakers expanded Medicaid from 68 to 138 percent of the federal poverty level.” Yesterday on the Exchange (NHPR) the took the entire hour to discuss the expansion. The Muddle Over Medicaid “The Affordable Care Act encourages states to expand Medicaid coverage and provides funding to do so. So far, the tally is roughly even between states opting in and opting out, but some are still undecided, including New Hampshire. Medicaid expansion has support from the House and Governor but the Senate has some serious doubts.” Listen to the entire episode One of the things that was brought to the surface during the Exchange interview is this idea that the federal government will not pay the money promised to states as part of the ACA. I reject this opinion because the federal government has never defaulted on payments for Medicaid. Lastly, I want to share with you a post from the NH Citizens Alliance who is one of the organizations who are pushing for the Medicaid expansion. Jillian Dubois was also on the Exchange. NHCA’s lead organizer on Medicaid expansion, Jillian Andrews Dubois, called in to suggest that New Hampshire try expansion, since the Supreme Court ruled that it is optional and federal funds will cover 100% of newly eligible beneficiaries for the first three years. It just makes sense to take this opportunity to bring billions of federal dollars and hundreds of jobs into our state. In addition, guests Sen. Sanborn and Rep. O’Brien kept mentioning a third option that they would consider, like a block grant for New Hampshire to run Medicaid its own way. However, Jillian pointed out that this option is not currently on the table and is not likely to be in the future. Staff member Karen Kelly called out Rep. Bill O’Brien for falsely claiming that the Affordable Care Act (which includes Medicaid expansion) would add to the federal deficit. In fact, the non-partisan Congressional Budget Office has rated the ACA as reducing the deficit, since its revenue provisions are estimated to bring in more than the spending will cost. She also pointed out that since opponents to expansion have claimed that it needs to be studied further, we might as well take the 100% funding while we can, study the program, and make changes as necessary down the road. The NHLN has also talked about Medicaid expansion and the Affordable Care Act. Could New Hampshire Be Setting Up A Failure Of The ACA Marketplace Obamacare Will Save You Money In Health Insurance Expanding Medicaid Will Greatly Benefit Veterans In NH My Letter To Editor On Medicaid Expansion (by NHLN blogger Matt Murray)
Source: bluehampshire.com

Medicaid Expansion: Maine Looks At Another Plan; Advocates Lobby N.H., Missouri Lawmakers

CQ HealthBeat: Maine’s GOP Governor Criticizes Federal Offer On Medicaid  Maine’s Republican governor says Washington won’t recognize his state’s previous generosity when it comes to negotiations on a Medicaid expansion. But federal officials say they are doing all they can under the terms of the health law to pick up more of the tab. Gov. Paul R. LePage has been at loggerheads with his legislature — and other interests in the state — over whether to expand Medicaid. On Thursday, he issued a statement criticizing the latest offer by Centers for Medicare and Medicaid officials that would meet some, but not all, of his demands (Adams, 5/30). The Associated Press: Expand Medicaid, N.H. Urged  Organizations that provide free or low-cost health care and mental health services across New Hampshire again urged the Legislature on Thursday to approve expanding Medicaid coverage to the state’s poorest adults. New Hampshire’s current Medicaid program covers low-income children, pregnant women, parents with children, elders and people with disabilities, but the state is deciding whether to expand it to include anyone under age 65 who earns up to 138 percent of federal poverty guidelines, which is about $15,000 for a single adult (5/30).
Source: kaiserhealthnews.org

Now A Proven Fact, NH Can Opt Out Of Medicaid Expansion At A Future Date

The idea that once New Hampshire took the money to expand Medicaid there was no way to go back was one of the sticking points for Senator Bragdon when he met with constituents in Milford a couple of weeks ago.   He said implied that it would not completely change his opinion but it would move him closer.  Senator Bragdon was not alone in this. It seemed to be one of the biggest questions to accepting the expansion money.
Source: nhlabornews.com

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